Q: I am a doctor (dermatologist) and suffer from a psychological problem. My mother had suffered a period of post-partum depression after my birth and my brothers (twins) and I since adolescence have suffered from recurrent anxiety and depression. There is family history of depression in other family members also. There have been periods of normalcy where I have been productive in life and was able to complete my education. My moods made me energetic at times and I also took certain risks in my career. Moreover I had a very overpowering brother who had dominating qualities but he was very much an introvert and did not allow his things to be touched. My father managed the house on his own and was the only emotional caregiver. He too was dominating as well but also had obsessive and interfering qualities. My father however managed his career well and this has given some positive qualities to us. I have had some difficulties in my work place a couple of times and have shifted my jobs which has also been experienced by my brother during times of stress. I have visited a psychiatrist who feels that this is probably a depressive spectral disorder and put me on antidepressants and mood stabilizers which have helped me recover but I still have low self esteem and lack motivation. Since I am married and issue less now for 7 years we tried fertility treatment which has not succeeded till now. My relationship with my wife has been reasonably good in the past 5 years before the onset of my present episode and seems to be slowly limping back to normalcy. Presently I am looking for a new job and wishing all things go back to normal. I am not staying with my parents now, but since my dad is suffering from early Parkinson's disease I sometimes wish that I could go and support him, however my wife is pursuing her education in this place and she wishes to complete it and then move, even though she is not totally averse to move in case the situation so demands. Should I seek help from alternative treatments like homeopathy for long term prophylaxis? How long can I aspire to stay in remission after completely treating my disorder? I wish to have a productive life despite the setbacks and ask you for your advise. Please help.

A:The first and foremost thing that I would want to look at is the mood stabilisers that you have been on, how appropriate these are and whether or not you have been taking these in adequate doses. With a recurrent mood disorder and with a strong family history, the medical or biological management is of utmost importance. With proper medication, I see no reason why long term remission cant be aimed for. In addition to this, I would recommend Cognitive Behavioural Therapy as an adjunct.