Stress-Induced Symptoms: A Journey Through Depression and Treatment

Every time I experience stress, it feels like this?

Whenever I experience stress, I develop dark circles under my eyes, feel weakness in my limbs, and notice a significant decline in my memory and comprehension.
Recently, I've even experienced soreness in my lower back and legs.
I remember the last time this happened was during my graduate school entrance exams, which was even more severe, accompanied by feelings of fear and palpitations.
A doctor diagnosed me with depression, and after finishing my exams, I took Wellbutrin, which did help.
This time, however, it doesn't seem as severe.

I've encountered some minor setbacks in my studies, leading to dark circles, limb weakness, and a decline in memory and comprehension, along with soreness in my back and legs (physiological symptoms).
Psychologically, there hasn't been much change; I consider myself an upbeat person.
I took Wellbutrin for two months this time, but it hasn't been effective.
Instead, I feel like a zombie, waking up after 24 hours and feeling as if I haven't slept at all.

I've seen several psychiatrists, and they all tell me, "You have depression; trust my expertise," including those from National Taiwan University.
However, I feel like they just listen to me and then suggest, "Try this medication for two weeks and come back." I understand that antidepressants take time to work, but after repeatedly seeing no improvement (I've visited five major hospitals), I feel like a guinea pig and am tired of it.

Now, I haven't taken medication for a while.
My condition hasn't improved or worsened, but I would prefer to be able to get up and do things every day.
I plan to address everything after graduation.
I've heard that depression is related to abnormal secretions in the brain; can't this be detected through chemical testing? Must it rely on observation and speculation? Is it necessary to keep switching medications?
To clarify: 1.
I'm not opposed to the idea that I have depression, but the medication needs to be effective.
2.
Normally, I am an active person who exercises daily and doesn't have high expectations for my grades.
Currently, I feel weak all over, so I've been less active and have gained weight.
3.
I previously mentioned taking Wellbutrin, and during that time, I experienced erectile dysfunction, which the doctor said is a symptom of depression, but this time, my sex life is still relatively normal.
4.
My sleep is also good; without medication, I sleep about 8-9 hours a day.
Aside from the aforementioned symptoms that leave me feeling drained, my sleep and appetite are normal.

It's been over a year like this, and perhaps after I graduate, everything will improve without medication.
However, I'm fed up with this fluctuating psychological state.
Can you give me some advice? Thank you.

Wu, 20~29 year old female. Ask Date: 2001/01/06

Dr. Li Junren reply Psychiatry

Your condition does not resemble typical depression, but symptoms such as decreased energy, reduced interest in various activities, and impaired cognitive abilities (memory, comprehension, etc.) may lead a physician to consider depression as a possibility.
Of course, these symptoms can also occur under conditions of high stress, physical and mental exhaustion, and excessive fatigue, which are common in graduate school.
Therefore, the notion that "everything will improve after graduation" is indeed quite plausible.
Generally, antidepressants like Prozac require continuous use for more than two weeks to be effective, but if there is no improvement after four to six weeks of medication, it may be worth considering that the medication is not effective for you.
If you experience decreased libido or erectile dysfunction during treatment, it is best to discuss switching medications with your doctor.

I recommend:
1.
Make a list of the issues or stressors that need to be addressed and tackle them in order to avoid procrastination or hesitation that could exacerbate stress.

2.
Even when feeling exhausted, push yourself to engage in regular exercise.
Remember, labor only depletes energy, while exercise can enhance it.
Good physical fitness will improve your ability to cope with stress.

3.
Finding appropriate ways to relieve emotions is also very important; choose a method you enjoy and make it a point to regularly unwind.

Reply Date: 2001/01/06

More Info

Understanding stress-induced symptoms, particularly in the context of depression, is crucial for anyone experiencing these challenges. Your symptoms, including dark circles, fatigue, memory and comprehension difficulties, and physical discomfort, are common manifestations of stress and depression. It’s important to recognize that while you may feel generally upbeat, the body can react to stress in ways that are not always aligned with your emotional state.

Firstly, let’s address the physiological symptoms you’re experiencing. Stress can lead to a range of physical symptoms, including muscle tension, fatigue, and even pain in areas like the back and legs. These symptoms can be exacerbated by mental strain, especially during periods of academic pressure. The connection between mental health and physical health is well-documented; stress can lead to the release of hormones such as cortisol, which, when elevated for prolonged periods, can contribute to various health issues, including chronic pain and fatigue.

Your experience with medication, particularly with the antidepressant "Bupropion" (often referred to as Wellbutrin), highlights a common frustration in the treatment of depression. Antidepressants can take several weeks to show effects, and finding the right medication often involves trial and error. It’s understandable to feel like a “guinea pig” when switching medications, especially when the results are not immediately apparent. However, it’s essential to maintain open communication with your healthcare provider. If you feel that a particular medication isn’t working for you, discussing alternative options or adjunct therapies (like cognitive-behavioral therapy) can be beneficial.

Regarding your question about the biochemical basis of depression, it is indeed a complex interplay of neurotransmitters, hormones, and environmental factors. While there are no definitive blood tests to diagnose depression, healthcare providers often rely on clinical assessments and patient history. This subjective approach can feel frustrating, especially when you’re seeking concrete answers. However, it’s important to remember that mental health diagnoses are often based on patterns of behavior and symptoms rather than isolated biological markers.

You mentioned that you are a regular exerciser, which is excellent. Physical activity is known to have a positive impact on mental health, as it can help reduce stress and improve mood. However, when feeling fatigued and weak, it can be challenging to maintain a consistent exercise routine. It’s crucial to listen to your body and find a balance that works for you. Even light activity, such as walking or stretching, can be beneficial.

As for your academic pressures, it’s common for students to feel overwhelmed, especially when facing setbacks. It’s essential to set realistic goals and allow yourself the grace to navigate these challenges without added self-criticism. Seeking support from peers, mentors, or counselors can provide a much-needed outlet and help you manage stress more effectively.

In conclusion, while it’s understandable to feel disheartened by the ups and downs of managing depression and stress, it’s important to remain proactive about your mental health. Continue to engage with healthcare professionals, explore various treatment options, and prioritize self-care practices. Remember, recovery is often not linear, and it’s okay to seek help when needed. Your journey through depression and stress management is valid, and with time and the right support, improvement is possible.

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