Courage, my BP friend, courage. (I am sorry to reply so late, but I just joined the forum.) As a fellow bipolar type (type 2 myself) I think I understand how you feel. But I seem to have my diseases (also OCD) more-or-less under control right now, so maybe I can help, or at least offer a sympathetic ear.

May I ask a few questions? What bipolar type are you? Any other DXs? What are your main complaints? Do you lean more toward depression or mania? How old are you? Are you male or female? (I'm not trying to be nosy, I just think these things are relevant. But if you don't want to share, please don't!)

In addition to being BP2 and OCD, I am a middle-aged woman on the verge of menopause (oh goody!). I got a bachelors degree last May (2004), so I know how hard it can be to be a student when you're ill.

I got my BP DX in 1998 and my OCD DX in 2003. When I first got the BP DX, I was happy because I had a label for what was wrong with me. And I figured once I knew that, I would get treatment... end of problem, right? In fact, the first couple of years of my treatment went very well (Depakote and Effexor). But then I started having problems -- some even different than I remembered before -- and I began to doubt my DX. I spent at least 2 years obsessing about it and eventually got my OCD DX. This made me even crazier, because I didn't feel that DX was right either. I thought I just had depression with anxiety. Or that maybe there was something wrong with my thyroid. (In fact, 3 small nodules were discovered, but they're benign and my various thyroid hormones are normal.)

Anyway, the turning point for me was to quit obsessing over my DX and just methodically search for treatment that would help alleviate my symptoms -- whatever they stemmed from!

I am currently on Trileptal, Cymbalta, and Wellbutrin, with good results, though I think the Wellbutrin "activates" me a little, so I'm not sure how long I can do that. (I tend more toward depression, but I do get hypo now and then.) My experience has been that more manic types need to use Wellbutrin with great care.

Here's my advice: It sounds like you've tried different antidepressants. Have you always used Depakote as your mood stablizer? Have you ever adjusted the dose? (I eventually got off Depakote because I gained 30 pounds on it, which was contributing to my depression. But not everyone gains weight on Dep.) Have you considered trying a different MS? I am having very good results on Trileptal, and it is weight neutral for many.

If changing your MS doesn't help, or you don't want to go that route, then you might need to just keep trying new ADs. I know it is such a pain, but there's probably one out there with your name on it.

Here is what I've learned the hard way over the years. 1) Never change two meds at the same time. (It's too hard to tell what's causing what.) 2) Unless you have life-threatening side effects, always give a new med MORE than two weeks. (Two weeks seems to be the standard advice, but I've sometimes found it takes 3-4 weeks or more to get a good response on a new med.) 3) Do talk therapy, and more often when you're at your worst. If you don't like your therapist, try a new one (or two, or three). 4) Keep a mood chart of some sort. 5) The most important, BE PATIENT, AND BE KIND WITH YOURSELF.

Reply or send me a private message if you have any questions.

I wish you well...

Minnie