My boyfriend is suffering a lot and we don't know what to do. Please help.

[Sanskriti018]

Hi.
My boyfriend was diagnosed with Anxiety early May 2016. Since then, he has been taking anti-depressants (started with Desvesflaxine, Etizolam etc.) and has also seen a psychologist for a few sessions of CBT. Recently, we have changed our doctor who has now diagnosed him with Depressive Syndrome and has prescribed my boyfriend Paxil (started with 12.5 mg and is now on 25 mg).
But unfortunately, there has been no improvement.
He complains of extreme fatigue, chest pains, tingling sensations, dull vision but flashy lights, dreamlike state, nights being worse than days, sad-dull mood, coordination and concentration issues, lack of interest in activities he used to earlier enjoy, memory loss, sleep problems, he often gets lost in his own thoughts and spaces out, also his rage is getting worse day by day.
He has this phobia that 'he has hit someone from his car' which wasn't there before. He obsesses over things and thoughts too much lately.

What we want to know and understand is, is this just depression, OCD, and anxiety or can it be something else as well?
Do you or anyone you know suffers and experiences similar symptoms?
How long can this take and how long will it take to find the right medicine that works for him?
Most importantly, what are the other ways to treat his condition? We have tried medicines and CBT but nothing is really working out for him.

Please suggest and help as you can. We are very distressed and we are losing hope with every passing day. Do answer the questions and let us know what you think.

[Paxiled]

First, you haven't tried CBT if he's only had a few sessions -- it doesn't work that way.  Therapy takes a long time, and while CBT can work more quickly than other forms of therapy it doesn't necessarily and sometimes it takes awhile to find the right therapist.  It also requires the patient to work very hard on his recovery, something depressed people don't do easily; often CBT therapists treating anxiety don't recognize the importance of the depression -- attitude is essential to do CBT.  In this case, there's so much going on as you describe it that the first thing he needs is a diagnosis.  You say he's seeing a doctor, but is he seeing a psychologist or psychiatrist who can talk to him awhile and make a diagnosis?  What you're describing could be so many things, and you also don't say how long he's been suffering from it.  You don't mention if he has had a thorough work-up to see if something physiological is going on -- concussion, blood sugar problem, thyroid problem.  You say he has a "phobia" about hitting someone with his car -- maybe something like that did happen.  That's not a phobia -- a phobia is a fear of some future event -- it's either a delusion, an intrusive thought that anxiety sufferers get, or something else.  This is someone with so many things going on he needs to get a firm diagnosis, and a regular doc isn't trained in mental health enough to do that.  As for the antidepressant you mentioned, if anxiety is his main problem, that drug can make it worse -- it's a very stimulating class of drugs.  If depression is his main problem it might work eventually, but it takes time to find a medication that works. The place to start is to see a mental health professional who can diagnose whether this is psychosis setting in or severe anxiety or depression or something physiological.  That requires seeing the right professionals.  CBT therapists don't generally do diagnosis -- they assume that's irrelevant and just train you how to think differently and then set you tasks to face down.  So you first need to know what's going on.

[Paxiled]

I should add, how long was he on Pristiq?  It's a very hard drug for most people to stop taking.  Paxil is even harder.  Why are your docs starting with the drugs with the most difficult records of use?  Just another point in saying, someone has to do some home work here.

[AnxiousNoMore]

She had a post in April that seemed to indicate it had started in 2015.

It mentioned "He keeps reading about diseases etc. on the internet and is going down the negativity trap. ", so that is another thing that will have to stop if he is going to get rid of some of the current problems. You can find any situation where a person dies if you search hard enough on Google, so if he thinks he is falling apart and looking to justify his own diagnosis then Google will find an example of someone to back up his fears.

[AnxiousNoMore]

Most of the sensations he is complaining about are likely just what everyone else gets but he might be so depressed that he is over-analyzing his body looking for symptoms that don't exist. He might have had all these things before and not bothered to notice.

We can't diagnose from here, but the fact they are unrelated makes it a strong possibility that everything but the depression doesn't exist as a problem - but he is just so depressed that he is perhaps subconsciously looking for reasons so every time he is out of breath he thinks this happens all the time because there is something wrong - just my guess, so don't take it personal and I do know how terribly hard depression can hit.

Some find the right med quickly but others trial all their life with not much luck. Lots off studies say meds work and others say they don't so the poor victim is stuck wondering if relief will ever come. I know they worked for me to get me to remember what happiness was again by peeling back the dark curtain that kept coming in at 5PM when the first one I trialed stopped working every single day.

[AnxiousNoMore]

So a good first step is to figure out if each of these symptoms are real or just imagined. ridding him of that will free his mind for the therapy like CBT. How many sessions did he take and how old is he? does he work now? What do you mean by "tried medicines", just the ones you listed at the top?