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Dr. Bob
Dr. Bob, Medical Doctor
Category: Medical
Satisfied Customers: 5419
Experience:  20 Years in Internal Medicine, Neurology and Sports Medicine
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Hello, thanks for taking my question.My son (34), whos been

Resolved Question:

Hello, thanks for taking my question.My son (34), who's been suffering with depression for several years, suddenly began to feel some presence and hear a voice. It scared him at first, then started taunting and demoralising him although he wasn't asked to harm any one, he isn't able to complete his final year at Uni. and even feels being physically attacked by the figure. This latest development has now been for 18 months and is throughout the day. He can only sleep by the use of (Zopiclone) taking also Mertazapine 30 once a day, we do not see any change. He refuses to see a psychiatrist and does not admit to his G.P that he hears voices. G.P does not want to force him for treatment .The questions are:
1) Is this condition reversible? can he recover fully?
2) What are the likely diagnoses and could the meds. he is on cause side effects?
can he have them changed without seeing a specialist? In this case what med. would you suggest?

3) We did not see any reason for his depression to take this turn. Why, in your view, did he reach this stage, and can this be related to his previous depression?

4) Can he get worse if he continues to refuse being seen? He is also too
Uncomfortable to be seen by the previous mental health team, can he be referred to a new team?. Finally, is he likely to be subject to any mental health act in his circumstances?. What is your advice to the family to help him recover on his own?
Your answers will be greatly appreciated. Many thanks for your time.

Andrea
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. Bob replied 3 years ago.

Dr. Bob :

Hi Andrea. This turn of events could indicate that your son has developed major depression with psychotic features. This is a mental health condition in which a person has depression along with loss of touch with reality (psychosis).

Dr. Bob :

It can be very subtle or very overt, and typically involves elements of delusions and hallucinations.

Dr. Bob :

Delusions are false beliefs about what is taking place or who one is.

Dr. Bob :

Hallucinations involve seeing or hearing things that aren't there.

Dr. Bob :

Psychotic depression requires prompt medical care and treatment.Treatment usually involves antidepressant and antipsychotic medication. He may only need antipsychotic medication for a short period of time.

Dr. Bob :

This is a serious condition and you are correct to be worried. He needs a careful physical exam and history taken by his GP and/or a mental health professional. Blood and urine tests and possibly a brain scan may be done to rule out other medical conditions with similar symptoms.

Dr. Bob :

Are you there, Andrea?

Customer:

Yes, I'm here.

Customer:

Thank you for taking my query.

Customer:

May I ask is this chat private?

Dr. Bob :

Unfortunately, there is no presumption of privacy online.

Customer:

Can a case like my son's get worse with time if not treated?

Dr. Bob :

Yes, it could.

Customer:

Also, my son is concerned about the side effects of antidepresant and antipsychotic medications. Is this something we need to be worried about?

Dr. Bob :

This can be a serious condition. He should ideally get prompt treatment and have close monitoring by a health care provider. He may need to take medication for a long time to prevent the depression from coming back. Depression symptoms are more likely to return than psychotic symptoms.

Dr. Bob :

The medications can have side effects, of course, but there are many options...so if one does not agree with him, he can try others...there is usually a bit of trial-and-error involved in getting the right med and the right dose for any individual.

Customer:

Can someone suffering from such an illness make a full recovery? Can they, for example, go back to the studies/work. Will they ever be free from the torment. A frank answer would be greatly appreciated.

Dr. Bob :

Yes, some individuals do recover, some can only manage the symptoms and continue to function as best they can.

Dr. Bob :

Most individuals improve with proper treatment.

Dr. Bob :

Most can get on with studies and work, and the like.

Customer:

One last question, is it possible that someone suffering from such an illness can experience/halucinate/imagine physical sensations like being touched or assaulted.

Customer:

Is this common?

Dr. Bob :

While auditory and visual hallucinations are well known to be common features of psychosis, tactile, olfactory, and gustatory (taste) hallucinations also can occur, though less commonly.

Customer:

Thank you Dr. Bob. We have no more questions at this time. We are grateful for your responses and greatly appreciate this service.

Dr. Bob :

Having a loving and supportive network of family and friends is a critical component of care in situations like this, and greatly improves prognosis.

Dr. Bob :

I suspect your son will do very well if he gets the professional help he needs at this time, as well.

Dr. Bob :

You're welcome. Please follow up at any time if you have additional questions or concerns.

Customer:

Thank you again. Goodbye.

Dr. Bob :

Best wishes.

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