Ask a Psychiatrist and Get Answers to Mental Health Questions ASAP
Hi! I believe I can be of help with this issue.
First, let me say I can imagine how distressing this situation is for you. You are a young man and you know that you should be flowering at this stage of life, yet you can't shake the part of you that is prone to sadness and depression. I have a feeling my answer will be long because there's a lot to say when it comes to life issues. I also want you to know that at the end of the posting I'll paste in for you a technique you can use to help when you are in that dark hole of depression and anxiety. When you are feeling depressed and in a dark hole, this is something you can use to help with some relief and you can use it over and over.
Because you are young and you need to take command of your situation and not wait for doctors to come up with the right prescriptions and dosages (which might not happen for a long time), we want to come up with a coherent program for moving forward. The six components of a total care program are: meds, diet, exercise, motivation, spiritual life, and psychotherapy.
Meds: I am concerned that someone your age is taking Prozac. It is known to diminish sexual desire in at least 25% of patients. And you don't need anything that takes away your desires of any kind. So please talk to your doctor about trying other medications. Viibryd, for example, is a new med of the same class as Prozac that has a lot of buzz because it has almost no complaints of lower libido. Risperidone is also a medication that tends to lower a person's enthusiasm as well as aggressive tendencies. Please discuss this with your doctor as you seem to need more enthusiasm and energy.
Diet: cut out coffee, sugar, white flour. That may be tough. But you will see results as some of the newer research shows. And lean meats only. No fast food restaurants, no fatty foods.
Vitamins can be useful for moods. A good quality daily vitamin, for example. One of the most important supplements is Omega 3 fatty acids, either in fish oil or capsules or in flax seed oil. Buy good quality. The clinical dosage is 1,6000 mg to 3,000 mg daily. Try the higher end of the range if you can afford it. Omega 3 is the main supplement. The research on it and depression is conclusive. All these things you should get at the biggest and most frequented health food store and ask them for the best brands they trust in terms of quality.
Exercise: 5 days a week moderate exercise, to include 3 days of strength training as you get more used to it. Your doctor will verify the research results showing the benefit. You're young and so you may need to increase the intensity of the program a notch at least.
Motivation: I recommend you apply the principles in the following videos and books. So that you can be yourself with more confidence and share it with others. Coach yourself. Be your own life coach! I want you to get really into motivational videos and books. In other words, accept your past fears, accept your past worries and hurts and traumas. Accept them and focus on becoming who you WANT to be now. Here's a simple YouTube search I put together on "motivational speakers":
Some like Tony Robbins are the classic big guys. Some are newer. There are now wonderful women speakers as well. Watch them all. Get inspired. Buy a book or two. Here are some possibilities, but they are only suggestions as there are so many good ones.
The first book is the father of all these type of books. How to Win Friends and Influence People by Dale Carnegie. There are classes in these books now! It was written in the 1930s and still has something to say to us today that is very worthwhile.
I think very highly of the second book on my list, which is a real classic: The Seven Habits of Highly Effective People by Stephen Covey. It is the book that has helped more people than probably any other.
The third book is by Anthony Robbins. He's one of those speakers who fills up huge auditoriums. For a reason. He's a terrific speaker and writer. The particular book (if you like it, try his others): Awaken the Giant Within.
Spiritual life: the medical literature is now rather overwhelming about the benefits to so many different areas of physical health of regular religious and spiritual practice. Going to church, meditation, etc. are all shown to produce benefits to the physical body. What about our mental health? Well, you will see that meditation is now a regular part of psychotherapy interventions. I don't know if you're a religious person or not. But if not, this may be a good time in your life to tune up your spiritual life. If you do not believe in G-d, that's not a barrier to your own spiritual life. Just thinking about the meaning of your life, of life in general, and studying spiritual texts and practices will help with the anxiety.
Psychotherapy: this requires to have you orient your thinking about depression and meds and remedies as treating the symptoms of your anxiety and depression and that it is important to treat your situation as a HUMAN problem. This would mean making your focus of your "work" be on exploring your emotional reactions, your history and behavior patterns you've learned from your history, and your negative thinking you've adopted from your history. We have emotions because they are part of how we grow and learn and become more fulfilled. But if we keep trying to get them just to go away without ever exploring what's going on, we NEVER get that chance to get anything important from them.
You need to find a psychologist or psychotherapist to help you with the underlying CAUSES of these symptoms, who can help with the depression itself. You need to feel comfortable with the therapist and I don't want you to accept just anyone. You have the right to interview them until you find one who you feel comfortable with and that you feel will understand your experience!
If your doctor isn't able to refer to anyone, here is the web address for Psychology Today's therapist directory. You can sort by zip codes and when you see someone who seems like they might be helpful (they show you a photo of the therapist!) look at the listing and see if they list CBT therapy along with psychodynamic therapy in their orientations and depression and anxiety disorders as one of the areas they work with. http://therapists.psychologytoday.com/rms/
In your situation, you are seeking someone who isn't as structured as a pure CBT therapist, and that's why the psychodynamic therapy is important to be in their orientation, which is a more insight based therapy. In psychodynamic therapy you are looking at the causes of your behavior, your history, and its effect on you. The idea here isn't that these types of therapy are magic. It's that you may want to find a therapist who will form a strong therapeutic alliance with you and will help you look at the sources of your emotions.
Okay, I wish you the very best!
Now for the technique: here are instructions on a therapeutic protocol called Progressive Muscle Relaxation (PMR). It's really quite easy to do almost anywhere. My patients, when I teach them PMR at first are amazed how simple it is and that it is a psychological protocol. It was first used in the 1920s! Since then, of course, it has been refined and many studies have been done showing its effectiveness. I want you to practice the PMR at least 5-6 times before an attack or feeling acute anxiety. Why? Because when you're in the throes of anxiety, you will only remember to do something you are very familiar with it. So practicing 5-6 times is really a minimum.
I want to stress the importance of breathing as well. Part of the physiology of what is happening to you when the anxiety of depression is present is that your breathing is getting shallower. This reduces the oxygen in your blood to your brain. That increases the anxiety and depression, which strengthens the emotion and you are in a vicious cycle! Not good. So breathing is the primary tool. I have found in my practice that learning breathing techniques can be helpful. But some of my patients are not interested in learning more than one thing at the beginning, so I have found that just reminding you to BREATHE deeply at the same time you are doing PMR is almost as good. If you are willing to take a yoga class and learn breathing techniques, that's the best. But, breathing deeply with your PMR will help. So, we're ready for learning PMR. I want you to print my instructions below my signature and have a copy in each of the rooms of your home where you may be when you have an attack. And again, you need to practice this easy technique at least 5-6 times as soon as you can. It needs to become as natural to you as breathing. Ah, remember breathing?
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Quickly focusing on each group one after the other, with practice you can relax your body like ‘liquid relaxation’ poured on your head and it flowed down and completely covered you. You can use progressive muscle relaxation to quickly de-stress any time.
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