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OK, I'll try to be concise, sigh.....My depression in the past has manifested with severe anxiety, no feelings of despair or sadness, other than "my life sucks with all this anxiety". I was on Paxil for about 11 years, with good results for the anxiety. Early this year, I noticed an increasing feeling of despair and sadness, feelings of "what's the point, I have nothing to look forward to, this will never get any better, etc". Obviously, the Paxil (30mg) wasnt doing the job. Now, my life DOES suck, as my husband and I have been raising our 2 granddaughters , now age 6 and 9, for the past 5 years, due to a father (my son) who cant pull himself together (read LOSER), and a mom in prison due to drugs and related felonies. This is a second marriage for me, and my DH, God love him, is no relation to these children but is wildly in love with them and determined to be the best thing that ever happened to them, which he is. I, on the other hand, want nothing to do with child raising ever again. When I was younger, all I ever wanted was to be a mom, and I was raised to believe, that love, hard work and consistent discipline were the keys to success. I worked VERY hard, feel like I did all the right things (no one is perfect, but DAMN, I tried)yet managed to raise a man (now 31) who cant even support himself, much less 2 children, despite very high intelligence. I have beat myself up about this for years, but have come to realize that he is who he is, despite a good upbringing. I do also have a 25 year old daughter, who is every parent's dream......Anyway, I love my granddaughters, but at age 57, I want to come home from work and relax, etc etc.DH does the bulk of the work, but is a poor disciplinarian and the girls are very spoiled. My house is a continuous trainwreck, and I cant keep up. I have given up even trying, which leads to more despair. I KNOW what needs to be done, and while I'm sure DH would cooperate, I just dont have the will or motivation to undertake this ENORMOUS task. I come home from work to find shoes, clothes and toys scatterd everywhere, the bathroom is a pigsty, so I just head for the couch and start flipping the remote.....that's a very small part of it, but enough hopefully to make you understand my state of mind. Oh, and by the way, the youngest has a condition calle Functional constipation-she is under treatment, but it is a slow process, bottom line is it involves ALOT of pants soiling. Guess who gets to clean it up?

All this to get to my question. Saw a p-doc who gave me a try w/Prozac (tapered up while tapering off Paxil). BAD reaction, felt like a zombie. After about six weeks, she said go off Prozac and lets see how that goes without anything. That was in early June. Well of course, my mood is still the pits, but so far OK on the BAD anxiety. I manage to drag my carcass to work every day, but I am a total bitch and my frustration tolerance is about nil. Began seeing a t-doc about 3 weeks ago, for some CBT-still in the information gathering stage. At first I said I'd like to give it a go without meds, but I cant take this anymore. T-doc agrees but doesnt seem real informed on the various ADs. She said she has seen clients have good luck with Lexapro for both depression and anxiety. I understand that MMMV, but I'm looking for something that will handle the depression without causing anxiety. My p-doc is out of town til next week, and then I'll have to wait for an appt. I'd like to at least get started now, and I'm sure my GP would be willing to prescribe. All this for....SUGGESTIONS?

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With SSRIs the statement YMMV is so true because people react to different ones very differently - what works for me might not work for you and vice versa. With that said, I found that Celexa helped my anxiety a lot. But I read that it makes anxiety worse in some people so go figure. I think you need to rely on your pdoc's expertise on this one. We really can't make recommendations as to what you should get from a G-doc.

There are always non-SSRIs such as Remeron with is considered very effective but is also very sedating and increases the appetite big time. Some people have had success with Effexor. Then there are AAPs such as Seroquel which I understand helps some people with anxiety as well as depression. But it is usually added onto an AD to improve the effectiveness of the AD.

The bottom line is that there are a lot of options, and you need to discuss them with you pdoc. While a G-doc can prescribe, it is really best to let the pdoc handle this. Can you call the pdoc's office and get an emergency appointment very soon after he gets back?

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It might be a little trite to say it, but maybe the children issue needs addressing rather than hoping to find a perfect AD. If the children situation is exacerbating your depression, that needs a resolution. In terms of that can other family get involved, do you have childcare options, maybe the discipline issue needs looking at (handbook, sitting down and making rules etc). Scheme's like Flylady can help with tidying too, I find a messy house stressful. Another idea I had was to create a space where you can be you without having to be Grandma/Mom, like a room of your own to relax in, or a bolthole to go to when you feel overwhelmed. That and making sure you make looking after you a priority, good food and sleep routines, exercise etc.

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Call the pdoc's office now and make an appointment, tell them you're in crisis and need to see the doc as soon as they return from vacation. (I'm assuming your pdoc has an office staff to make appointments.)

All the SSRIs turned me into a zombie. I've had good luck with Wellbutrin, and then adding in Lamictal. The other suggestions about getting the home front sorted out a bit better makes sense, too.

P.S. Try to hit the 'enter' button more often when posting. Trying to read large blocks of text is hard, and lots of people won't try, so you'll improve the number of responses if you break things up a bit.

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I'd agree that much of your situation sounds like life stressors, so some of that can be improved with therapy.... I don't blame you for not wanting to raise another set of children, but it sounds like you also want to hang in there and do the right thing. I'd advise continuing therapy to develop better coping skills.

As far as meds, really, none of us can advise you. WB does start taking effect more rapidly than some other meds, such as the SSRIs but it's really not noted to improve anxiety much. Rememron is a non ssri that works well for some folks, and can help with sleep too, but again, that may not be what you need. The SNRIs are a possiblity but again, anxiety there CAN be a problem.

All I know of lexapro (haven't taken it, personally) is that it can be quite activating. My husband takes it and does well on it. He started low dose. if you absolutely cannot wait for pdoc it might be a way to start something now, while you are waiting for pdoc, but honestly, if I were in your shoes I might wait. And I'm surprised there isn't a covering doc (though this seems to be less and less the case in private practice lately).

Anyway, yeah, get pdoc appt in place now, and uh, try to hang in there.

Anna

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