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 DrRussMD Your Own Question
DrRussMD, Board Certified Physician
Category: Medical
Satisfied Customers: 65319
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, health, prevention, complementary medicine, etc.
Type Your Medical Question Here...
DrRussMD is online now
A new question is answered every 9 seconds

I am diagnosed with MDD, anxiety and PTSD. My question is

This answer was rated:

My name is ***** ***** I am diagnosed with MDD, anxiety and PTSD. My question is why exactly do I spiral into a deep depression, becoming completely dysfunctional for days and then snap right out of it as if it never happened? This has been my experience fir years.
JA: How long have you been feeling this way? Have you reached out to anyone about this yet?
Customer: I've been treated for many years. I've become basically medication resistant, however I currently take Efffexor as it has always been the most effective. I've tried ECT and that didn't work. I've just gotten progressively worse over the past five years. I'm 55 years old, post menopausal and do not work anymore-I am on SS Disability. I'm just mainly curious about the brain mechanism that causes this up and down with no triggers. I'm not bi-polar, but I am clinically depressed and have no control over my mood changes.
JA: Anything else in your medical history you think the doctor should know?
Customer: I don't think so. I believe my case is pretty standard

Welcome to just answer. I am here to answer questions for education and information. I will respond shortly with an answer, or a question for you

Customer: replied 1 month ago.
Ok, thank you

What medication are you on?

Customer: replied 1 month ago.
Effexor, clonapin, adderall

What type of doctor?

Customer: replied 1 month ago.

OK, and if you are not bi polar, which would explain your description, what does your psychiatrist say as to the cyclic nature of your symptoms?

Customer: replied 1 month ago.
I haven't asked her because I'm not due for an appointment until November and she is not covered by my insurance so I thought I might be able to find an answer online

A diagnosis can not be made on line.

Bi polar would explain this description.

It is often under diagnosed.

That said, your symptoms are not controlled on your current regimen.

Why are you on adderrall

Customer: replied 1 month ago.
I've been diagnosed with bi-polar twice and each time the medication was very detrimental. I do not suffer from mania at all. I take Adderall for motivation.


The treatment is still the type of treatment that can fight the depressive epidodes, but the mood is not stable.

This implies the treatment needs to be more global.

IN other words, something that treats the entire brain in terms of mood stability.

Depakote would be one example, and might replace the need for the clonipin [not a good long term drug due to cognitive dysfunction] and even the effexor.

Also, SNRIs like effextor are not for everyone.

I would ask your psychiatrist several things:

What is your hormonal status: thyroid, sex hormones, adrenal hormones.

What is your metabolic status [are there any genetic deficits causing problems such as high homocystein and the inability to matabolize or carry minerals and nutrients].

Magnesium level. Probably is under 2.5 which is low in this situation and is a chronic problem.

All B vitamin levels and D should be measured as well.

There is now also genetic testing for compatability with psych meds. This might be useful as well.

Ok let me know if you have further questions.

Also, please click a positive rating on the rating scale. [This must be done manually at the top of the page]. In fact, a 5 rating squares me with just answer and allows me to provide prompt and accurate service to you, but does not increase your cost. And, I will be here for any follow up

DrRussMD and 5 other Medical Specialists are ready to help you
Customer: replied 1 month ago.
Good information. Thanks!


Any questions.

Find me by requests as needed.

Here daily.