Q:  Is Diazepam Adequate for My Depressions & Mood Swings?

Good morning,

I have had several depressions since my 20s and also (mild) irritable episodes, with high energy and anger outburts. I have unsucessfully tried 4 types of antidepressants, and actually one of them caused more anxiety, panic and suicide thoughts. I have close relatives with diagnosed Depression and Bipolar Disorders. My current psy. says my mood swings are not strong enough to be labeled and treated as "Bipolar" or "Cyclothymia". However, despite my recurrent depressive states, he avoids putting me on antidepressants, because he says there is a high risk of manic switching. He recently put me on Diazepam (small doses) and Psychotherapy. I am quite confused... I have been reading that Diazepam is for anxiety disorders, not really mood disorders. So, is this medication adequate for my depressions and mood swings? On the other hand, if I am not "Bipolar" or "Cyclothymic", should not we make more trials of antidepressants?

Many thanks,
Phil
 

Dear Phil --

Sounds like your current psychiatrist is thinking that you have sufficient "bipolarity" to warrant concern about using antidepressants.  Besides, you have tried four different types, and you're still having trouble.  Some psychiatrists would think that such experiences with antidepressants alone would warrant very serious consideration of a "bipolar perspective".  That perspective opens the option of using medications typically used for patients with bipolar disorder.

On the other hand, diazepam is not a typical medication for bipolar disorder, so there may be something else going on (in terms of your psychiatrist's assessment of your condition). If at some point the two of you decide to pursue the "bipolar perspective", or even just for some clarification on your current situation, you may find my website about bipolar II and "soft bipolarity" useful.  It includes a section on treatment options.  Here's a starting point for that material.

Dr. Phelps