Our expert says:
That's actually a very complex technical question I haven't the space here to answer in full. Elsewhere in this site you'll find a good description of these disorders. Basically, Depression is clear ; Dysthymia is a somewhat milder depression, spread out long and thin, lasting longer ; and Bipolar Disorder is normal Depressions which recur, but also includes episodes when your mood goes in the opposite direction, and becomes far too good, too energetic, too happy and unthinking.
Some people talk of a "Double Depression" when there is Dysthymia AND episodes of Depression on top of it.
The more recent addition of some u[pbeat episodes is harder to assessm without the benefits of a thorough examination and assessment. These could be simply small outbreaks of "normal" among the regular gloom. In Bipolar Disorder the shifts in mood are not so small and rapid --- a manic episode comes on over days, and lasts for days or weeks, even months, the mood shifts don't occur within a single day.
Sorry to hear that you've had bad xperiences in the past with psychiatrists and psychologists, but it really is worth continuing to search for one with whom you can work really well, and exploring differing combinations of treatments to find what works best for you. Similarly, persist in seeking out a psychologist who uses CBT ( Cognitive-behaviour Therapy ) as this might suit you well, either alone or in combination with a careful choice of medications. And clearly the continuing job stress must be playing a part. Really, though it may sound like more of the same, what is most likely to help is seeing a good local psychiatrist for a fresh re-evaluation of the whole situation, a re-assessment, and a discussion of treatment options. There are groups of antidepressants you haven't tried yet, as well as CBT. Apart from ACT / Shock Therapy, I'm not aware of any effective treatment for depression that doesn;t involve medications or talk-therapy / counsellign.
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