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

### input:
I have noticed new onset of worsening short term memory loss. I am on Paxil (quite awhile) Doxepin, Lamictal and quite a few vitamins and diabetic meds. No med changes in at least 3 months. I have been diagnosed for months now with severe PTSD (years for PTSD and depression), depression, unknown borderline personality disorder and bipolar DO. I have been able to have social security disability; had to quit my job at the end of May last year..I had little concentration; memory, etc. I am now seeing that very simple things are forgotten...reaching for (right at hand) a slip of paper to write down a item needed from groceries that I just thought of; the meeded info is gone and I cannot get it back. Occasionally find myself not recognizing usual landmarks that I have known for years..it is just for a split second but scary ... not able to focus on driving and have had a few close brushes with backend collisions. I have had 2 brain CT s in the last year and a half; the last one about June of 2013. I spoke with neurology and they truly believe this is PTSD and anxiety; no issues with the scans. I am now having alot of bone pain in my pelvis area left hip and femur and rt hip and midback. I can no longer lie on either side while sleeping due to back pain; need to lie on back. I am a Oncology nurse (or was for 25 years)..so you know what I worry about. I have a doctor appt feb 3rd but I have no insurance so unsure if I will be seen. I have considered the ER if pain worsens. right now I can get by on ibuprofen 600 mg every 4-6 hrs; occ switch to tylenol........My life is really ok; I keep myself busy and , volunteer on the phone for a couple of agencies a few hrs a week; got to the YMCA at least 4 x a week and have done that for over a year now...I am obese and working on that. I did have major surgery 2012 for gastric sleeve; lost a whole 20 pounds but sure I have lost a few brain cells due to the anesthesia. I had to be narcanned to wake up after surgery.(that was about 16 months ago...Good Luck; I think I already have the answer; but nurses are bad at thinking the worse. Thank you

### output:

HiT hanks for using Chat Doctor I think, you have underline depression along with anxiety disorder. In that case, you should consult a psychiatrist for proper management. If you are not getting any benefit with pail or domain, then you can try venlafaxine. It is one of the best antidepressant and has good effect on depressive as well as anxiety symptoms. You can also take help of psychologist for relaxation exercise. Thanks