Depression Medication: Are My Symptoms Getting Worse?

Regarding medication for depression?

Good evening, Dr.
Ding.
In the clinic, I don't really ask the doctor about my condition because I don't know how to start the conversation.
I just answer whatever the doctor asks.
So, I don't know if my condition has worsened or improved.
Initially, I was prescribed one 10mg dose of Trazodone before bed and one dose of Escitalopram.
Later, it was changed to Stegno.
However, after my last follow-up appointment, all my medications changed.
Now, I take one 30mg dose of Venlafaxine in the morning, one 0.5mg dose of Quetiapine three times a day, one 7.5mg dose of Zolpidem before bed, and two 25mg doses of Lamotrigine.
I wonder if this increase in medication means my condition has worsened.
If this is the dosage I'm on, what severity level am I at—mild, moderate, or severe?
I often feel very low at night, with emotions that drop to the point of self-harm, and I even have thoughts and actions of suicide.
I've been seeing a doctor for a year now, and I feel like there's been no improvement.
Am I beyond help? I can't muster the energy to do anything and have completely lost motivation.
I can't even find meaning in living; it feels like I'm just existing.
Do I still have value in living like this?

Yu Ai, 10~19 year old female. Ask Date: 2015/07/02

Dr. Ding Shuyan reply Psychiatry

Hello, depression is quite common and is generally considered a treatable condition in psychiatry.
If patients adhere to their physician's prescribed treatment, most individuals can experience significant improvement within a few months.
The primary reason for the persistence of depressive symptoms is often that patients do not consistently take their medication as prescribed, which includes missing doses or selectively taking medications, such as only using sleep aids while discontinuing antidepressants that may not provide immediate noticeable effects.

Another reason for ongoing symptoms may be inadequate response to the current medication.
In such cases, the physician may consider switching antidepressants while ensuring that the patient is taking their medication regularly.
Your situation likely falls into this category.
Sometimes, it’s not that the condition is worsening, but rather that the improvement is insufficient and has plateaued.
The dosage of medication does not necessarily correlate with the severity of depressive symptoms, so there’s no need to overthink that aspect.
Depression is treatable, much like waking from a bad dream; eventually, we will recover from it.
Suicidal thoughts can occur with depression, but suicide is absolutely the wrong option, just as I believe that someone with a severe cold should not consider suicide.
With proper treatment and time, improvement will come.
When thoughts of not wanting to live are strongest, they often last only a few minutes.
It can be helpful to distract oneself by engaging in other activities or calling someone trustworthy for support to get through those difficult moments.
Wishing you all the best,
Dr.
Ding Shuo-Yan

Reply Date: 2015/07/02

More Info

It sounds like you are experiencing a very challenging time with your mental health, and I want to emphasize that you are not alone in this struggle. Depression is a complex condition that can manifest in various ways, and it often requires a multifaceted approach to treatment. Your symptoms, including feelings of hopelessness, emotional instability, and thoughts of self-harm, are serious and warrant immediate attention.

From what you've described, it seems that your medication regimen has changed significantly over time. Initially, you were prescribed a lower dose of medication, which has since escalated to a combination of several different drugs. This increase in medication can sometimes indicate that your symptoms have not improved sufficiently, leading your healthcare provider to adjust your treatment plan. However, it is essential to understand that changes in medication do not necessarily mean that your condition has worsened; they can also reflect a need for a more tailored approach to your specific symptoms.

The medications you mentioned, such as antidepressants and anxiolytics, are commonly used to manage depression and anxiety. However, the effectiveness of these medications can vary from person to person. It is not uncommon for individuals with depression to go through several different medications or combinations before finding what works best for them. The goal of these medications is to help stabilize your mood, improve your overall functioning, and reduce the risk of self-harm.

It's crucial to communicate openly with your healthcare provider about how you are feeling. If you are experiencing thoughts of self-harm or suicide, it is vital to seek help immediately. This can include reaching out to a mental health professional, a trusted friend or family member, or a crisis hotline. Your safety is the top priority, and there are resources available to help you through this difficult time.

In addition to medication, therapy can be a valuable component of your treatment plan. Cognitive-behavioral therapy (CBT) and other therapeutic approaches can help you develop coping strategies, challenge negative thought patterns, and improve your emotional regulation. Many individuals find that a combination of medication and therapy yields the best results.

It's also important to consider lifestyle factors that can impact your mental health. Regular physical activity, a balanced diet, adequate sleep, and social support can all play a significant role in managing depression. While it may feel challenging to engage in these activities when you're feeling low, even small steps can make a difference.

Lastly, I want to emphasize that your life has value, and there is hope for recovery. Many people with depression find that, with the right treatment and support, they can regain a sense of purpose and joy in their lives. It may take time, and there may be setbacks along the way, but healing is possible.

Please take care of yourself and reach out for help. You deserve support and understanding as you navigate this difficult journey.

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