Do your depression symptoms vary a lot with time: crash into depression, fine for a while, then crash into depression again, sometimes for no clear reason. Do you feel like you are on a mood roller coaster?

• If you answered yes to some of these questions, your depression is complicated and maybe on the spectrum of bipolar. Treatment with antidepressants alone can make this worse.

Do you have episodes of profound anxiety? Do you feel like there is too much energy pent-up in your body? Does your mind race with thoughts that go over and over again? Do ideas fly through your mind so quickly that you can't stay on one topic? Do you paste because of pent-up energy?

• If you answered yes to some of these questions, your depression is complicated and maybe on the spectrum of bipolar. Treatment with antidepressants alone can make this worse.

Do you have episodes of uncharacteristic irritability? Even to the point of rage, even though you know it is out of proportion to the situation?

• If you answered yes to some of these questions, your depression is complicated and maybe on the spectrum of bipolar. Treatment with antidepressants alone can make this worse.

Have you had repeated episodes of depression, but your antidepressant stopped working? Or has no antidepressant ever helped you? Have antidepressants made you feel worse: severe agitation, irritability, severe insomnia, or even feeling suicidal?

• If you answered yes to some of these questions, your depression is complicated and maybe on the spectrum of bipolar. Treatment with antidepressants alone can make this worse.

Do you have severe insomnia with your depression? Falling asleep fine but awakening a few hours later unable to return to sleep, going days with just two to three hours of sleep? Do you wake up completely unrested?

• If you answered yes to some of these questions, your depression is complicated and maybe on the spectrum of bipolar. Treatment with antidepressants alone can make this worse.

When you are depressed, do you sleep more than 10 hours a day? When you are depressed is your energy and activity lower? But your appetite has increased? When you are depressed are you very sensitive to perceived slights from other people?

• If you answered yes to some of these questions, your depression is complicated and maybe on the spectrum of bipolar. Treatment with antidepressants alone can make this worse.

Have you been depressed 4 separate episodes or more? Was your first depression before age 25? Do you have seasonal shifts in your mood and energy? Have you tried 3 or more antidepressants without any of them working or they stopped working? Do your depressions last 3 months or less? Have you ever lost touch with reality when depressed? Did you have an episode of depression shortly after giving birth? When you are not depressed, are your mood and energy a bit higher than other peoples’? 

• If you answered yes to some of these questions, your depression is complicated and maybe on the spectrum of bipolar. Treatment with antidepressants alone can make this worse.

Nature Coast Psychiatry provides excellent treatment for Complicated Depression!