Psychiatry & Psychology--General/Depression 4th. Episode.

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My dear friend,
As you probably know, 10 tears ago, I suffered two episodes of reactive depression, due to de fact that I fall in love with a con woman. The second one, I thought I had a vaccination against depression because I sufered a previous one. The second episode was really terrible. I did not have money to pay a psychiatrist and to buy medicines. 2 years ago I suffered a 3rd, episode of reactive depression just for having sexual intercourse with a girl that was just pulling my leg, twenty years younger than me. This episode was different I loss the appetite, I could not sleep, but a psychiatrist cured me with huge amounts of venlafaxine and agomelatin........! year ago I had  a 4th.episode of reactive depression just for kissing a girl on her mouth 30 minutes, without sexual intercourse. But this episode was different, not to much pain, wishes of cry, not sexual desire, anhedonia but three months ago I met a good psychiatrist who recommended me to take
*in the morning: 100 mg of lamotriyine, 150 of efexor
*Lunch time: 100 mg of lamotrigine and 20 mg. of escitalopran.
*At night:200 mg of lamotrigine, 2 mg of clonazepam and 1 mg of risperidone.
I feel good enough even the fact that I do not have sexual intercourse with my wife since 1 year. I have erection at night but I do not desire, even with Sandra Bullok. The worst thing is that according what I read in Internet due to the previous 3 painful episodes my neurones are almost destroyed,  and it is almost impossible to heal them. I really like you to give me your opinion about if my depression is chronic, recurrent or  distimia.
I am really terrified. I  am angry with my self beause all my psuchistrists (I am married) adviced me to look for calling girlsor masturbate or avoid fall in love with girl due to my pesonality ( I fall in love inmediatelly when I like a girl.
Please help me.

Answer
If the medications are not working, then electroconvulsive therapy should be considered, or Transmagnetic therapy.  Otherwise, psychotherapy should be continued intensively.  While medications are likely to be of some help, they do not appear to be the complete answer in your case.  

Psychiatry & Psychology--General

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Daniel S. Harrop, M.D.

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Dr. Daniel S. Harrop received his B.A. and his M.D., both from Brown, and his M.B.A. from the Edinburgh Business School, Scotland. Board-certified in adult and geriatric psychiatry, he is a past president of the R.I. Psychiatric Society and a member of the Committee on Medical Quality of the American Psychiatric Association and the Committee on Continuing Medical Education of the R.I Medical Society. He serves as a consultant to four of the top five major medical management companies, including OptumHealth/United Healthcare, Magellan Behavioral Health Services, ValueOptions and APS Healthcare, and maintains a private practice in Providence, R.I. He also serves as chief psychiatric consultant on the Medical Advisory Board at the R.I. Workers Compensation Court. He was formerly on the faculty at the medical schools at both Brown University and Harvard University.

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