Expert: Ivan Goldberg, M.D. - 2/20/2009

Question
Hi, I have been taking Cymbalta for three months or so.  I was hoping that it
would eliminate the never ending cycles of sadness, anger, and elation that I
experience.  I have always suffered from depression.  It intensifies around my
premenstrual cycle and my symptoms have become more strange over the
years. I think that I am bipolar, but my doctor does not because I don't
compulsive gamble or max out credit cards. I feel like my problem is a little
more complex than my doctor realizes.  He just prescribed me Cymbalta and
Citalopram and said that it should easily take care of my mood swings.  But
things are fairly the same as before, except instead of withdrawing, crying,
and contemplating not existing, I erupt.  I used to hold everything in for
awhile and now I can't control myself.  I feel so controlled by my impulses.  I
am trying to work my way through this month's breakdown, but I really
wonder if this is the medication that I should be taking.

Answer
Hi Kimberly . . .

Antidepressants are known to often worsen depression and cycling in people who are in the "bipolar spectrum." You might Google the words "bipolar spectrum" and read about it.

I think you should see a psychiatrist who is an expert in the diagnosis and treatment of people with mood disorders. A list of such psychiatrists may be found at:
http://www.psycom.net/depression.central.psychiatrists.html

Best regards . . .

Ivan
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