Hai I am in depression since 2015. I am on medication jan 2016. I am fighting recurrence depression. I am taking bupron sr 150 mg, amitriptyline 25 mg, venlor 75 mg, licab xl 400 mg. please advice.

Dr. Saul PereiraPsychologist47yrs exp

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I think you are being treated for bipolar depression. At the outset let me inform you that is a very difficult situation to rely on medication alone. You need to combine intense counseling to learn coping skills and techniques to handle the complications of life that is anyway challenging even for the ordinary person. There are certain adaptations that will suit you during the elation phase and there are certain behaviors that are required during the depressed phases. In the meantime you can do certain things that will give you benefits anyway. Emotional therapy will alleviate a lot of the problems faced in this condition because it is a mood disorder. You need to particularly look at your levels of anger both for its reasonableness and to express it in appropriate manner. I suspect that much of this anger may have origins in early childhood that you may never be aware of it now. Talk to your parents and explore that angle. This information will help the counselor too. Also you will need to check whether there is any genetic factor involved. You must exercise regularly, eat healthily and sleep normally too. If your motivation and cooperation is good much can be achieved. You must have a time-structured schedule filled with interesting and reasonable activities and it must be monitored for compliance and delivery. The reason I say this is that many times you will be inclined to have grandiose notions and confidently believe that you can do without the medication. This will set you back many months in the treatment and delay and sabotage the recovery: forewarned you are forearmed. If this combination of medication with therapy is maintained for at least three years without any episodes or breakdowns, it is possible to taper the medication in consonance with the doctor.  

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