Persistent Symptoms: Headaches, Dizziness, and Nausea in Depression Treatment

Headache, drowsiness, dizziness, and nausea?

Hello doctor, I am a patient with depression and I am taking medication for it.
Initially, I had no issues with the medication, and any side effects were considered normal.
At first, I experienced nausea and drowsiness as side effects, but after stopping the medication, I still have nausea, a feeling of fullness, vomiting, dizziness, and persistent sleepiness.
I then started to experience headaches, particularly in the area behind my ears, which come and go.
My sleep duration has been increasing day by day, my eyes are often dry and irritated, and I feel extremely fatigued with a lack of appetite.
Sometimes, I can hardly eat anything, and occasionally I experience sudden chest pain.
Additionally, my physical strength and overall condition are deteriorating; I have a runny nose without having a cold.
I am unsure what is happening and whether I should go to the hospital for a complete examination.

Jiao, 20~29 year old female. Ask Date: 2020/12/08

Dr. Cai Zongzhang reply Neurology

It is recommended to undergo an examination by a neurologist.

Reply Date: 2020/12/08

More Info

It sounds like you're experiencing a complex array of symptoms that can be quite distressing, especially as a patient dealing with depression. Your symptoms of persistent nausea, dizziness, headaches, fatigue, and changes in appetite are concerning and warrant a thorough evaluation.
First, it's important to understand that depression can manifest in various physical symptoms, often referred to as somatic symptoms. These can include headaches, gastrointestinal issues (like nausea and loss of appetite), and fatigue. The medications used to treat depression, such as selective serotonin reuptake inhibitors (SSRIs) or other antidepressants, can also have side effects that mimic or exacerbate these symptoms. Common side effects of antidepressants include nausea, dizziness, and fatigue, especially when starting a new medication or adjusting dosages. However, if these symptoms persist even after discontinuing the medication, it may indicate an underlying issue that needs to be addressed.

The specific location of your headaches—around the area behind your ears—could suggest tension-type headaches or even migraines, which can be triggered or worsened by stress and anxiety, both of which are common in depression. Additionally, the sensation of dry eyes and fatigue could be related to prolonged use of certain medications or even to the depression itself, which can lead to decreased motivation for self-care, including hydration and nutrition.

Your mention of sudden chest pain is particularly concerning. While it could be related to anxiety or panic attacks, it is crucial to rule out any cardiac issues, especially if this symptom is new or has changed in intensity. It’s advisable to seek immediate medical attention if you experience chest pain, as it can be a sign of a serious condition.

Given your symptoms, I recommend the following steps:
1. Consult Your Healthcare Provider: Schedule an appointment with your psychiatrist or primary care physician to discuss your ongoing symptoms. Be open about all the symptoms you are experiencing, including the nausea, dizziness, headaches, and any new symptoms like chest pain.

2. Comprehensive Evaluation: Your doctor may suggest a complete physical examination and possibly some tests, such as blood tests, to rule out any underlying medical conditions that could be contributing to your symptoms. This could include checking thyroid function, electrolyte levels, and other relevant parameters.

3. Medication Review: Discuss your current medications with your healthcare provider. They may need to adjust your dosage or switch you to a different medication that might have a more favorable side effect profile for you.

4. Mental Health Support: Consider engaging in therapy or counseling, which can be beneficial in managing both depression and the physical symptoms associated with it. Cognitive-behavioral therapy (CBT) has been shown to be effective for many individuals with depression.

5. Lifestyle Modifications: Incorporate healthy lifestyle changes, such as regular physical activity, a balanced diet, and adequate hydration. These can help improve your overall well-being and may alleviate some of your symptoms.

6. Monitor Symptoms: Keep a journal of your symptoms, noting when they occur, their intensity, and any potential triggers. This information can be invaluable for your healthcare provider in determining the best course of action.

In conclusion, while it’s not uncommon for depression and its treatment to lead to a variety of physical symptoms, the persistence and severity of your symptoms indicate that a thorough evaluation is necessary. Don’t hesitate to reach out for help; your health and well-being are paramount.

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