[1ofakind]

Hey all,

This is my first post but I've been reading through the forum for a little while now. I'm not sure if I really have depression so I'd like to lay out my situation and see what you guys think.

I've been suffering from chronic fatigue and difficulty concentrating since early teens. My mother took me to the doc back then, he ran some blood tests, and it was decided that I had a clean bill of health. Knowing that didn't make it any easier to get up in the morning or do what few chores I was assigned.

Fast forward 10 years... I went to the doc about a year ago and told him I was tired all of the time, that even a little bit of exertion made it worse, and that I was starting to have trouble focusing on my work. I work from home as a writer (self-employed against my will... can't find full-time or part-time work so I do what I have to to get money). He ordered a CBC and a metabolic panel (I'm guessing he did more than a CBC) and it came back clean, so he said I had symptoms of depression and wrote a prescription for Citalopram 20mg.

The citalopram worked at first... I had more energy, which made it easier for me to concentrate. But, the effect was too fast, in my opinion, to be anything other than Placebo effect. I've been taking it for about six months now (took it for two months before and stopped and started taking it again because the fatigue was horrible) and I really don't think it's having any effect on me.

Here's the thing: I am generally happy. I enjoy all the same things I enjoyed before, I sleep enough (a touch of insomnia but I listen to music and it knocks me out), and, while I experience the normal emotional ups and downs, I don't feel sad. On top of that, I have symptoms like orthostatic hypotension (dizziness when standing) and lack of appetite (could be from the Citalopram).

So, do you think I'm clinically depressed or could it be something else? Why am I so tired all of the time? It's so bad that I actually have to make a concerted effort to move my legs sometimes - they feel like they're weighed down with concrete or something.

Thanks in advance for any advice/answers/suggestions.

[Sam2]

Generally, people who are depressed lose interest in the things they once enjoyed. Many start to isolate themselves and don't feel like carrying on a conversation. Some of your symptoms, like poor attention sapn can go along with depression, but there are enough symptoms that don't fit the profile that I'd say there is some doubt.

Realize that no one can tell you for sure, obviously we are not Dr.s here, but it would probably be a good idea to see a nuerologist. That doesn't mean you have a serious disease, but its worth having it checked out by someone who deals with the types of symptoms you are experiencing.

Have you taken any of the quizes for depression? They aren't a substitute for a Dr., but may give you an idea of how closely you fit the profile of someone with depression.

Anti-depressants can cause orthostatic hypotension and lack of appetite, but again, I really think you need to see a neurologist. I wish you luck.

Sam2

[ramster_hall]

A common questionnaire used by doctors (in the UK) to diagnose clinical depression is the PHQ.

Bung that into bing or google and i'm sure you'll get a site somewhere with a version of it.

Extensive medical workup is what I would think is called for. Hemoglobin, white blood cell count, liver panels, kidney tests, stomach enzymes, pancreatic function, the whole works. Something is going on for you to have endured this so long.

In addition, allergy tests should be made to determine if you have serious allergies which can cause the symptoms you describe as well.

Get a good internest to start the ball rolling for you. Afterwards, if there are no
biological reasons for your feelings, see a psychiatrist, because it's going to likely
be an emotional thing then.

Psychiatrists, unfortunately, don't often do the bloodwork before they prescribe.
I think it's much smarter to have all the bloodwork done with an internist's and
allergist's authority and then submit the results to a psychiatrist if it turns out you
need psychiatric help.

The whole process is skewed by going in to see a psychiatrist before having all
the critical work done first when it's a problem with the blood or organs.

[doodlefrog]

Did the doc ever check thyroid function? I have heard that sometimes when your thryoid is out of whack, it can cause depression-like symtoms. Just a thought.

[montanan4ever]

My first thought is to get a comprehensive set of labs done. I'd be wondering about thyroid, sagging iron (even if not enough to qualify as anemia), certain B vitamins, maybe protein....

[1ofakind]

Thanks for the replies everyone! I just checked in at the forum for the heck of it and realized there were replies - I didn't get email updates like other forums do. I agree with those of you who say I need a complete medical work-up. I'm going to a new doc in a few days and will let them know what's going on. I read something that might be causing the trouble that I wanted to share with you guys: when you sit for extended periods of time (more than 40 minutes), your body starts to release melatonin because it thinks its time for sleep. I've never been one to exercise and I'm sitting more than ever the last few years since I started writing for a living... I feel great after I do some yard work so it seems to fit. I've always been kind of lazy (thankfully never overweight, though) so, since both doctors did do a pretty thorough blood screening (read through the records and saw that he did, indeed, run my blood for Thyroid function, electrolytes, blood sugar, a complete CBC, and much much more), I'm going to just assume it's a lack of exercise.

You guys are great, by the way. It's amazing that total strangers are willing to extend a helping hand Have a great day!