Navigating the Path Ahead: Insights from a Young Psych Patient
I’m a 17-year-old grappling with severe recurring episodes of major depressive disorder, a diagnosis I've carried since October 2024. I've experienced multiple crises that led to seven 5150 involuntary holds and five hospitalizations primarily due to suicidal thoughts. The count of my suicide attempts and self-harm events is more than I can easily recall. Currently, I’m prescribed 20mg of Lexapro and 450mg of Wellbutrin. Throughout my treatment journey, I have experimented with various medications: - *Sertraline* was initially promising but ultimately didn’t provide the necessary results when I needed a faster relief. - Upon switching to *Lexapro*, I felt an incredible uplift from day one, which kindled a sense of hope. - Unfortunately, *Abilify* was disastrous for me, triggering a serious allergic reaction. - Conversely, I truly appreciate *Wellbutrin* for assisting in weight loss and diminishing my anxiety levels significantly. - Medications like *Risperdal*, *Seroquel*, and *Latuda* each posed their own challenges—one made me feel shaky, another robbed me of sleep, and the last didn’t show efficacy. - I just stopped using *Zyprexa*, which had been beneficial in alleviating psychotic symptoms. - Lastly, while *Vistaril* is not psychiatric medication, I’ve developed a tolerance to it, rendering it ineffective in managing my anxiety and insomnia. Now, I’m left pondering what steps to take next. My psychiatrist hesitates to assign a diagnosis of dysthymia, citing its rarity and preferring to maintain simplicity in my case. While I am not attempting to self-diagnose—hence my engagement with a psychiatrist—I can’t help but wonder if this could account for my long-standing battle with depression, characterized by consistent symptoms throughout the years. Moreover, I’m also pursuing an evaluation for ADHD; however, my doctor has postponed this agenda, stating it’s not a priority until I commence school. I've faced symptoms since childhood that complicate daily life. I previously received treatment for major depressive disorder with psychotic features, which included episodes of hallucinations, but I recently discontinued my antipsychotic medication two weeks ago due to a lack of further psychotic symptoms. My doctor has mentioned various options in the past, such as residential treatment, mood stabilizers, ketamine therapy, and ECT. After eight months of treatment, I've found myself at a baseline—similar to my state before severe episodes, though with reduced motivation but also decreased anxiety, thanks in large part to Wellbutrin. During our most recent appointment, my doctor advised me to focus on making lifestyle modifications going forward. This leads me to wonder: should I consider additional medications? Would it be wise to consult my primary care physician regarding weight management, given I’ve gained 40 pounds while on antipsychotics? Is it now entirely up to me to instigate change? I tend to overthink things, so I’m merely seeking some advice or perhaps a fresh viewpoint. P.S. Residential treatment is not an option for me, as it's not covered by my insurance.
Answers (1)
7/16/2025, 8:11:12 AM
OpenHealth AI
Thank you for sharing your experiences and concerns; it sounds like you’re navigating a challenging journey with your mental health. Here are the main points to focus on moving forward: exploring additional treatment options responsibly, considering lifestyle modifications, and addressing your weight management.
Explanation
Your diagnosis of major depressive disorder (MDD) has brought many complexities, especially with the need for multiple hospitalizations and adjustments in medications. It’s clear that certain medications have had different effects on you, which is common in mental health treatment. You're currently taking Lexapro and Wellbutrin, both of which have provided some benefits, but it seems you're still looking for ways to improve your overall situation without jumping too quickly into drastic measures like residential treatment or ECT.
Given your concerns about your weight after being on certain medications, addressing lifestyle changes and consulting with your primary care physician regarding weight management would be beneficial. Additionally, since you mentioned the possibility of further medication adjustments, keeping an open line of communication with your psychiatrist about your experiences and new symptoms is crucial, especially regarding your recent discontinuation of antipsychotics.
Next Steps
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Speak with Your Psychiatrist: Request a follow-up appointment to discuss your current feelings and explore the possibility of trying additional medications or adjusting your dosages. Be open about your concerns regarding weight gain and how you feel on your current regimen.
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Consult Your Primary Care Physician: Schedule an appointment to discuss your weight management. They can help create a plan that considers your mental health and physical well-being, possibly involving dietary changes or exercise recommendations.
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Focus on Lifestyle Modifications: Implement gradual lifestyle changes that can positively affect your mood and energy levels. Consider:
- Nutrition: Aim for a balanced diet rich in fruits, vegetables, whole grains, and lean proteins.
- Physical Activity: Find an enjoyable form of exercise, such as walking or swimming, to safely incorporate movement into your routine.
- Sleep Hygiene: Establish a calming nighttime routine to promote better sleep quality.
- Mindfulness Practices: Consider integrating mindfulness exercises such as meditation or yoga to help reduce anxiety and improve mood.
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Keep a Journal: Document your daily experiences, thoughts, and feelings. This will help you articulate your experiences better in your appointments and track any changes or patterns over time.
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Education and Support: Keep learning about your mental health conditions and treatment options. Consider connecting with a support group, either virtually or in person, where you can hear from peers who have shared experiences.
Remember, progress can take time, and it's essential to be patient with yourself. You're taking proactive steps by seeking advice and expressing your thoughts, which is commendable. If you have any further questions or need additional support, please reach out.
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