A thorough investigation is needed into what precedes your episodes of extreme sadness. You have described them being random but that’s unlikely. Some event, mood or emotion precedes them and knowing what that is will help to determine what is wrong and how to fix it.
This is best done with the assistance of a therapist. You have consulted a psychiatrist but seemingly not a talk therapist. It is often the case that psychological problems require both medication and talk therapy.
Psychotherapy involves the intellectual analysis of thoughts and emotions for the purpose of identifying problems that are causing distress in one’s life. The therapist works with you to solve problems and teach you new skills to cope with the evitable problems of life. Psychotherapy could help to determine what’s causing your episodes. I would highly recommend it.
You have received one diagnosis. When something is important it is common practice to seek a second opinion. Whenever there’s uncertainty about a diagnosis or a condition, a second opinion can be useful.
Ask your primary care doctor for a referral to a therapist. You also ask your friends and family for a referral or you can consult one of the various directories on the Internet. Psych Central has a therapist directory as does Psychology Today.
In the meantime, start a journal. Track daily events and moods. It could help you and your therapist identify what’s causing these episodes. Please take care.
Dr. Kristina Randle