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Severely Depressed

Question:

I’m suffering from a severe depression. I’ve had it for a year. I’ve tried various treatments such as St. Johns Wort and Paroxetine but nothing has helped. I took ecstasy and related drugs from 1990 through 1996 when I gave them up with the aid of counseling. I’m at my wits end. I’ve lost family, friends and my girlfriend because of my depression. I’m frequently feeling suicidal. I want to know what treatment you can recommend, and if the drugs have caused my condition.

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  • Dr. Dombeck responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
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Answer:

There is no way to tell if your past drug use caused your current depression but it is safe to say that it didn’t help. You will need to be completely sober from now on if you want to help your mood. It sounds like you’ve been trying (unsuccessfully) to manage your depression by yourself with over the counter remedies. That didn’t work. Now try something different that will have a good chance of working. Make an appointment to see a Psychologist or Psychiatrist as soon as you can. A Psychiatrist can prescribe anti-depressant medication (sometimes they are half decent therapists too), while a Psychologist is an expert in psychotherapy. You want a therapy that is specific to depression such as Cognitive Therapy for Depression, or Interpersonal Therapy for Depression. A more general sort of psychotherapy might be helpful too, but is less likely to teach you the skills you need to get and stay better. Often a combination of both medication and psychotherapy is the best treatment. Please start making these appointments today. You can’t afford to wait given your suicidal feelings.

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