Posted by Racer on February 3, 2006, at 19:32:39
In reply to Help Me Please, posted by KCSLL on February 3, 2006, at 18:39:18
First the bad news: I don't think you can go in to your doctor with an answer that will work for you. These drugs are way too variable in people's responses to them, so there is no one right answer, not even for people with very similar symptoms. If your doctor does not know enough about antidepressants to prescribe one to you, then I strongly recommend that you see a psychiatrist who specializes in medications to find the right drug for you. If that's absolutely not an option, then I guess asking your GP to do some research himself to help you. Maybe find a couple of drugs that might be options for you, and suggest that one of them might help, and then ask him to find out which would be the most appropriate to start you on?
As for your situation, yes, antidepressants will help with it, but I think some behavioral work will help, too. I say that having been in very similar circumstances (without a child in the equation), and knowing that it's very close to impossible to get up enough steam to start any sort of project like that. I guess the first step would be to try to make a list of baby steps that would add up to an improvement in your situation. Maybe a list that starts with "make a list of all the bills that are behind; make a list of all the bills that are up to date; call the first bill on the first list to make payment arrangements; etc." (Trust me on this -- the accounts receivables people you're going to be talking to are much easier to deal with when you call them to arrange payments.) Baby steps, like do one thing per day. If you do that one thing every day, eventually everything on your list will be done, although you'll have a new list by then ;-) Seriously, though, once you get a chore or two done, it'll get easier.
I think getting in touch with some friends would help, too, just because it sounds as though you've gotten pretty isolated. Doing something with a friend, even just a nice long sit down together, might just give you the jump start you need to do something.
Back to meds: generally, doctors do things in a sort of order, based largely on safety. First they'll try SSRIs, because they have the fewest and most benign side effects. It seems as though doctors are really liking Lexapro right now, and that the people who find it effective like it a lot, too. Next would be the newer drugs, like Effexor and Remeron, which have a different set of side effects, which can be more problematic than the SSRIs. If those options don't help, the next class would probably be the tricyclics, or TCAs. They have more and more significant side effects, though, although they are very effective drugs. If that fails, too, MAOIs are the last major class of antidepressants, and they're usually the last t be tried, because they require a somewhat restricted diet, and the effect of eating a forbidden food can be quite serious. If you're more concerned with getting relief, and are willing to give up certain foods in order to do it, then MAOIs are sometimes considered the big guns of ADs, because they work pretty reliably, by all accounts.
Good luck.
poster:Racer
thread:606003
URL: http://www.dr-bob.org/babble/20060129/msgs/606049.html