How to manage depressive symptoms in BPAD?

Question

Hello doctor,

I have BPAD, currently in a severe depressive phase. My doctor has prescribed me the following medicines: morning -Fluoxetine 80mg, Venlafaxine 150mg, Bupropion 150mg, Lithium 450mg, Methylphenidate 60 mg, and Pramipexol 26 mg twice daily. At night - Venlafaxine 150 mg and Quetiapine 25 mg. I feel low energy, lack of motivation, and irritability. Also, self-blaming always feels like a failure. The doctor also gave me 15 ketamine infusion sessions. Initially, it worked but in the last two sessions, I felt like I would die. Please review my medicines and give your suggestions.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your situation and concerns.

You are on one of the best medications for your current phase of depression. You can go for ECT (electroconvulsive therapy) or rTMS (repetitive transcranial magnetic stimulation) if you do not feel better with the above medications. You should also try to follow the below guidelines to deal with your depression. It will help you.

Exercises daily for 30 to 45 minutes like at least going for a walk. If possible join the gym or swim, it will uplift your mood.
Do meditation for 20 minutes daily, just sit in one place in a comfortable position, and try to concentrate on your normal breathing, do not stop or force yourself to stop your thoughts, just let it be. It will help you to relax.
Eat healthy home-cooked foods, and avoid junk foods.
Drink enough water.
Spend quality time with friends and family daily.
Spend time on creative hobbies like reading good books, writing journals, painting, drawing, and learning new skills or language or musical instruments.
Get enough sleep daily.
Avoid tobacco, alcohol, or any substance abuse.
Find a reason to live your life, do not just spend it.
Be bold and confident.

I hope this helps you. Please, let me know if you want some help.

Thank you.