> Hello,
Hi.
> Now, after off all medication my symptoms have changed quite a bit. When i wake up in the morning i feel extremely sick- so sick to my stomach like i was pregnant, but i'm a guy :S
>
> Anyways, after noon i slowly start to feel better, by 6PM Eastern European Time, I feel fine- normal actually, but I know when I wake up in the next morning I will be back to square one. Is there any way to short circuit this mood variation?
The circadian pattern of depression that you describe is what is referred to as "endogenous" or "melancholic". It often responds to tricyclic antidepressants (TCA). Imipramine works, but can produce unpleasant anticholinergic side effects. Desipramine and nortriptyline are better choices to start with. Melancholic depression was once considered the typical type that represented the majority of cases. The reverse circadian pattern (better in the morning) came to be known as "atypical". The name stuck, even though this type of depression is actually more prevalent in the outpatient population. Melancholic depression tends to be worse in the morning and often includes early-morning awakenings. Psychomotor agitation or retardation often exist. Psychomotor retardation is more common. Weight loss occurs more often than weight gain in melancholic depression.
Does this set of symptoms fit your presentation?
- Scott
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