A misdiagnosis of depression?

Patient

Q: I want a second opinion. I was diagnosed with severe depression eighteen months ago. After a recent medication switch to Zoloft/Sertraline, I became much more sensation seeking, relaxed about substance abuse, racked up lots of debt due to all the plans I made etc. After a couple of weeks, I decided to slowly take myself off the medication. After this, I experienced two weeks of extreme depression, unable to shower, work, feed myself properly etc.

In response to this, my doctor has decided to not prescribe me with any new medication. I have a history of bipolar disorder in the family, and she wants me to see a psychiatrist in six-eight weeks time so that it can be determined what I really have.

The last week or so (after receiving plenty of assistance from friends) has been much better. First time in months I've been feeling positive about the future. Slowly getting there. However, I'm not sure whether it's a sensible idea. I see both sides, obviously it allows medical professionals to see my behaviour without the use of SSRIs which could assist a diagnosis, however, I'm concerned that without them, I will slip back into old ways and become self loathing, lathargic etc over the next few weeks. Should a doctor be able to distinguish between depression and bipolar disorder from the get-go, why should it take six weeks to get a second opinion when it's my mental health in question?

Symptoms:  Sensation seeking behaviour, drug/alcohol abuse, restless/irritated/unable to sleep - followed by inability to 'live life', lack of motivation, unable to shower/sleep consistently
Doctor

A:   Hello
Thanks for using "Ask The Doctor" for posting your query.

The change in behaviour that you showed was a hypomania switch. It occurs in people who have a pre-disposition to develop bipolar mood disorder. At present, you are having a depression and in all probability, its a bipolar depression. You need not wait for this long to see a Psychiatrist as history is good enough for a diagnosis. You can request for an early consult.

Hope this helps,
Wish you a good health.

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