QUESTION:
Dear Dr. Heller,
I have been diagnosed with depression for at least 10 years now but suspect I have been ill longer. I have been to three or four hospitals within that time. I have just spent seven days in the psychiatric wing of our county’s biggest and best teaching hospital–diagnosed as possible manic depressive. I have been prescribed Depakote (so far only up to 750 mg), and trazodone (50 mg).
Do you agree or disagree that this is a good combination, and if so, how long will it take to start noticing a difference or feeling better?
Thanks in advance for your answer. Love Always Wins!
ANSWER:
The screening test I use for my patients may be invaluable to you. I have a section explaining the Borderline Personality Disorder (BPD) and many other common disorders in this website, and theyre all discussed comprehensively in my book “Biological Unhappiness.”
Ive seen many, many individuals who have been chronically depressed for years and years. The usual answer is the BPD combined with additional diagnoses. Bipolar can also be present, but youve obviously not responded so a look at other options seems reasonable.
I strongly recommend you find out what your diagnoses are so they can be comprehensively treated. Unfortunately, many in the mental health profession dont believe in the “Borderline Disorder” – which can profoundly hamper treatment.
Regarding medication, Depakote can be useful for bipolar and the BPD, although side effects are often a problem. Dose doesnt matter, blood levels do. Trazodone–particularly at that dose–in my experience isnt that useful.