Introduction

The psychiatrist looks at me. I am pleading for antidepressants. I stumble, inarticulate, over why I think I am now depressed enough to warrant the magic pills. The words don't come out of my mouth. There is a loud roar. I wake out of the nightmare to the sound of the first plane of the day thundering over the bedroom. I stumble into the bathroom, decide I can't face a shower and head off to the kitchen to grab some coffee to wake me up and get me into the land of the living.

There is something horribly familiar about this scenario. It is the recurring cycle of sliding into depression, trying to decide if this one is a ‘normal’ depression or if it will continue as weeks of a bleak, grey existence – or if it is just the fear that the usual stresses of life will precipitate a depressive episode.

The early episodes of Bipolar II Disorder (BP II) are dominated by depressive bouts, with a few nice periods of high activity, creativity and elation to spice things up. But eventually, the periods of depression drive most of us to seek help. Life stresses, getting older, medical crises and too much risk-taking lengthen and deepen the depressions until, finally, it is hard to ignore that there is something badly wrong.

So – the diagnosis has been made and the treatment has been prescribed. Now what?