Hi Laure,

I think it is natural and logical to question a diagnosis or conflicting diagnoses and meds when they really don't seem to be helping...not much anyway.

Some things for your friend to think about:

- who is the doctor? A general practitioner with a MD or a psychiatrist (MD) or a psychologist (PhD) or several different providers?
- how much experience does that current doctor have? Do they specialize in an area of mental health? How long have they been in practice?
- if your friend summed up in one sentence why she feels awful, what would that sentence be? That can be a starting point.

I read that bipolar and borderline personality disorder are often confused by some clinicians though a very well experienced specialist should be able to parse those out.

If unipolar and bipolar depression get mixed up, that can indeed be dangerous as the medications can make some of the symptoms worse.

The first concern I see is that you are not the patient and so, as a loving friend, there is only so much you can do. You can offer kindness and empathy but you cannot make medical decisions for her....you need to respect her boundaries. How does she feel herself? Does she trust her doctor or wants to try something else? It needs to be her decision since it is her body and mind.

Do doctors get things wrong sometimes? Yes. I've lived with unipolar depression since childhood and doctors told me over and over again that this drug would work or that one would work. The meds never helped me. The doctor eventually agreed. I later found out that some of the meds I was prescribed in childhood should not have been because they can increase suicidal ideation in children. The meds only made me sick from side effects and never improved my mood. I stopped trying meds many years ago. I feel better in about the last two years than I have in my whole life. That's just my truth. Other people's situations are different. What greatly helped me was cognitive behavioral therapy and holistic providers (addressing health for body and mind) and mindfulness and meditation.

If the questioning and searching is coming from your friend herself, rather than just you, I would recommend that she find an experienced psychologist (at least 15 years experience) with a PhD. She could start from scratch. Focus on what bothers her most. And take it from there. For example, 'I think about ending my life because I never have any energy and want to stay in bed' or 'I feel terrible because it feels like nobody loves me' or 'I push people away when I get angry and I don't mean to do that but I can't stop.' those are just a few random examples but they can lead an experienced provider in the right direction as a starting point. Sometimes I wonder if the diagnosis matters as much as truly listening to the thoughts and feelings which are troubling a person...going back in their history as to the origins....and then troubleshooting ways for them to feel better....to have balance in life. Though of course without an actual diagnosis, people cannot be assessed or treated, it's part of the process.

Meds do seem to help some people with mental health problems but it is far from an exact science. And they do make some people feel worse. For others, there seems to be very little impact at all. A case by case analysis from someone who has been treating long enough to see patterns and trends is necessary. I would steer clear of any provider trying to simplify things or making it sound like there's a one-size-fits-all approach. There are still some doctors who are convinced that everyone with depression will benefit from anti-depressants. And I know that to be false based on my own experience. Have you seen those commercials on TV for anti-depressants with the little bouncing balls passing from one side to another? How ridiculously reductive. The human brain is highly sophisticated and complex. Any good neuroscientist will tell you that they have barely scratched the surface of it. And a good psychologist knows that chronic and severe mental illness cannot be quickly or simply erased. It takes time and individualized analysis and empathy.

I don't know if this helps you? I wish you and your friend peace, hope, and a bright future.