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Running away from depression

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This probably sounds a bit stupid, but for the last month or so, I've felt like depression is right behind me. Like it'll catch me if I don't keep running from it. I'm studying constantly, and seeing patients, and revising with friends, and generally keeping my head so busy that I don't have time to cogitate or let the depression in. But I'm exhausted, and I don't know how much longer I can keep doing this. I'm scared, because I've got my Finals in about four months' time, and I can't afford for the depression to take me out for that. I've given five years of my life to this course, I have to graduate.

Since I was 17, the pattern has looked like this:

8 months of hypomania

6 months of depression

6 months of normality.

9 months of hypomania

10 months of crippling depression, then saw my GP. Started fluoxetine.

6 months of "up and down," I can't put my finger on where I was then. I'd have a couple of weeks of being really productive, then a couple of weeks of feeling really low.

7 months of depression again, alternating between depressed-with-no-energy-whatsoever and depressed-but-agitated

5 months of relative "normality." Or possibly a little bit hypomanic - I thought I was fine, but in retrospect, there are the huge achievements and grandiose plans and unexplained debts. Hmm.

Then a horrible mixed episode last term, with full-on psychosis. Started Quetiapine, and was feeling OK by about the Christmas holidays. Got some work done so I passed my exams in January.

And now, every time I stop mentally running, that heavy teary guilty depressed feeling is getting in again. So I'm working harder to keep it out, so it only gets me when I'm in the shower, or walking home, or otherwise not keeping my mind too busy to let it cogitate on things. And an ever-growing part of me just wants to go home and hide under the duvet (preferably with a bottle of vodka, but I've given up alcohol to see if that helps.)

I don't really know why I'm posting this - I don't know whether there's a way to keep it out. I've requested a review with my psychiatrist, but she works for the psychosis team, so my pnurse (who also works for the psychosis team, but doesn't seem to mind that I'm not that kind of crazy any more) reckons it might take a while before she can fit me in to see her. Do you reckon there'll be anything she can do to help? Do you reckon there's anything I can do in the meantime to keep it out?

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Once I had to make a list of things for my therapist that I could do when I was upset. I'll post some of them for you. Am I good at doing these things when I'm totally depressed? No, not really, but they do work when I actually do them.

1. Eat good food

2. Listen to relaxing music

3. Take a bath

4. Watch a funny show or movie (my choice is Family Guy but that's just me)

5. Exercise

Those were my top 5. If you have something very wrong inside your brain it's not like these will fix everything, but they still help. I love the comedy stuff best. I can't help but smile at that stuff. Maybe you should see someone who can fit you in sooner? It's kinda tacky that they won't and that isn't your fault.

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Thanks guys ;)

SashaSue, I'm on Quetiapine as a mood stabiliser, 400mg. I'll make an appointment to see my GP, but I don't know whether he'll change the dose without my pdoc's say-so. Worth a try. I'm still on fluoxetine 40mg, never came off it, and my GP might be willing to alter that, I'll ask him.

Koali, that sounds like good advice. I'm not really doing any of them at the moment - I'm spending so much time trying to keep my mind busy, that I'm not really looking after myself. Which is probably not helping. I'll go home and have a bath tonight, see if that helps :)

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Ah, I feel for you Bex - medical school is stressful enough without a mental health problem to cope with at the same time. Good self-care is vital, although medics as a whole are notoriously bad at looking after themselves properly ("Do as I say, not as I do..."). Good idea avoiding alcohol, I expect that that might well help.

Some of my friends are currently doing their 5th year medical school exams and applying for F1 posts and it sounds like terribly hard work. All the people without pre-existing mental health problems are moody, tearful, experiencing disrupted sleep patterns and drinking too much! So I imagine that things are very difficult for you at the moment.

Can you get some help sooner from Occupational Health? I had mental health problems at medical school and found the hospital's Occ Health consultant extremely helpful, even though he wasn't a psychiatrist. You can self-refer to Occ Health, just look them up on the hospital switchboard and give them a ring. The Occ Health doctor also referred me on a rush to a private psychiatrist - apparently the NHS often has those sorts of arrangements for its own staff, partly because of confidentiality reasons (few patients want to see their own doctor/medical students attached to their healthcare team sitting waiting for treatment in the local mental health outpatient clinic...it doesn't fill them with confidence).

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