Managing Mixed Depression and Anxiety: When to Seek a Second Opinion

Adjustment disorder with mixed anxiety and depressed mood?

Doctor, I was diagnosed with "adjustment disorder with mixed anxiety and depressed mood" by a psychiatrist six months ago after experiencing significant emotional distress from my girlfriend's infidelity.
Initially, the medication was effective, but recently my symptoms have returned and seem to be worsening.
The psychiatrist prescribed me Suvenil (Sertraline), and I am currently taking 1.5 pills, but I feel like it’s not having much effect.
I’ve read online that this condition can improve within six months if one stays away from stressors, but despite taking medication for half a year, my symptoms seem to be getting worse.
I'm unsure if my condition is accurately diagnosed.
Should I consider switching to another clinic, or should I continue discussing my situation with the same doctor?

Wen, 20~29 year old female. Ask Date: 2022/07/10

Dr. Qiu Junda reply Psychiatry

Hello, the description in the text suggests that there shouldn't be significant issues with the physician's treatment.
However, the effectiveness may not meet your expectations, and it is evident that the stimulation at that time was indeed substantial.
You can choose to switch doctors if you wish (perhaps another physician's medication might be more suitable for you?).
However, you have also researched that this condition cannot be quickly improved solely through medication.
It is essential to incorporate some non-pharmacological methods as well, including stress relief techniques (these are actions you need to take proactively, and of course, you can discuss the methods with your physician).
Only by addressing both aspects can you achieve improvement sooner.

Reply Date: 2022/07/10

More Info

It sounds like you are going through a challenging time, and it's understandable to feel uncertain about your diagnosis and treatment. Mixed depression and anxiety can be complex, and it's not uncommon for individuals to experience fluctuations in their symptoms, especially in response to stressors or changes in their life circumstances.

Firstly, it's important to recognize that the diagnosis of "mixed depression and anxiety" indicates that you are experiencing symptoms of both conditions simultaneously. This can manifest in various ways, including persistent sadness, anxiety, irritability, and difficulty concentrating. The fact that you initially responded well to medication but are now experiencing a resurgence of symptoms suggests that your current treatment may need to be re-evaluated.

Here are some considerations regarding your situation:
1. Medication Effectiveness: You mentioned that you are currently taking 1.5 tablets of a medication called "舒美寧" (which I assume is a form of antidepressant or anxiolytic). It's crucial to communicate with your prescribing physician about your concerns regarding the medication's effectiveness. Sometimes, it takes time to find the right dosage or the right medication that works for you. Additionally, some medications may take several weeks to show their full effects, and others may require adjustments.

2. Therapeutic Options: Beyond medication, therapy can be a valuable component of treatment for mixed depression and anxiety. Cognitive-behavioral therapy (CBT) and other forms of psychotherapy can help you develop coping strategies, address negative thought patterns, and manage anxiety more effectively. If you haven't already, consider discussing the possibility of incorporating therapy into your treatment plan.

3. Second Opinion: If you feel that your concerns are not being adequately addressed or if you are not seeing the improvement you expect, seeking a second opinion can be a reasonable step. A fresh perspective from another mental health professional may provide new insights into your condition and treatment options. It’s essential to feel comfortable and confident in your treatment team.

4. Monitoring Symptoms: Keep a detailed record of your symptoms, including 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. It can also help you identify patterns in your mood and anxiety levels.

5. Lifestyle Factors: Consider evaluating your lifestyle and stressors. Engaging in regular physical activity, maintaining a balanced diet, practicing mindfulness or relaxation techniques, and ensuring you have a support system can all contribute positively to your mental health. Sometimes, lifestyle changes can complement medication and therapy.

6. Communication with Your Doctor: It's crucial to maintain open communication with your healthcare provider. Share your feelings about the current treatment and any changes in your symptoms. A good doctor-patient relationship is built on trust and collaboration, and your input is vital in shaping your treatment plan.

In conclusion, while it’s understandable to feel hesitant about your current treatment, it’s essential to take proactive steps. Whether you choose to continue with your current doctor or seek a second opinion, make sure to advocate for your health and well-being. Mental health treatment is often a process of trial and error, and finding the right combination of therapies can take time. Remember, you are not alone in this journey, and support is available.

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