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Suggest Treatment For Symptoms Of Depression

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Posted on Mon, 13 Jul 2015
Question: hello doctor,
i am a 26yr old female.im a general surgeon by profession,working in a medical college.married recently in jan2015.
i m constantly having thoughts in my mind..n its like there two or more people living inside my mind..im constantly talking to myself..and imagining situations and scenarios..and unfortunately off late i imagine or rather get only unpleasant thoughts..there is some conversation in my mind all the time either to myself or to anybody.
i am also paranoid about my inlaws.i m convinced that they hate me.and i have been only fighting with my husband.i have been in a relationship with my husband for 4years before we got married.
i am feeling trapped in my life in famiy life..in career..in every aspect.
i have been thinking seriously of injecting myself with atracurium and ending this everyday struggle.
could you please help me doctor?
doctor
Answered by Dr. Shubham Mehta (57 minutes later)
Brief Answer:
more possibility of depression.

Detailed Answer:
Hello Doc,
Welcome to HCM.
I have read your details thoroughly and completely understand your concerns.

With these details, I think your symptoms are still not suggestive of schizophrenia.
I feel it to be depression.

Usually, there are clear auditory hallucinations in schizophrenia. The patient hears these hallucinations clearly just like a normal voice is heard.

Do you hear clear voices when no one is around or these voices/thoughts are just within your head?

Fragmentary hallucinations are seen even in depression also.
Paranoia is also common is depression.
Where are your parents? friends?

Do you feel that some external agency is controlling your mind?

Feeling trapped in life in every sphere and suicidal ideas suggests you are having anhedonia. This is more common in depression.

I would suggest you to not take such extreme step of killing yourself.
Life is precious. You are precious for people around you.

Alcohol is certainly a CNS depressant and will further precipitate your depression. Please do not turn to alcohol as a solution.

Do not be hopeless. Continue with your antidepressants. Increase the dose if there is no response with a particular dose. If still there is no response, addition of low dose antipsychotic drug can be considered.

Kindly keep in regular touch with your treating psychiatrist.

Feel free to ask further if you have more issues to discuss. I will try to help you in all possible ways.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Shubham Mehta (1 hour later)
Hello doctor
Thank you for ur kind words..
My parents are currently with my sister in the U.S..
My friends are there..but I have never shared my feelings with friends or parents..its only my husband with whom I have been sharing everything till now..
N now I feel like I'm losing him.we are no longer the couple we used to be..and its not even few months since we got married.
He says we are still the same but I fail to feel so.
Adding to these problems is the uncomfortable situation I'm in with his family.
And how much ever i make myself understand to let go d past n move on I invariably get irritated n depressed by their presence.and I hav been thinking of a divorce..but again I fear being alone so I feel its best to end my life.
The thoughts and voices are in my head only..but they are there constantly..how do I tackle them?
With the fear of upsetting my parents I hv never told them of my mental problems.
I'm very very impulsive.
Infact I got into a relationship wit my husband during the time when I was dealing wit a break up from previous relationship..and even before I had got control of myself from previous break up I was with my husband.
I'm all the time confused about everything in life.
To any outsider it will look like my life is very picture perfect...
But im miserable..
I have tried going for counselling sessions but im ok till some time and I snap back soon or with any trigger..
I'm feeling lik giving up job and further studies..whereas I always aspired to study more and go abroad to work..
Pls help doctor.
Currently im not on any medication..
Which tablet do u suggest?
Do u feel I could be having borderline personality issues?
I have always had very few friends..have always fought in school..changed many schools..fought in residency wit seniors n juniors..have always labelled people as best or worst..n unfortunately cos of certain incidents i have ended up labelling my in laws in d bad group..and I m just not able to trust them or forgive Dem..i feel restless when my husband talks to them specially in my absence..
Pls help..
I can't go on living like dis for long..
doctor
Answered by Dr. Shubham Mehta (11 hours later)
Brief Answer:
borderline personality can be a possibility.

Detailed Answer:
You are most welcome.
Sorry for the late response.

From your description, I understand that you have little emotional support.
It becomes difficult for person to handle all the stressors alone.

Its always a good idea to share your feelings with someone from family or friends. This lessens your tension and gives you relief.
So, I would suggest you to discuss these issues with your friends who are nearby you.

As the thoughts are disturbing you, you must practice relaxation exercises like deep breathing and meditation. Biofeedback therapy with a psychologist can also help you.

See, we get into this profession with very hard work. Do not think of leaving this. Do not kill your aspirations. Everyone has tough times in his life. But then, it does pass away.

Regarding drugs, If you would have been my patient, I would have started you with Lithium (prescription drug). This drug will act as a mood stabiliser and will help in depression as well.

Yes, the symptoms which you listed in the end of your query does match to those of borderline personality.
Anyhow, the treatment approach remains rhe same.

Do continue with your sessions from your psychologist even if you snap back. This is the nature of this illness.

How much miserable the life may be, but there is always a positive side of it. Do not give up.

Hope to have addressed your concerns satisfactorily.
Always available for further help.

I wish you well.
Take care.
Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shubham Mehta (1 hour later)
Hello doctor
Thank you very much for ur efforts in making me feel good about myself.
I agree that sharing of tensions helps...but in today's busy world hardly anyone has time for others..and I hav really never been able to feel that close to anybody as I felt wit my husband in the last few years.so I feel it difficult to share my weaknesses with others..because for others its like I'm a general surgeon..hav a good family..a good husband..wat is der for her to b depressed..
Neither do I choose to be in this state of mind nor do I feel good about it.ofcourse I'm so tired now that I don't see any ray of hope..
My husband has supported me throughout my residency..and even in the family dispute wit his sisters and mom..but he's as normal as normal can be..n he's tired n wants me to move on..n he fails to understand why I cant move on..this has caused fights between us almost every third day..and the remaining two days go in patching up..im tired of all dis..
He has often said that I'm just faking mental illness to use it as an excuse to avoid my family..
But I kno how I was..once I fought with someone I never look back..ofcourse my mom dad n my sisters n my husband r d only exceptions..he's trying to reason out saying so y I my family not like ur family to u..
I really hav no answer to this..it might be all very logical n correct..but the fact is I was very normal wit them til they acted smart..n now I'm just being the way I hav been always..hav put Dem in the bad basket..
My husband makes me understand nicely i agree..but doctor I do understand wat he says but I'm nt able to behave that way..and that stress of doing something forcefully puts me more down..
I always dreamt of a happy married life but right from day1 I'm regretting being married..i was better off as my parents little daughter..
The last time my husband read a msg on my phone to my friend about his mom and he went mad..so that's another reason I don't tell anything to my friends..
My parents wil tell same response this happens in every home u hav to move on.
But doctor if I can't then I cant..
In fact I hav begun to believe that probably I'm so selfish that I hv no illness and I'm just faking being mentally unstable..do u think so doctor?
And as a result of so much fights between me n my husband im all d more angry against my in laws..n I hv pent up so much anger n hatred..and its driving me mad...
When wit great difficulty I somewat calm myself my mother in law will create a drama that throws me back in the pit...

Wat are fragmentary hallucinations?

Doctor my thoughts are in my mind all the time..n even wen I'm busy doing something..its like d minute I finish my work lik I notice Dem..n sometimes Dey bother me even in my work..i can't concentrate...
In my fights wit my husband I hv imagined dt he dies n I gt married to another nice guy and I'm finally happy in life..which in real life I want b able to live if anything happens to him..
I constantly find myself saying in d head I hate her( my mother in law)..i hav imagined killing her or she dying and finally me n my husband being happy..
Just cos once they spoke behind my back I constantly feel they do it even now..and I hav imagined my inlaws beating me and trying to set me on fire..
Who on earth imagines such things?
I even find other guys cute now..thing which I nvr did even wen I was a single..
Its like I'm living in my own world n I want people to react the way I hv imagined..
Like for instance i say something to my husband n he replies back in a particular way which is not what I expected then I go really mad..n I start taking my own meanings of his reply..which probably are really far fetched..but we end up fighting..
Ill tell u one example ..we were in a mall n I saw a saree n told my husband I want that one..to that he replied its nt for ppl like u..its for ppl lik my friend's fiancée..shes one butterfly..now I got offended thinking he said his friends fiancée is better looking..but he defended himself saying he really found d saree to gawdy n he said so cos she like s to show off n I nvr do dt..
Dis is one of d few instances I remember...
2013 valentines day my fiancée made me feel really spl..since we wer just engaged den..n I expected a similar response dis year after wedding..failing which I assumed he doesn't love me anymore..
He was really caught up in work..n we both wer quite broke after d wedding..
But dis is how I end up fighting...
N I'm sure sooner or later he ll leave me..
And Il b alone again..
So I feel ita better to die..
Doctor wil I hav to tak treatment life long?
And d sessions also life long?
Will pregnancy and childbirth put me at risk of postpartum depression and psychosis?
I love kids..n I always dreamt of having kids with my husband..but now I hav convinced myself that having kids wil worsen my life and i don't want kids..
Pls help.
Thanks a lot..

doctor
Answered by Dr. Shubham Mehta (1 hour later)
Brief Answer:
start treatment without worrying about duration.

Detailed Answer:
Dear Doc,
I would be happy if my suggestions could help you in any way.

You have difficulty to share your weaknesses with others.
I do not say that you share your weaknesses with anyone. But when you are emotional, you always take wrong decisions. So its better to take help of your friends in such case.

What positive point I see here is, that you can find out your weaknesses. Not an easy job for everyone when everyone has one or the other weakness. When you have pointed out your weaknesses, you can also list out your strengths.
Discuss this with your psychiatrist and work on these areas. Let your stengths overpower your weaknesses.

An outsider will not see and understand your problems. People take you to be good and healthy. But we dont feel happy or sad for people. We feel for ourselves first.
How does it what an outsider perceives about you. You have live for yourself.

There is always a ray of hope. You have a supporting husband, loving parents, a good career prospect. What else do you want. Do not feel hopeless. Think of those who do not have even this privilege.

I understand its easier said than done, but you have to move on.

You have some absurd thoughts and imaginations because you are frustrated of your circumstances. Take a break. Go for a movie, roam around with your husband.
Practice relaxation exercises as I mentioned earlier.

It is always to leave a place when you are angry. If you back off in an argument, this will automatically prevent the surge of anger. Consequently the number of arguments will decrease.

Mental illnesses are hard to fake. I understand that you are in a miserable situation and not faking this illness. Give a chance to others as well, that they understand that your are facing great emotional turmoil.

Fragmentary hallucinations are like occasional hallucinations which are not complete and clear as those in schizophrenia. They are commonly seen in depression.

The treatment may not be for life. But it all depends on how you respond to it.
Pregnancy can be a source of stress as it creates additional burden of child-caretaking. I would first suggest you to get emotionally stable with drugs and psychological treatments. So that you van handle stress of pregnancy.
You are just 26 and its not too late to have kids even after 2-3 years from now.

Hope I have addressed your concerns satisfactorily.
You are welcome for more queries.
Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shubham Mehta (35 minutes later)
Thank u doctor
I have always been lik dis in stress..and I do agree that its best to leave d place wen angry or while arguing..but my husband interprets it wrongly..as though I want to go away..
Subconsciously I still hv hatred against my previous boyfriend..cs dts wen I started facing these problems..or at least I realised I had these problems..my husband has known everything about my state of mind..yet wen he says things like dt I feel I'm ruining his life..isnt it better if I just die den..
Me and my husband hav had an intercaste marriage..n its d frst intercaste marriage in my entire family..
I m a pure vegetarian and my husband a hard core non veg..n in initial days of closeness he promised me dt he wd nvr eat non veg with me..which he still maintains.. But then I feel bad cos I know he must b loving his food..I thot Il try to eat fr his sake but I could not..
I know if u truly love someone u would not care about food n other things..
But I feel very lonely if I'm d only one eating veg in a group wen we go out to eat food wit friends n family..i hv even tried my best to avoid such situations..
My husband has done a lot of things for my comfort..i appreciate it..
But just cos I cant adjust does it mean I don't love him or I love him less doctor?
Dis man has been d only reason why I dint end my life 5years back..and today the dream which I saw with him seems to hav broken to pieces..i will really not b able to live without his love...he said he loves me d way I am..he said he dint care even if we don't hav kids at all..he said he ll love me even if I become very difficult...den where hav those promises gone?y does he talk like wat hav u done for d relationship?
It kills me.
Wat can i do if I'm like dis?
N if he said he wud love me n now cant Den Il end my life...
I actually doubt if I love him now..
D fact is I hv always seen myself frm his eyes..n he putting me down like dis I falk in my own eyes...I hv tried talking to him properly about all dis..
N finally I feel I shud just end my life..
He's hell bent on me being normal with his fly...how do I convey it to him that its hard for me...he's killing our relationship in d bargain..
His mom throws a temper tantrum every few days n we both sit n sulk..i really wish i could kill dt woman..
My husband gives me example of how his sisters r tortured by inlaws but Dey still are okay n they move on..but i don't find that behaviour of keeping quite normal d way my husband doesn't find my nature normal..
His sister is forced to hv a second child by her husband for a baby boy by threatening her wit divorce n she has got pregnant now..dis is how life is it seems..but i wud nvr listen to such a husband...i wd file a police complaint against dt man long back...
So my husband is like if i hav been supporting u y cant u frgive my family..
I'm really going crazy...
N at dis rate I just cant focus on work n studies..
I ansd jus one entrance dis year n without studying I hv gt quite a good score..but wont get field of my choice for mch..
I'm just frustrated with everything...
I hav tried going out with husband for movies n stuff..but we just don't feel d same anymore...
Its like we both r pretending to b having a good tym wit each other..he was away in XXXXXXX to work til XXXXXXX frst..n I hv been in Goa always..so its jus since dis month that we r together properly likes husband n wife..but den we hardly hav had any romantic or intimate moments...
I'm tired of dis wedding..of my life...everything in my life was a mistake..me coming to life was a mistake itself..
Yesterday evening I was sitting in parking lot n totalling d numbers on number plate of vehicles...n seeing if it totals to my fav number den it means I shud end my life...
I'm very sure at dis rate I will surely do it someday..
thanks a lot for your precious time and patience doctor.
Have a good day


doctor
Answered by Dr. Shubham Mehta (43 minutes later)
Brief Answer:
take decision when in peaceful state of mind.

Detailed Answer:
Dear, I feel you have had an argument with your inlaws or husband recently.
May be, thats why you are reacting like this. Very upset and depressed.

I would request you to not take any impulsive step right now.

There are problems in every relationship. You have to understand this.
Keep your expectations low.
Do not react impulsively to anything.

Adjustment is always from both sides. If you will take a step forward in continuing your relationship, your husband will also co-operate.

Life cannot be judged in black and white. Its never "all positives" or "all negatives". Suicide is not the solution to a problem. The aftermaths for your family will be bad, if you take such extreme steps.

My advise to you is, sit back and relax for now. Let this phase pass. Think over your relationship again in peaceful state of mind. Involve your husband in your decision.
You will definitely find a better solution then.

I wish you a happy life ahead.

May I request you to close the discussion if you have no more queries and give your feedback.

Take care.
Thanks.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shubham Mehta

Psychiatrist

Practicing since :2008

Answered : 2145 Questions

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Suggest Treatment For Symptoms Of Depression

Brief Answer: more possibility of depression. Detailed Answer: Hello Doc, Welcome to HCM. I have read your details thoroughly and completely understand your concerns. With these details, I think your symptoms are still not suggestive of schizophrenia. I feel it to be depression. Usually, there are clear auditory hallucinations in schizophrenia. The patient hears these hallucinations clearly just like a normal voice is heard. Do you hear clear voices when no one is around or these voices/thoughts are just within your head? Fragmentary hallucinations are seen even in depression also. Paranoia is also common is depression. Where are your parents? friends? Do you feel that some external agency is controlling your mind? Feeling trapped in life in every sphere and suicidal ideas suggests you are having anhedonia. This is more common in depression. I would suggest you to not take such extreme step of killing yourself. Life is precious. You are precious for people around you. Alcohol is certainly a CNS depressant and will further precipitate your depression. Please do not turn to alcohol as a solution. Do not be hopeless. Continue with your antidepressants. Increase the dose if there is no response with a particular dose. If still there is no response, addition of low dose antipsychotic drug can be considered. Kindly keep in regular touch with your treating psychiatrist. Feel free to ask further if you have more issues to discuss. I will try to help you in all possible ways.