I am on my third anti-depressant this year and I am feeling much better. However, on this one I was beginning to exhibit signs of mania--in my case hypomania--which is a too-common side-effect of anti-depressants in bipolar patients. For me, hypomania presents itself with bouts of insomnia, an insatiable desire to spend money, and other unpleasantness. It was scary to experience these again, since I had been doing well in that area for many months. On my next visit to him, my psychiatrist upped my dosage of mood-stabilizer in the hopes that it would be a shield to the anti-depressant's ill effects. So far, so good. (I hate being hypomanic even more than being depressed. I fear all the time that it will worsen and my behavior will hurt those I love.)
There is a great article about the need for mood-stabilizers when anti-depressants are prescribed for bipolar patients today at Bipolar Beat. Click on the link if you would like to read more on this subject.
(Thank you to this photographer for the picture.)
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There is an important editorial in the Feb. 2009 American Journal of Psychiatry that touches on this problem. My colleagues and I urge great caution in the use of antidepressants for anyone with bipolar disorder. If you would like more on the recognition of bipolar depression, you can find my article at: http://www.currentpsychiatry.com/article_pages.asp?AID=4806&UID=71765
--Ronald Pies MD
Thank you, Dr Pies. I appreciate your concern, and that you made the effort to direct me toward the Current Psychiatry website.
It is now some six months since I wrote that post, and I continue to have problems with antidepressants. I'm up an hour past my bedtime right now, waiting for a dose of Benadryl to put me to sleep. Hypomania is getting worse, and my depression is back, as well.
I will definitely discuss once again the downside of antidepressants with my psychiatrist on my next visit.
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