Author Topic: Is this depression or anxiety?  (Read 8293 times)

Kaikou

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Is this depression or anxiety?
« on: August 27, 2015, 12:40:45 PM »
If your friend told you that they needed "everything to stop". That they felt like they didn't have time to do anything and scared to waste time. Couldn't focus etc.
That they feel best laying in bed at the end of the day and waking up early in the day before everything starts.

What would you say? This is pretty much depression right? At what point do you go to the ER? Or just make an appointment with your doctor?

She said she doesn't always feel like this, but often 2-3 days a week.

AZDude

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Re: Is this depression or anxiety?
« Reply #1 on: August 27, 2015, 12:55:17 PM »
Hard to say, but a conversation with a doctor/psychiatrist cannot hurt.

lhamo

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Re: Is this depression or anxiety?
« Reply #2 on: August 27, 2015, 01:03:22 PM »
Sounds more like anxiety to me.  I have dealt with both.  Some people have them together.

She should seek help.  Anything that is disrupting your daily life/ability to function on a regular basis like that is not normal, and should be evaluated by a medical professional.  There are also physical health conditions (esp thyroid issues) that can manifest in this way. 

BeardedLady

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Re: Is this depression or anxiety?
« Reply #3 on: August 27, 2015, 01:08:09 PM »
Your friend does not need to go to the ER since this is not an emergency. She needs to be evaluated by a mental health provider. Any GP can write a script for meds, but for real help she should see a psychiatrist or similar. As I do not have experience diagnosing and treating either disorder, and since this is secondhand information about symptoms, I would be irresponsible to try to guess her diagnosis.

forummm

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Re: Is this depression or anxiety?
« Reply #4 on: August 27, 2015, 01:22:30 PM »
You can't diagnose anything 3rd hand over the Internet. But there could be any number of non-serious reasons for this. It could be as "simple" as too much workload at work or something going on in their family or just going through a phase.

Kaikou

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Re: Is this depression or anxiety?
« Reply #5 on: August 27, 2015, 01:31:42 PM »
I will encourage her to contact her doctor or go to urgent care.

This isn't normal for her and she has never expressed these types of feelings with me. She is the one that has it all together, as they say.

forummm

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Re: Is this depression or anxiety?
« Reply #6 on: August 27, 2015, 01:46:40 PM »
It's unlikely that urgent care is the right place to go. If she's at risk of harming herself or others, then calling a suicide hotline or 911 is a better option. Your description did not sound that urgent, but that is impossible to know 3rd hand over the Internet. A primary care physician or therapist (either psychologist or psychiatrist) may be a better option for non-urgent care as a first step.

Kaspian

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Re: Is this depression or anxiety?
« Reply #7 on: August 27, 2015, 02:08:06 PM »
Before encouraging your friend to go to a doctor and stuff anti-depressants down her throat, I would suggest a vacation.  It's not necessarily depression, it could just be a personality type.  I'm very similar though nobody who talks to me would know it.  Go somewhere warm on the ocean, with beach and palm trees, a small, low-key low-cost quiet all-inclusive resort that doesn't have many rooms and no Internet.  By herself!!  Somewhere there's very little to do except chill on the beach, read, and drink margaritas, rum & cokes.  It's not necessarily anxiety or depression, it could very well just be she's got the hermit gene lurking in her DNA.  People, stuff, chaos, malls, traffic, workplaces do give us hermits anxiety.  She could just need escape not psychotherapy.

Hermitism and needing lots of "alone time":  Being misdiagnosed since the founding of Pfizer.
« Last Edit: August 27, 2015, 02:23:36 PM by Kaspian »

dcheesi

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Re: Is this depression or anxiety?
« Reply #8 on: August 27, 2015, 03:02:40 PM »
Sounds like stress/overwork/burnout to me.

I will encourage her to contact her doctor or go to urgent care.

This isn't normal for her and she has never expressed these types of feelings with me. She is the one that has it all together, as they say.
That could just be part of an image that she tries to uphold. Which of course would only add to her stress and prevent her from coping by talking about her feelings. The fact that she's talking about it now could be another sign that she's exceeded her limits and is suffering from burnout.

Kaikou

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Re: Is this depression or anxiety?
« Reply #9 on: August 27, 2015, 03:12:16 PM »
Sounds like stress/overwork/burnout to me.

I will encourage her to contact her doctor or go to urgent care.

This isn't normal for her and she has never expressed these types of feelings with me. She is the one that has it all together, as they say.
That could just be part of an image that she tries to uphold. Which of course would only add to her stress and prevent her from coping by talking about her feelings. The fact that she's talking about it now could be another sign that she's exceeded her limits and is suffering from burnout.

I agree with this

Rosy

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Re: Is this depression or anxiety?
« Reply #10 on: August 27, 2015, 04:19:57 PM »
[quoteBefore encouraging your friend to go to a doctor and stuff anti-depressants down her throat, I would suggest a vacation.  It's not necessarily depression, it could just be a personality type.  I'm very similar though nobody who talks to me would know it.  Go somewhere warm on the ocean, with beach and palm trees, a small, low-key low-cost quiet all-inclusive resort that doesn't have many rooms and no Internet.  By herself!!  Somewhere there's very little to do except chill on the beach, read, and drink margaritas, rum & cokes.  It's not necessarily anxiety or depression, it could very well just be she's got the hermit gene lurking in her DNA.  People, stuff, chaos, malls, traffic, workplaces do give us hermits anxiety.  She could just need escape not psychotherapy.

Hermitism and needing lots of "alone time":  Being misdiagnosed since the founding of Pfizer.][/quote]

+1 For some of us there comes a time when we need downtime - peace and quiet - sleep. Just because we are upbeat and on the go all the time, doesn't mean we can't run out of juice.
Too many people, too much pressure, you just want to get off the threadmill.
You don't have to be sick or suicidal - sometimes it is simply a feeling of being overwhelmed. How tough are things at work?
Sometimes you just need to breathe - think nothing - do nothing - be on your own.
Needing distance. Sometimes the only place you are allowed to do that in our society and in some households is when you are in bed alone or get up before everyone else, so you can somehow find the strength to make it through the day.

It happens, not enough time for herself, feeling out of control. Give her time out - vacation? in a calm quiet spot - communicating with nature. No nightclubs or Disney or Vegas - just Mother nature and maybe some vino or Margarita watching the sunset.

From where I sit this is a form of stress and anxiety. It does not sound like depression to me at all. An opportunity to chill is preferable to meds and clinics. Don't be so quick to medicate.

Anyway, I'm no doctor and I may be way off. She may welcome your support or not, but it is good for her to know that you are genuinely concerned for her and that is a good start.

milesdividendmd

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Re: Is this depression or anxiety?
« Reply #11 on: August 27, 2015, 10:23:49 PM »
Here's a nice survey of questions to screen for depression.

Sleep difficulty?
Trouble taking interest in things you usually enjoy?
Feelings0 of guilt?
Decreased energy?
Difficulty concentrating?
Agitation or lethargy?
Appetite disturbance or unintended weight loss?
Suicidal thoughts?

5 yes' for 2 weeks is suggestive of depression.

And I am all for prescribing SSRI's for depression. They are very effective, for a true illness, and can often be literally life saving.

(Disclosure: While I am an MD I an not a psychiatrist)


DrSweden

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Re: Is this depression or anxiety?
« Reply #12 on: August 27, 2015, 10:56:01 PM »
Without any background information it is very hard to say. I am a resident in psychiatry and we usually talk to patients for one hour the first time to being able to make a correct diagnosis. It does not sound as you need to go to the ER but it would be wise to book an appointment with a GP/Psychiatrist.


Melody

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Re: Is this depression or anxiety?
« Reply #13 on: August 27, 2015, 11:04:48 PM »
Is this driven by an increase in must be done activities. I can recall feeling the same way after starting my first full time job, picking up studies on top of job, starting a weekly sporting commitment etc. Each time I add something extra to the routine these feelings of "how will I do it all" compound me. I use a four square grid to prioritise and make sure I tick at least one task off every day. (Important urgent/important not urgent/not urgent not important/urgent not important). As soon as I started thinking about things in this way I started to feel a lot better. I saw lots of things that could be allowed to slip and I actually got to do all of my should do things I was feeling guilty about (not urgent but important)

FLA

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Re: Is this depression or anxiety?
« Reply #14 on: August 28, 2015, 12:28:50 AM »
Your friend does not need to go to the ER since this is not an emergency. She needs to be evaluated by a mental health provider. Any GP can write a script for meds, but for real help she should see a psychiatrist or similar. 

Unless she is suicidal or could harm herself or others, she should not try to use the ER as a place to get mental health care. It will not happen, nor is it set up for that.  Anxiety and depression often go hand and hand and it sounds like she needs to see someone now.  Ask her primary to recommend someone. Also, mayo clinic site has good descriptions of what these illnesses can be like and they may even have self screening tools she should use. 

Kaikou

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Re: Is this depression or anxiety?
« Reply #15 on: August 28, 2015, 12:32:09 AM »
Thanks all. I'm going to touch base with her in the am. Will report back.

Lis

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Re: Is this depression or anxiety?
« Reply #16 on: August 28, 2015, 09:14:55 AM »
Wow, that sounds like me in college. You've gotten a lot of good advice so far, and I'm bumping to follow and hoping for the best.

I second (third, fourth, whatever) trying to get her to a psychologist, psychiatrist, or even a counselor - someone trained in being able to ask the right questions and truly tell where she is mentally. When I went, I was overly stressed, had an (imaginary) image to uphold, and was just SO BUSY ALL THE DAMN TIME. I was suffering from anxiety and well on my way to depression. Going to talk to a professional was honestly the best decision I ever made.

I agree that the ER, Urgent Care, and even a GP's office are not the right places to go right now.

I may be preaching to the choir here, but there is NOTHING WRONG with seeing a trained professional. You go to a GP when something is "off" physically, go to someone when something is "off" mentally.

purple monkey

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Re: Is this depression or anxiety?
« Reply #17 on: August 28, 2015, 09:52:25 AM »
If your friend told you that they needed "everything to stop". That they felt like they didn't have time to do anything and scared to waste time. Couldn't focus etc.
That they feel best laying in bed at the end of the day and waking up early in the day before everything starts.

What would you say? This is pretty much depression right? At what point do you go to the ER? Or just make an appointment with your doctor?

She said she doesn't always feel like this, but often 2-3 days a week.

Going to the ER can be demoralizing, unless serious symptoms like suicide, worthlessness, etc.

Maybe you can talk more about what the problem is and listen to your friend, you might can help.

A doctor that she knows will be better than one that she does not.

Good luck and hope your friend gets better soon and can identify some route causes and/or adjustments.

Kaikou

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Re: Is this depression or anxiety?
« Reply #18 on: August 28, 2015, 12:06:52 PM »
Talk with her this morning and she shared more things with me. First she doesn't have a PCP (one that she has seen consistently) that's why I thought urgent care but most have expressed that they really can't help her. Should she just call her insurance and have them recommend someone. She doesn't have anything on her medical history related to this.

She said she has felt this way for about 8 years, when she doesn't have something to distract her and her time, she feels this way. She says she is not thinking about harming herself, rather just that she feels like she wants to be left alone and that normal "hustle & bustle" of the day: go work, make dinner, car repairs, bills, school, phone calls annoy her and she puts them off so much that most times it is too late to even do them. But even when she is at home doing nothing or "vacationing" she worries about the things she has to get done or ignores them so she doesn't have to do them.

Of the symptoms milesdividendMD posted she said she feels:

Trouble taking interest in things you usually enjoy (sometimes)
Feelings of guilt (over not getting things done, yes)
Decreased energy (yes)
Difficulty concentrating (yes)
Agitation or lethargy (yes to both)

She said she saw a counselor for a few sessions early on (maybe 6 yrs.), but said because she was so articulate, put together, and knew what was going on, that particular counselor had little to nothing to offer. Just an ear.

She wants help, but the whole process of getting help and then the right help is confusing to her.

Is there places you can walk in today and see someone qualified to make a diagnosis?

milesdividendmd

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Re: Is this depression or anxiety?
« Reply #19 on: August 28, 2015, 12:53:11 PM »
If she is depressed it may be very difficult for her navigate her way towards help.

If you want to help her, get her  insurance information and find out if she can see a psychiatrist without a referral. If so find some mds  who are taking new patients and do some due diligence and get her in for a new pt appointment. If not she'll need to go to a primary care provider first.

wenchsenior

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Re: Is this depression or anxiety?
« Reply #20 on: August 28, 2015, 12:55:32 PM »
While I agree that a GP often can' t help diagnose or treat psychiatric symptoms, some of that sounds like how I was before I was diagnosed with a chronic hormonal disorder. I had intermittent anxiety and depression issues though my teens and twenties, and a large element of it had to do with an underlying medical condition that sadly wasn't diagnosed until I was almost 30.

Hormones can really affect mood a great deal, so you might suggest that she get a basic blood screening for all reproductive hormone levels (and I mean ALL, not just estrogen and progesterone), insulin, blood sugar, thyroid, etc. I have PCOS, which is a syndrome somewhat similar to diabetes, where poor processing of sugar feeds back into abnormal reproductive hormone levels. It most DEFINITELY affected my mood. Not saying she is likely to have that unless she has physical symptoms associated with it, but it is worth ruling out a physical cause first.

Even today, with my PCOS very stable and controlled, I find my mental state easily slips into the bad anxiety/depression patterns if I don't eat a clean, low carb, low sugar diet; exercise regularly; get plenty of sun/natural light.

Also, as a side note, hormonal birth control can also strongly affect mood, both positively and negatively. My depression-free, healthy-lifestyle sister was a basket case on Ortho Tri Cyclene, thought she was going insane for a couple years. Finally I convinced her to go off it for a while, and BOOM, instantly back to normal. She subsequently found a pill brand/type (there's tons of different ones now) that didn't affect her negatively.

Anyway, something for her friend to consider. Sometimes the simplest fixes (underlying condition, medication side effects, diet) get overlooked as the first things to test.

Kaikou

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Re: Is this depression or anxiety?
« Reply #21 on: August 28, 2015, 01:24:59 PM »
So the next steps would be contacting her insurance for a psychiatrist referral or recommendation and to schedule hormone levels check and physical? I'm here to walk with her.

Kaspian

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Re: Is this depression or anxiety?
« Reply #22 on: August 28, 2015, 01:32:25 PM »
go work, make dinner, car repairs, bills, school, phone calls annoy her and she puts them off so much that most times it is too late to even do them. But even when she is at home doing nothing or "vacationing" she worries about the things she has to get done or ignores them so she doesn't have to do them.

Yes, no, yes, no, yes, yes, yes...  Mostly same as me.  Still not necessarily a form of depression.  I'd rather not go to work, answer the phone, go to the mall, hang out in crowds, go to a restaurant, see lots of people, put up with people, etc., etc., etc., and all those other things people think is "normal" behaviour.  There must be something wrong with us if we'd rather lay in bed all day staring at the ceiling than doing whatever everyone else does.  Act and feel like others or there's something wrong with you!  Under that definition, there'd never be any Smiths, Sex Pistols, Leonard Cohen, Van Gogh, or a million other great artists. Despite all its lip-service, our society makes very little variance for actual personality types.  Moody?  Disorder.  Lethargic?  Disorder.  Lazy?  Disorder.  Single?  Issues.  Anti-Social?  Major disorder. 

I haven't opened my snail mail in months.  Know why?  Just don't wanna.  Anxiety is often actually caused by having to (or feeling you must) do things you don't want to do.  It's not the cause or the issue, it's the result.

Re:  the vacation thing.  I intentionally had to book myself into the middle of nowhere--2 hours from the closest town.  Just so I wouldn't get itchy feet, do daytrips, not have Internet, feel the need to visit places.  There was nothing I could do but chill the fuck out and let social noise escape.  By day 3 I thought I was losing my mind.  By Day 7?  A happy, empty slate.  :)

« Last Edit: August 28, 2015, 01:39:07 PM by Kaspian »

MRae99

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Re: Is this depression or anxiety?
« Reply #23 on: August 28, 2015, 01:54:02 PM »
I would have her look into some mental health support, whether that be a counselor, psychologist, or psychiatrist. Just be sure they are licensed! Some employers even provide mental health services through EAP (I think that's the acronym-- too many to remember sometimes!). That might be a more low stress way for her to get started and if she needs more intensive support, the counselor through EAP should be able to refer her somewhere. Usually, a certain number of appointments through EAP are free. Just another option if she has that at her disposal!

Taran Wanderer

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Re: Is this depression or anxiety?
« Reply #24 on: August 28, 2015, 02:02:40 PM »
EAP = Employee Assistance Program.  This is good advice.

wenchsenior

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Re: Is this depression or anxiety?
« Reply #25 on: August 28, 2015, 04:52:31 PM »
So the next steps would be contacting her insurance for a psychiatrist referral or recommendation and to schedule hormone levels check and physical? I'm here to walk with her.

That seems reasonable. Look for obvious causes first. Try to get a handle on basic lifestyle issues (food, exercise, sleep, medication, etc.) and see where she is with those and keep them in mind going forward. Get a basic physical. Then, if nothing is wrong physically (or even if it is, counseling can be a helpful tandem treatment), pursue counseling.

The reason I'd look into physical causes first is that if you don't, and she is prescribed anti-depressents, you might be layering a new factor on top of existing factors that should be treated first or concurrently. And if you don't know this, you can have less than optimal results.

Seriously, with me, it was nearly all because of improper diet affecting my hormones, and thus my moods, in an ever increasing cycle of dysfunction. I am also slightly wired to be anxious, so the effects magnified easily. I definitely would have pursued counseling and antidepressants if changing my diet and lifestyle hadn't fixed it. But I examined the lifestyle stuff first.

Allie

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Re: Is this depression or anxiety?
« Reply #26 on: August 28, 2015, 05:15:42 PM »
Most literature suggests that a combination of meds, therapy, and lifestyle changes is the most effective for alleviating the symptoms of depression and/or anxiety.  I would encourage you to assist her in finding a psychiatrist or GP who can prescribe meds, a therapist who can work with her on internal dialogue, and lifestyle changes (increased exercise, light exposure, good nutrition, building social supports, developing fulfilling hobbies etc.).  Any one of these could help her, but all three will likely have a larger impact. 

Most areas have a crisis line with trained assessors, give her that number and encourage her to call if she feels like harming herself or completely overwhelmed. 

It can take a while to find a good therapist, especially if you are a functional adult.  Look for someone with a license, the more experience the better.  If she meets with someone and it doesn't click or she doesn't feel good about the direction of the therapy, encourage her to try someone else out.  Therapy isn't like car mechanics, where anyone can tighten the right bolts with the right training, it's about relationships and trust. 

It may end up that all of this leads her to reevaluate her decisions and get a new job, go on vacation, choose a different path, or feel comfortable letting go of the obligations that are weighing her down.  That she isn't able to step back, evaluate what she needs to find happiness, and then do whatever that is on her own makes me think she may need some outside help.

8 years is a long time to feel like your life is a burden, especially when it doesn't have to be that way.

Kaikou

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Re: Is this depression or anxiety?
« Reply #27 on: August 28, 2015, 07:08:49 PM »
thanks

lhamo

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Re: Is this depression or anxiety?
« Reply #28 on: August 28, 2015, 07:13:47 PM »
It isn't a substitute for professional help, but you also might want to suggest to her that she read the book "Feeling Good:  The New Mood Therapy" by Burns.  A lot of people (myself included) have found the cognitive behavioral therapy techniques it recommends to be very helpful.  It is widely available at libraries and used book stores.

It also sounds like she might want to read some books about introversion and being a "highly sensitive person".  I am introverted and when I have to do too much direct interaction with people it really sucks the life out of me.  I also have a phone aversion, though I'm getting somewhat better about that.

wenchsenior

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Re: Is this depression or anxiety?
« Reply #29 on: August 29, 2015, 08:00:22 AM »
It isn't a substitute for professional help, but you also might want to suggest to her that she read the book "Feeling Good:  The New Mood Therapy" by Burns.  A lot of people (myself included) have found the cognitive behavioral therapy techniques it recommends to be very helpful.  It is widely available at libraries and used book stores.

It also sounds like she might want to read some books about introversion and being a "highly sensitive person".  I am introverted and when I have to do too much direct interaction with people it really sucks the life out of me.  I also have a phone aversion, though I'm getting somewhat better about that.

I strongly agree with this. Not to encourage her to take on too many drastic changes all at once (if she's anxious or depressed that might overwhelm her). But once I got all my physical stuff on track, this book was definitely helpful to me to self-track and fine-tune some of my habitual negative thought patterns. It's great. (Though I admit, I still hate the phone LOL).

Goldielocks

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Re: Is this depression or anxiety?
« Reply #30 on: August 29, 2015, 10:10:31 AM »
I had many of the same symptoms described here.

Some mild depression for me, and what I call the ' never ending hampster wheel' spinning in my head.

Either doing too much, or avoiding and doing nothing, yet feeling guilt for that.  When I had a glass or two to drink, I would no longer feel the guilt, so watch out for that in your friend, too. Does she drink alone and have enough to feel a bit tipsy?

What finally resolved it was a regular Dr checkup, and having blood pressure and anxiety pills prescribed.  I said no to both but it was a wake up call that unless I changed my approach, I would be on bp pills for life, likely, and I was not yet 35.

It took me six months to learn to listen to my body signals, to stop and take a walk whenever I felt like there was not enough time to do X.  I needed to allow myself 'me' time and realize that failure was part of the human condition.  Accept, listen to your body, and slow down is OK.  Of course the result is opposite of failure.  (And I never ended up with a drinking problem, either).


flyingaway

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Re: Is this depression or anxiety?
« Reply #31 on: August 29, 2015, 10:15:21 AM »
Do a routine blood test in annual physical exams. I have similar symptoms for about a year. A blood test  recently revealed that I have an underactive thyroid (less thyroid hormone). This may or may not be the reason, but lack of thyroid hormone can result in those symptoms. I am currently on some medications and will get another blood test in a month.

RobinAZ

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Re: Is this depression or anxiety?
« Reply #32 on: August 29, 2015, 09:22:30 PM »
Sounds very much like my anxiety.  Sometimes I can't bring myself to do my work- then Inhabe incredible guilt and shame about the work not being done.  I feel exhausted and lazy at the same time.  Blood work didn't reveal anything, counseling is helping a little, Meds both help and have some side effects that are pretty rough. 

Not much advice to add to the stuff above, just wishing your friend the best.

rubybeth

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Re: Is this depression or anxiety?
« Reply #33 on: August 31, 2015, 09:23:06 AM »
Some of this sounds like anxiety (which I have), but I also wonder about ADHD (possibly inattentive type, which my husband has). Getting overwhelmed is common with this diagnosis, and both lifestyle and possibly medication can help with either.

I will add that seeing a psychiatrist (a medical doctor) or psychologist (who holds a PhD) may not be her best option in terms of regular mental health care--these practitioners are often very busy seeing people with more severe mental health issues. She may just need a counselor or therapist (who hold master's degrees). I would suggest looking up one of the following her area/insurance coverage, as any of these designations could help to diagnose/treat without medication needed (unless they refer her for medication, too):

LPC (licensed professional counselor)
LMHC (licensed mental health counselor)
LPCC (licensed professional clinical counselor)
LMFT (licensed married and family therapist--what my husband is studying, which is why I know about this; these practitioners can also do individual therapy)
LSW (licensed social worker)
LCSW (licensed clinical social worker)

Or look up a mental health center that takes her insurance, and take the first available appointment with the practitioner who is available.

Also, I find the statement very weird regarding the previous counselor not being able to help her because she is articulate and "put together" so they had nothing to offer--maybe they just weren't a very good counselor or weren't a good match for her. That can happen. If she doesn't find a counselor/therapist helpful, she can try a different counselor/therapist--sometimes people just get along better with someone else. Good luck!