I don't have a background in medicine, but a manic episode almost always turns into a depressive episode for me.

I've read that dopamine receptors can be "overloaded," and depleted by stimulants and can cause a mood dive because a person's brain cannot replenish dopamine naturally for awhile. Granted, I am no doctor and I've read it for chronic usage. Prescription stimulants and meth. Not implying your situation is related, at all.

I did read your "beware" thread and while my experience was stress-induced, I became delusional and had psychotic paranoia like you described. It was awful. It kept getting darker and it was a mixed episode, which is part-depression. A lot of meds pulled me out of it.

My worst depression of mine was not situational. My life was going well (I thought) and I had ... I was suicidal. It was awful and I believe it was simply a chemical imbalance and part of my bipolar disorder. I felt like I was in a deep hole and things were hopeless. I eventually became emotionless and the world seemed grey. I was disassociating, too.

I've had situational depression, but for me, it's shorter in time length and I respond to med changes quickly. However, if it is a huge loss like a death of a loved one...depression lasts longer as I go through the grief process. Therapy and time helped me more than meds.

My pdoc told me that thinks being physically ill or having significant financial problems can trigger depression. Pain meds, opiates, make some people depressed.

Hope that helps. Take care. Try to remember depression WILL pass. I've needed meds to help me, every time. Med changes or dosage increases. Raising Lamictal, too.

Drinking alcohol always made recovery from depression impossible. It made my anti-d's not work. It made me feel worse and the anxiety the next day...awful. I self-medicated with alcohol early on in my diagnosis.

I hope this helps. What does your pdoc say?