Q. I have suffered from depression since I was 19, with many visits to the doctor and medication I have been feeling good for the past two years. Within the past month or two I have started getting depression really bad again. I have been to my new doctor who has helped me see a lot of my depression has come from having OCD. He increased my medication which is Effexor, after the increase my depression got much worse and I am now having obsessive thoughts that life is pointless and has no point. I feel like there is no point in bettering ourselves or even enjoying anything because we are all just slowly dying anyway. I think maybe this could be another part of OCD/depression. Since we have lowered my meds back down these thoughts have eased a little but are not gone. My doctor now says it is possible I have bipolar disorder but I have never had any HIGH episodes just extremely low ones. Could bi bipolar really be my problem?

A. There is no way for me to know if you have bipolar disorder. You have not mentioned that you have any of the symptoms of the disorder. You only have mentioned that your medication has not worked. For many people with depression or OCD, their medication is not effective, but that does not mean that they do not have depression or OCD, it could just mean they have not found the correct medication or other types of treatments besides medication are warranted. Many studies show that psychotherapy is an effective treatment for depression and OCD. I would suggest that you try psychotherapy as way to deal with your issues, perhaps in addition to medication or as a singular alternative. If you have not tried psychotherapy for your issues, then you really have yet to deal with some of the reasons why you may be suffering from depression or OCD. My advice is to try therapy before you seek out other diagnoses. In my opinion and in the opinion of many psychiatrists the correct treatment always involves talk therapy. Thanks for writing.