Struggling with Persistent Low Mood: Seeking Help and Understanding

Emotions have been consistently low?

Hello, doctor.
I don't know why my emotions have been so low.
I've noticed that my coordination has worsened, and even when I try to feel angry, I can't.
My libido seems to have diminished as well; I feel indifferent when seeing women naked.
Previously, I was upset because a girl I liked ignored me and possibly deleted me from her LINE.
I've been feeling very sad about this, but I can't show it at work.
I can't express any sadness, and when colleagues talk to me, I can't show that I'm unhappy.
I force myself to act normal and smile, but this is seriously affecting my thinking.
I feel a persistent headache and pressure on my forehead that won't go away.
I can't feel happy either.
I just stopped taking my medication, Depran, which I had been on for one to two months, and I was taking two pills daily.
Now, at night, I'm taking one Meishuyu.
I recently just started working and have only been on the job for three months.
I don't know what to do; it feels like I've lost control and can't feel my true self.
This has been going on for a week, and I don't know if it will get better.
I'm very anxious about how to talk to my doctor about this.

lin z j, 30~39 year old female. Ask Date: 2023/02/19

Dr. Li Guanying reply Psychiatry

Dear Sir/Madam,
From your letter, it is evident that you are experiencing discomfort and distress.
If these symptoms have arisen suddenly, it is important to consider whether they may be related to a COVID-19 infection.
The Centers for Disease Control and Prevention (CDC) defines the symptoms that persist after an acute COVID-19 infection as "Post-COVID Conditions," also known as "Long COVID." Recently, daily confirmed cases of COVID-19 have exceeded ten thousand, but current public health policies are leaning towards a balanced coexistence with the virus.
This includes monitoring for "Long COVID" symptoms, even in asymptomatic individuals, as the resulting physical and mental stress can easily lead to the recurrence of anxiety, depression, and other mental health disorders, which should not be underestimated.
Clinical findings indicate that, in addition to moderate to severe cases, individuals with mild or asymptomatic infections may also experience Long COVID, with symptoms sometimes lasting up to four months.
According to outpatient statistics, the most common Long COVID symptoms include respiratory issues, followed by fatigue, and cognitive dysfunction, often referred to as "brain fog," which ranks third.
This can lead to memory impairment and difficulty concentrating, subsequently affecting work and daily life.
Sometimes, individuals may not realize they have Long COVID, and the impact of cognitive dysfunction can lead to a decline in job performance, increasing mental and physical stress, which may trigger the recurrence of mental health issues.
Some individuals who contracted COVID-19 may only experience mild respiratory symptoms, such as coughing, and recover within a week through telemedicine consultations and adherence to medication.
However, they may later find it difficult to express their thoughts clearly and experience a decline in physical stamina.
Athletes often feel fatigued and worry about missing competitions, leading to insomnia.
Individuals who have recovered from COVID-19 may still face mental and physical stress in balancing family life and work, resulting in ongoing symptoms such as insomnia, fatigue, restlessness, anxiety, depression, and cognitive dysfunction, which should prompt consideration of Long COVID.
Moreover, among patients experiencing Long COVID symptoms, women are more likely to encounter complications related to mental health, emotions, endocrine issues, and fatigue.
Maintaining a regular exercise routine, normal sleep patterns, adequate rest, and practicing self-relaxation can help mitigate concerns about the duration of Long COVID symptoms.
However, if related symptoms persist for more than a month without improvement, it is advisable to seek professional medical assistance to prevent the emergence of more complex issues, especially for those with pre-existing mental health conditions, who may be more susceptible to relapse.
In addition to medication and psychotherapy, repetitive transcranial magnetic stimulation (r-TMS) is a non-invasive treatment method that does not require anesthesia, has a high safety profile, and does not necessitate hospitalization.
It can improve anxiety and depressive symptoms significantly, especially in patients with treatment-resistant depression or those unable to tolerate medication side effects.
Our clinic offers outpatient services from Monday to Friday, both in the morning and afternoon.
We recommend that you consider visiting our clinic for a personal assessment of your symptoms, allowing us to collaboratively discuss the best course of action for you.
Wishing you good physical and mental health.

Reply Date: 2023/02/19

More Info

It sounds like you are going through a very challenging time, and I want to acknowledge the feelings of confusion, sadness, and frustration that you are experiencing. From your description, it seems that you are dealing with persistent low mood, emotional numbness, and physical symptoms such as headaches and a sense of loss of control. These feelings can be overwhelming, especially as you navigate the early stages of your career and personal relationships.

First and foremost, it’s important to understand that what you are experiencing is not uncommon, especially in the context of significant life changes, such as starting a new job or dealing with emotional setbacks in relationships. The feelings of sadness and emotional numbness can be symptoms of depression or anxiety, and they can significantly impact your daily functioning, including your ability to interact with colleagues and perform at work.

The fact that you have recently stopped taking medication like Depranil (which is often prescribed for depression and anxiety) can also contribute to these feelings. It’s not unusual for individuals to experience withdrawal symptoms or a resurgence of depressive symptoms after discontinuing medication. It’s crucial to communicate openly with your doctor about how you are feeling, especially since you mentioned that you have been feeling this way for about a week. Your doctor can help assess whether your current medication regimen is appropriate or if adjustments are needed.

Here are some steps you can consider taking to help manage your situation:
1. Open Communication with Your Doctor: When you meet with your doctor, be honest about your feelings. Describe your symptoms in detail, including the emotional numbness, headaches, and any changes in your physical health. This information will help your doctor understand your condition better and make informed decisions about your treatment plan.

2. Consider Therapy: In addition to medication, therapy can be a valuable tool for managing depression and anxiety. Cognitive Behavioral Therapy (CBT) is particularly effective for helping individuals understand and change negative thought patterns and behaviors. A therapist can provide you with coping strategies and a safe space to express your feelings.

3. Engage in Self-Care: While it may feel challenging, try to incorporate self-care practices into your daily routine. This can include physical activities like walking or exercising, which can help improve your mood and reduce stress. Mindfulness practices, such as meditation or deep-breathing exercises, can also help you reconnect with your emotions and reduce anxiety.

4. Social Support: Reach out to friends or family members you trust. Sharing your feelings with someone who cares can provide relief and help you feel less isolated. Even if you don’t feel like socializing, maintaining connections with others can be beneficial.

5. Set Small Goals: Given that you are feeling overwhelmed, it might help to set small, achievable goals for yourself each day. This could be as simple as taking a short walk, reading a chapter of a book, or preparing a meal. Accomplishing small tasks can help build a sense of control and accomplishment.

6. Monitor Your Symptoms: Keep track of your mood, energy levels, and any physical symptoms you experience. This can help you identify patterns and triggers, which can be useful information for your doctor and therapist.

7. Be Patient with Yourself: Recovery from emotional distress takes time, and it’s important to be patient with yourself as you navigate this process. It’s okay to have ups and downs; what matters is that you are taking steps to seek help and support.

Remember, you are not alone in this journey, and there are professionals who can help guide you through these difficult times. It’s commendable that you are seeking help and trying to understand your feelings better. Take one step at a time, and don’t hesitate to reach out for support when you need it.

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