Depression and more

I am a 54 year old male. I was diagnosed with depression some 5 years ago. I had a course of CBT arranged by my then employer which did nothing for me, I was referred to a mental health assessment but they decided there was nothing wrong with me other than depression as I had made no attempts to take my own life.

In general I have been successful in life, nearly always employed and generally capable in the career I spent 24 years in. I also have my own business which is successful and employs 9 people.

However I feel emotionless. My mood can be considered as poor most days. I have difficulty in getting out of bed and always feel like I have had a really bad nights sleep. Years ago I did have tests for sleep apnea but these showed that this was not present. I more often than not stay up until the early hours as my mind seems to peak at this time, constant thoughts racing, ideas and planning. I take little pleasure in most activities. Socially

I am distanced from most of my friends and make little effort to interact with them either personally or via social media/email. I have no other family other than my wife. She works in the business and has little time for what she considers is her 'lazy, grumpy husband'.

I suffer with poor hygiene as I frequently forget to wash or clean my teeth, rarely comb my hair (it's short) and often wear the same clothes day after day. I am overweight which does not help and frequently binge eat. If I have to go to social events I drink heavily and will use illegal narcotics. If I need to go somewhere for an appointment I begin to panic regarding time to get there and frequently suffer with panic attacks and coughing until I am sick, heart palpitations and feelings of panic. If I drive anywhere I suffer with extreme road rage so often I use public transport such as trains. However if a train is late I frequently just give up and go home again.

When I am out in public such as at the shops or doctors I feel like I have some form of extreme Tourettes syndrome. If people get in my way or are rude I tell them in no uncertain terms what I think of them. I observe people all the time and often make comments about what I think of them and their actions, usually derogatory, loudly. I have no fear of anybody.

At home I tend to fixate on things such as a new hobby and then overspend acquiring all the equipment necessary for that hobby, leading to financial problems.

I have been on Citalopram 40mg until a month ago when my doctor thought I would benefit from a change - I felt that the drug wasn't having any effect any more. I have never felt it did anything other than slightly take the edge off. My doctor prescribed Metrazapine 15mg. I have taken this for a month now. I suffer dizzy spells when I move my head rapidly, as a sleeping tablet it seems to have no great effect. I still feel like I have not had enough sleep. I am still rude to people, including my wife and aggressive in demeanour and this is getting worse. I also have a sore throat, have headaches and feel like I have aged about twenty years - I walk about like and old man with joint pains, stiffness and a sudden lack of any physical strength. In essence I seem to be worse off than I was. All my other mentioned symptoms still occur.

I also have a couple of physical issues, aside from being overweight. My rotator cuff is so damaged that I struggle to lift one arm above shoulder height and one of my legs has damage to the foot/achilles tendon which means I cannot walk properly and am frequently in pain.

I understand I am depressed but is there something else going on too? How can I get diagnosed if I don't know what's going on. Has anyone else had experiences of Metrazapine like this?

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