Agitated depression

Posted , 5 users are following.

i have been diagnosed with this.  It is very difficult to prescribe normal anti deps for it as they make the agitation worse so far in my experience.  The psychiatrist has changed three times during this episode and i am no further forward.  Presently tailed off mirtazapine which i couldnt get to therapeutic level. 

Latest psych says its just anxiety but i feel its more than that with all this inner restlessness now worse since mirtaz gone.

i dont know what to do as there are no appointments and i am not needing crisis team which is only other option.

will this get better just working at it with a bit of cbt and benzos?  Will time take care of it? 

Anyone out there with agitated depression offer any help.

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  • Posted


    I've had agitated depression before. It's an absolute nightmare. Probably worse than near catatonic motor retardive depression. It's like being on the edge of a panic attack and incredibly low for weeks on end. I had this after a bereavement.

    It did last a good 6 weeks. Benzos, even at low maintenance dose definitely help and doing the CBT is good too.

    Of course getting on an appropriate and efficacious AD will help. Also try mindfulness, body scan on YouTube everyday for a week. Getting into a peaceful outdoor environment can help to alond with exercise.

    Eventually mine just receded but it did take a while and when I deteriorate mood wise, it can recur.

    Hope this helps

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    • Posted

      This definitely sounds like my problem, too. Are you able to persuade your GP to give you benzos as needed? I always seem to have a lot of trouble persuading him/her that I genuinely need them from time to time due to my mental problems, and it seems like it's only when I'm really at the end of my tether that they give in and prescribe them. Maybe this is the case for everyone else, too, however?.  

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  • Posted

    Yes, I have it.  I know I have talked to you about this before, but answering this on the forum in case anyone else needs the info.

    Your agitation or anxiety can actually be your high (mania) even though you are not bipolar.  This kind of depression takes mood stabilizers.  You might have to try quite a few,combinations to get the right mix.   Some people need to try alot of medications before you find the right stabilizer.  There is a something called mixed depression, and it is more common than people realize, and that is why they don’t get rsolution to their depression.  

    I have taken the genetic test to see how I metabolize drugs.  I am a slow metabolizer of antipsychotics.  

    I have taken antipsychotics: risperdone, seroquel, and zyprexa (olanzapine).  Those just threw me though the roof.  I realized I cannot take antipsychotics.

    I can take anticonvulsants.  I have tried lithium, gabapentin, and lamictal.

    I have tried antidepressant:  Zoloft, celexa, wellbutrin, and paxil

    I have also tried cogentin for the restlessness (did not help)

    benzo: Klonopin

    Many people, and even psychiatrists miss this.  It has taken 14 months to find something that I believe will work.  At leaet I know I am getting better. I can now go out at night, anad have fun. I still have problems in the morning and afternoon, but I can feel I am getting better.

    Don’t give up.  Maybe you need a new pdoc who understands mixed depression.  Just because 1 or.2 antipychotics didn’t work doesn’t mean you don’t have mixed depression.

    I hope your psychiatrist doesn’t throw his hands up.  He is not trying hard enough to get you well. 

    Take care, and let me know how you are doing.


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  • Posted

    I get this, too, and still haven't found a satisfactory solution, despite a variety of different meds. being tried  and lots of CBT etc. The only thing which calms me down a bit is Diazepam, but I am only allowed to take a small amount of this on a very short term basis- about 1 week- by my GP when things are really, really bad. The rest of the time, I'm afraid, I just have to try to get on with life despite the agitation and the depression (which is, however,  kept under  a degree of control, so I'm not actively suicidal constantly, but only when I'm in the grip of a very severe episode, by taking Fluoxetine at max. does on a long term basis..Sorry I can't be more helpful or hopeful -I would love to find a solution to this problem myself, but having tried a lot of things, I'm not confident I ever will.

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    • Posted

      So kind of you to be in touch.  How long have you suffered this agitation and anxiety?  Am not able to use fluoxetine due to having to take warfarin but they havent managed to find another anti dep to help me.  I am like you, tried several meds and 25 cbt sessions but no help. Tried hypnosis and mindfulness but still it wont shift.   I can see how some people cant go on. I too find the only aid is using diazepam. People suggest books etc but my mind wont engage. If i had an antidepressant like you to keep the worst effects away then it would give me hope.  

      Did you see the response from greentea who suggested maybe it needs lamotragine to cover mood changes.  I wonder if thats feasible, have you tried it ?

      i dont know how much longer i can go on like this. How you can baffles me. When its bad i cant see friends or go out or anything.

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    • Posted

      I have never heard of Lamortigine. The only thing my psychiatrist suggested last year when I was in a very bad spell was Busipirone, but as it takes 6 weeks before it starts to work on anxiety, and mine was through the roof and unbearable, it didn't seem like a sensible option, so I settled for my GP's prescription of 7 days worth of diazepam (2mg x3 daily) to get me through the worst of it, after which, I was back on my own again. Fortunately, by that time my anxiety was not quite so intense, and I was able to cope using Fluoxetine, which apparently has some anti-anxiety properties, and propranolol. I was also given amitriptylene to help me with sleep disruption (I kept having severe nightmares and eventually found I couldn't sleep at all) . Again, I took the amitripylene for a few weeks and then managed to do without, except for the odd one now and again. I'm actually in the midst of another really bad spell of combined anxiety and depression currently, so have made an appointment with my GP to discuss whether I might be best to give the Busipironent

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