[crazytired]

Good evening! I posted a similar thread earlier today on the BP board, but wanted to get input here as well.

I have a long story (I'll try to only add the imp't. info), and would love some input. Originally ('97 or so), I was dx with Dysthymic Disorder. I have been down for as long as I can remember (back to kindergarten and I am now in my early 40s). In fact, I can only remember a six month period in '96, and then a 12 mo. period in '11 where I didn't feel down 99% time. I've explained DD to people as akin to looking up on a cloudless day, only to see clouds. There is never a fully sunny day in my world... I believe that I have had many episodes that would qualify for MDD (double depression?) and I also am 110% convinced that I have SAD. I have always been more "down" in the winter months, and far more so after moving from a lat. of 37 deg. N. to a lat. of 49 deg. N. in '09. Daylight during the winter is so much shorter here.

So, I have tried the following ADs - some several times: Prozac, Effexor, Zoloft, Wellbutrin, Lexapro - and combinations of some. None have worked past 6 mos., and in the last 4-5 years, all have made me very agitated/irritable within the first week or two of taking them (one of the reasons that I have suspected BP). On a side note, I was Dx with ADHD in '06 or '07 and have a Rx for Adderall - which I am not currently taking b/c of unrelated heart palpitations.

Here's my main issue: In the fall of '10, I became highly agitated/irritated (SAD?). Even sounds such as chewing made me want to crawl out of my skin. Because ADs didn't seem to work for me anymore, and I was so miserable, I begged my p-doc for Lamictal. I read that it could be used as a mono-therapy for treatment-resistant depression. For the first time in my life I felt normal: no depression or mood swings - just peaceful and calm. But that "normal feeling only lasted about a year and I now wonder if the Lamictal has "pooped out" just like the ADs did before. The fall mos. seem to bring on an exaggerated agitation and irritability, on top of feeling a crushing depression that can sometimes lift for a day or two and then come right back. I have never been manic. I have never ever felt euphoric. So what could this be? Agitated depression? Atypical? Is it possible to be chronically depressed and just go back and forth between mildly depressed (which still feels awful) to really depressed with a bunch of agitation and irritability thrown in for good measure??? TY so much if you read all of this and also if you have any suggestions. I feel like I don't "fit in" anywhere (as far as a name for whatever this is).

And just to add one more thing, we live overseas (husband works for the DoD), and although I do have access to the US bases for psy. care, I am on my 3rd provider in 4 years. First it was on a base 20 min. from me. Then one that was 1.5 hours away, and this Wed. I start at a base 2.5 hours away. For the past four years, I have basically dx myself, briefly discussed it with a p-doc, and asked for a particular med. I hate it, but that's what I have to go with while we are overseas.

Thanks for reading

[online user]

MDD is Major Depressive Disorder. Can be recurrent, which is what I have. I think I'm also worse in winter months. When I am the most depressed, I get easily irritated and angry. That's the sign I'm in pretty bad shape. When I am well-regulated, I am calmer and behave normally I think. I can be happy and enjoy things when calmer, too. I take 120 mg of Cymbalta, 30 mg of Remeron, and 2 mg of Abilify each day.

Can you get therapy where you are at all? I think that's helpful for us too.

[crazytired]

Originally Posted by online user

Can you get therapy where you are at all? I think that's helpful for us too.

No options for therapy here. I was grandfathered in - when we arrived four years ago, there was plenty of room in the system for DoD employees/family members. I'm pretty sure only active duty can be seen now (unless you are already in the system, like I am). Deployments, cut-backs, and base closures have left me with 15 min. med-checks only. I have to take what little I can get

[Rohag]

Hello, Crazytired. I'm sorry opportunities for care in the DoD system(s) have been cut back so.

Long ago, back on AD, when someone suspected there was a SAD component to my depression, they outright got me a lightbox. I used it faithfully, and it did nothing for me. If you, however, are convinced you have SAD - your evidence is convincing, then look into a lightbox or at least "full spectrum lighting."

Though it has no practical bearing on your treatment, the DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) was released earlier this year. According to reports, "Dysthymia" is no more:

Dysthymia is gone, replaced with something called “persistent depressive disorder.” The new condition includes both chronic major depressive disorder and the previous dysthymic disorder. Why this change? “An inability to find scientifically meaningful differences between these two conditions led to their combination with specifiers included to identify different pathways to the diagnosis and to provide continuity with DSM-IV.”