### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
HELP..........I HAVE NEVER BEEN THIS LETHARGIC AND DOWN LOST MY MOM NEW YEARS DAY. ALSO HAD TO MOVE MY FATHER-IN-LAW IN HOUSE. BEEN TAKING CARE OF HIM AT HIS HOUSE HE NOW NEEDED DIALYSIS. ALOT OF OTHER THINGS I CANNOT FUNCTION.I AM SCARED TO EVEN LEAVE THE HOUSE,EMBARASSED,HATE MYSELF. FEEL LIKE A LOSER.NO ENERGY AMBITION ETC. I FEEL UGLY FAT AND DO NOT WANT TO CONFRONT ANYTHING...NEED HELP BAD STARTED CYMBALTA 30 MGS. GETTTING SHAKES SWEATS...AMOST 4 WEEKS HAVE MEDICAID....HELP  SHARI...

### output:

Hi, I can understand what you must be going through> with so much going on in your life, you really must be very stressed out. You definitely seem to be in a depressed state.It's good that you have already started treatment. In your case, since its already one month on cymbal ta at 30 mg/day and still the symptoms are persisting, I feel that it is time to increase the dose further up. We can go up to 120 mg/day gradually depending on how you are responding to the medicine. If you don't show response to it, another Chat Doctor.  You can discuss the options with your psychiatrist. Hope that I was able to answer your query. Best wishes for a speedy recovery.