A Family Member Has Been Dealing With Severe Depression And

Posted on Fri, 23 Nov 2018

Question: a family member has been dealing with severe depression and suicidal thoughts since a few months now. We think it started due to these reasons- issues at work due which the person had to almost quit his job, issues at home ( daily quarrels and arguments with other family members) and lastly, inability to confide in/share thoughts with someone. We have visited two psychiatrists so far. They have prescribed medicines which makes the person feel sleepy and tired but are not helping much. He still gets suicidal thoughts specially when he is left alone. He seems better when he is at work (now things are better in the office). . Medicines do not seem to help. One of the doctors advised taking time off work for few days and take more medication but we are not sure if that will help. Please suggest best course of action - for short term as well as long term benefit.

Answered by Dr. Seikhoo Bishnoi (1 hour later)

Brief Answer:
Please provide me more details.

Detailed Answer:
Hello thanks for using ask a doctor service

Kindly provide me more details. What were his presenting symptoms?

How they started? How the symptoms progressed?

Any specific aggravating factor apart from work stress?

Provide details of his treatment and medicines he is taking.

He has suicidal thoughts and difficulty in sharing thoughts. Please mention his other symptoms too.

Thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Seikhoo Bishnoi (12 hours later)

As per his current doctor, he is diagnosed as "Bi-polar". His symptoms started 9-10 months back. He has been on medications ever since but suicidal thoughts are not going away. He finds it difficult to get out bed and says he has no energy or motivation.

He has been prescribed below medications:
1. LICAB TAB
2. ALZOLAM O.25MG (H1)
3. QUTIWEL 50MB TAB
4. PRESTIQ 50MB TAB
5. ROSUVAS 10MG TB

His doctor has recommended to admit him to a hospital and proposed Electroconvulsive therapy.

I believe there are multiple side effects to ECT.

Please advise on best course of action. Also, I would like to understand if "Bi-polar" and "severe depression" are curable or can simply have to be managed lifelong. Can family/emotional support help or would it be better to leave the patient in a hospital

Answered by Dr. Seikhoo Bishnoi (17 hours later)

Brief Answer:
ECT is safe procedure

Detailed Answer:
Hello again

Yes family therapy and support help a lot. But he is in persistent depression and has suicidal ideas. At this state it’s difficult to manage him on psycho-social therapies.

Bipolar disorder and Depressive disorder both are mood disorders. In bipolar disorder symptoms of either mania or hypomania with depression symptoms are seen. In depression mostly depressive symptoms are seen. No past episodes of mania or hypomania are seen.

For his suicidal symptoms if not remitting with medicines best treatment modality as per guidelines is ECT. These days modified ECT is given and the procedure is safe and main treatment for severe resistant depression. Lithium or Licab has great efficacy in controlling suicidal thoughts. But if her symptoms are persisting then please keep option of ECT in mind.

Thanks

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Above answer was peer-reviewed by : Dr. Yogesh D