Embarrassed, but need some help please..

[Q007]

I have been diagnosed with severe (off the scale) depression, very bad anxiety indeed and I'm very sad. For reasons I don't understand I'm embarrassed and ashamed of being depressed and I've confided in but a few. I thought I was emotionally bomb-proof but came crashing down like a giant cedar wood several years ago funnily enough around the time the news I was T2 came along. I've no idea at all what has prompted me to openly confide on a website, I hope no one recognises me.

To explain a little further, the depression is classed as treatment resistant, I've been through A-Z in mims of available drugs, we're now trying poly-pharmacy which is mixing drugs together, drugs that are for other mental conditions such as bi-polar and schizophrenia both which I am not. For reasons they don't understand mixing combinations of drugs together can break the hold depression has but it seems to have the same odds for me as trying to win a lottery jackpot, I know which one I'd choose, I feel cursed by this depression. I've lost my purpose.

I'm taking a drug that seems controversial for diabetics - Quetiapine, whilst I've read it can elevate blood sugar levels, my consultant says not to listen, but I realise he's only concerned about my mental health not my diabetes. Does anyone, please, know anything about this drug when you're diabetic?

Secondly, they have started preparations for me trying Lithium along with Quetiapine, now I know that Lithium vs Diabetes ain't a good mix, but I get told to stop reading about these things and whilst I rate my consultant highly, it's my mental health only that's on the menu and I have to be sure I'm thinking seriously about diabetes as well as my mental health.

My depression has destroyed my career and left me almost completely socially isolated, but I've gotten away with no meds for T2 but to take drugs that might worsen diabetes isn't a good call is it. If anyone has advice about these two drugs vs T2 I would listen carefully. I'm concerned I may add to my problems as I think if lithium and quetiapine did work I may be on this combination for a very long time, like years. What effect would this have?

Hoping this day has found you well,

My kind regards,

Q..


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[anteater2012]

Hi Q
I know no-one has replied to you yet and I am not even sure that I can be of any help regarding the questions you are asking about the two drugs (Lithium and Quetiapine) in conjunction with T2. But your email made me think.

I had a read up on the two drugs and both do seem to cause issues in diabetics. I certainly see why your consultant says"stop reading the internet" . It is a bit scary sometimes doing that and more than once I have frightened myself to death / caused myself to panic unnecessarily, but I usually go and find someone to talk / re-read the article / sit down and have a good think about things and usually come to some more sane conclusion than I did the first time around. I would rather be informed than ignorant and I suspect you do too, so keep reading. My argument would be (to the doctors) that if you do decide to take the drugs and you are aware they can affect your T2 you will be better prepared if it does happen. (And say yah boo sucks to them).


With regards to the depression and taking drugs I am going to ask some questions for you to think about. I get the impression you are not entirely happy with the thought of embarking on this regime and perhaps your gut instinct may be telling you not to go down this path yet. So here goes:

You state that the depression is treatment resistant. I am assuming that you have tried counseling / CBT somewhere along the line? The life changing event - have you ever discussed this with a third party counselor on how to deal with its ramifications? The T2 diagnosis by itself is enough to deal with - add other events and things get really crazy. Perhaps several years down the line the life changing event may not be an easy event to revisit, but it not be a bad idea. (Not asking for details here - only you can judge whether this is a good idea or not). Sometimes hindsight is useful as we can look back a bit more dispassionately at things - so long as we don't spend too long on the "if only I had done..." bit! (I do this - it drives me nuts sometimes, but I do usually manage to move on). The other challenge is finding someone good to talk to. The right person can make a wealth of difference to discussing these things.


If your instinct at the moment is to not take the drugs, then tell the docs you want more time to think about it. Have the consultant teams (Mental Health) and (Diabetic) communicated with each other and included you in the conversation? You are concerned enough (and with good reason) about the side effects of these tablets and T2 - so should they be as well - although I think you may have to go trawling the US web sites to get some articles and plaster them to the various consultants foreheads.

I tried to put myself in your shoes and thought about if I DID take the drugs:-

[*]At the moment you are a T2, not using diabetic medication of any variety. (I am so jealous of you right now!) I am assuming you have good / reasonable control and if you are not testing using a meter that you have a good indication of when you may experience hypos or hyper sessions.

[*]One main area is that the drugs may cause you problems is with the blood sugar levels - but there are drugs that can assist you with controlling BSL i.e. metformin being the most common as you know. If worst comes to the the worst you may have to start out on these to help you control the BSL. I am on these and it is not the end of the world. I see them as a useful tool to help me keep the BSL under control. You have good control via diet, you might find that if you keep control of the diet you may not need these tablets or it might be a light / small dose. I am also assuming the docs are going issue low doses of the lithium etc, anyway, so you may not even notice any changes immediately.

[*]I would ask the doctors to issue you strips for a meter however as it documented that the drugs DO have an effect on BSL then you would want to monitor this to see if you really do need to supplement your diet with something like metformin.

It may be the case that at the moment you need to treat the depression you are suffering from and let the T2 take a bit of a back seat for a while. You know how to deal with T2 in your life and you know there are medications that can assist you with the T2. The diabetes is 99% known quantity. Concentrate on your mental health more so at the moment.
You may also find that once you get on the drugs, then the social interaction and perhaps a return to a working /volunteering environment will be easier.


I tried to put myself in your shoes and thought about if I DIDN'T take the drugs:-
[*]Think about the options if you were not to take the drugs

[*]Is the drug regime I am on now working in ANYWAY at all. (Has any previous tablets worked in the past that I could go back onto?)

[*]Could this be a good time right to revisit former depressions treatments i.e. CBT / Therapy etc.,?

[*]Stop the social isolation - go and volunteer for something. Go shake a tin for something on the high street. You can be all alone in the middle of a crowd! I know this is easy for me to say and it is not easy to do, but sometimes... ( Just don't volunteer to be a chugger though!)

Every now and then I sit down and write myself a "where do you wan to be in 5 years time" document and sketch out how I would get there. I general split into Relationship / Home/Work / Health and then work on what I should do in each section to reach that 5 year goal. Often in 5 years time the goals (and goal posts) have moved but the "what if I do" and "I will do" that I thought about make things a bit more interesting. The plan I come up with usually last about 12 months on average before something causes it to veer off track, but hey - out comes the notebook again. Life is always a work in progress.

Eater of Ants

 

[Dougal]

Q,

Please try not to feel embarrassed. Depression can happen to anyone, unfortunately it chose both of us. For me, the worst part is always feeling alone, even in a room full of people. The isolation is almost unbearable.
If you think it could help, please PM me. You never know, it might help to chat with someone who has trodden a similar path.
I have a question, have you tried ECT? It is a frightening suggestion, but I was on the edge of being put on all kinds of combinations of drugs. My psychiatrist sat my husband and I down and said that short of ECT, he didn't think anything would work. So I agreed to ECT. It took a good number of sessions but finally I could see the light at the end of the tunnel. Then he put me on Magnesium supplements and I slowly but surely returned to normal. I still take the Magnesium supplements and every now and again I sink into depression, but my doctor has recommended that I take anti-depressants for the rest of my life as he believes that I have a naturally low seratonin level. The only problem I have still is that the memory I lost during the ECT is still gone, and is unlikely ever to return.
I feel for you, please feel free to talk if you can.


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[stillo]

Don't feel embarrassed i was treatment resistant to depression for 10 years until i was re diagnosed with type 2 bipolar a further two years and i am on the perfect medication and have done really well for the last 10 months.

Never give up it will as they say get much better i for one never thought it would after 10 years but it did and it will for you take care

Stillo

 

[Morganator]

Don't be emberrassed by your depression, it is a horrible debilitating condition.
It may be that your mental health team feel that if you can get the depression under control you will be more capable of dealing with the diabetes. In my opinion it is more important to get you out of this dark horrible place then look to diet, possible meds or whatever you need when you get to that point.
Give yourself a pat on the back for posting here, it is a positive sign that you want to defeat this "black dog". Keep posting and I will keep reading and rooting for you. Take care.

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[Giverny]

Don't feel embarrassed i was treatment resistant to depression for 10 years until i was re diagnosed with type 2 bipolar a further two years and i am on the perfect medication and have done really well for the last 10 months.

Never give up it will as they say get much better i for one never thought it would after 10 years but it did and it will for you take care

Stillo

Out of interest, which medication are you taking to combat bipolar symptoms?

 

[stillo]

Hi

Sorry i have not yet replied to this post, i can tell you at the moment i am taking Carbamazapine and Venlafaxine and i feel like new, it has taken a long time and many different combinations to get to this point, i was under the care of a Psychiatrist from 2003 to March of this Year, i can tell you that some people have have quite good results with Mirtazapine and Venlafaxine(Known as Californian rocket fuel) this is used to treat treatment resistant depression

Stillo

 

[Dalekkiller]

Mental health problems are supposed to affect 1 in 4 people and is common in people with a long term condition like diabetes. I'm diagnosed with depression and borderline personality disorder and take a combination of pills for it. The stuff I'm in isn't helping me lose weight and is known to give problems with my blood sugars. To counter this I try to eat healthily to maintain good levels. Admittedly I'm now on insulin but at least I'm fairly sane and I'd prefer that as I'm not good without my psych meds. You need to weigh up the pros and cons of medication but it may be that you need some for both your mental health and your diabetes in order to keep you well.


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