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Treatment Resistant Depression
Mr Patra, a 64-year-old retired Coal India employee, presented with persistent low mood, no interest in daily activities, talking to people, or physical activity, plus reduced appetite, weight loss, and insomnia. He also has a hiatal hernia and GERD. In 2016, he had repetitive thoughts and sleeplessness, managed for four years with Fluoxetine 20 mg, Clomipramine 25 mg, and Lorazepam 2 mg. In 2020, an ischemic stroke (PCA territory) triggered a relapse of depression. Prior meds failed; Fluoxetine rose to 80 mg (no effect), Escitalopram 20 mg (ineffective), Venlafaxine 75 mg with Bupropion 300 mg (helped but stopped due to gastritis), and Mirtazapine (unhelpful). Lorazepam dependence persists despite trials of Clonazepam, Diazepam, Melatonin, and Trazodone. For four years, refractory GERD, on Esomeprazole and Levosulpiride, continues. Currently, he has ongoing low mood, disinterest in socializing and activity, poor appetite, weight loss, and insomnia, with treatment-resistant depression.
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Consult psychotherapist
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Hi
Focus on what aligns with you
Start small, with tiny expectation
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Graded Exposure with Pleasurable Activities
What it is: A step-by-step reintroduction to enjoyable or meaningful pursuits,
How it helps: It prevents overwhelm while rebuilding interest.
Technique: Pick an old hobby (e.g., painting). Break it into steps: 1) Gather supplies (Day 1), 2) Doodle for 5 minutes (Day 2), 3) Paint a small shape (Day 3). Adjust pace as needed.
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hi
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Hi,
consult with a Psychiatrist
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Consult with a Psychiatrist
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seek help
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It seems to be psychosomatic changes. It needs to be addressed asap otherwise it may get complicated.
It can be treated well with counseling sessions and homeopathic medicine effectively.
It needs to be treated in a holistic approach for complete recovery.
You need an expert Psychologist who is a good homeopathic physician.
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I have been working as a Homeopathic Psychiatrist and Counseling Psychologist for the last 17 years. You can contact me through an online appointment for further assistance
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Hi, Consult a psychiatrist for assessment and renewal of medication if required
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Hi, kindly consult a Psychiatrist.
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Ms. Jesin John
Counselling Psychologist
21 yrs exp
Hyderabad
Hi
Next Steps
Connect with a psychiatrist
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Ms. Smriti
Counselling Psychologist
18 yrs exp
Bangalore
Connect with psychiatrist
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consult
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connect
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Dr. Rupali Mohbe (PhD)
Psychologist
26 yrs exp
Ahmedabad
Hi, I appreciate that you reached out with your concern.
I suggest to take medicines and therapy both together as prescribed. Seek therapy and consider techniques like cognitive-behavioral therapy (CBT) and psychometric testing to understand is there any personality issue.
Practice energising breathing techniques like bhastrika pranayam, kapalbhati pranayam.
Maintain a balanced diet, exercise regularly, going for walks, prioritize adequate sleep, engage in social activities and hobbies.
Next Steps
You can book an appointment with Rupali Mohbe/BIRDY ME at Practo
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Daily do bhastrika pranayam and Kapal bhati, help in energizing your body.
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