What's the longest a recovery period can be after a depressive episode? And, is it possible to exist in a state where depression kind of hovers over you constantly?

Your question, unfortunately, is a common one. Many people who live with bipolar disorder experience lingering or persistent depression. The mood stabilizer medications currently available are typically more effective for treating or preventing mania or high periods than they are for treating or preventing depression.

Adjustment in medication can sometimes be helpful with lingering or persistent depression. You should certainly let your doctor know about what you are experiencing. Doctors may sometimes pay more attention to the acute or dramatic aspects of bipolar disorder (like mania) than to less dramatic problems like long-term depression. Your doctor would probably look first at adjusting mood stabilizer medication. Use of antidepressants to treat depression in bipolar disorder is complicated and somewhat controversial. Antidepressants my help some people, but there is a significant risk of antidepressants causing mania or more frequent mood swings.

Counseling or psychotherapy is probably the preferred treatment for persistent depression in bipolar disorder. Research shows that specific kinds of psychotherapy are effective for reducing and preventing depression. And psychotherapy will not increase risk of mania or cause other side effects.

The types of psychotherapy shown to be effective are more than just general support or “venting” about life situations. Effective psychotherapy concentrates on specific positive changes, such as: establishing a healthy daily schedule, identifying and confronting exaggerated negative thoughts, scheduling specific activities that are rewarding and enjoyable, developing positive social contacts. Those may sound like things everyone already knows about, but they are things that are hard to do—especially if you feel depressed. Seeing a counselor or therapist can help people to actually do those things that we all know are helpful. DBSA’s online wellness tools can help you make and stick with your own plan for positive change.

About the Doc

About the Doc

Greg Simon, MD, MPH, is a psychiatrist and researcher at  Kaiser Permanente Washington Health Research Institute in Seattle. His research focuses on improving the quality and availability of mental health services for people living with mood disorders, and he has a specific interest in activating consumers to expect and demand more effective mental health care.

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