Have Mental Health Questions? Ask a Psychiatrist Online
depression / may I speak with a psychiatrist
I am a psychiatrist and ready to chat. Let me know when you're back online.
Are you still available?
is there another psychiatrist available?
Hi, sorry, I was with another person. I am here now. What can I help with?
I am here
Tell me what's going on & what you need help with.
I am really depressed. I have been taking Wellbutrin x 3 weeks and trying to get the dosage adjusted. I don't know if it is menopause, stressful job or husband being in Afghanistan, maybe a combination of all.
Depression is almost always multifactorial...so likely related to all those and possibly more reasons.
I really do not want to do anything. I work full time at a middle school and am a social worker. I am typically very task oriented, more outgoing, have a list all the time trying to get something accomplished. I need desperately to know if I have a diagnosis and need a different type of treatment.
As far as the menopause part, your doc can check your hormone levels. Some women do better emotionally with hormone replacement....while others either get worse or have no effect.
Keep in mind, making one med change at a time is best. If you start hormones and antidepressants at the same time...and then feel better in a month, you may not know which one is helping more.
Tell me more about your wellbutrin dosage...and whether you've tried other meds in the past. Is there any family history of depression, anxiety, bipolar, etc? If so, try to find out what meds have worked or not worked for family members (sometimes patterns run in family....otherwise, despite all the science, taking meds can be a trial & error approach).
Also, keep in mind seeing a psychologist is a long term therapy that doesn't work after only 2 sessions. But tell your psychologist you don't feel it's helping yet so you can make concrete goals and plans for your treatment.
I have tried Celexa, one year ago took it in Feb. for two months to complete the school year...went off of it and didn't have any problems again until this Feb. Celexa worked, no libido, but I tried it again this time with no success. I may need to try something different.
My brother has been diagnosed bipolar. My father is deceased but I believe he had depression most of his life, I just didn't know what it was.
What dose of celexa worked last time and what dose did you try this time? Has the wellbutrin had any effect?
Bipolar is highly genetic. Even if you don't have "full fledged" bipolar, it's possible your depression "leans in that direction," so to speak.
I am sorry but can't remember, the celexa dosage. The wellbutrin has helped, I don't think I could continue working without it.
If you havent seen a live psychiatrist or psych-nurse practitioner, try to find one. These meds are too complicated for most family docs.
Ok, so what's the wellbutrin dosage? The average dose needed is 300mg & the max is 450mg.
150 mgs. two times a day, I have tried 1 time a day as well...I have hand tremors as a result.
Are the tremors worse on the twice/day dose?
Are the tremors getting worse or staying the same recently...?
staying about the same
If they are tolerable, I would stick with the current dose for now. Sometimes side effects go away with time...and other times they don't. This is difficult if not impossible to predict. Also, keep in mind the full effect of a med like wellbutrin can take 1 month (some studies say even longer).
okay, I will stay with the Wellbutrin
Traditional antidepressants can make bipolar worse...or also patients with depression that "lean in the bipolar direction." The good news is wellbutrin is the least likely to do this.
okay, my brother has a dual addiction, alcoholism and bipolar.
A couple other options to discuss with your doc are trying a low dose of lexapro in combination with the wellbutrin; if that works, perhaps you could lower the wellbutrin if the tremors continue and or completely transition to lexapro (it's similar to celexa, but can be better for some).
Low dose lithium can also help augment meds like wellbutrin.
The key is seeing a live, trained specialist to see if they think you have any bipolar tendencies. Lamictal is a great medication for people with depression that is of bipolar origin.
Lexapro / lithium...okay, I know that it is trial and error. I think my first thing is to find a psychiatrist...how can I find a good, really good psychiatrist in my area?
There are also several self-help books you can read which can help including: 1) "The Seven Spiritual Laws of Success" by Deepak Chopra, 2) "The Feeling Good Handbook" by David D. Burns, 3) "The Relaxation & Stress Reduction Workbook" by ***** *****, & 4) "The Depression Workbook: A Guide for Living with Depression and Manic Depression" by Mary Ellen Copeland and Matthew McKay.
okay, thank you for those suggestions
Where do you live? The best thing is a referral from a trusted doctor, or friends or family. it doesn't hurt to check to see who your insurance will cover unless you can afford to pay cash (which can be very expensive).
Clovis, NM closest cities are Lubbock, TX and Amarillo, TX
Probably the best thing is to check with your psychologist for a psychiatry referral.
okay, I will do this
http://www.ucomparehealthcare.com/drs/new_mexico/psychiatry/Clovis.html I don't know these people, but I just googled that link.
okay, thank you...I hope I can save all the suggestions you have made so I can refer back to them
Anything else I can help with?
I thank you, ***** ***** given me some good suggestions.
Use your strengths to overcome your symptoms. There is always hope. Especially as it doesn't sound like you've had ideal treatment yet.
thank you again!!!
Please hit ACCEPT when you're ready to end the chat. Take care.
You are very welcome.
I'm trying to write some of the dialogue down before accepting.
Take your time. You could try copying at pasting it into a word document to print as well.