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Major depression 13 months; On 200 mg. of generic zoloft and the depression will not subside. What should I do?

By January 12, 2010 - 5:50pm
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History of clinical depression: major; this is my 7th episode.

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I would love to echo Pat's feelings about how great you are doing in the spite of a major depression. I have suffered from depression and I know how hard it is to force yourself to do things like do your work and take a shower.

I, too, would be curious about the reasons to be prescribed the lithium, since you are not bipolar.

Is the generic zoloft the only medicine you have tried during this depression? Did it work for you before or is this the first time you have tried it? Have other medications worked for you before?

Is there an anxiety aspect to your depression?

Pat gave you wonderful advice about how to talk to your doctor. If it helps, print it out and take it with you. Understand that the depression's JOB is to KEEP YOU DOWN. It doesn't want you to laugh, enjoy things or understand things. It doesn't want you to work or play. Depression's major biochemical effect is to blunt our enjoyment of and participation in things, so we find ourselves cocooned on the couch in front of the television, or in the bedroom on the laptop. But every time you fight these inclinations, you are doing something good for yourself.

Since you work at home, I imagine you feel cloistered away from the world. Is that true? I know how difficult it is when getting out in the world is an effort. Some days go by when you never even leave the house; other times, when you do, it's a major chore. Getting groceries is a big deal. One of our HER writers, who has chronic fatigue syndrome, wrote about the life of those isolated with chronic illnesses, and how interacting with the grocery cashier or the postal clerk might be the biggest thing we do all week. It's true, and it makes it easier to stay at home in our safe place.

Keep fighting, Dunger. Keep getting out of bed, doing your work, and trying to get out of the house. Press your psychiatrist a little bit. Say, "After 13 months I should be feeling better. I'm not. Do we need to examine my medications? Do I need to be doing something else?"

And try to get SOME exercise, even a very little bit. Pat is right, it has a major positive effect on us when we have depression. If you can just make yourself walk around the block once today, that's huge. Then, keep it up. Maybe next week you can walk around two blocks. In one book I read, a doctor had his patient begin by exercising ONE MINUTE a day. That's all. She had to promise to deliberately exercise for one minute. He wanted her to do that for three weeks. His whole point was that it's not time or endurance that builds a habit, but repetition. You don't have to walk three miles to get the good out of a new bit of exercise and fresh air.

Is there anythng that you might be interested in in a volunteer manner? Working with animals at a shelter, perhaps, or shelving books at a library? (By the way, libraries are wonderful places to go when you are dealing with depression. Because they are open, they are free, they are filled with interesting people. You can browse, you can be quiet, but you can still feel that you are part of society.) Finding another external -- not internal -- reason to get out of the house can be crucial for those with depression.

Overall, though, please know that you're working hard and that it shows. You are fighting and it shows. All you can do is constantly take baby steps forward. When you don't want to get out of bed and you do it anyway, that's a victory. I am filled with admiration for all you manage to do and for your attitude.

Write back to us, tell us more about yourself. We're here, and we're interested.

January 15, 2010 - 9:07am
Expert HERWriter Guide Blogger

Hi Dunger - Thanks for writing back. You know, the first step in resolving a problem is to recognize that it exists, and you're doing really well in that regard and seem to have a handle on what's bothering you. You're seeking answers as to WHY you have these concerns, and that's very healthy.

One of the things I suggest for your doctor appointment is to review all of the medications you're taking, including the herbal sleep meds, in terms of whether they could be having some type of compounding effect on each other. A pharmacist might also be able to help you with this. Since lithium is typically prescribed for the manic phase of bi-polar disorder, and you said you're not bi-polar, I'd want to know why you're taking it and if you even should be taking it. Be sure you understand everything that has been prescribed for you and why it has been prescribed.

It's not surprising that you're not wanting to get out of bed or really "be there" for activities since you have major depression. The fact that you're able to force yourself to do those things, and you know you're forcing yourself to do them, is great self-awareness and also shows how hard you are working to ease the impact of having depression. So pat yourself on the back! I would definitely share what you're experiencing with your psychiatrist but I would also push for some answers on how long it will take for you to see some relief - how will you recognize the signs - is there a better anti-depressant that would help you? - and so forth. Here's a link to more information on depression which you may find helpful.


In addition, as much as you can, you need to get some type of movement in your life as exercise has been proven to be one of the most effective natural things you can do to help with depression.

As far as not wanting to talk to your counselor - again, you know what you're experiencing but are not sure why. As women we often have an intuitive sense about things. It could be that your intuition is telling you not to work with this person, and that's okay. Our intuition is usually right even when we can't pinpoint exactly what it's saying to us. Do you have another resource you can go to? Perhaps through your health plan, if you have one, or by a referral from your psychiatrist? If you need help in locating resources just let us know and we will help you.

Does this information help? Is there anything else we can do to help you? It's not easy for any one dealing with major depression, but with patience, the right treatment and support, you CAN make it through this.
Take care, Pat

January 13, 2010 - 5:48pm
Expert HERWriter Guide Blogger

Hi Dunger, and welcome to EmpowHer.

It's not uncommon for patients to have to try several different medications, and different dosages, to figure out which treatment is right for them. Are you under the care of a psychiatrist or a general physician? You mention you have a history of clinical depression and this is your seventh episode. Hopefully a trained specialist is assisting you. In addition to medication you might benefit from other support such as counseling and perhaps even changes in nutrition and the amount/type of exercise you have in your life. It's not possible to diagnose your needs and prescribe the right treatment for you over the Internet, you need to see a medical expert, and I hope you will do so as soon as possible. Depression is a medical condition, and you need and deserve full support.

Will you let us know what you decide to do? If you need help locating resources in your community we would be happy to help.

Take good care,

January 12, 2010 - 7:01pm
EmpowHER Guest
Anonymous (reply to Pat Elliott)

I am seeing a Psychiatrist. I do have a counselor but I cannot bring myself to call her and I am not sure why. She is someone that I trust and is a member of my own church. When I awaken in the morning, I do not want to get out of bed for 4 hrs. or more. It is not that I am tired; I just do not want to face another day. In addition to Zoloft, I take .5 mg. generic Ativan, 2 tabs herbal sleep meds, 600 mg. Lithium at night and 300 mg. Lithium in a.m. My diagnosis is Major depression and not bi-polar. I see my Dr. on Friday, 1/15. Each time I go I do not know what to say to him except that I am still depressed and it is hard for me to function on a daily basis. My husband and I have a tree business and I have to do the accounting work on the computer. I have to force myself to do that work, take a shower, be around other people, cook dinner, etc. Please give me some encouragement and hope and thank you for writing back to me. Dunger

January 13, 2010 - 3:56pm
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