[if you arrived here from a search engine and there is no "navigation" banner down the left side of the page, you'll need to go to the HOME PAGE to get anywhere easily within this very large program!]
Mood Swings without "Manic" Episodes
(Updated January 2008)
James R. Phelps, M.D.
My depression is really complicated. Have I come to the right place?
This site is for people with depression that doesnt get better with antidepressants or psychotherapy. Or who, even before such treatment, obviously dont have "depression" alone. Not everyone will find a "fit" here. There are several different kinds of complex depression. Only one of those kinds is discussed here. But if what you find on this site seems to fit your experience, I hope you will learn some useful things that may guide you to an effective treatment.
This site describes what for now well call "depression plus". In addition to depression, you might have extreme anxiety; or severe difficulty sleeping; or fits of anger over something minimal; or episodes of crying over something like a TV commercial. Or you may have noticed "mood swings": big changes in mood or energy for no clear reason.
There is an energy side of "depression plus" that can show up as anxiety (often severe), finally leading into attacks of panic. It can show up as episodes of rage. It can interrupt sleep so much people go night after night with 3 or 4 hours of broken sleep, and even that doesnt feel restful. People can find themselves thinking a lot, often thinking fast, or about lots of things at the same time, or thinking so much they cant even keep track of what theyre thinking about, and become confused!
Psychiatry finally put this very different kind of depression into the diagnosis rule book about 5 years ago, though many mood experts had been talking about it for years. It is a relative of manic-depressive disorder, even though people who have it do not have "manic" episodes as such. Instead, the manic energy shows up in all different ways, without any loss of contact with reality (not "going crazy").
Many people have figured out that they have a complicated depression that seems to keep changing, or cycle up and down, or keep returning. They even wonder if they might be "manic-depressive". But then they say to themselves "That cant be Ive never had a manic episode!"
But bipolar disorder, as it is now called, is much more complicated than this. If you have depression or anxiety that has not gone away with antidepressants or psychotherapy, or if you havent had those treatments but already recognize a cyclic energy part of your depression, you definitely need to learn about Bipolar II. It is not something anyone would want to have, but it is often very treatable.
This site seeks to serve as a single, "one-stop shopping" place for accurate, up-to-date information on versions of bipolar disorder that dont have typical "manic" episodes. The official names include Bipolar II, Bipolar Mixed State, Cyclothymia, and other variations. If you feel like you know nothing at all about bipolar disorder and want some basics, try this 8 page summary of expert opinion, but beware: it mentions Bipolar II only briefly. A thorough emphasis on the diagnosis and treatment of Bipolar II , and similar non-manic versions of bipolar disorder, is the purpose of the site youre reading now.
The outline below shows what you'll find on this site; use the links in the left column to navigate. If this is your first visit, read the Trust section first.