Am I Still Depressed? My Mental and Heart Health

Is this considered depression?

Hello, Doctor: Since June of last year, I have been experiencing insomnia, which has led to further discomfort, particularly related to my heart.
I underwent an electrocardiogram, a 24-hour Holter monitor, and an EEG, all of which came back normal.
Consequently, the doctor diagnosed me with depression and prescribed various medications, but I have a high tolerance to them.
A friend mentioned that I might be too mentally strong.
I tried several different sleeping pills, and eventually, the doctor prescribed a medication similar to FM2 green pills, but it didn't help either.
After two hours, I would still get up to walk around or use the bathroom.
I switched doctors, and the new one prescribed a lower dosage (as he said), which actually worked! However, I still experienced significant discomfort in my heart, so I returned to the cardiologist, who arranged for an echocardiogram.
Later, I was referred back to Taichung and was hospitalized in the cardiology department for a month, which was in April and May of this year.
I am unsure how to adjust my mood.
I often find myself unable to sleep due to various issues, and at night, I feel quite alert until midnight.
What should I do? Additionally, if I feel discomfort in my heart before bed, I start to worry and fear that my heart will act up during the night, leading to more insomnia.
Sometimes, if I haven't slept well for several nights in a row, I take some of the previous antidepressants.
I don't know what to do because I feel anxious about my heart.
Doctor, could you please give me some advice? What is my current condition? Am I still considered to have depression? However, I feel that I have improved significantly, as many of the uncomfortable sensations I used to experience are gone, and what remains might just be related to my heart issues!

doni, 20~29 year old female. Ask Date: 2002/11/21

Dr. Lin Yanhong reply Psychiatry

Hello, I have carefully reviewed your concerns, which seem to involve three main issues: 1.
Cardiac problems 2.
Insomnia 3.
Whether or not it is depression.
From your message, you only mentioned discomfort in your heart without specifying any symptoms.
Do you experience palpitations? Chest tightness? Or chest pain? Since both your electrocardiogram and echocardiogram are normal, the likelihood of the issue stemming from the heart itself is significantly reduced.
It is more likely that autonomic nervous system dysfunction is the primary concern, especially considering your sleep disturbances and strong anticipatory anxiety.
Anxiety disorder combined with insomnia appears to be the main issue.
As for whether you have depression, it cannot be determined from your message.
Here are some common symptoms of depression: If you have experienced five or more of the following symptoms for more than two weeks, you may have depression: persistent sadness, anxiety, or a feeling of emptiness; sleeping too little or too much; weight loss or decreased appetite; loss of pleasure and interest in activities; restlessness or irritability; persistent physical symptoms that do not respond to treatment; difficulty concentrating, memory problems, or difficulty making decisions; fatigue or loss of energy; feelings of guilt, hopelessness, or worthlessness; thoughts of suicide or death.
If your previous discomfort has resolved and you are left with only heart issues, consider evaluating the possibility of anxiety.
Of course, it is essential to discuss this thoroughly with your physician, as online consultations have their limitations.
Wishing you a speedy recovery.
Dr.
Lin Yan-Hong

Reply Date: 2002/11/21

More Info

It sounds like you have been through a challenging journey over the past year, grappling with both mental health issues and physical symptoms related to your heart. Your experience of insomnia, feelings of discomfort, and the subsequent diagnosis of depression are significant and warrant careful consideration.
From what you've described, it seems that your mental health has been impacted by a combination of stressors, including your heart health concerns. It's not uncommon for physical health issues to exacerbate mental health conditions, and vice versa. The interplay between mind and body is complex, and many individuals experience symptoms of anxiety and depression when facing chronic health problems.

You mentioned that you have undergone various tests, including ECGs and brainwave studies, which have all returned normal results. This is a positive sign, as it suggests that there may not be any underlying physical conditions that are contributing to your symptoms. However, the persistent feelings of discomfort and anxiety, particularly related to your heart, indicate that you may still be experiencing anxiety symptoms, which can often accompany depression.

Regarding your question about whether you are still depressed, it is essential to recognize that depression can manifest in various ways, and its symptoms can fluctuate over time. You noted that you feel you have improved and that many of the uncomfortable feelings have diminished. This is a positive development, but it is crucial to remain vigilant about your mental health. If you are still experiencing significant anxiety, especially related to your heart, it may be beneficial to address these feelings with a mental health professional.

Here are some suggestions to help you manage your mental health and emotional well-being:
1. Seek Professional Help: If you haven't already, consider consulting a mental health professional, such as a psychologist or psychiatrist. They can provide you with tailored strategies to cope with anxiety and depression, and they can help you navigate your feelings about your heart health.

2. Medication Review: Since you mentioned trying various medications with mixed results, it may be worth discussing your current medication regimen with your doctor. They can help determine if adjustments are needed or if alternative treatments might be more effective for you.

3. Cognitive Behavioral Therapy (CBT): This form of therapy is particularly effective for anxiety and depression. It focuses on identifying and changing negative thought patterns and behaviors, which can help you manage your anxiety about your heart and improve your overall mood.

4. Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation, deep breathing exercises, and progressive muscle relaxation can help reduce anxiety and improve sleep quality. These techniques can be particularly helpful when you find yourself feeling anxious at night.

5. Establish a Sleep Routine: Since insomnia has been a significant issue for you, creating a consistent sleep schedule can help. Try to go to bed and wake up at the same time every day, and create a calming bedtime routine to signal to your body that it's time to wind down.

6. Physical Activity: Engaging in regular physical activity can have a positive impact on both your physical and mental health. Exercise releases endorphins, which can improve your mood and reduce anxiety. However, be sure to consult with your healthcare provider about what types of exercise are safe for you, especially considering your heart health.

7. Stay Connected: Reach out to friends and family for support. Sharing your feelings with trusted individuals can help alleviate feelings of isolation and provide you with a support network.

8. Monitor Your Symptoms: Keep a journal of your feelings, sleep patterns, and any physical symptoms you experience. This can help you identify triggers and patterns in your mood and anxiety, which can be valuable information for your healthcare provider.

In conclusion, while you may feel that you have improved, it is essential to continue monitoring your mental health and seek professional guidance as needed. The journey to mental wellness can be complex, but with the right support and strategies, you can work towards feeling better both mentally and physically. Remember, you are not alone in this, and there are resources available to help you navigate your challenges.

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