So about 2 years ago I was diagnosed w/ GAD, PD and MDD triggered when I quit smoking. During the course of treatment I had a brief hospital stay, followed by a partial hospitalization program then follow up care. I achieved remission (for the most part) through therapy and Paxil about 6 months later and discontinued Paxil much later in July, 2011.

One month after discontinuing Paxil my depressive symptoms returned (early morning awakenings, feelings of dread, depressed mood) and I resumed my Paxil regimen. Things seemed to be pretty good by October and thought that I had it licked again, although w/ the Paxil, and I figured I would just need medication long/life-term.

That is until the Monday before Thanksgiving when I had a Panic Attack at work. This floored me for about a week and my Pdoc recommended I increase my dose of Paxil and told me to take Trazodone (I had left over from earlier) after I had a crying jag the day after Thanksgiving. With the Trazodone, my sleep improved, and with that, my depression. Things had been going better for the most part and while my mood wasn't great, it was stable.

However the last couple of days I've been feeling pretty down. Especially in the mornings. Not having any crying spells, but overall feeling pretty fatigued, empty, anxious and blue. I'm still able to function for the most part and my depression has been pretty mild-moderate, but for some reason I just can't seem to shake it. I don't remember much from my last recovery but is this normal? The up and down nature of it has been really discouraging.

Sometimes I doubt that I have depression/anxiety at the moment because every self test out there says that my mood is a concern but within normal levels. Even the sanity test here says I scored a 33 or something. Still, I don't feel like I think I should. I think I'm being honest in my responses, but I get such low scores. I don't get it.

I feel kind of lame for even posting because I know in the grand scheme of things, my depression is no where near as bad as many of the other posts I've seen here nor as bad as it was when I was hospitalized in 2009, but I just wanted to see what the community had to say.

Any way, my symptoms:
Fatigue
Anxiety
Restlessness
Feeling sad/down
Occasional lump in throat/shortness of breath
Anhedonia
Low Motivation
Disturbed Sleep

I don't typically suffer from guilt, feelings of worthlessness, etc, which I believe, drives my depression score down.

Currently I'm on 30 mg Paxil and 25-50 mg Trazodone for sleep. I also take a B-complex, Fish Oil, Magnesium and Calcium.

I'm just so upset. I quit smoking (14 months as of 12/23), limit my caffeine, eat well, take my vitamins, comply with my medication regimen, try to get relaxation in daily, try to be socialble and not isolate, exercise 3-4 days a week, and lost weight (in a good way). I have a wonderful wife that I love dearly, supportive family, friends, a stable job and am comfortable financially. I've done everything I could and yet here I am. It makes it worse knowing I have no reason to feel this way. No one or nothing to blame. This is all rubbish..

Any input would be helpful.