Reply to Great life, great wife, but I'm unhappy

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[quote=Anonymous]OP, after reading this entire thread and your responses, I'm concerned that your depression isn't appropriately managed.  You say you are on an anti-depressant but you are still having 6-8 week mini-depressions 3-4 times a year.  That shouldn't be happening if you are on the right medication.

There are several possibilities:

1) you are not on the right anti-depressant and need to be on a different one.  have you tried more than 1 AD?  does your psychaitrist know that you are still getting depressions?  you need to share that info and ask to try a different med. maybe a different anti-dep. would work better.

2) you may actually be misdiagnosed as having general depression when what you may actually have is Type II Bipolar Depression.  Bipolar II presents as repeated depressions with periods of intervening hypomania.  Your description of 6-8 week depressions and then feeling OK fits the cyclic nature of BP II.  My exH has this.  It is common for people with Biploar 2 to go undiagnosed or misdiagnosed with general depression or ADHD  for many years.  He, like many Bipolar 2 persons, is very high functioning.  IME, much of his discontent with our relationship was a function of his illness.  During the hypomania, he had a mild sense that he was better than us and could have a cooler happier life without us. During his depressions, he had a sense of failing us which transitioned to being irritated by us as he moved towards hypomania.  Read up on BpII and talk with your psychiatrist.  If you have tried 2 or more antidepressants that failed for you, then the literature shows that a mood stabilizer - either as an add-on to the AD or instead of an AD - might be a better option.

3) there might be a seasonal or light-based component to your depression.  You describe being depressed over Xmas, but then feeling better on vacation.  Any chance you went somewhere warm and sunny for vacation?  For many with seasonal depression, it starts in the fall as the sun starts to set earlier, and deepens in the winter as it becomes dark in the morning when you get up.  There is a special light therapy that can really help (10,000 lux light box in the AM for about 30mins).  Light therapy can also be effective in depression.  It would be inexpensive and easy to try and continue, but you should do it with the guidance of a pdoc since it can trigger mania in those with a predisposition.  but, since you've been on an AD, presumably w/o the AD triggering mania, this is probably a very low risk for you.

Finally, are you getting your anti-depressant from a psychiatrist with a lot of experience in mood disorders? Your case is too long-running and complex to be getting anti-depressants from a general practitioner; they just do not have enough experience to be helpful in a case where the first AD isn't working well enough. [/quote]

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