Antidepressants are not for everyone.
In fact, select individuals can get WORSE while on antidepressants.
Factors that predict a bad response include:
- Lack of a mood stabilizer (dangerous for bipolar patients)
- Bipolar I vs. II- the further you are toward the manic side of the spectrum, the worse the reactions tend to be.
- Recent manic symptoms- starting an antidepressant within six months of a hypomania or mixed state is asking for trouble.
- Rapid cycling- if this has occurred in the year before starting the meds, it may get worse.
- Past worsening- any history of worsened mood on antidepressants increases your risk.
- Younger age- the risk for young adults, especially children and teens, is great
- Substance abuse- The more recent the abuse, the higher the risk.
- Suicide- If you’ve had a past attempt, there is a greater risk of worsening on antidepressants.
- Genetics- Those with the gene for the short-arm of the serotonin receptor are at greater risk for mania as well as suicidal thinking on antidepressants.
Source: “Bipolar, Not So Much”
The Calculating Mind 