Low neurotransmitter levels - help

Can low dopamine levels produce hibernation like symptoms? I am so severely depressed that I am unable to get up from bed in the morn. Today my Mom forced me to get out of bed around 10am. My therapist/doc say that I have very low dopamine levels.

I was in a good job but had to leave coz of depression and I have been w/o a job for 6yrs now. There is a chance of my getting back my old job by this May, but if the state, I am currently in, continues how will I do a job and lead a normal life like everybody else?

Please me help with your suggestions.

I understand that dopamine deficiency may lead to fatigue and lack of motivation as well as other symptoms. Any treatment, however, needs to be tailored to your specific medical history and circumstances.

Have you discussed these questions with your doctor and/or therapist? Do you have access to any vocational counsellors having experience with people like yourself?

My psychiatrist has prescribed me an anti-depressant(SNRI) for neurotransmitter boost and a benzo to reduce my panic attacks. But it would take time for the meds to take effect - 4 to 6 wks. Till then I'll have to suffer. I am worried what if the meds are not effective.

I have no access to any vocational counselling here.

It may take a while for your antidepressant to take effect, but benzodiazepines for anxiety often have immediate effects. I'm on long-term benzodiazepine treatment, and it slows me down considerably. Depending on your personal reaction to benzos and the dosage, it may not help with your efforts to get out of bed earlier.

There are other causes of tiredness common in psychiatric patients. Often this is medication based. Take parathyroidsm for example. Your doctor should be sending you for blood tests before jumping to the conclusion this is a dopamine issue.

I check my thyroid hormones regularly. They are fine.My neurotransmitters - may not be only dopamine but some of the others too- are surely at fault.

I take only 1mg of lorazepam every day. Previously it was sufficient to control the panic attacks. But now the panic attacks are getting too severe. I'll have to see my Doc about this.

Make sure you have your 'parathyroid' numbers checked too (they are different)

If you and your therapist think it's really dopamine specifically that's causing the problem, you may want to ask your therapist and doctor whether an SNRI is the best choice. I think some serotonergic drugs can affect dopamine indirectly, but raising serotonin levels can also affect dopamine levels negatively. I'm not a doctor, of course, but maybe just double check with your doc about the med or even possibly adding something.

How do you test for these transmitter substances?

I think it's not only dopamine. The therapist must have had discussions with the doctor and told me about dopamine. Maybe dopamine was the lowest. But she wont commit further. I guess they are supposed to tell the patient everything, at least in my country(India).

I do so many tests - is it blood test or brain scan? - Doctor and therapist wont tell me.

There is no science that tells us that you, or any depressed person, can know that with certitude. How did your therapist know that you "have very low levels of dopamine?"

Desiree, I'm sorry you feel so bad . . . especially since this has been going on for so long. I'm a healthcare professional and a longtime depression sufferer. I know of no lab test that can tell us that a person has "a chemical imbalance of the brain." Also, though we associate low neurotransmitter levels with depression (and some science seems to support that,) we don't know whether low serotonin causes depression, or maybe depression causes low serotonin levels.

Medication believed to affect neurotransmitters may help you. Such a medication did help me. (amitriptyline, a tricyclic antidepressive helped me.) The SNRI your doctor prescribed may help you. But I ask you to open your mind to the possibility that your problem may not be purely physiological. You may have an approach to life that is not working for you. You may have some beliefs about how life works that are not serving you well.

That you were able to function in a job in the past is a good sign. What happened that led to you not working?

Many people with depression are not restored to normal functioning by psych meds. Talking to your therapist can be a source of support. Your mom seems to be supportive. But you will need to alter your daily behavior. I hope medication makes that less difficult for you. But you will have to alter your daily routine, or you will not get better.

It's very hard work, but start with small daily goals.

But the drug is going to increase norepinephrine too apart from serotonin. Norepinephrine is believed to boost some dopamine receptors.

So wont serotonin and dopamine balance each other by reaching their own optimal levels?

I had to leave the job coz of severe depression. Then I started having conc and memory problems. And now morn I have continuous sinking and terrifying feelings with palpitations. It's as if I will be executed in a short while. It's so silly, but it's not in my hands. It seems to be physiological. I toss and turn in bed for a couple of hours before I can get up and carry on with my daily routine that me and my therapist have chalked out. The same thing happens in the aft. The feeling is so painful that at one time I had felt that it would have been better if I died.

Dont know when the anti-depressant will start to take effect. I have started it only a few days back.

So you have an anxiety disorder, as well as depression. I really think those are two distinct problems. It is common for depressed people to also suffer from anxiety. (That's true of me as well.)

In your case, your anxiety disorder may even be a bigger problem than your depression. Most people with depression are not as severely anxious as you are. So it might help to thing of them as two separate illnesses. Of course, one illness can aggravate another. That's true with both physical illnesses and psychiatric illnesses.

Having a therapist who helps you plan a daily routine is an excellent approach. The benzo may help reduce the anxiety. An antipsychotic might also be worth trying, since your anxiety is so severe. They can be calming.

There certainly is a physiological dimension to anxiety and depression. You can be born with biological vulnerabilities. I, myself, believe that most people with depression also have other factors that contribute to the problem. I think of depression as similar to cancer. Usually, there are multiple factors - including behavioral ones - that contribute to developing this disorder. (Like - smoking can cause lung cancer. But some people smoke a lot and never get cancer. And some people who never, ever smoked get lung cancer. No way to know for sure exactly why a particular individual gets lung cancer.)

Once you get depression, it changes your behavior in ways that make the depression worse. Consider emphyzema. Once you get it, you find it very hard to move around because it makes you so tired. So people with emphyzema will sometimes avoid doing anything at all. That leads to further weakness and it gets even harder to do anything because the person loses muscle strength and the lungs get further impaired in their oxygen carrying capacity. Depression works the same way.

Recovery for you will take a long period of reconditioning yourself, which takes a major commitment on your part to do things that are very hard to do right now. But, if you force yourself to do them, it will gradually get easier. But improvement can be so slow and gradual that you think it isn't even happening, and that can make you so discouraged you give up.

Start by trying to get just a little more active, and stick with that for a while before you push yourself a little harder. Even if you accomplish just one goal a day, give yourself a pat on the back. The smallest thing you accomplish can be a big victory in beating back the disease of depression.

Meds may help, but a lot of the recovery depends on you changing how you spend your time. We have a thread where we give ourselves a pat on the back for taking a shower. I think it helps to celebrate the small successes. For a depressed person they're not small.