Bipolar vs. Postpartum Depression?

My son was born in 3/00.  I was 34 then.  About 1 mo later, I felt myself getting depressed.  I had 2 episodes of moderate depression about 10 yrs and 5 yrs previous.  1st episode was treated with Prozac, Xanax and brief therapy.  2nd episode was treated without drugs, but I was in therapy for almost 3 yrs.  For this 3rd episode, I went to the ob/gyn first, who put me on small dose of Prozac and sent me to therapy.  After going back to him several times (still in therapy), but without improvement, he sent me to a psychiatrist.  The psychiatrist and I did not get along, but he did put me on Effexor, which helped tremendously.  Still in therapy, I switched to a new psychiatrist.  We had to keep increasing the Effexor dosage, until I started getting dizzy, etc.  We tried a variety of medications/combinations.  The new psychiatrist diagnosed me as not having postpartum depression, but really "bipolar II in a mixed state," even though I told him I never feel the "high."  He said I was "agitated" and had "pressured speech."  He put me on Depakote and Celexa, with Xanax as needed.  I am still on these meds.  However, in the meantime, I have been divorced, have moved three times, and had three different full-time jobs.  I have used up my life's savings, partly on therapy (since the medical insurance only covers a small portion of it), partly on babysitting (even if I'm not at work, sometimes I can't handle my son and I need to pay for help if no one is available), partly on things to help me get by in handling my son (i.e., getting pre-made foods like Boston Market because I am not able to cook).  I have struggled through these past 3 years without hospitalization and still working full-time, thankfully, but I don't know how much longer I can continue, especially now that I don't have the money for therapy at regular intervals.  I now live closer to my ex-husband, who has agreed to share custody.  Usually my son spends 2 wks/mo with him and 2 wks/mo with me, since I feel I cannot handle him full-time.  I have dedicated myself to doing nonprofit work, partly because I feel it gives me a reason to stay alive (and with my son, there is not much time for volunteer work), but I don't get paid well.  Some people say I should go back to what I was doing before I had my son - corporate paralegal work - but I hated it and I don't see how spending so much time on something I hate is going to help my depression.  I guess the bottom line is:  how long does postpartum depression last?  or am I bipolar?  Am I treatment-resistant?  BTW, I have yet to find any books/resources on being a "depressed parent."  I have seen them for ADD parents, etc.  If you know any, please let me know.

[Roger Gould, M.D.]

Usually the diagnosis of post partum depression would not cover the 3 year period you described, so you might start rethinking about what is  going on without having a specific diagnosis.   YOu are depressed,overwhelmed, and don't have a good career path to go on.  NOthing in your life is working well for you.  That is the problem, and as long as that persists, you will be unhappy.

The question now is how to take charge of your life and get it moving in  the right direction.  That is what you should focus on in the limited treatment time you have.  You must find a way to get positive momentum.   YOu might want to supplement your therapy work with etherapy sessions which will move you along quicker.  Go to www.masteringstress.com.