Manic depressive disorder misdiagnosed? No euphoric episodes.?

Question

My husband says a doctor told him that he was manic depressive when he was a teenager (he is 32 now). I will admit he tends to be "down in the dumps" quite often. However, there are no euphoric episodes. (He kind of reminds me of Eeyore off Winnie the Pooh). He has been on various meds that didn't work. He said Effexor did work...but, I hate for him to get on that as it is extremely difficult to get off of. He has tried Zoloft, Depakote (which seemed to make him more depressed). He is now on Wellbutrin XL....he is starting 450 mg. today...upping the dose from 300. What do you think? Does it sound like manic or something else? He has been this way since he was a teenager....otherwise very level headed...no big mood swings just consitently (and extremely) bummed out. I am curious what others may think about this.

Answer 1

If he has not been on any mood stabilizers for years and years with no agitation (looks like anxiety but is different) or mild manic symptoms occurring, especially on antidepressants, then he might not have manic depression.  However, when antidepressants don't work or only work for a short period and then stop, being somewhere on the bipolar spectrum is suspected.  That does not necessarily mean manic depression, just that it's the middle ground between depression and bipolar.  (Bipolar and manic depression are the same thing.)  If that is the case, mood stabilizers can be effective antidepressants.  The challenge is finding the right one.  Lithium is a good antidepressant augmentor.  On the other hand, Depakote is known to cause depression in some.  Lamictal is the stabilizer with the strongest antidepressant action.  There are others if his trial on Wellbutrin doesn't work, which hopefully won't be the case.  

Backing up for a sec, the symptoms of bipolar II can be very mild and hard to recognize.  This link is the best description of soft bipolar that I've found on the web.  It might help you get a better understanding of depression w/anxiety versus bipolar II.

http://www.psycheducation.org/depression...

Answer 2

i'm 40 now and had the same problem since teens. i was recently diagnosed add and started treatment.  i had been previously diagnosed bipolar but did not have the ups, just the downs. being treated for add has gotten my off the couch and doing things again.  i've stopped procrastinating as well.  just something to think about.