Cyclic major depressive disorder

[Monny]

Hi, I'm writing on my sons behalf to see if there is anyone else out there with the same symptons and cycle as my 17year old son who was diagnosed with major depression nearly 2 years ago and psychiatrist thinks it could be bipolar 2. He has tried 5 antidepressants with no change just more frequent episodes and with bad side effects so stopped. His psychiatrist thinks the cycle is strange because my boy has around 1 to 2 weeks of being perfectly fine then within a day will have 1 to 2 weeks with deep depression, no energy, no motivation, no self worth, social isolation.Then goes back to normal again. Is there anyone else with the same cycle? I would really appreciate any answers. Also has anyone tried transcranial stimulation? My son is on the waiting list for that treatment.

[Dr_Kim]

Hi Monny,

Your son's situation sounds extremely difficult to manage and must be very frustrating for everyone involved - you, his psychiatrist and mostly your son.

My suggestions are:
1. In cases where there are things that are not clear cut, I often get a second opinion. Ask your GP or the psychiatrist involved who they think might be good to look at the whole situation with " fresh eyes " and see if there might be something to add.

2. In situations where the diagnosis is unclear or the response to medication is poor, I go back to really working intensively with therapy - often a mixture of solution focused , CBT and family therapy . What I mean is, instead of focusing on the big picture actually focus on the small picture! Things like when your son is in the midst of his down weeks ,can he try small interventions to fight the lethargy and lack of motivation ? Sometimes a very intense and scheduled regime in " good weeks " of exercise , sleep, eating, daily agendas and mindfulness can help mitigate the " bad weeks" . Maybe just really focusing on managing the lack of motivation for example by working with a therapist to teach him to try to notice and then challenge that part of his brain that is telling him " no I can't" and maybe then try to notice what the " healthy" part of your brain might be saying " maybe I can" or " I really want to try".

I'm not saying it's easy . I'm not saying you learn to do this overnight but I wonder if with the support of a mum like you and a team of people around him , he might be able to start to overcome the bad weeks more effectively whatever the cause of them may be.

PS re the transcranial stimulation , my understanding is that although there are some early good reports , it is not widespread in its use and the criteria are not 100% clear and this might be a good reason to seek that second opinion I was thinking of earlier

[Monny]

Thankyou for your help Dr Kim. Do you think that it's possible for the body to get itself into set cycles like this so the same cycle happens over and over? Because there are no triggers for his downs, it just happened overnight and he is a completely different person, so sad and withdrawn. During his good weeks he does have a full schedule, works as an apprentice, loves the beach and eats well. Then it's like his body just shuts down for a while. We tried mindfulness but that was hopeless as it turns so quick that focussing/concentrating is impossible. We might consider therapy again with a new approach. The pyschiatrist hes seeing is the second one who seems quite good but just keeps trying new meds to no avail. At the moment he's having a break from meds as they haven't helped anyway and since the break has stayed on the same cycle(had 12 good days and now into the 5th bad day as of today). We will keep trying everything we can though that's for sure and I appreciate your help. Unfortunately we need to put his apprenticeship on hold as he can't commit to enough work days so that could go one way or the other. Thanks for your help

[Adam K]

Hi Monny, Adam here in a very similar situation as your son.

Exactly as you describe, on average there is a week I am completely fine and out of a sudden (usually takes one or two days for complete switch) I am one week not able to function at all.

I am 29 and having this sine 20 yo, with minor fluctuations, but in general the state is still the same - good week following by bad one (sometimes 8,10 / 5 days, usually depression is longer)

I have been on probably almost every possible antidepressant; also on mood stabilizing medications for bipolar disorder and combinations with almost no effect at all (not even much of the side effects, maybe faster moods swing as you mention).

Currently I am on a new antidepressant which my doctor calls “last chance”. I am on another long term medication and I think it was the only one which – slightly - prolonged the “feeling good” episode.

I have also been on TMS (Transcranial magnetic stimulation), 2 rounds of about 10 sessions each. With not much of a recognizable effect ☹.

I am on a psychotherapy for about 2 years now. Not much of effect on the swings but helps sort things out. However, when depressed I find I pointless, we almost don’t talk at all. Thinking about hypnotization therapy.

As you mention – my psychiatrist finds this kind of cycling also strange; and haven’t found much info about it on the internet as well.

Do not want to make you worried, but me personally am very desperate. It is almost impossible to live like this. 

At the time I have a good mood, I am grateful to be there, have lots of hobbies, enjoy life and still believe some new treatment will come (or me being “stronger” or “trying harder” or whatever). But honestly, I cannot imagine living like this for the next 10 years. I cannot imagine living like this for one more year.

Please how are you and your son? Any tips how are you dealing with it? Tell me you have some good news 😊. I pray both for you and me as well. With love, adam

[SerendipityCat]

Hi,
I came across this post this morning, although its 2 years old I felt compelled to post. How is your son, is there any improvement?
I too suffer from almost the exact kind of thing you are describing. It is pretty exact and I can predict when I will change. I have approx 2 weeks of what I call the good, optimistic me, then approx two weeks of what I consider the bad me.....and it seems to run like clockwork....with my cycle, which suggests to me my experience is extremely hormonal. If I am to reflect on this I would say I've experienced it now for a long time, probably since my teen years(I am now 40).
I have never been diagnosed with anything and I have never used antidepressants. I guess it is something I have managed, maybe now I am more aware of it and the very precise cyclical nature of it....maybe it's because I feel worse, like it is worse. I blame this on life events in the last 19 months which has exacerbated the way I feel. After the death of my love of my life, my partner, I feel I have gone downhill in a big way. I now have quite strong lack of motivation, depression, isolation and antisocial feelings and a deep wish to not exist. Then almost like magic, ill get my period and a few days later I feel like me again.....the 'good' me. It is becoming something I am so tired of and I dont want to carry on feeling this way, pretty much 50% of the time I'm relatively ok and the other I'm miserable. It affects my whole world, my relationships, my ability to be social, my family life and my ability to commit to pretty much anything. While I am in the low phase everything seems so pointless to me, I struggle to get moving and I just want to isolate and be alone, I find things and people very irritating.
I just wonder who else relates? ☹

[BT2137]

I feel exactly the same, and have really only just come to understand this isn’t normal, I didn’t realise what I was experiencing was this. I’ll be happy for a couple of weeks and then in a few days I just Can’t escape this crushing feeling of pretty much pain from constantly thinking, very insatiable, isolating myself, very negative although I counter this with logic because I know I am inaccurate with how I feel of course. I want to mention I ruminate and meta think a lot, my mind obsessively thinks and I am a ‘fixer’ so I will think all day about how to fix this and it becomes a negative feed back loop. I started experiencing a large amount of anxiety a couple of years ago and I recently, pretty much got rid of that and panic attacks, however that was a symptom of this depression. Thought I really should just post and say I too relate. I’m going to a psychiatrist soon, I too cannot imagine living another year like this, and I really want to try medical aid to help with my psychotherapy.

[Adam K]

Hi there, i feel sad your troubles but as i could relate it actually helped me to feel better. Maybe it is just the way we are supposed to live? 😕

There are no news with me unfortunately. I am looking to alternative therapies with psychedelics now, not that i am happy about it

Please update me if you have any news and how you are. Wish we all find the right path

[Adam K]

Hi there, i very much relate to your story and i am thankful for it.

Please update on how it went at the psychiatrist, did you get any diagnosis.., recommendations? And how is all now?

Many thanks

[_sweetheart_]

I know some of these posts are very old but just wanted to let you all know it actually made me feel better reading them, for my partner is in exactly the same 'cycle' of depression. I have no answers to give you but am happy to listen and hope you've found the right treatment combination

[Adam K]

HI MONNY or ANYONE, PLEASE REPLY

any update on this? I am still struggling the same. Maybe can have something to do with personality problems?

Thank you for any suggestions