Q. I was recently diagnosed with Bipolar II (added to the other diagnoses). This was after a bout of severe depression which was treated with a course of seven ECT treatments. The ECT worked very well but then I seemed to become hypomanic, which also happened five years ago when I had ECT. My doctor put me on 600 mg of Tegretol. At this point I feel depressed although not as depressed as I was before ECT. I just feel scared and frustrated. I've been on a lot of meds and nothing has worked long term. I have never been treated as bipolar however. Will the Tegretol help with everything? What about the depression? Are there any meds that help with the dissociation and the depression as well? She did say that if the depression doesn't lift she will try an MAOI. Do you have any thoughts or suggestions? I work very hard in therapy and have resolved many of my "issues" but feel very frustrated with the return of the depression and other symptoms.

  A. Tegretol is good medicine, but it has a high incidence of depression associated with its use. Basically, it gets rid of the mania and does not help or worsens depression in most folks on it. I would consider that you might be a borderline (BPD) instead of a bipolar as one possibility. That would account for the dissociate problems. Likewise, if you have anxiety, somatic complaints (irritable bowel, PMS, headaches, TMJ, etc.) the BPD diagnosis is a more likely one.