Expert: Ivan Goldberg, M.D. - 12/11/2005

Question
hi,
I have suffered from major depression for more than a year.I think it is a refractory depression.My last doc put me on anafranil,paxil and lastly seroquel.I was put on seroquel about four weeks ago.Seroquel helped me with my anxiety states and obsessions.I had some hypomanic-like states(i think they are hypomanias) during i was on ad's.I got more talkative,active(out-going) and had racing thoughts about life itself and myself before i was on seroquel.I was so excited about my thoughts about diagnosing my depression.I believed in i had bipolar like disorder(depressive mixed state) so much.I felt irritated and agitated so many times before i was on seroquel.Now I am more calm against situations than before.I read that antidepressants(specially anafranil)may worsen this disorder(depressive mixed disorder).Lastly my doc inreased my dose(anafranil).With the days i increase the ad's dose i felt more depressed and agitated.I don't know whether this situation is associated with the increase in my dose.I want to know more about this disorder and might i be suffering from it? as i read on internet,many people could be misdiagnosed with unipolar depression in fact they are having this bipolar disorder(DMS-depressive mixed state).Might i be having this because my depression isn't getting better since one year though i was on lots of ads.I think this all time.What are the predominant symptoms of depressive mixed state?Could i be misdiagnosed?

Answer
Hi . . .

It is certainly possible that your have a mixed state and that your true diagnosis is a disorder in the bipolar spectrum. I suggest that:
1. You do Google searches on "bipolar spectrum" and "soft bipolar"
2. complete the bipolar screening scale at:
http://www.psycom.net/depression.central.bipolar-screening.html
3. get a second opinion regarding your diagnosis and treatment with a psychiatrist expert in the diagnosis and treatment of people with mood disorders, such as the ones listed at:
http://www.psycom.net/depression.central.psychiatrists.html

Best regards . . .

Ivan
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