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Dr. Kaushik
Dr. Kaushik, Doctor
Category: Medical
Satisfied Customers: 4748
Experience:  Doctor ( General Medicine)
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Hi I have a history of depression, I am on medication and I

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Hi I have a history of depression, I am on medication and I am seeing a counsillor once a week. I was doing exceptionally well, i weaned myself off medication, was excercising, lost weight, first time ever I have reached my goal weight and then, life truma circusmstances, one after another I started experinacing anixity attacks, huge anger but at the same time understanding of the circumstances but so angry at every one to be in this position. I have eaten non-stop for 4 months (mainly sweets and carbs and i am constantly craving both), i put on 8kgs - i want to call it a day, i wake everyday and think today I can do this, I have a sensible breakfast of bran, or oats, but by 9.30 / 10 the cravings have started. I am wondering if it is the stress and depression is driving my uncontrolled eating or could there be something medically wrong that is causing this. Please please please help. I have been to my GP, she said it is the depression, had blodd tests for menapause as i am 51, 2nd tests for same in 6 months and I am not pre-menopausal.
Greetings !

Welcome to the site.

I am Dr. Kaushik and i am a psychiatrist and i believe i can help you with your problem.

Please answer a few queries first.

1) How did you come to conclude that you are not pre-menopausal ?

2) What anti depressant drug are you currently taking and since how many days in total and please tell me the dose of the drug as well ?

3) Please confirm this -- did this recent condition of yours where you started feeling angry / temperamental, irritable , not in usual good mood , eating more than you actually do, started after a stressful situation in your life?

4) Are you having regular menstrual cycles or have them become erratic ?
I will get back to you once you reply to my queries.

Customer: replied 4 years ago.

question 1: full blood tests in March, iron was low, everything else fine, put on iron tablets for 6 months. 2nd blood test just checking if I was premenopausal about 5 weeks ago, came back, quote doctor "definately not".

question 2:cilift for +- 7 years sorry cannoy remember dosage, then sandoz 20mg, now pristiq 50mg.


question 3: yes immigration - family split, daughter aged 23 immigrated with me, as I had sponsorship, separation from husband and son for 4 years,husband stayed in home country as afraid we would not be successful and not sure how we would obtain jobs again if he came with and we did not have positive outcome, took 1 year in final stage, very stressful, and asked husband for divorce after 29 years marriage - angry at being on my own, scared and mentally exhausted.


question 4: menstrual cycle regular, +- 25 days.

Thanks for the valuable inputs.

Well there are definitely strong stressors which seem to have precipitated your condition which seems like an amalgamation of stress + impending depression. While you have been rightly placed on paxil but it takes a while for the drug ( say 3-4 weeks ) to produce the desired effects of countering your symptoms.

Perimenopausal syndrome cannot just be ruled out by checking blood levels as the tests need to be clinically correlated and since you are in the perimenopausal age and some of your symptoms like sore body and temperamental swings are found in this syndrome too so one cannot rule out perimenopausal syndrome just as yet from being a co-morbid ( accompanying ) condition worsening underlying stress+ depression.

So i feel for better and faster outcome kindly ask your doctor to make some simple additions to your current drug regime such as

-- Vitamin B12 and folate to be added once a day with the currently used iron and paxil.

-- Buspar ( buspirone) at dose of 10 mg twice a day shall be added to paxil as an augmenting agent to counter your present predicament.

Kindly discuss these simple additions to augment and potentate actions of the current drug regime which seems to be lacking the edge to counter your present condition so by these additions you shall be able to counter and vanquish these symptoms more effectively and faster too.

I hope this helps.

Wish you all the best.

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