A. It must be painful having to feel so badly all the time. It made me sad to
just read your synopsis. There are possibilities. It is very unusual for
bipolars to have bulimia and chronic suicidality and the other maladies you
talk about. You have a mood disorder, but I am not sure where bipolar comes
from. The mood swings you likely have are affective instability, and part of
the depression. Anyhow, if what you are doing is not working, and you keep
doing the same, nothing will change. So, either you find an add on or new
medication combination or change diagnoses and attack the problem differently.
One option is to get a second opinion. This is always a good way to go. There
are plenty of good doctors out there, and maybe someone can help. As always,
I recommend University based teaching programs for that second opinion. Not
to detract from private practitioners at all, it is just that there tend to
be more doctors that specialize in treatment refractory depressed patients at
Universities.
Another option is to ask you current doctor about your diagnosis, and why he
or she thinks you feel so poorly. It is not a matter of therapy. No one wants
to feel bad. You do not need more therapy yet, you need corrective
pharmacological management. The illness is like having torn knee ligaments.
No amount of therapy will reconnect ligaments. You need a physical
intervention, surgery, which is analogous to the taking of medications. Then
you do therapy for the knee so it works well. In illnesses like yours,
therapy is much better after things are corrected physically with the proper
medications.
You may want to read the medication letters on borderline personality since
the treatments for long-standing depression are almost identical in the
majority of institutions and centers that treat chronic depression.
