I am diagnosed with bi-polar and I am currently taking celexa (Citalopram) as prescribed. I have been having issues with med compliance lately. About a month ago I started to feel a low mood coming on and I stopped taking my medication for a about a week. It was horrible, I was a tearful, agitated, exhausted, aggressive, and I called in sick for work ALOT.I resumed taking my medication and it improved 100 percent. Recently I have been starting to feel like I am coming down again, and I know that stopping the medication isn’t a good idea but I find myself wanting to. I feel like it’s a natural cycle and while I’m feeling “happy”, I feel like it’s fake happiness. I feel like I miss being depressed. Like I lost my comforting best friend by taking this medication. I know my life is terrible without the medication but I like to feel even if it’s pain, and I feel like the medication makes me feel nothing. I know it sounds strange but I’m unsure of what to do. I guess I’m just looking for an answer as to why I feel like I miss it and also if there are other medications maybe that might let me have feelings without getting horribly depressed.

A: Thank you for writing such a clear letter about your experience. I would like to begin by reframing what you have said, then make a suggestion.

With any emotional state we develop a familiarity with it more than anything else. I doubt you miss the actual depression, but the familiarity of it provides you with a sense of comfort. My grandmother made the worst Irish soda bread every Christmas. No one liked it. But the first year she didn’t make it we were disappointed because it had been such a familiar part of the routine.

The suggestion is “dare to be happy.” Changes in our emotional makeup can make us feel unregulated because we are losing the familiarity. My strong encouragement is to make your medication an adjunct to individual or group therapy to accelerate your healing process. You can find help at the tab at the top of this page. Study after study shows that the combination of medicine and psychotherapy is the best way to facilitate change.

As for my Christmas story? Eventually we all brought more and better desserts, and once we did, we never missed the Irish soda bread.

Wishing you patience and peace,
Dr. Dan