Question. After using alcohol and amphetamines to dull my “bad feelings” for many years, I was diagnosed with clinical depression and put on antidepressants in 1999. I went through several before finding success with Paxil and Ritalin. Then I moved away. I now don’t have insurance and the medications are not working. I feel totally immobilized, and literally cannot work on a regular basis, even though I know I will lose everything I have left if I don’t pay my bills. I’ve let everything go to hell, including not filing taxes (for seven years) and not tending to my present business. What can I do to pull myself up out of this?

Answer. The first step in “pulling yourself out of this” is to stop pulling alone. You need to get professional help right away.

First of all, I’m not clear what you mean when you say the medications aren’t working. Are you still taking leftover Paxil and Ritalin, or has a new doctor prescribed other medications? In any case, you are clearly in need of a different approach.

It is very common for people with serious depression to feel “immobilized” and unable to work. Of course, it is important to rule out medical causes for this before assuming it is due to depression. So you probably need a thorough physical by a general physician, followed (if appropriate) by referral to a psychiatrist. If you lack insurance, or other means of paying for treatment, I would suggest you speak with a clinical social worker to see what your options are, vis-а-vis some form of temporary disability benefits.

Alternatively, try calling either the National Alliance for the Mentally Ill (NAMI)  or the National Depressive and Manic-Depressive Association  for support and advice on your predicament. When you are feeling a little more energetic, you may also be interested in the book Feeling Good by Dr. David Burns. Good luck, and don’t give up!

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