I've been on a multitude of antidepressants, on and off, since I was 15 y/o. I wasn't diagnosed with bipolar until I was 24, so my teenage years were awful due to the misdiagnosis and being improperly medicated.

Since my diagnosis in 2014 I've been consistently on Lamictal 200mg. I was eventually put on both Seroquel 50mg and Zoloft. My memory and sense of time is garbage, so it's hard to remember, but I believe I was on that combo for at least a year. It was perfect...until it wasn't. I had my first big hypomanic/manic episode in 2016, which was awful and scary as I had a lot of paranoia and mild psychosis (I was hospitalized as a teen for depression with psychosis, so I use the term mild in reference to that time). 

I got off the antidepressants (which SUCKED) and stayed on the Lamictal/Seroquel combo. The only thing that's changed since then is I'm now on Seroquel ER 50 and Seroquel 25 instead of just the Seroquel 50.

I've had a lot of depression since then, at times with suicidal thoughts, with loads of crying and breakdowns. I also struggle with derealization/depersonalization, which is extremely hard to deal with and push away. It's exhausting to know that your next depressive episode is just around the corner, with very little peace in between.

But I'm terrified to go back on an AD. I had a second hypomanic episode (with no psychosis thankfully) last year, so the fear is heightened even more. But I don't know what else I can do. It's not that my depression is treatment resistant, per say, but more that it's guaranteed to cause mania at some point.

I've talked to my pdoc about ketamine, but they said absolutely not because (her words) it's not regulated and there isn't enough studies showing that it's actually effective, and what the long term effects are.

I don't want to do ECT because my memory is already full of holes and I have a hard time remembering things from a few days ago. My life is documented in my hobonichi (journal/agenda) and dictated by 10+ alarms, just so I can remember the basic things I need to do each day and so I can reflect back on what happened each day.

I'm absolutely at an end here. I don't know what else to do. I'm going to be 33 this year, and I've been dealing with suicidal depression since I was 12. I'm so exhausted with life, and I know this will never go away. I just want to have some semblance of normalcy, for more than a few months at a time.