I have been struggling with symptoms of depression for a couple of years already. Of late, my thoughts have gotten darker, I get angry very easily, my inferior complex has worsened and it has started to affect my relationship with my loved ones in a significant way. It has even affected my memory (but of course it may be due to age - I am in my late thirties).
I have been doing so-called self-regulation all this while - meaning I exercise regularly, I eat well, and try to get my rest, spend time with my family, etc. But I have noticed that a week before my period, the symptoms get more pronounced. I get very withdrawn and quiet and I think it is to the point that my work is now affected. I suspect that I have low serotonin levels, which get significantly worse off during the PMS stage (I keep a diary to monitor my moods).
I am thinking of trying antidepressant drugs, and would like your advice on the following:
(1) where can I go to get prescription for such drugs? I do not want to go to my family GP as I think I am not comfortable to tell him my condition. Please be specific where I can go (eg. IMH, polyclinic, any other GP).
(2) will I gain weight as I read that most of these drugs do have this side effect?
(3) how long will I be on medication? Are they for life (like people who take drugs to control their blood pressure) or does one normally improve with a short-term medication and can stop? I know you will say it depends but I just want to know roughly what is typically the medication duration.
Thank you for answering my questions.
Hi,
(1) where can I go to get prescription for such drugs? I do not want to go to my family GP as I think I am not comfortable to tell him my condition. Please be specific where I can go (eg. IMH, polyclinic, any other GP).
You may like to consider seeing a psychiatrist at the KKH Mental Wellness Service, as one of the conditions the team of doctors routinely see is Premenstrual Dysphoric Disorder, which is basically depressive episodes that occur during the premenstrual stage. You may wish to visit the website,
www.kkh.com.sg
, and search under the Mental Wellness Service, and read the information on Premenstrual Dysphoric Disorder to see if your symptoms are similar. Of course, a proper detailed clinical assessment is necessary before medication or therapy is recommended. It is also possible that what you have may be a depressive condition with premenstrual exacerbation, due to the progesterone load at this phase in the menstrual cycle.(2) will I gain weight as I read that most of these drugs do have this side effect?
Patients respond to medication differently, and it is not possible to ascertain what your response will be. There are some medications that do tend to cause a little more weight gain, so do let your psychiatrist know your concerns about this. Very often, one possible treatment strategy is to use the lowest effective dose of antidepressant, whilst engaging in psychological therapy to deal with some of your negative thoughts, and what you mentioned about - your issue with low self-esteem, for example.
(3) how long will I be on medication? Are they for life (like people who take drugs to control their blood pressure) or does one normally improve with a short-term medication and can stop? I know you will say it depends but I just want to know roughly what is typically the medication duration.
I'm afraid I will have to say "It depends..." You see, every patient is different, and every depression is different. Your psychiatrist will do a full assessment of your condition, make a diagnosis, and identify critical issues that need to be dealt with. And the therapy - which may be medication or psychological therapy, or both , or suggest other alternatives methods (and some of these depend on the expertise of the psychiatrist, and the resources available in the centre/hospital) - will then be recommended. You are certainly free to discuss these options in detail, and choose the methods you're comfortable with. I should perhaps advise you that given that you mentioned you have the depressive symptoms for couple of years already, you will need to be patient, and allow the treatments to take time, and also that perhaps it will entail a duration longer that just a few weeks. So this will not be like a course of antibiotics we commonly take for infections, as if you have depression for 2 years, the chances are it will take a while for your mood to stabilize, and that treatment needs to be maintained to prevent early relapse.
I do wish you all the best. Take heart that you are courageous to address your need for help, and keep this as your focus to improve your emotional well-being, and do go forward for help.
Regards,
Depnet