How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr John B Your Own Question

Dr John B
Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience:  PhD in Clinical Psychology, registered clinical psychologist.
40845682
Type Your Mental Health Question Here...
Dr John B is online now
A new question is answered every 9 seconds

agitated depression

Resolved Question:

Hello

Is agitated depression considered a severe psychiatric illness?

What are the symptoms of agitated depression?

How is agitated depression diagnosed?

Can a mental health nurse make a diagnosis of agitated depression?
Submitted: 3 years ago.
Category: Mental Health
Expert:  Dr John B replied 3 years ago.

Hi,

 

'Agitated depression' is a term used to refer to a specific type of mixed episode (mood disorder) where Depressive symptoms are occurring in addition to some hypomanic symptoms. Mixed episodes are generally considered to indicate a serious mood disorder has developed.

 

The symptoms of agitated depression can vary from person to person but generally there should be significant Depressive symptoms (depressed/low mood, anhedonia, sleep disturbance, loss of energy, low motivation, cognitive impairment, etc) and also some hypomanic symptoms (usually agitation, irritability, anxiety, etc).

 

Agitated Depression is diagnosed in the same way the majority of mental illnesses are diagnosed; by clinical interview and assessment. A clinical assessment can involve gathering a range of relevant information (usually information the confirms or discounts the presence of specific symptoms) from the patient and also sometimes other family members, friends or work colleagues. A diagnosis is simply a persons opinion, nothing more. So, when I make a diagnosis I am making a formal declaration of my opinion on my patients psychological status. As a diagnosis is only an opinion a mental health nurse can make a diagnosis but as a general statement psychiatric diagnoses are usually made by Psychiatrists or Clinical Psychologists. While there are undoubtedly Psychiatric Nurses who are very knowledgeable and are good at making a diagnosis´s I would generally recommend that you get a second opinion from either a Psychiatrist or a Clin. Psychologist.

 

I hope this has been of some help. Please let me know if you have further questions or would like me to clarify any part of my answer.

Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience: PhD in Clinical Psychology, registered clinical psychologist.
Dr John B and 2 other Mental Health Specialists are ready to help you
Customer: replied 3 years ago.

Hi


Thank you for your response. One more question please?


I have recently noticed that I was diagnosed with aggitated depression in 2003. When I read this diagnosis, I took it to mean 'depression' caused by stress. However, I recently learnt what the symptoms of 'aggitated depression' are and I am sure that I did not have or describe the majority of these symptoms to the nurse when I saw him.


I believe the nurse's diagnosis was incorrect and I would appreciate it if you could tell me if his letter seems right to reach a diagnosis of aggitated depression.

I have highlighted the symptoms that I remember telling the nurse. Please note, the letter says I denied panic attacks. I do remember having my first panic attack around the time that I saw the nurse but I cannot specifically remember him asking me about this.


The nurse's letter is as follows;


The above named made a self referral by walking into our health centre to be seen as an emergency case today. His main complaint is that he is anxious and agitated for no apparent reason.


During the interview he complained of depression and low mood. He lacks motivation and both his concentration and memory are poor. He has difficulty in going to sleep and whenever he sleeps he tends to wake up at 3 or 4 a.m. and cannot not go back to sleep. He denies any suicidal ideas and feels life is worth living. He said that he is fatigued but cannot rest as he is anxious and agitated. He denies any panic attacks.


Mr Precilla does not present any signs or symptoms of psychotic behaviour. He denies any hallucination, delusion or illusion, no flight of ideas noted. He is well orientated to place, time and person. His speech is clear, coherent and good volume. He was well dressed for the weather and both his behaviour and manners were good.


Furthermore, Mr Precilla said that he was very stressed while working for the MOD as an engineer. He did not get on with his first line manager and he was transferred to the computer section where he had to work on his own in a single small room and did not see the daylight. He became depressed and anxious. Also finding accommodation in Cambridge put a lot pressure on him. He could not cope with the work at MOD. He became suspicious of people around him and he had to resign and take a job at London Transport. He bought a house in London and found that the mortgage of £900 per month is too much for him to pay. He said that this is another stress on top of his depression and problems. He has moved in with his brother and rented his own house to pay the mortgage.


Whenever he is in trouble, his family help him and now he realises he is putting a lot of pressure on his relatives. He feels insecure and lacks confidence. He expressed a lot of somatic illness such as headache, pain in the shoulder and chest, etc.


He does not have any past mental health history and he denies any forensic history. He does not smoke but admitted to drinking 3 – 4 pints of lager at the weekend. He denies abusing any illicit drugs. He does not have any relationship and his last girlfriend was 1 year ago having been together for 8 months.

Conclusion


I feel that this patient suffers from agitated depression related to stress. His Lustral

tablet of 50 mgs should be increased to 100 mgs (therapeutic dose) for a period of 6

weeks, then reduce the dose back to 50 mgs with a view to stopping it in a few weeks.

Plan


I have asked him to see you with regard to referring him to your local Psychotherapy Department for some counselling. I am afraid I cannot supply him with this service as he lives outside our catchment area.


Community Mental Health Nurse


Does this letter seem right?

Expert:  Dr John B replied 3 years ago.

Hi,

Based on the information contained in his letter I would not presume agitated depression but rather a mixed Depressive/Anxiety condition. I would base this primarily on the fact that the letter does not appear to describe any hypo manic symptoms. I also note that he recommends increasing the dosage of an SSRI, something you certainly wouldn't do if a person was displaying manic or hypo manic symptoms.

I obviously can't know this persons intentions but if I had to take a guess I'd say he's just used the wrong terminology and used 'Agitated Depression' to describe the presence of both Depressive and Anxiety symptoms.

Customer: replied 3 years ago.
Hi

Just for me to be sure, can you tell me if a "mixed Depressive/Anxiety condition" would be considered as a severe psychiatric illness?
Expert:  Dr John B replied 3 years ago.

Not necessarily. It would depend on the severity of the specific symptoms. If a person was experiencing mild Depressive symptoms and mild anxiety symptoms it would not usually be considered t be a sever psychiatric illness. If the person was experiencing more sever symptoms (for example if they were intensely suicidal) then they would usually be considered to be severely unwell.

Based on the information contained in the report I would not have thought it was a situation of 'severe psychiatric illness'.

Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience: PhD in Clinical Psychology, registered clinical psychologist.
Dr John B and 2 other Mental Health Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr.Keane/2013-8-20_204325_drkeane.64x64.jpg Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
  • http://ww2.justanswer.com/uploads/RE/resolutions66/2011-1-17_05728_IMG8202smilingeditedforJustAnswer.64x64.jpg Elliott, LPCC, NCC's Avatar

    Elliott, LPCC, NCC

    Psychotherapist

    Satisfied Customers:

    5024
    35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
  • http://ww2.justanswer.com/uploads/formybunch/2010-12-06_191055_img_0975.jpg Kate McCoy, M.Ed, NBCC, LPC's Avatar

    Kate McCoy, M.Ed, NBCC, LPC

    Therapist

    Satisfied Customers:

    3733
    Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
  • http://ww2.justanswer.com/uploads/DR/DrAkiraOlsen/2012-2-20_746_AkiraADpicmain.64x64.jpg Dr. Olsen's Avatar

    Dr. Olsen

    Psychologist

    Satisfied Customers:

    2336
    PsyD Psychologist
  • http://ww2.justanswer.com/uploads/norriem/2009-5-27_134249_nm.jpg Norman M.'s Avatar

    Norman M.

    Psychotherapist

    Satisfied Customers:

    2193
    UK trained in hypnotherapy, counselling and psychotherapy and have been in private practice. ADHP(NC), DEHP(NC), UKCP Registered and ECP.
  • http://ww2.justanswer.com/uploads/PsychologyProf/2010-07-15_171248_logos060400409.jpg Dr. Michael's Avatar

    Dr. Michael

    Psychologist

    Satisfied Customers:

    2177
    Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
  • http://ww2.justanswer.com/uploads/KURTEMMERLING/2010-07-23_215531_just_ask_picture1.jpg Steven Olsen's Avatar

    Steven Olsen

    Therapist

    Satisfied Customers:

    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education
 
 
 
Chat Now With A Mental Health Professional
Dr John B
Dr John B
Clinical Psychologist
557 Satisfied Customers
PhD in Clinical Psychology, registered clinical psychologist.