So severely depressed anxious and sick I can't stand it

Patient

Q: I think I have severe anxiety and depression. I wake up and feel sad and just barely get through the day. I do not have a job because I have daily chronic migraines, and even when I get a job I quit right away because having a job stresses me out. I worry about every little thing and have no ambitions or goals because I do not enjoy life. I lay in bed the majority of the time because i never want to do anything, I just feel like sitting around. Nothing makes me happy. I always can't wait to go to sleep because when I'm sleeping I don't have to be unhappy. I always sit and dwell on my past and get insanely unhappy over the mistakes I've made. I am stressed over debts I have but can't pay them due to my not working. I have attempted suicide through drug overdoses and have been placed on 72 hour holds about five times. I have been to several ostiopaths neurologists headache specialists physciatrists and general practice doctors to try to control my migraines but have not found a cause or a treatment to help. I have tried almost every preventative and abortive there is but they only help a little. Sometimes I have anxiety attacks to the point of not being able to breath. I am currently taking zoloft 50 mg, hydroxyzine 50 mg, atenolol 50 mg, tizanidine 4 mg, ambien 5 mg, stadol 1 mg injections, diclofenac, and was just weaned off clonazepam 1 mg. I am scheduled to see a pain management doctor next month since I have never seen one. I am also going to see a ostiopath for manipulations and as a general practice doctor. What can I do to treat such a severe depression? I actually wish I was never born and can't wait to get old and die. I would kill myself If I didn't fear hell. My depression and anxiety are out of control, I've been this way for 8 years. I have tried chiropractors, physical therapy, biofeedback, accupuncture, vitamins, counseling, and many other things to try to control my migraines. I have gotten pretty much every test done as we'll like mris cat scans EKG EEG blood tests and more to try to find a root cause of migraines. I even went to a doctor who refused to treat me because he said I tried everything and I was a hopeless case. Do you have any suggestions? What type of things will a pain management doctor do? I am also going to see a physcologist to try to control my depression and anxiety. Do you think my depression anxiety and migraines severity is enough to try to recieve disability benefits? Please suggest anything, I am dreading going through the rest of my life like this as I'm only 28. Thanks

Symptoms:  Depression anxiety migraines
Doctor

A:   Hello,
Thanks for choosing "Ask The Doctor".
From what you have stated it is quite clear that you are having a depressive episode. Depression can occur with regular stress and it can also occur biologically without any stress as well. You need proper treatment for the same. There are various effective therapies for depression like fluoxetine, venlafaxine, bupropion, mirtazapine or escitalopram and they are all very effective and mostly safe. You may also require some benzodiazepines like clonazepam or lorazepam for a short period like 2-3 weeks to reduce the anxiety and help with your sleep. At present you are on only one antidepressant called zoloft and that too at 50 mg it is quite a small dose. You will be required to take other stated antidepressants as well.
If you are averse to the drug therapies then there is also an option of cognitive behavioural therapy. This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help you with your illness.
I would suggest that go for a combination of medicines as well as CBT.
Regarding the pain killer doctors, they will definetly help with your migraines. You should see him.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you in future.

Wish you good health!

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