I suffer from Major Depressive Disorder. I was in remission for a few years -- just a tiny (12.5 mg) maintenance dose of Zoloft, and I was doing great. Then my depression became psychotic. You can read that whole story here.
The problem is, SSRI's (meds like the famous Prozac) put me to sleep and impair my cognition -- at best. At worst they strip me of my thoughts, feelings and personality. Wellbutrin makes me aggressive. Tricyclics do nothing.
I needed a new antidepressant. One where the dose could be raised if I started to notice the warning signs of psychosis. My doctor suggested Lamictal (actually, he suggested the generic version, lamotrigine). It's one of those anticonvulsants-cum-mood stabilizers that's been effective off-label to treat refractory depression.
It's a complicated medication, but then, my depression is complicated. It seems to cycle quite a bit, being noticeably worse around 5 pm, and decidedly worse in winter. It's also very reactive. I need to get enough sleep every night. I need to exercise at least three times a week -- vigorously; none of that "15 minutes of light cardio can improve your mood!" crap for me. I need to eat right; in my case this is a high protein diet with lots (and I do mean lots) of greens, without too much carbs, and almost no refined sugar.
I also have ADHD. This is a disorder that mimics Bipolar II in some ways. Instead of hypomania, we have impulsiveness and hyperactivity and hyperfocus, but the end result feels very much like the autobiographical descriptions I've read of Bipolar II.
In the course of researching lamictal/lamotrigine, I came across the website PsychEducation.org. The author of that site is a psychiatrist who treats patients on the bipolar spectrum as well as those with treatment-resistant depression. His belief is that major depression, or "unipolar depression", is on one extreme of the bipolar spectrum. Perhaps, he writes, it's so resistant to treatment because it has more in common with bipolar disorder than with other types of depression. Perhaps mood stabilizers should be the first line of treatment for depression, instead of SSRI's.
All this has left me questioning my diagnosis. But at the end of the day, it doesn't matter what name I put to my disorder. It matters that I find something that allows me to live a normal life.
