Well...here it goes. I haven't had a depression this bad in a while. Usually when this happens I try to get on some sort of medication. They don't work for me. (This cycle's been going on over half my life) Lately I've been getting a feeling that I might be bipolar. This is due to some episodes that I've been having in the last few years that can really only be described as mania, even if they are mild and don't cause me to be tooooooo impulsive or destructive. I'm wondering if this is why medication hasn't worked for me in the past.
Has anyone out there (on this forum) been misdiagnosed with depression, and therefore been prescribed medications that do not work? And then later been properly medicated with a positive outcome? I know this isn't too uncommon, so I thought I'd give it a shot.

I haven't seen a doc but I feel lately a lot like you have described yourself. It's so tough when you start getting in that mood. My sister is on medication and she seems to think it really helps her. Most of my life I have been able to deal with my moods but in the last year or so its gotten pretty bad peaking just lately. If things don't change this week, I'll probably check with a specialist on this.

Anyways, I wish you all the best in dealing with this.

There are different types of bipolar disorder. In addition to the classic "manic-depressive" type, there is bipolar II, which presents as depression without the mania. There are still others, as well. WebMD has a pretty decent page about bipolar disorders.

Do you get manic or hyper? Like Kisal said, BPD2 has "hypomanic" episodes, which are often ignored as simple hyperactivity. Not good, because anti-depressants can set off full-blown manic episodes in BPD patients. The diagnostic criteria are really hard to nail down, though, so if you suspect it maybe you should try keeping a journal?

FYI, my husband is rapid cycling BPD1, meaning he swings from manic to depressive to baseline (within 24 to 48 hours). He goes months between cycles, but will have several "mini cycles" over a 1 or 2 week period. During a true manic episode, he's next to impossible to deal with. During hypomanic episodes (quite common), he'll be hyper, jittery and easily agitated if someone interferes with his work - contrasted to simple hyperactivity, where he's got a ton of energy for no apparent reason but no real mood changes. The former are the days where he programs for 16 hours straight and snaps at anyone who offers him a sandwich; the latter are the days the house looks like someone brought in a team of Merry Maids!

In my experience, BPD2 can be misdiagnosed as general depression. If you've tried several different SSRIs with no benefit, I would talk with your doctor about what you're experiencing. Good luck and I hope you find something that works for you!

I'm a mental health counselor... so...

1.) How old are you?
2.) What type of depression were you diagnosed with? (Dysthymia/Major Depressive/Not otherwise specified?)
3.) Describe your episodes of mania. How long do they last? When do they start? How are you feeling when you have them? Do you notice delusions of grandeur? Heightened ego? Do you have any strong urges?
4.) Describe your episodes of depression? How long do they last? How do you feel? Do you have any suicidal urges?
5.) Are either your manic or depressive episodes triggered by anything? What happens right before them?
6.) Do you have periods in between these episodes where you feel fine? What happens in between episodes?
7.) Tell me anything else you consider relevant... Family history, medication types, etc.

1.) How old are you?: 25
2.) What type of depression were you diagnosed with? Major Depressive
3.) Describe your episodes of mania. How long do they last?: Anywhere from 12 hours to a week. When do they start? : Really anytime, without warning. How are you feeling when you have them?: High energy, racing thoughts, impulsiveness (not reaching a debilitating level, thank god), little need for sleep. At first I welcome these episodes because they seem better than crippling depression, but after a couple of days they are too much. Do you notice delusions of grandeur? No. Heightened ego? No. Do you have any strong urges? Yes, mostly to spend money and I have to be around people or I go a little nuts.
4.) Describe your episodes of depression? How long do they last? A week to a year. How do you feel? Absolutely no energy, it takes everything in me to get out of bed, everything in my life falls apart because I just stop going to work/school/whatever. I isolate myself from everyone. I eat constantly and abuse alcohol. Do you have any suicidal urges? Thoughts, but they never escalate to plans.
5.) Are either your manic or depressive episodes triggered by anything? What happens right before them? Manic episodes seem to come out of nowhere but depressive episodes can be triggered by something in my life going to hell (ie a relationship ending, losing a job) but these can also just happen for no apparent reason, even when things are going really well.
6.) Do you have periods in between these episodes where you feel fine? What happens in between episodes? In between the extremes I usually at least feel a twinge of depression. I can feel genuinely happy for a day or two, but for the most part I've had a fog over me most of my life.
7.) Tell me anything else you consider relevant... Family history, medication types, etc.
*I've tried various SSRI's, including 80 a day of Prozac combined with Wellbutrin, which at the time I thought was helping, but looking back I was more lost then that ever....
*Both of my parents take medication for depression, but no bipolar disorder or schizophrenia that I know of...
*I have a really hard time concentrating on anything, but it's way worse when I feel “manic”.

I read over your responses. I may have more questions for you tomorrow, because I want to think about it. It's late and I'm tired (2am). But it doesn't sound like Bipolar. I'll try to help you work out what's going on. I should be around some time tomorrow. I'll get out my DSM for this and everything!

Some thoughts... It sounds like you're definitely depressed hence your initial diagnosis, but am I right in assuming that you are not content with it? That may seem obvious, but some people are depressed and just let themselves be that way with no motivation or desire (or energy) to get out of it. Sometimes people with depression as a coping mechanism subconsciously try to shock themselves out of it which results in periods of what appears to be hyperactivity. If you were bipolar, your manic episodes would more likely last weeks and you would definitely notice delusions of grandeur or heightened ego. Basically the exact opposite of depression. Of course, someone mentioned hypomanic states so I'm not ruling out BPDII. In order to do that, I need more information. During these "manic" states, how do you sleep? How does it compare to how you sleep otherwise? Are you easily distracted (think of your best example of someone with ADHD)?

From what you've said so far... this on the go and needing to be around people... It sounds like you're trying to connect. Which makes sense if when you're depressed you feel isolated. Your mind may well be deciding it's time to get out of the depression and it's kind of like a blow back. Sudden bursts of energy from your subconscious attempting to balance itself. When it gets tired or decides the balance isn't going to be achieved, you go back to the depression.

Also, I want to look at possible anxiety. Do you feel anxious during these episodes? Are you fidgety? Panicky? Please describe anxiety as it relates to the times you feel "manic."

It is somewhat common, although not much discussed, for someone to be what I term anxious-depressive. Either your subconscious is fighting back in a way that is anxiety producing (thus puts you on high alert + adrenaline) or you have a co-occurring anxiety disorder.

My gut is usually pretty good in diagnosis, but it's difficult to say for certain without seeing you in person. Whatever doctor chose to put you on Wellbutrin and Prozac simultaneously should not be a doctor. Wellbutrin can cause anxiety-like symptoms. I've been on Wellbutrin myself in the past and didn't make it more than three days on it because the side effects were awful for me. Typically Wellbutrin is best prescribed with an anti-anxiety med such as Buspar. What meds are you on currently and how are they working for you?

My gut in this situation tells me it's not bipolar disorder. Bipolar disorder is commonly misunderstood as rapid mood swings, when in fact more than 4 manic or depressive episodes in the course of a year is considered atypical and has a special qualifier called "Rapid Cycling." My gut could be wrong, but we'll keep talking. If you can get a better idea of what's going on from our discussion, then that's something for you to discuss with your doctor. Keep in mind that this is me helping you out in a very unofficial capacity, and any doctor who has physically come in contact with you is more likely to have a better idea of what's going on.

Sorry for responding so late!

It's not that I want a different diagnosis...I just want to be on a medication that WORKS first a for most, and doesn't make me fat(ter) and cause sexual side effects. I also would like like a unicorn and a million dollars...but hey, if I could at least find something that worked, maybe I could have the energy to cope with the side effects.

During my "manic" periods I sleep okay...not too deeply but well enough, and I only sleep about six hours (I usually need about 8-9 to feel perfect) and I'm incredibly easily distracted. Like if I'm trying to study I need to be in a room with no windows, nothing on the walls, and I need to leave my phone and laptop at home if possible. And yet I can still get distracted by something.

I'm always fidgety, but when I'm "manic" is more pronounced. I've also got some anxiety that I've just kind of always lived with, and I'm not sure off hand if it's heightened when I'm feeling manic.

Thank you so much for helping me out with this, by the way. I'm hoping to get into the medical field someday, and I'm in love with diagnostics (you can probably imagine that I self-diagnose quite a bit).

Oh and by the way, I'm not currently on any medication. I just got my health insurance back last month (thanks, Obama!) but I turn 26 in December, so I'll get kicked off again. So...I hope I can find something with a generic available so that I can continue it after my insurance runs out.

Well, first thoughts for the moment... Next time you're feeling manic would be a good time for a doctor to re-evaluate you to determine if it's anxiety. It sounds like if you've always had some measure of anxiety then it's just more pronounced during those times. 6 hours, although not great, isn't what they'd consider clinically significant. I usually only get 6 hours myself. You probably should go for something in the same class as Wellbutrin, but without being combined with an SSRI. If Wellbutrin isn't working, there are plenty of other non-SSRI options. I also think if you went with Wellbutrin (or its generic form) you should have an antianxiety prescribed with it. You should talk to your doctor about concerns of increased anxiety with Wellbutrin alone, and they usually do prescribe it along side Buspar.

From what I'm reading, it definitely sounds like Major Depressive, but that the doctors either were unaware of or ignored your anxious symptoms. You've really got to advocate for yourself with doctors because they'll just throw anything they can at you. Also keep in mind that given the nature of depression in everyone is different, the doctors pretty much have to guess what medication would be right for you and adjust and change as necessary.

I was diagnosed Major Depressive when I was 16 and it took 4 different meds to get it right. I haven't been on meds for quite a long time (nor have I needed them), but I also had anxiety on the side in bursts similar to what you're describing (although it didn't really look like what you'd stereotypically believe anxiety to be like). The medication that eventually worked for me was Celexa (but I've also tried Luvox, Prozac, Paxil, and Wellbutrin), but it is an SSRI. Once I felt like I was in a good place to handle my issues without medication, I quit the medication and received counseling. I actually go to a counselor every week or two just as a preventative measure. I no longer have a diagnosis of Major Depressive. But I do have a diagnosis of Dysthymia (chronic low-grade depression). Once I identified what I needed to do, my dysthymic symptoms really began to improve.

If you can get counseling in addition to your meds, that's going to be the best option for you. Medication won't fix the problems forever, but it will definitely get you to a place where your issues are more manageable and can be addressed through counseling.