DE - Docs usually don't really know what is going on with a person. The diagnoses are so concrete and subjective, while our disorders have no solid edges. The way to get a best diagnosis is to write a list of troublesome symptoms; try a med &/or a certain type of therapy; rewrite the list; add a med &/or therapy or try different ones; rewrite the list...ad nauseum.

I am not a big fan of stimulants outside of those who really can get a descent diagnosis showing a lack of dopamine (ie. ADD, ADHD, etc) via symptomatology. Stimulants, for the most part, are short-term gain resulting in long-term pain. They are okay until your mood deflates again at a specific dose. Something happens to your natural dopamine supply &/or certain subtypes of dopamine receptors. The "reward" (ie. increased dopamine flow in the nucleus accumbens and other brain structures) you get in the beginning will last a year, maybe more, but eventually it seems that those who do not have a real dopamine transmission problem, will get one. This is not always the case, but I have seen it in many cases.

That being said, who's to say that you don't have a dopamine neurotransmission problem. We just don't have any really reliably test to tell if you've got a dopamine receptor or neurotransmission problem.

Anergic depression responds to antidepressants and stimulants, but you can't even keep these people on stimulants long-term, without increasing the dose. Like they said in the Haight in the 60s, "speed kills". Give the

Topamax a chance; then if it doesn't do anything in a month or two, what have you lost, but 2% of your lifetime (hey, at our age 2 months is nothing <smirk>). When you show the doc that you've tried his/her way, they seem to be more receptive to try your way next time.

Hang in there, I cheering for ya. - Cam