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Ralph LMHC
Ralph LMHC, Therapist
Category: Mental Health
Satisfied Customers: 872
Experience:  20+ years as therapist, supervisor, clinic director at mental health, substance abuse treatment ctrs
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I am so very discouraged and crying right now. I am in the

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I am so very discouraged and crying right now. I am in the middle of a painful episode of depression, which I have suffered on and off since age 35. I am a 55 year old female and maintain my job and functionality but it is so very, very difficult for me. I had been on celexa with welbutrin for 10 yrs and stupidly quit for a yr. The depression came back and I now I find I cannot tolerate the celexa or welbutrin this go round. This time, it has been 18 months with unrelenting depression. I have tried 4 different SSRI medicines and had such terrible side effects, like anxiety, that I could not continue. Why would that be when Celexa had worked before ? On Lithium now which helps the most of all but not much. I am functioning at about 75%. Next the doc wants to try Lamactil. I am deathly afraid I will not find a medicine this time. I have had therapy since age 35 so I am getting support....but this is all biological for me. Will this last my whole life ? I am so very frightened
Submitted: 4 years ago.
Category: Mental Health
Expert:  Ralph LMHC replied 4 years ago.

Hello,

It is often that once you have use a medicine and cease to use it when you resume it, it is no longer effective. Lithium is not an antidepressant. It is a mood stabilizer that stops mania, Lamictical likewise is not an antidepressant but also a mood stabilizer. When you used the SSRI's were your doses raised slowly? Also have you been tried on the latest form of anti-depressant medications called SNRI's which work both on the Seratonin and Noreprinephrine systems. You have been in therapy, but certain therapies are more effective on depression than others. The most effective for depression and anxiety is Cognitive Behavioral Therapy or CBT. In CBT one is taught new ways of thinking and behaving and as a result, one's mood improves.and anxiety decrease. In addition CBT is evidenced based as the most effective form of treating anxiety and depression . See:

 

The next question you need to think about. How painful is the depression. If it is extreme painful you may wish to consider ECT or electro convulsive therapy which is not as portrayed in the media. If you are in extreme pain it is something you might wish to consider which I would be happy to explain. So please get back to me on the level of pain and any other questions you may have. In the meantime best wishes and good luck and remember that the depression will not end on its own, but the episode will cease and so will the tears-so hang on.

 

Sincerely,

Ralph LMHC

 

 

 

 

http://www.rcpsych.ac.uk/mentalhealthinformation/therapies/cognitivebehaviouraltherapy.aspx

Customer: replied 4 years ago.
To answer some of your questions: Yes, the ssris were raised slowly...I started out on celexa at 2.5 ...can you imagine?: I was breaking up a 20mg pill into eights!!! then I would go up from there ....by 10mg i could not sit still....I hung on for weeks...could not take it..Did that with lexapro and welbutrin and remeron....yes I have tried effexor (snri) I have tried every kind of therapy. am doing emdr now....After 20 yrs of therapy - I know it does not work....I need medicine What do you mean by the depression will not end on its own but the episode will cease? After my daughter was born ( by the way, that's how this depression started) I was depressed all through my pregnancy and for yrs after until i started the celexa....so that episode was 5yrs? The pain is enough to where I can do nothing much social...barely make it through the day. Does ect really work ? My aunt had it in the 50s and could never remember anything ...thankyou so much. i really appreciate it....
Customer: replied 4 years ago.
To answer some of your questions: Yes, the ssris were raised slowly...I started out on celexa at 2.5 ...can you imagine?: I was breaking up a 20mg pill into eights!!! then I would go up from there ....by 10mg i could not sit still....I hung on for weeks...could not take it..Did that with lexapro and welbutrin and remeron....yes I have tried effexor (snri) I have tried every kind of therapy. am doing emdr now....After 20 yrs of therapy - I know it does not work....I need medicine What do you mean by the depression will not end on its own but the episode will cease? After my daughter was born ( by the way, that's how this depression started) I was depressed all through my pregnancy and for yrs after until i started the celexa....so that episode was 5yrs? The pain is enough to where I can do nothing much social...barely make it through the day. Does ect really work ? My aunt had it in the 50s and could never remember anything ...thankyou so much. i really appreciate it....
Expert:  Ralph LMHC replied 4 years ago.

Hello,

Ect in the 50's and now are 2 different worlds. It is true that the major side effect is short term memory loss, It lasts for 2 or 3 weeks. The procedure is done on an outpatient basis with a psychiatrist and anesthesiologist. The anesthesiologist gives you a brief anesthetic so you are asleep and there is no fear. He/she also gives you a muscle relaxant so the seizure is so mild you can barely notice it. When I observed the only way a seizure was noticed was the twitch of a finger. It was given for a series of 4-6 sessions. The change was remarkable from some one that was so depressed that all they could do was stay in bed and sleep and cry to some one who was bright and functioning. The memory returned almost totally after 3 weeks (which is different for each individual. But the positive change in affect (loss of depression) was rapid and long lasting. If you do consider it I would recommend a University Teaching Hospital where it is done as I said on an outpatient basis. For some it has been a life saver and it is definitely worth investigating if as you have said you have been suffering for decades. I have personally seen the result and would definitely advise looking into it to end the horrific pain you must be experiencing. Best wishes and good luck.

 

 

Sincerely,

Ralph LMHC

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Ralph LMHC, Therapist
Category: Mental Health
Satisfied Customers: 872
Experience: 20+ years as therapist, supervisor, clinic director at mental health, substance abuse treatment ctrs
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