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Re: Anyone else 'brief recurrent unipolar depression'? cubic_me

Posted by Fi on September 27, 2004, at 15:27:05

In reply to Re: Anyone else 'brief recurrent unipolar depression'?, posted by cubic_me on September 22, 2004, at 17:04:14

> I am in the UK and have this too, but sometimes my cycles are short (4 days - 2 weeks) and sometimes up to a couple of months. It is totally unpredictable and no-one here really seems to understand it. I've found that I have to pretend I'm depressed all the time to get any treatment at all - then I feel guilty about it!>

Oh I know that one so well! My main GP has actually never seen me unwell, as you have to book an appointment about 10-14 days ahead to see anyone (apart from a locum). I asked for a copy of my notes recently, which reinforced the impression I had that they think such a short episode means it must be mild.


>
> How many doctors have you seen? Have you seen a psychiatrist? Some seem to be more open to new ideas and diagnoses than others.
>

Well, its been clear the GPs at my practice dont have a clue, but they also didnt refer me on. I had never seen a psychiatrist until I was referred as an emergency when I couldnt cope. Then I saw 4 different ones in 2 weeks (once each)! The 2 that knew what they were talking about work in the emergency mental health team, so I wont meet them again unless I get suicidal.

The GPs have since relied totally on the letter one of the those psychiatrists wrote, which unfortunately has a typing error! It suggests increasing my seroxat a bit, and starting on a gradually increasing dose of lamotrigine (ie 50mg after a couple of weeks)- then in the last para it says the lamotrigine can be increased 'to 50mg'!

The consultant psychiatrist I saw for 5 minutes was the key- he was very familiar with the concept of brief recurrent depression. Apparently its recognised in the UK classification of mental illness, but not the US one. He's the one who also said that lamotrigine was a newly recognised treatment for it.

I was referred to the community mental health team, but they didnt want to take me on then (they are inundated). However, I have nearly reached the upper limit of the drugs mentioned in the letter, so I may get referred again.

I suppose I should be grateful not to have been referred (as a sign of getting on reasonably OK). But it would be good to have more expert advice.

I've had 11 episodes since Feb 2003. 2 were while I was on leave, but I am wary of how much longer my boss will put up with me taking a week off due to this, unpredicatably too. Would also be impossible to get another job at the moment with such an awful sickness record..

I cant find anything spot on, but there are some professional articles on recurrent unipolar:

http://bjp.rcpsych.org/cgi/content/full/bjprcpsych;178/4/294

http://bjp.rcpsych.org/cgi/content/full/bjprcpsych;178/4/304

The 'GP Notebook' (not sure how much they actually use it) lists recurrent brief depression in its 'classification by course'

Disappointingly, its description is
'recurrent brief depression

In this relatively benign disorder the patient suffers recurrent bouts of mild to moderate depression which last days to a few weeks. Symptoms resolve spontaneously and completely'

I wouldnt call it 'relatively benign'! 9 weeks off sick in 19 months; one episode of emergency admission...

Of course,I am also glad for the breaks in-between.

Anyway, lots of luck. And dont feel guilty- you are 'managing your doctor'; its a shame to have to do that!

And you are not alone. There's at least 2 of us coping with it, and coping with a lack of understanding into it...

Fi


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