Long term depression

[SteveW]

No suicide themed voices today. Instead I woke to a voice repeating "you'll never get better" for 10 minutes. This worries me because there is the possibility that it may be true. From reading the literature and personal experience over the years I know there is something called chronic depression. You can throw all the drugs in the world at it but you remain exactly where you are. Some psychiatrists claim as many as 30% of people not responding after two trials of anti-depressants at maximum dose. I am currently in the middle of one of the strategies for dealing with this. Essentially this says if one doesn't work take two at the same time from different chemical classes. You can pay quite a high price in terms of side effects but it often works.

It doesn't seem to be working for me at the moment. I am deeply depressed and making no progress on Mitazapine and Venlafaxine, though I'm not on the maximum dose of Venlafaxine yet. All I can do is press on and hope for the best because depression has reduced me to the point of complete inactivity at the moment. Oh for the days when I could take Prozac and be back to normal in 12 weeks.

[Zaf]

Hopefully your GP will have some answers when you see him steve

[Got]

Hi Steve, sorry to here that you have got it so rough. I hope that things start to get better for you soon and that you start feeling  better.

Are you still feeling isoloated?

[SteveW]

I'm still feeling isolated. It isn't helped by experiencing hallucinations, which make me feel different to other people. I'm aware that psychotic depression isn't that unusual but it makes you feel like a strange and unusual person. For instance I'm not aware that there is anyone else with it on this Forum.

[Got]

I'm sure  having psychotic symptoms would make you feel odd, I was supprised to learn how common it actually is, and how common hallucinations to a degree can happen in non psychotic people. I went through a bad patch a while ago, in which I slept only about an hour an night. I permenantly could hear bagpipes playing in my ears.

I hope you manage to overcome the isolation, it must very very difficult for you having lost two close people from your life. I have being feeling quite lonely recently, I've started going to the shops etc, and just being friendly to people I come into contact with, I find it helps my slightly. That could be completly useless advice for yourself, I don't know.

[SteveW]

Thanks for your post. At least I've been spared the bagpipes- I don't think I could cope. I have trouble getting out of the house because of various physical problems I have with arthritis. I do go out to the shops once a day to stock up on bread and milk and do chat to the shop assistants, which does help. Then I have to go home and spend a couple of hours recovering from the pain in my knees. I still spend the bulk of my time on my own and don't see that changing anytime soon. I'm in touch with a couple of friends through email but they are running out of encouraging things to say.

I hope your loneliness eases for you.

[Lol]

Roll on your appointment on Friday then! I hope that your GP has a plan for what to do next. Are there any social groups in your area that might help with your isolation? Are you able to drive and have transport?

[SteveW]

I am confident that my GP will be able to help with the voices. This will be the third time we have gone through it together and we both know what to do. At least this time I know the dose of anti-psychotic that is needed to solve the problem so I don't have to go through a starting dose and gradual increments process. I can jump straight to the effective dose.

There are no social clubs around here - I have checked. I really do live in the middle of nowhere- 12 miles from the nearest very small town- which has few facilities. I live surrounded by wheat fields-literally. There are a few services for the over 65's but I'm a bit too young for tea and bingo. Luckily I can still drive but in terms of social contact there is nowhere to drive to. I also find it difficult to walk which makes things like going to the pub an insurmountable obstacle.

[Lol]

I'd love a bit of tea and bingo me. 

I'm glad your GP is some one you can rely on and has been through this with you before. You sound like you have confidence in each other which must make for a more comforting relationship through this very difficult time.

What other hobbies and interests do you pursue?

[SteveW]

I have an excellent relationship with my GP. She has an interest in psychotherapy which being my former profession we shared. She used to visit my dad every two weeks to see how he was so we had a lot of contact outside of my own illnesses.She trusts my judgement as to what drugs I need,which helps no end.

As to hobbies and interests I remember those. I used to be into photography and music mostly. I lived in a university city so there were always plenty of bands to see. While I was a carer I did nothing but care. It was 24/7 and I was lucky if I got time to read the paper most days.The only rest I got was when my dad was sleeping by which time I was ready to sleep myself.

Since he died I've had difficulty picking up things again. I should have had surgery on my knees years ago but had to hold on because of the caring. I've left it far too long and am in a lot of pain. All I can do these days is listen to music on my iPod which I do virtually full time. The upside to being free from caring is that I can now go back to orthopedic outpatients and see about surgery which would help the depression no end. Being virtually unable to walk really gets you down.

[Lol]

That sounds like a sensible aim then? Getting your knees sorted would bring such new realms of possibility for you and could be just the breath of fresh air you need! (literally!!). Suddenly having all this time on your hands must feel very strange. Have you ever been interested in art? Painting/drawing? There are lots of really good 'teach yourself' DVDs out there, could you start a project like this do you think? Could you like building things? - a kit plane maybe? are there any musical instruments you have always wanted to learn? Could you even publish your experiences with your depression, complimented by what you know as a psychotherapist?

It is difficult to find the entheusiasm for new projects and the thought can be more daunting than exciting can't it. This is such a difficult period for you, and such a stressful change.

[SteveW]

You're right. The thought of starting new projects seems extremely daunting indeed. At the moment it's taking all the energy I have just to stop from going under. But you are right about extra time on my hands. The morning my dad died I found myself sitting in a chair without the faintest idea what to do with myself. It was worse than that because the regular visits I'd been getting from health professionals like District Nurses and doctors stopped dead too.

The trouble is I am really reaching the bottom of depression, I'm not eating, am barely drinking, have no energy at all, and have the concentration span of a goldfish. Cleaning my teeth on a regular basis is becoming a major task. I can't imagine taking on anything that I could actually achieve. A book seems as difficult as climbing Mount Everest. I am hoping that my state will improve and I'll be able to do routine tasks like cook a meal again. For the moment I am effectively paralyzed. But thanks for the suggestions.

[Lol]

I understand your explanation. This is so difficult for you. Even the simplest tasks are almost impossible and the amount of energy it takes just to do the simplest things is exhausting. You have been used to keeping going full time 24/7 and now that you don't have to you simply can not. You miss the need to terribly and this is something that is hard to come to terms with on so many levels. All the trappings of your life have suddenly disappeared and it is not a welcome change. Getting through this period is going to be the most difficult thing you have ever had to deal with.

Can you identify anything that might make a positive difference? Your medication and consultation with your GP is coming up and getting this done will be quite a milestone of accomplishment. Are you entitled to home help yourself? either for your depression and grief, or for your arthritic incapacity?

You have been a wonderful son. Thank you for caring for your father so tenderly every moment of his last phase. Your compassion and loyalty for your beloved father did not go unnoticed by him. You gave comfort, stability, kindness and reassurance. You are an amazing person. I admire you very much. You have suffered such loss.

[Zaf]

Its a nightmare feeling like that, I do hope hings improve for you very soon

[SteveW]

Woke up this morning without the benefit of any voices-perhaps the anti-psychotics are starting to kick in. Celebrated by having a couple of pieces of toast-the first time I have eaten in 5 days. Still incredibly depressed though. It's getting difficult to look after myself and force myself to wash etc. In 40 years of depression I have never been this low. Started planning my next move if Mitazapine and Venlafaxine don't start to lift me soon. I guess it will have to be Lithium. Lithium is a pain. You have to get it to a certain level in your blood, below this it's ineffective, above it it's toxic. So you have to have weekly blood tests until you get it right. Lithium always gives me a spectacular tremor but I'll put up with anything to get even a bit better. I'll settle for improvement never mind cure.