Maybe schedule starting a major new med with your vacation or time off. When there are intense side effects, it is often the first week or so that is worst. Sometimes if you push on through that first week, there is a better experience on the other side. When I started the relatively benign Buspar, I almost didn't make it through the first 3 days. Very intense and I had to decided to give it up by day 4 if I wasn't improved, but by day 4, it was less intense and I was able to persist.

Also, there are non-drug approaches to dealing with mood instability, depression, etc. Your T can help you with those--maybe you are already working on your depression in therapy and outside of therapy using non-drug approaches. (Pdocs are usually focused on the drug approach.)

Meds don't necessarily work for everyone. I also read a really interesting article recently on the use of very low doses of narcotics to treat depression. According to this article, this approach can help some whose depression has not been helped by SSRIs, tricyclics, MAOIs, etc. This approach, however, is also very controversial because of the phobia our society has about narcotics. (I can send you the reference if you want.)

Also, maybe you will never have a completely even mood. Maybe that is OK! Maybe that is who you are. I think there is room for some people to grow into an acceptance of their own personal biochemistry. Maybe, for example, a person will always have shifts in mood to some extent and could learn to control their responses better when that happens through what they learn in therapy and approaches such as meditation, etc. I know that may sound lame, but I have come to greater acceptance of how my brain is and that has helped me. I am never going to be one of those up up up extrovert people, I just am not and I am OK with that. I have beat my depression without meds through psychotherapy. Doesn't work for everyone, I know, but psychotherapy is an important tool to fight depression. It feels so great to not be depressed after years of feeling that way!

Good luck, pinksoil.