I am 46 year old with clinical major depression since last 10 years. I currently use paroxetine 50 mg and lamotrigine 200 mg. For most part of 10 years I was on antidepressant only. Since last 2 years lamictal added. Lamictal along with antidepressants helped me to improve my mood. But still long way to go. Can I increase my lamictal dosage or suggest any add on medication that can lift my mood further.

Dr. Saul PereiraPsychologist49yrs exp

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Its been a long time in depression for you and I am almost sure that you have not done any therapy in tandem with the medication. This is something highly recommended. Medication has its merits but it is a chemical way of dealing with the depression and would have had a lot of impact if it was supported by counseling too. I believe there may be some genetic predisposition or there has been some childhood issue, related to anger, that needs urgent attention. You must go and meet with a counselor immediately and cooperate to your utmost. Please visit these professionals along with your parents, if they are still around. Otherwise you may know a lot of relevant information from childhood to facilitate further understanding of your depression. In the meantime please do the following sincerely because you could resolve the problem better with good cooperation: have a good night?s sleep, have a good breakfast of more proteins, meditate often, remain free of stress, eat a lot of fiber, nuts, avocado, exercise regularly, eat dark chocolate, do yoga meditation exercises, spend time in nature or gardening, etc. I suggest you do the opposite of what this depression makes you feel like doing (actually, not doing): you will need to fight this condition. You must become active; stay upright during the daylight time; meet people; never sleep during the day, wake up by 6 am every day, play some active games, especially contact games, do physical exercises, talk to people and join some social clubs, attend yoga classes etc. Watch sitcoms on tv or comedies and cheer yourself up. Go for excursions in groups, for outings, camps, conferences, and religious conventions. Get a pet dog and spend time training it, exercising it and relating to it. Expose yourself to some sunlight every day, at least, 30 minutes but not in the scorching heat. Whatever happens, please incorporate these three important adaptations in your life: always be responsible, be respectful, and be functional. If you did these three, lots of things will go well in life. Please pray and have faith in god to alleviate your sufferings. Don?t wait for others to help. Use your own motivation, which might be at its lowest, but persevere and win this battle. Above all to be really happy, you need to live in love and for love. Learn all about emotions and how to handle them and that will get you out of the depression rather easily and quickly. A counselor is there only to facilitate you, all the hard word must come from you, and your cooperation with that person is very critical for your success. Be positive every day and learn to be contented with what you have. Do some left brain exercises: it is the happy brain. Here are a few suggestions: shut your left nostril and breathe, move your eyes from right to left and vice versa for at least half a minute at a time, and do callisthenic exercises with some form of counting, regularly. Whatever happens please cooperate with the therapy and do not discontinue until the condition is completely resolved.  

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