@tisme: I made it to 59 and a lifetime of deep depressions and finally a hospitalization after an extremely close call before I received a bipolar 2 diagnosis. I'd been on Effexor for quite a few years prior, and as it turned out, it had been amplifying my depression to the brink of self-harm. It's an uncommon but not unknown response.

It's worth talking to your psychiatrist about this potential. Mine had never seen a case until she had me as a patient. I was the one who found a study on PubMed that detailed exactly what had been happening to me. And that was only after quitting cold turkey in another self-destructive rage (not easy and not really recommended) . Within days my depression was easing, not worsening as I both expected and had intended. That's when I went digging.

My wife picked up on it faster than I did. She came home five nights after I quit and I was singing along with some music. I hadn't told her yet, so she had no grounds for thinking something had changed.

"You're singing," she said. "You used to sing all the time. I haven't heard you sing in years."

"You're singing!"

For the first time in years, I was genuinely happy right then.

Despite horrific withdrawal symptoms, I was determined to ride it out after finding the study (I've since found another on BMJ). It became a matter of saving my life from myself, and it did. I didn't inform my psychiatrist for a week, I had to get over the anger that had motivated me to quit first (extreme rampages and serious dishonesty had also become factors; I didn't tell my wife until after I told the doctor). I arranged an appointment walked into her office yet a week later with an entirely new demeanor regarding my depression. She was skeptical about my claim when I arrived, but within half an hour couldn't deny the evidence in front of her face.

I'm still seeing her, and I told her I don't harbor any resentment over the fact that she initially kept me on the Effexor and had added a mood stabilizer. I only began seeing her after being released by the hospital, and she went with the standard treatment. She also didn't want to shock my system by withdrawing the antidepressant, which my MD had prescribed years earlier. I get why she did it. And she's the one who made the bipolar 2 diagnosis, which I believe is correct because it explains too much of my life.

She put me on Lamictal, which has made the difference between night and day. I've basically been in a good mood for two years now, nonstop, and this is after decades of deep cyclical extended depressions hitting me several times a year. For the first time in my life I feel the darkness is truly gone.

I'm still seeing a counselor. Talk therapy is essential. Especially because it terrifies me how close I came to ending it. That's one moment of fear I don't think I'll ever be able to fully come to terms with. But the gratitude that I'm still here can't be understated.

It's worth discussing this with your psychiatrist, and getting a second opinion if they don't consider it a possibility. I'm not saying it is the cause in your case, I'm not qualified to do so. But I am saying it's a potential. And since you're saying your depression is deepening, which is what happened to me, it should be looked into in my opinion. I marched right up to the brink before realizing what was going on. I don't want anyone else to go through what I did.

@tisme I can relate to over-doing it during a (hypo)manic episode. I come up with a list of things I can do ahead of time that aren’t super intense exercise which is what I would otherwise default to. For example, I can exercise, but for no more than 3 hours a day, and no later than 7pm. If you can think of active but lower intensity things, that can be good. For example walking, yoga, bouncing on a yoga ball, dancing to music while cooking, etc.
otherwise I have found that I simply run way too much, do too much intense yard work, and I don’t stop to eat or drink. Finally it catches up with me as is tale as old as time with bipolar cycles.