Why do I relapse so quickly?

I am a 46 year-old female with a life long history of depression and post traumatic stress disorder.  I am seeing a psychiatrist and a counsellor.  I have been taking Paxil for 14 months...for the past six months, the dose was increased to 40 mg/day.  I also take trazadone (50 mg) before bed and clonazapam (.5) when needed.

This week I had a couple of set backs...a tiff with my lover...very minor, really.  I wrote my father and told him I never want to have contact with him again...then cried for 24-hours afterwards.  I am afraid I am about to be hired for a job I need but don't want. I am very anxious about that.

Over the past 48-hours I have sunk to a very low point.  I am thinking about suicide, but know that logically, that is inappropriate and not an option.  I have intrusive thoughts about injuring myself.

This kind of sudden plunge has happened before...despite my compliance with medications. I start to lose hope and feel that I will never be free of depression.

How can I sink so low while I am on so many medications?  Why are my thoughts so intrusive and negative?

Cathy

[HFHS.MD-AJ]

Cathy,

I can understand your frustration with suffering from what you describe as a life-long history of depression. First of all, it is imperative that you immediately inform your psychiatrist and therapist of your suicidal thoughts, which are not uncommonly associated with major depression. If these thoughts become uncontrollable, please go to the nearest emergency room for immediate psychiatric evaluation.

Your psychiatrist may consider increasing your antidepressant dose, or switching you to another antidepressant medication, if Paxil is no longer effective. There are studies which suggest that depression is best treated with a combination of medications and cognitive-behavioral or interpersonal therapy. Psychotherapy may be helpful in dealing with the difficulties with your lover, as well as your ambivalence about your new job.

[M]

Yeah. know how you feel, its strange when reactions seem to be too extream  for the situation. kinda gets like feeling there is something really wrong. but there are people that feel this way. Everyone doesn't but some people do. dont feel alone. emotions are funny things...unstable and powerful.