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"My GP has upped the dosage of my antidepressants as I’m constantly sad. Where do I go from here?"

empty blister packs pill packets, chronic illness concept
"What do I do after upping my antidepressants?"MirageC - Getty Images

While we, as a society, are getting better at understanding and discussing depression – we’re broadly aware of the symptoms and common treatment options – there’s still a long way to go. One in four people experience a mental health issue every year in England and three in 100 are diagnosed with depression every week, and yet, we still know startlingly little about what actually causes depression.

Stressful events, illness and substance abuse are all known triggers, as is having a family history of depression. Hormonal changes and imbalances, such as during menopause or post-pregnancy, are also thought to increase the risk of developing depression, and low levels of oestrogen and progesterone, in particular, can cause mood fluctuations. But while we’re gaining new ground all the time, it’s still very difficult, if at all possible, to pinpoint the cause of someone’s depression. And, not knowing the cause makes it harder to prevent symptoms from worsening or returning.

So, what can you do if you’re struggling to manage depression symptoms? We asked Dr Sayyada Mawji, registered NHS GP and Women’s Health panellist.

My GP has upped the dosage of my antidepressants as I’m constantly sad. I don’t think this is necessarily the answer, but I don’t know where to go from here

'There can be a number of reasons for feeling sad or disinterested,’ says Dr Mawji. 'This can include physical causes, such as iron or vitamin deficiencies, and changes to your thyroid hormone levels.’ She recommends, as a first step, speaking to your GP to arrange blood tests which could help to rule out or treat any underlying causes.

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'Fluctuations in female reproductive hormones can also play a part, so if there have been any changes to the menstrual cycle or associated symptoms, or any relevant family history of early menopause, for example, this should be discussed with your GP.’

Signs that you may have a hormonal imbalance, along with low mood or mood swings, include sleep problems, fatigue, memory issues, a decline in sex drive, hot flushes, and night sweats. Blood tests can check thyroid hormones, testosterone, oestrogen and progesterone levels, which will provide an indication of whether a hormonal shift or imbalance is contributing to the worsening of your depression symptoms.

Antidepressants treat depression symptoms, but can’t always resolve the cause. There are various types of antidepressant, so if your current prescription isn’t working for you there are other avenues to explore, and many people find them more effective when taken as part of a treatment plan that includes therapy. Lifestyle changes, such as increased physical activity and eating a balanced and nutritious diet, may be beneficial if you suffer from depression, and hormone therapy may be appropriate in some circumstances where a hormonal imbalance is present.

'The next step would be to share your current symptoms and concerns with your GP/doctor who can review you and arrange the most appropriate investigations for you. I wish you all the best.'

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