Posted by ed_uk2010 on February 15, 2015, at 14:29:23
In reply to Re: Medical conditions know to cause depression!, posted by topdog on February 15, 2015, at 4:36:06
Hi TD,
>I'm 30 by now, i have been suffering for total of 12 years, it hit me like lightening, during the second half of 2002. In six months i got severely sick and never recovered, the illness took over my life.
>I have no other medical conditions that I'm aware of.I can certainly see why you want to rule out medical causes. On the other hand, a 12 year history of depressive illness but no 'medical' signs is highly suggestive that you will not have an readily identifiable 'medical' cause. If your depression was due to some underlying medical condition, it is very likely you would have pronounced physical symptoms after suffering for 12 years. An example is thyroid disease, which can cause depressive symptoms. After 12 years of an underactive thyroid, you would generally have a substantial medical as well as psychiatric problems.
Anyway, if you've not had any blood tests recently, there are some tests you may be able to get from your doc. I will outline some suggestions and why they might be performed.....
Full blood count - this is a routine blood test which is used in the diagnosis of many common conditions, including anaemia. Many types of infection produce abnormal blood count results.
Urea and electrolyte profile - this exceptionally common blood test, like the full blood count, is performed on almost patients admitted to hospital. It is inexpensive, and is very valuable test to detect kidney disease in the elderly. Although inexpensive, I don't think you need it. In psychiatry, it is normally performed in specific circumstances only eg. to monitor kidney function when prescribing drugs such as lithium which can reduce kidney function, and which rely on the kidneys for excretion.
Calcium level - this is a useful test to perform on older patients who are depressed and vaguely unwell, especially post-menopausal women. Elevated calcium resulting for parathyroid disease can cause depression and various physical symptoms. Calcium levels are very unlikely to be abnormal in young people with depression, unless they are on lithium, in which case is it useful to check it yearly.
Liver tests - blood tests for liver function may be useful if you have risk factors for liver dysfunction eg. high alcohol intake. Liver tests are also sometimes performed for patients on Nardil. Abnormal liver tests would result in further investigation. Some of the tests Tomatheus had done (copper and caeruloplasmic) would normally only be performed after other results were abnormal eg. liver tests. Only private clinics generally perform tests such as copper levels without a pre-existing reason, so they can charge more money!
Thyroid function tests - normally including TSH and free T4. Free T3 is a specialist test, and not a routine screening test. Thyroid dysfunction can be a cause of depression. Although you would probably have clear physical symptoms by now, it would be worth having this basic test if you haven't had it done recently.
ESR, or preferably, plasma viscosity. This is a vague test for inflammation in the body. An abnormal result requires further testing to establish the cause.
Vitamin D level - vitamin D deficiency is very common in depression, mainly as a result of spending a lot of time indoors. Vitamin D deficiency has been hypothesised to aggravate depression. Since vitamin D deficiency is common and easy to treat, it's a useful thing to test for in those at risk.
Vitamin B12 level - vitamin B12 deficiency can worsen depression. This test is not always performed, but is useful in some circumstances eg. the elderly (who often don't absorb it well from food), vegans (who have a low intake of this vitamin), those with certain types of anaemia on the blood count and people who drink a lot of alcohol. In someone of your age, the test would be most suitable if you are vegan or a heavy drinker. Otherwise, it is probably not useful unless your blood count is abnormal.
Folate - red cell folate is the most useful measure. This test is performed in several circumstances eg. when the full blood count shows macrocytic anaemia, in heavy drinkers, and in people who eat very little, or who have a very poor diet. Deficiency is most common in the frail elderly who eat little, and in alcoholics. For you, I would suggest this test if you drink heavily or if you eat very little due to your depression, especially if you're underweight. Otherwise, it may be worthwhile only if you are anaemic with an unknown cause.
Ferritin level - this test is performed if you have signs of iron-deficiency anaemia. In a 30 year old, iron deficiency is dramatically more common in women than in men, due to menstrual blood loss. In women, this test can be performed routinely if there are symptoms of anaemia and fatigue, at the same time as checking the full blood count. In men, it is best to do the full blood count first, unless there is a history of blood loss (eg. haemorrhoids, blood in faeces) or strong clinical symptoms of anaemia.
Autoantibody screen - this test, normally including 'anti nuclear antibodies', or ANA, is used to look for autoimmune diseases, if one is suspected. Various autoimmune diseases such as lupus can cause depression, but in general, a large variety of physical symptoms (rash, joint pain) would be present as well. In the absence of any physical signs, performing this test is not likely to be helpful.
Testosterone and related hormonal tests - these tests are suitable if you are male and have signs of deficiency eg. reduced body hair, reduced facial hair growth, severe loss of interest in sex and erectile problems even when not taking meds which cause sexual dysfunction. This is not a routine test performed in young people with depression and no signs of deficiency.
Blood glucose - if your meds have led to a large weight gain, this test checks for diabetes. It is normally performed on a fasting sample takes in the morning. Blood lipids (cholesterol and triglycerides ie. fats) can be checked at the same time. These tests are to monitor healthy and medication safety, not to test for causes of depression.
Prolactin - in psychiatry, this hormone is measured in patients on certain antipsychotics, which can elevate it.... it is not measureed otherwise. You do not need this test, but I included it for other readers.
Lyme disease blood testing - in the US, some doctors looks for Lyme disease in people with unexplained symptoms, including psychiatric illness. This test is not suitable in countries where Lyme disease is rare, unless the is strong medical reasons to suspect it eg. signs of Lyme arthritis.
>Though one time i had stop because of the drugs unavailability to me- this was the worst 6 months i could ever imagine possible to be felt by a person.
I'm so sorry to hear that. Was this due to a problem importing the drug? I'm not aware of there being any supply problems with Nardil in the UK recently.
>I have understood that only thing that takes away the pain and makes my life somewhat livable are the drugs that strongly elevate dopamine levels.
The effects of MAOIs are only partly to do with dopamine. Indeed, Nardil is very different to stimulants. MAOIs are clearly effective antidepressants, whereas stimulants are not. MAOIs potently effect quite a number of different neurotransmitters.
>Modafinil for few months which also removed the main symptoms.
That's interesting. Modafinil is very different to the other stimulants. It is not very dopaminergic.
>I know if i go back on Nardil i will never stop it unless i am forced to or a better med comes out.
Have you tried Parnate?
>I still remember the smell of the fresh grass and the feel of the ocean breeze in spring and all of the emotions i could feel back then. Waking up, feeling refreshed and excited for the new day and how the sun felt in hot summers day, The music felt alive, the colors where vivid and everything was interesting and exciting, i felt alive back then.
That's a beautiful description of health. For me, I've not really felt excitement for the new day since childhood either. This hasn't always been related to depression though. I don't think life is ever quite so exciting as being a child at Christmas!
Hope my post is useful to you.
poster:ed_uk2010
thread:1076605
URL: http://www.dr-bob.org/babble/20150129/msgs/1076673.html