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Should I stop taking anti-depressants?

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Mental Health Health & Fitness

Hello doctors,

I’m going to turn 21 in a couple of months and been facing these issues for a couple of years.

I do not know whether it’s really depression, and an eating disorder which is caused by the stressful environment I’m living in.

I’ve seen and been to many psychiatrist, counsellors and therapist in the country. SGH, IMH, C&C, NUH, NTFGH, Gleneagles and many more but none has really helped much. I was always told that everything was stressed induced and things would get better but it never did.

I was prescribed with Fluoxetine/Prozac and Quetiapine to help with my insomnia which didn’t really help and my mum didn’t like the idea of me taking too much medication.

After years of seeing psychiatrist here and there my mum got tired and decided to stop the session. With the sessions and medications stopped things has gotten worst.

Doctors, can I ask what would your advise?

DOCTOR’S ANSWER (3)

Dear MMF,

Thank you for sharing your story with us. It appears to me you may have eating disorder with co-morbid depression. Both conditions can be aggravated by stress and both need to be treated.

It will be good if you can carefully recall all the treatments that you have received over the years and write down all down. If you have been admitted to hospital, you can also refer to the discharge summaries that you have received from the hospital. You can create two columns, 1 for the type of treatment (including medication) and the other for the response that you have following that treatment modality. Your response can be in the form of gaining control over eating and/or improvement in mood or sleep.

You may also try to recall amongst the psychiatrists that you have received treatment from, do you have good rapport with any of them? If you can identify a particular psychiatrist whom you are comfortable with, it will be a good idea to arrange for an appointment with him or her and discuss your case records. Very often after taking such a chronological history, the psychiatrist will have a better idea of what works and what will not work in your case. The psychiatrist will also try to figure out the perpetuating factors for your condition and what cause the conditions to relapse.

You may also consider the use of talk therapy like cognitive behavioural therapy (CBT) which works for both depression and eating disorder. There is evidence that CBT may prevent relapses in depression and eating disorder.

Cheers! Take good care of your mood, sleep and food intake!

Consult Doctor
0 135 views 0 Doctors agree 4 Nov 2018

Dear mm_f,

Sorry to hear that you’re going through such a tough time. Individuals struggling with eating disorders often experience low mood, and these symptoms are very frequently associated with stress.

It appears to me that you’re actively seeking help, which is a good sign. However, as what Dr Ethan has pointed out, it may be good to stick to one psychiatrist and/ or psychologist whom you feel comfortable confiding in, for treatment. Treatment for depression and eating disorders can take years, and recovery can be and will be a difficult journey. Having multiple therapists may confuse you further as they may have different approaches to your problems.

I would also like to explore why your mum isn’t keen on medications/ therapy, even though they have definitely helped you. Is she concerned about potential addiction to the pills, or long term side effects? Perhaps you can raise these issues with your mum/ therapist and engage in dialogue to address her concerns. Family support can speed up your recovery!

Lastly, I hope you’ve turned 21. Happy birthday! With your newfound adulthood, you can make treatment decisions for yourself too. Please go forth and seek the treatment you think benefits you the most.

Good luck!

Consult Doctor
0 594 views 0 Doctors agree 26 Jan 2018

Hi MMF – thanks for your question.

What you’ve been told by your doctors is correct – Stress can often be a trigger for depression: they are not mutually exclusive phenomena. The fact that “things have gotten worst” after you stopped therapy supports this.

Antidepressants generally don’t aid sleep, but there are some e.g. Mirtazapine which are known for their effects to make patients a little drowsy. There are other sleep adjuncts like Valium (diazepam), which can be prescribed as a short term measure to bridge a very difficult period for your insomnia.

Seeing as how you’ve been jumping between many different hospitals and psychiatrists, my advise would be to continue with your medical treatment (as you mentioned, things have clearly got worse since you stopped the medications), and stick to one psychiatrist whom you are able to establish the best rapport with – ie someone you find most sympathetic and understanding of your condition, and who takes the time to explain to you more about your condition, and why it’s important to continue with therapy.

All the best

Consult Doctor
0 596 views 0 Doctors agree 26 Jan 2018
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