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First time poster, long time reader. I've gotten so much advice from this site so I'm hoping someone can help me try to figure out what's going on with me or at least lend some advice.

I was first diagnosed with MDD at 19 years old during an 3 week inpatient stay after a severe, paralyzing depression, with anxiety, from a traumatic car accident. I'm now 40 years old and have suffered 4 moderate recurrent episodes, including this current one that slammed me out of blue about 6 weeks ago. I should also mention there is family history of bipolar, addictions and unipolar depression, so I'm well versed in symptomology, treatment and therapy.

Anyway, this current episode of depression is VERY different than any other episode I have suffered thru. I have no problem with motivation, concentration or energy and my mood is decent most days. I get up every morning at 6am (although I'm usually awake at 4a or 5a) with no problem and shower, get dressed, take care of my 2 dogs, drop my teenager off at school and then to work for an 8 hour day. Weekends are a little lazier and although I'm usually awake by 430a-5a, I don't get out of bed until 830a-9a. 

Here's the dilemma...besides some days here and there that I feel hopeless, the biggest problem in this episode is insomnia and suicidal thoughts and intrusive thoughts. Just this morning, while laying in bed before I got up, I was thinking what my suicide plan would be and then had a disturbing image of my wrists being wrapped in gauze. Then I started thinking about who would miss me, what would my obit say, how many people would be at my funeral and what would my note say.  I have NEVER had these thoughts in this intensity or this many in any other previous episode, at least to this extent. But as disturbing as this was this morning, I still got out of bed, showered, took care of the dogs and came to work like it was just a normal day. And the thoughts went away, for now.Needless to say, I find this very disturbing and nerve racking, because I don't and can't understand why I feel like my normal self during the day and then the dark thoughts are rampant in the morning when I wake and sometimes before I sleep.

About 4 weeks ago, my podc started me on Prozac, thinking it would be best for the ruminative, intrusive thoughts. However, about 12 days on 10mg, it was clear I was having a paradoxical reaction as the depression, intrusive thoughts and crying spells got worse and my mood was Ultra low. So, the pdoc changed to Viibryd and Seroquel and Gabapentin. I've now been on Viibryd for 24 days total (7 days at 10mg, 7 days at 20mg and 40mg for 10 days). Seroquel 200mg at bed with 600mg Gabapentin and 50mg Vistaril to help with insomnia. I also take 25mg-50mg of Seroquel at 9a, 1p and 5p as an adjunct to the Viibryd. 

So, what gives?

How can I feel completely normal, like I'm almost back to 100% me but then be plagued by suicidal and intrusive thoughts at the same time?!? Is it simply a matter of that being the last symptom that will abate with the meds or do I need to ask pdoc to change meds again? I really hate to do that bc the Viibryd has worked so well for the anxiety, motivation and energy and mood. 

Has anyone else ever experienced this?

Any advice, suggestions or feedback would be much so much appreciated!


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Welcome to CB!

I'm sorry you are going through this!

I've been fine on prozac for years, but it is known to cause suicidal thoughts and mania. 

I haven't been on the med combo you are currently on, so I can't really comment on that.

All I can think of is to talk to your pdoc (psychiatrist) about this.  Your pdoc is prescribing the meds, and I think would appreciate knowing how you are doing on them, good and bad.

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yes...I had a suicide attempt while totally functioning. Also have had self injury during manic episodes. If it were me (with all my web md doctors deegrees ha) I put the intrusive thoughts into more of an antipsychotic category. The only thing that stopped them for me was clozaril added to lithium. Now obviously Im not saying go get some clozaril, just that in my experience some aps are better than any of the 5 or 6 ads ive tried. That said- my pdoc just told me in the course of a conversation (not about me) that he's had pretty good luvk with viibryd for what its worth. im bipolar so my reactions will obviously be different, but if symptoms continue I might consider titration to a high dose of Seroquel or trying a different aap...of course the viibryd could work and maybe it wont come to that

stupid me- 300 is the max for MDD, so your already there. But I still think you could go up if you really had to

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Melissa & Iceberg: thank you for your reply!

Iceberg: Out of curiosity, were you on any ADs when you were highly functioning and had the attempt? I'm sorry if that comes across as offensive, I'm just trying to wrap my head around all of this.  So far this particular episode is very atypical for me so far, so trying other atypical meds is not out of consideration. Are you able to function and work on clozaril? I'm a single mom with one source of income, so I can't be on anything that jeopardizes my job. But on the other hand, if I land in the hospital, I won't have a job anymore anyway. I've never had a manic episode myself, but have seen my sister suffer thru them and I don't think I'm in a manic phase, but then again I have no idea what it feels like, so I really don't know.  I am at the point where I feel ok mood wise, have some energy, and anxiety is pretty much under control BUT these intrusive thoughts are scary and SO annoying. 

Thanks so much again for your support!


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I was on no meds actually for the suicide

i was on an geodon and trileptal for the manic thing

i would only use clozaril if you've tried everything else...there's a big adjustment/sedation period and like every side effect in the world. But it gets rid of my ideation for the most part

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