Dear Dr. Archer,
I found your site after you followed me on Twitter. It is very interesting timing, as I was discharged from the hospital on December 31st. I was on the Mental Health Unit for 2 weeks because I didn't want to live anymore. I was discharged still not knowing if I wanted to live or die. To be honest, some days I still don't know.
I was found to be deficient in a few vitamins (D, B12, Iron, Folate) and I suppose this could be a contributing factor. It was recommended I get a work up for malabsorption, but my family doctor doesn't think it's necessary. I am not underweight; quite the opposite, so maybe it is unnecessary.
Here's my history: I am 25 years old and I've struggled with depression and anxiety since I was around 14. I was hospitalized multiple times both as a teenager and an adult -- 13 times in the past ten years. Two times was as residential treatment as a teenager. I have abuse issues and I was raped at age 17.
My current diagnoses are major depression, anxiety, PTSD, ADD and borderline personality (BPD), though my therapist disagrees with the BPD diagnosis. He has known me since I was 17 and I am inclined to agree with him.
I have suffered from occasional paranoia, delusions, and possibly hallucinations over the past few years; the hallucinations are more like shadows, things moving but nothing concrete.
The walls and floor move frequently, and I'm wondering if the paranoia might be more of a vitamin deficiency related state -- it started when I was found to be deficient. I was treated for it but now, a couple years later, I'm once again deficient, hence the hospital wanting me to be evaluated for malabsorption.
The paranoia never went away so I don't know what to think. I guess that's good enough for my history. I don't even know what I want, though. Why I am sending this to you? I have a therapist and an ANP who prescribes my meds. But I seem to be trapped in this cycle of depression. I live in Alaska and I have no friends. My anxiety keeps me indoors; I know I need to try and get out more.
I believe it's also depression and sometimes I don't want to leave the house. When I think about the future I don't see anything. I can't imagine where I will be in five years. Maybe I don't have a future, or maybe I can't see it because I'm undecided? I want so much, yet it seems impossible, especially with the mood fluctuations. Despite all the help I've received, I still feel lost.
I'm on disability with no job. I have my GED but do not have a college education. Hopeless and lost are the two dominant words to describe me. Some days are better than others but those feelings are always there. Emailing some online psychiatrist I don't even know, if you are legit, makes me realize how desperate I have become.
In person I don't talk often, and my eye contact is very poor which I can't help. I guess it makes it difficult to connect to people, or so I've been told. I don't know what you do but maybe you have some psychological advice, some direction I can take. I'm starting to wonder if there are people who are better off dead.
Teresa
Dear Teresa,
From your letter, it sounds like you have your GP overseeing your mental health, a nurse practitioner prescribing your medications and a therapist. If this is, indeed, the case, you need a psychiatrist. I’m not saying your team is doing a bad job, but you need an expert in depression and that would be a psychiatrist, at least for a second opinion.
I also believe you need the malabsorption test. Tell your doctor you would like to have it done. Regardless of whether you're under or overweight, get the test; you both might be surprised.
Also, put yourself on a gluten-free diet for at least a week. If gluten is the problem, you'll start feeling better within two or three days, but I'd give it at least a week -- what do you have to lose and it could make a big difference. I'd like you to check out
Celiac.com, which gives you information on malabsorption, celiac disease and how to maintain a gluten-free diet.
And, make yourself get outside everyday. You may have a seasonal affective component to your illness and light will help.
Paranoia, moving floors, shadows and hallucinations. All suggest psychosis. So you may have something more severe than depression. Again you must make an appointment with a psychiatrist that specializes in mood disorders asap.
Never, ever give up. Help is out there; it just needs to be found. You are not better off dead, I assure you. You're better off in the hands of someone who has major expertise in treating your symptoms. Best of luck to you, and please check back later and let me know how you're doing. I care.
Dr. Archer
