Expert: Libby Bonner - 6/23/2004

Question
Hello !! Libby, I have had sad depressing thoughts off and on for several years."But" due to some recent health issues I am feeling even more hopeless with my current situation. I have a good marriage of 30 yrs and family nearby and I know I should'nt feel depressed but I still do. I have not seen a doctor for this. I am dealing with a debilitating achilles tendonitis condition that is taking months to heal and just when I think It's better I get another set back. It is effecting the bussiness I own as I have had to rely on other people to do my work which further depresses me. A couple questions I have--
Are there some depression meds that I can try short term to see if they help and what are they called ?
What are the side effects involved ?
I currently take a B/P medicine {accupril 5 mg daily} and Naproxin 500 mg 2 times daily. Occasionally for pain I take percoset "However" my podiatrist will more than likely not renew it once there gone so I use them sparingly.
What is your opinion on this illness {depression} with regards to it being in my medical records once I decide to seek a doctors help. Would counseling be more beneficial than meds or a combo of both.I really dont know anyone with experience so I need your help/advice.
I would greatly appreciate your input.
Thank's !!!!
Ron

Answer
Here is a PS:  The reason I suggested sports physical therapy, or any PT, is because of your pain.  It's very likely that some of your pain can be relieved very effectively via physical methods.

Also, amytriptyline [sp?] is an older anti-depressant that has found new use in treating pain syndromes.  It probably would also help you get better sleep at night, if that has  been a problem, and might even help your depressed mood.  All w/o triggering undo interest from your health insurer!

I hope that you are also scrupulous about doctor's orders for activity, whatever they might be - for instance, regarding weight-bearing, use of crutches, etc.  All of this is a true pain in the neck and cheating is so-o-o much more conventient......but it will prolong your already frustrating recovery.

Now, again about your depression.  Sad and depressing thoughts on and off for years/ good family etc and you shouldn't be feeling this way but you do.  That's depression.  IF those thoughts, of late, deal w/ death or suicide, time to stop worrying about the insurance and get to a psychiatrist, not the family doc.  You need good care, without further delay.

I wish you good luck and some progress w/ that miserable tendonitis.

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You sound like someone who has likely had untreated depression for years.

Most family docs are pretty comfortable w/ a handful of anti-depressants and any of those drugs would likely solve your problem, which seems to be uncomplicated chronic mild/moderate depression.  Half the world in now on anti-depressants and many are prescribed by family docs.

IF the family doc prescribes you may not have compromised your entire health insurance future.  Probably will compromise it, to the point of uninsurability, if the same meds are prescribed by a psychiatrist.  ---  If your family doc prescribes, de-emphasize, in the chart at least, "chronic" and maybe chart it as an acute reaction to recent medical problems.

Check w/ someone else about this.

I now put on my medical hat:  I hope your achilles deal is being treated by an orthopedist, probably a sports med doc, AND by a sports med physical therapist.  Yes???  Or -  maybe time for a 2d opinion???

Your insurance situation becomes moot if you have a spouse covered by med insurance, tho look carefully at her mental health coverage - it might be very limited for mental health.

Do I think talk therapy would help?  No.  Or, only  minimally without meds.

Sorry to be in a bit of a rush.  Let's talk some more soon if you like.