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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4438
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Ive been suffering from depression for as long as I can remember

Resolved Question:

I've been suffering from depression for as long as I can remember but have always been able to control it without seeing anyone or taking anything. I have highs and lows but while I was doing my bachelors and masters it was easier to stay social and forget my problems. When I first was out of school I started at a job that didn't pay very well and I picked up another job nights and weekends which kept me so busy that it was hard to think about anything else. I was left with no time to wallow. Now I have a good job, am independent and left with free time... but I have no energy, drive or desire to do anything. I'm feeling alone and depressed. I have to push myself to go out with friends or do anything active, not because I'm nervous or anxious, but because I feel apathetic all the time. I end up sleeping my weekends away which is causing migraines. The feeling is becoming stronger and more pronounced as time goes on and I know I need to control it, it unhealthy mentally and physically, but my insurance isn't great and I don't have enough money to see a psychologist regularly. What can I do? Are there any state funded doctors I can see (I'm in Wisconsin)? Can my GP help? And what medicines should I inquire about? I can't keep feeling like this all the time.
Submitted: 9 months ago.
Category: Mental Health
Expert:  Dr. Z replied 9 months ago.

Dr. Z :

Hello

Dr. Z :

I believe I can help you with your concern

Dr. Z :

Give me a couple minutes to look over your question, so that I can provide you with the most helpful information

Customer:

No problem, thanks.

Dr. Z :

I am sorry that you have been exhibiting these symptoms, I can imagine how distressing this must be for you.

Dr. Z :

So I understand that you may not be able to see a psychologist regularly, would you be willing to try effective self-help therapy?

Dr. Z :

And then I can also go over the medication that you can ask your doctor about too

Customer:

If you think that is effective, sure.

Dr. Z :

Well I would like to teach you some techniques that can be able to help you. The best type of therapy for your symptoms would be something called Cognitive Behavioral Therapy (CBT). CBT has a premise that your symptoms are caused by negative thoughts, so if we change your thought process to be more positive and objective as well, then your symptoms will lessen.

Dr. Z :

So this link may help you, it contains a technique I use with patients called a thought record. It will help you keep track of any negative thoughts you have. You put the negative thought on paper, the emotion accompanying, the evidence to support it, and the evidence against it. Then I want you to come up with an alternative thought for the situation (more objective and plausible). This will help you change your way of thinking to be able to think more positive and not automatically go to a negative type of thinking.

Dr. Z :

In addition, these two worksheets are very good at helping lessen depressive symptoms. It can help you focus on the big picture and the objective/positive thoughts and outcomes.

Dr. Z :

Also individuals with severe depression have a poor coping mechanism, so this worksheet will help you develop a better coping strategy to manage your symptoms better.

Dr. Z :

These books are also very helpful in teaching you more techniques to lessen your depression

Dr. Z :

For medication, the use of an SSRI antidepressant, I would recommend Lexapro at 10-20mg, can be very beneficial in lessening your symptoms of depression.

Dr. Z :

Now I know you want to try to find a psychologist to possible talk to in your area as well. While there are free mental health clinics available they are not always well advertised. I would call this hotline tomorrow to help you find cheap or free psychological services.

Dr. Z :

In addition, most therapists work on a sliding scale and can charge less according to your income. I can look for therapists in your area that work on a sliding scale if you like

Customer:

I'm sure they may not consider me to be a low income candidate. I have high expenses which limit my ability to spend on doc. etc. Student loans, car payments etc.

Dr. Z :

Well they might, it does not hurt giving it a shot if you want to inquire

Dr. Z :

I can come up with a list of therapists in your area that provide sliding scale fees

Customer:

Sure.

Dr. Z :

What is your zip code, so I can look in your area?

Customer:

53005

Dr. Z :

Okay give me a few minutes to compile a list for you.

Dr. Z :

So these 4 therapists state that they provide sliding scale fees (sliding scale fees are not advertised and you will have to ask about them) and they also specialize in treating depression too

Customer:

Would you say what I'm experiencing is depression and how severe is it?

Dr. Z :

I think you are experiencing stress/anxiety and depression. This is not uncommon because anxiety and depression occur together 68 percent of the time.

Dr. Z :

I think once your depression is treated well, then your stress and anxiety will lessen as well.

Customer:

I've heard that before but I don't feel anxious.

Dr. Z :

I think the stress may cause an exhaustive feeling in you, I still think primarily what you have is depression though

Dr. Z :

I think the CBT techniques combined with the Lexapro or any other antidepressant that you choose to take will help relieve your symptoms effectively

Customer:

And have you heard of St John's Wort working? Should I stick with it or is it a lost cause?

Dr. Z :

St. Johns Wort is a great natural supplement, but it is no where near as effective as the antidepressant. Actually SSRI antidepressants and St. Johns Wort do the same thing, but the SSRI and the other SNRI antidepressants do so more effectively and efficiently.

Dr. Z :

Also you cannot take the St. Johns Wort and the prescription antidepressant at the same time.

Customer:

Right, I read that. One more thing, my GP couldn't help me with this could he? I have to go see a psychologist?

Dr. Z :

Your GP can prescribe you with an antidepressant, but a psychologist cannot. Only a GP or psychiatrist are qualified in your state to prescribe medications.

Customer:

Right sorry I meant psychiatrist.

Dr. Z :

So a psychiatrist can prescribe the medication, but psychiatrists are usually more expensive and have longer wait times. I would think your GP you can see sooner for yourself

Customer:

I guess what I'm asking is, do GPs generally prescribe antidepressants without going to see a psychiatrist first?

Dr. Z :

Yes GP's do routinely prescribe antidepressants for their patients without seeing a psychiatrist. Now if you tried multiple antidepressants with no improvement, then you may be referred to a psychiatrist.

Customer:

Great, thanks, XXXXX XXXXX calling him tomorrow as well.

Dr. Z :

Good, I think it will benefit you a lot. The Lexapro is the most effective of the SSRI antidepressants, with the least amount of side effects, and works the fastest too

Customer:

And it wont make me more tired or in a daze?

Dr. Z :

The Lexapro usually does not, but most side effects are temporary and last 4-6 weeks at the most. And usually you want to start using Lexapro in the morning because it can cause stimulation feeling in the beginning and keep you awake

Customer:

I'll ask him about it. Any other suggestions?

Dr. Z :

The Zoloft and Paxil are very good. Also Effexor, Cymbalta, and Wellbutrin are effective and popular as well. Unfortunately most psychotropic medications are not an exact science and there is a trial and error method to find the right one for you because everyone's metabolism is different and everyone reacts to the medication differently. This is why we have so many different types of the medications classified as "antidepressants."

Dr. Z :

Here is a good link on helping you choose a good antidepressant

Dr. Z :

Is there anything else I can assist you with?

Customer:

No, this is a good start. Thanks.

Dr. Z :

Anytime, I am always happy to help. I wish you the best of luck and I hope your symptoms of depression resolve swiftly. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime.

Customer:

I will, thank you.

Dr. Z :

You are most welcome :)

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4438
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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