Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.
You are being given antidepressants, but nothing specifically for anxiety. The two medications you are taken are both seretonergic agents with major risk potential for causing serotonin syndrome. You should be monitored very closely by your physician, who should give this combination only if the benefits outweight the risks.
Nortriptyline is not indicated for anxiety, and in fact can increase anxiety.
Effexor is an antidepressant that is also indicated for anxiety. For those who don't have anxiety, Effexor does cause anxiety in 6% of users however.
Both of these drugs can increase suicidal ideation.
Some doctors prescribe effexor and add
abilify as well. There are side effects and they can include weight gain, tiredness, and other serious side effects from taking antipsychoitc medication.
Before I went this route, I would ask my doctor to prescribe something to help the anxiety, particularly a benzodiazepine, such as Ativan (lorazepam) which is indicated for General Anxiety Disorder.
I do not know if you have been seen a therapist, but sometimes talk therapy (psychotherapy) is as effective as medication in reducing depression and anxiety.
There is a newer MAOI antidepressant, taken as a patch, with fewer side effects and has proven effective for many. It is called selegeline HCl.
Another option is implanting a micro-pulse generator that stimulates the vagus nerve to affect the brain's mood centers. This is yet another way to treat chronic depression that is resistant to treatment.
Finally, there is Transcranial Magnetic Stimulation, using electromagnets which are placed on your forehead in order to produce an electric current in your brain for the purpose of affecting those same mood centers.
Drugs are not always the answer. You should explore a number of options, including the ones I have mentioned.
I understand how horrible it is to live with depression. It is important, however, to make certain that the cure isn't worse than the disease.
My best wishes to you.
Elliott Sewell, LPCC, NCC, CCMHC