Your Mental Health: Am I Diagnosed with Depression?

Q: Your Mental Health: Am I Diagnosed with Depression?

Hello： It must be very difficult for you to deal with long-term emotional distress. <br>I recommend that before your appointment, you take notes and write down the questions you want to ask so you can discuss them with your doctor during the visit. <br>You should also share your

I want to know if I am actually diagnosed?

Hello Doctor, I started visiting the psychiatric outpatient clinic on December 13th of last year.
In the past, I was bullied in middle school, which led to the habit of cutting my arms with a utility knife.
In high school, due to my emotional disturbances, I developed a tendency to isolate myself from interpersonal relationships and succumb to academic pressures, which caused me to retreat to a corner and hit the wall when I fell into depression.
There was also a period in high school when I often had a blank stare, silently cried, and couldn't stop my mind from racing with self-blame and feelings of inferiority.
My body began to exhibit various strange symptoms, including amenorrhea, irritable bowel syndrome, and orthostatic hypotension.

In the past, both I and those around me only thought I was often in a bad mood and easily irritated, but as I grew older, I realized something was wrong.
I frequently had suicidal thoughts and frantically searched online for methods of suicide.
I fear that one day I might become a social problem.
Even minor arguments with my boyfriend can lead me to lose control, resulting in self-harm such as choking myself to the point of injury or yelling and hitting myself.
When I am alone, I often have racing thoughts and even resort to cutting my arms with a utility knife, constantly thinking about the day I might suddenly swallow all my medication.
I lack motivation to do anything, and even talking to others feels difficult.

These reasons prompted me to seek treatment.
Initially, I was very afraid of seeing a psychiatrist.
During my first visit, the doctor prescribed me 0.5 mg of fluoxetine (Prozac) per day, but after three weeks, I saw no improvement.
Two weeks later, I lost control again, which scared me into returning for an earlier appointment.
The doctor adjusted my medication to one fluoxetine pill per day and added half a pill of venlafaxine (Effexor).

The doctor has never explicitly mentioned whether I truly have depression (I fear giving the impression of being unreasonable, and I sometimes think that way myself), so this question has lingered in my mind without an answer.
After five visits (either I was too afraid to ask or I forgot to ask), the diagnosis code given by the doctor has always been F32.8, other depressive episodes, which has left me confused about my condition.
With three weeks until my next appointment, which feels like a long time, I hope to gain some understanding of the severity of my illness.
Thank you!

C, 20~29 year old female. Ask Date: 2018/01/31

Dr. Wu Enliang reply Psychiatry

Hello: It must be very difficult for you to deal with long-term emotional distress.
I recommend that before your appointment, you take notes and write down the questions you want to ask so you can discuss them with your doctor during the visit.
You should also share your concerns with the doctor, such as "I'm afraid of coming across as unreasonable" or "Is this really depression?" A psychiatrist should be patient in listening to your questions and may appropriately refer you for psychotherapy or other counseling and treatment options.
Wishing you a speedy recovery.
Sincerely, Wu Enliang.

Reply Date: 2018/01/31

More Info

It sounds like you are going through a very challenging time, and I commend you for seeking help and trying to understand your mental health. From what you've described, it appears that you have been experiencing a range of symptoms that could be indicative of depression or another mood disorder.
Depression is a complex mental health condition that can manifest in various ways, and it often involves a combination of emotional, cognitive, and physical symptoms. The symptoms you've mentioned, such as self-harm, feelings of worthlessness, difficulty in social interactions, and thoughts of suicide, are serious and warrant attention. It’s important to recognize that these feelings are not just a phase or a sign of weakness; they are symptoms of a mental health condition that can be treated.

The diagnostic code you mentioned, F32.8, refers to "other depressive episodes," which suggests that your healthcare provider is recognizing that you are experiencing depressive symptoms, but they may not fit neatly into the more commonly recognized categories of major depressive disorder or persistent depressive disorder (dysthymia). This can sometimes happen when a person's symptoms are complex or when they have a history of trauma, such as bullying, which can complicate the clinical picture.

Your history of self-harm and the physical symptoms you mentioned, like irregular menstruation and gastrointestinal issues, can also be linked to depression. It’s not uncommon for mental health issues to manifest physically, as the mind and body are deeply interconnected. Chronic stress and emotional pain can lead to a range of physical health problems, which can create a vicious cycle where physical discomfort exacerbates emotional distress.

Given your experiences, it is crucial to continue seeking professional help. If you feel comfortable, I encourage you to discuss your concerns directly with your psychiatrist during your next appointment. You might want to ask specific questions about your diagnosis, the implications of the code given, and what treatment options are available. It’s also important to express any feelings of confusion or fear you have regarding your mental health status. A good psychiatrist will appreciate your honesty and will work with you to clarify your diagnosis and treatment plan.

In the meantime, consider engaging in self-care practices that can help manage your symptoms. This could include mindfulness exercises, journaling your thoughts and feelings, or finding a supportive community, whether online or in-person, where you can share your experiences without judgment. Therapy, particularly cognitive-behavioral therapy (CBT), can also be beneficial in addressing negative thought patterns and developing coping strategies.

Lastly, if you ever feel overwhelmed or have thoughts of self-harm or suicide, please reach out for immediate help. There are crisis hotlines and mental health professionals available who can provide support in those moments. Remember, you are not alone in this, and there is help available. Your mental health is important, and taking steps to understand and address your feelings is a significant and commendable action.

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