What do I do here?

[monkeyc]

I am lost right now, I have no idea what to do so I am truly open to suggestions.  My depression has not lifted since my father in law's death its gotten worse steadily, I guess its grief for him and some from my mothers death because it made that loss feel very recent again and grief at the way my marriage has headed.

My wife is sitting in the lounge crying, im sitting in my office trying to work out what to do now.  For the first time ever I am thinking about leaving.  Its not her fault, its mine - yes she knows that I am having a bad day and when I get like this I have a lot of anger I cannot control but no matter how hard she tries she cannot surpress the one major irritating behavior she has - her need to try and talk me around to her point of view by talking me into the ground and ignoring what I am saying - normally this is irritating but today its explosive because my head hurts so much I do not know what to say, I dont want to be argued with or convinced I just want to be alone.

18 months of speaking to her therapist and reading and still no learning it seems, I know i am to blame, I know I get so angry and I cannot control the way I snap and yell at her, yes I love her but I am hurting here, I am hurting a lot of people it seems right now.

What do I do here?  What do you do?  I am at a loss, I truly do not feel hospital is the answer : for one thing it would seriously damage my job at a very bad time for that to happen and I think it would damage me as well - I dont want that, im fighting that.

Drugs are not working - the AD is a mess (any suggestions other than Remeron or SSRI's would be great) and they have caused me to put on weight and my diverticulitis is back.

I could really use some suggestions or advice right now because I do not know what to do, I cannot live like this much longer and something has got to give.

[bernie40]

I'm glad you've managed to get an appointment for Monday and yes being able to have a chat with your wife is a step forward and I hope she gives you your alone time while you get through this.

Hugs

[monkeyc]

An update, still cannot get into my pdoc, one of my psychologists is missing in action as well (im a bit worried about her as she had a heart attack earlier in the year) but I am seeing my clinical psych on monday.

Ive been thinking a lot about the advice some of you have given and my wife and I have discussed some of the things I am feeling and the problems we have, thats got to be a step forward - my mood has lifted a little but it tends to mid week, however I still feel deeply depressed and I hate that.

[monkeyc]

I hear you, guess im just so worried right now about it getting worse.  Warm and happy perhaps who knows.

This is the worst I have been in 15 years, thats the scary thing

[LeftCoastChick]

Sweetie, compared to the side effects of other MS's, they're pretty minimal with Lamactil, especially if you titrate the drug slowly, 12.5mgs at a time.  I am truly amazed this works as I have refractory depression.  I now have a libido, I don't get as hypomanic or dizzyness, dry mouth or constipation that I felt on most of the SSRI's and trycyclics.
It's a first line drug. I had a slump when still titrating up on the Lamactil, and was placed on 150mgs of Lithium, between the two, I'm pretty much back to norm, and I was happy as a clam today, first time in months. I also have more energy, a feeling I haven't had in 10 yrs.  I have 2 other chronic health issues, and I haven't had any reactions because of this drug. It's not as bad as it sounds.  I just want to see monkey even keeled again, you're in my prayers. Jane

[monkeyc]

I know more about mixed episodes than I ever wanted to.  SSRI's are not the only AD that can cause them BTW - so can MAOI and Tricyclic AD's - SSRI's are the most commonly prescribed now which is the major risk profile.

My last mixed episode almost cost me my life (thank you Prozac).

I appreciate the advice on lamactil - its one a number of people have given me but I am extremely hesitant to insert another drug into the mix  and Lamactil has some nasty side effects I am not very thrilled about included SJS and TEN not to mention some of the other side effects - I would need to be very convinced by a doctor to take the drug as Lithium is working as an MS and adding another AC or MS or AP into the mix is something I would need some serious guarantees on at this point.

Keeping my job is vital and I cant do that with some side effects of some drugs.

I really appreciate all your help guys, truly its so valuable.  I do have a routine and a plan, have had for 10 years now, without it I am lost and if i was not working right now I think I would be in serious trouble.

I havent tried Yoga yet, my psychologist swears by it but the problem I have is pure depression, I cant get energy and feel sick all the time, motivation to do something new is low.

Looking back the Mirtazapine (Remeron) have been a disaster - they have not lifted my depression at all and have mad it worse but thats only part of the problem, the other stuff and a pile of things I am not so comfortable talking about in the open are just so hard to work through, my mind is full of wire some days.

Trying to get into my pdoc.  Hopefully soon.

[azalea82]

As far as meds go, ADs, especially SSRIs, have the risk of inducing a mixed episode.    Perhaps adding Lamictal to the Lithium would be something to consider.  Lamictal has strong antidepressant properties and can be taken with Lithium.