I am diagnosed by my doctor as to have bipolar disorder. I am under medication for last 9 months. But I am still depressed. I am prescribed to take Divalproex Sodium 250 m. G. And Fluoxetine 40 mg a day. What should I do?

Dr. Saul PereiraPsychologist46yrs exp

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It can be a crippling disease if not treated, and if treated early, the prognosis is good. So quickly visit a counsellor apart from your psychiatrist and you must then follow the medication and therapy prescribed. Comply with all the medical prescriptions and work in tandem with a counselor for a long time and learn coping skills and techniques to handle the daily challenges you will face. There are certain adaptations that will suit you during the elation phase and there are certain behaviors that are required during the depressed phases. In the meantime, you can do certain things that will give you benefits anyway. Emotional therapy will alleviate a lot of the problems faced in this condition because it is a mood disorder. You need to particularly look at your levels of anger both for its reasonableness and to express it in an appropriate manner. I suspect that much of this anger may have origins in early childhood that you may never be aware of now. Talk to your parents and explore that angle. This information will help the counselor too. Also, you will need to check whether there is any genetic factor involved. You must exercise regularly, eat healthily and sleep normally too. If your motivation and cooperation are good much can be achieved. You must have a time-structured schedule filled with interesting and reasonable activities and it must be monitored for compliance and delivery. The reason I say this is that many times you will be inclined to have grandiose notions and confidently believe that you are doing fine and that you can do without the medication. This will set you back many months in the treatment and delay and sabotage the recovery: forewarned you are forearmed. If this combination of medication with therapy is maintained for at least three years without any episodes or breakdowns, it is possible to taper the medication in consonance with the doctor. 

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