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Forum Name: Psychiatric Topics

Question: Antidepressants don't help...could I have something else?


 nomoregoldlights - Mon Aug 06, 2007 10:33 pm

Hello, I am writing to you for advice because I am desperate at this point. I'll get the demographics out of the way. Female, age 20, diagnosed with anxiety/depression in October of 2005. The only I've ever had was a tonsillectomy in November of 2005. My father has a history of psychological disorders, but I am unsure of the details, since he is not in the picture. I do know, however, that they included depression and psychosis. I am taking Lexapro right now (actually, I just weaned myself off),and I have taken Celexa, Buspar and Xanax.

I am writing today because I feel like I have been misdiagnosed. The anxiety I definitely agree with.I have had panic attacks the past few years, and I even remember having them when I was little. But I have symptoms that no one seems to want to pay attention to. They include constant fatigue, lack of motivation, tension headaches, bruxism, hopelessness, and constant negativity. I can never relax and everything stresses me out. But, the physical aspects have me at my wits end. I can be perfectly happy, but still miserable on the inside because I can't relax my muscles and can't stop obsessive thoughts. Also, the headaches are about to push me over the edge. I feel dizzy and nautious more often than not.

So, could this be something else? Hyperthyroidism? Even a bigger problem? I can't find relief in the medications I've been on. The only thing is, at the time of diagnosis I had a normal thyroid test. Should I get tested again? Or do I really "just need to relax"?
 Debbie Miller, RN - Tue Aug 07, 2007 8:57 am

User avatar It can be very complicated getting the correct diagnosis and effective treatment when it comes to mental/behavioral health. You definitely need to give new medications several weeks to evaluate their effectiveness as some need to bring up blood levels to a therapeutic range, which can be a slow and gradual process. Then, if a medication appears to be ineffective, it is back to the drawing board, starting something new (either in place of the first or in addition to it). So, it is no unusual for it to take several months and even years to find the right combination of psychotherapy (counseling) and medication.

It is important to keep a journal of your feelings and experiences as you evaluate the treatment so you can share this with the prescribing physician. Often it takes multiple medications taken simultaneously to treat the varied disorders that can occur. This may be accomplished by adding others one at a time rather than starting several at once. You may be one of these who needs additional treatment.

You were right that thyroid disorders can masquerade as psychiatric problems so getting this test was a good idea. Repeating it after a time can be wise so it certainly wouldn't hurt to check it out again now.

I would also suggest you see a mental health therapist. Make sure it is someone you can relate to and open up to honestly. It sometimes takes changing therapists to find one that "fits" but it can be a tremendous help to talk things through and get her perspective on your treatment. Family members can also offer good insight about your behavior which can help the professional. It sounds like you are in touch with your symptoms and this is the most valuable information so the record keeping and sharing of your feelings will be invaluable to your providers.

The brain is very complex and the chemicals that come into play here are multiple and varied but difficult to evaluate because imbalances of neurotransmitters do not show up in blood testing. This is why it takes lots of patience and good health care professionals to help you be your best self.

I hope you will stay with this and be diligent in your treatment while you find your correct balance of medication and therapy. It is not easy to "just relax" even though we could all benefit from some of that. Let us know how it goes or if you have other questions we can answer.

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