The nice thing about Lamictal is that it does not cause weight gain. And if people have these recurrent, depressive bouts maybe with a manic episode here and there, but predominantly their bipolar disorder is of a depressive nature, Lamictal can be a very nice medication. Go very easy on your dosage for Lamictal. You're shooting for a dose of 200 mgs at bedtime, and you're going to slowly get up there at about five or six weeks. Go very slow on the dosage because the faster the dosage is kicked up for Lamictal, the more likely you're going to see the rash and the more likely you're going to have the liver failure that's associated with it.
Double depression is major depression with dysthymic disorder.
These people have been depressed since they were kids. They had a low degree of depression that might not have met the criteria for major depression, but they're always depressed. Even when they get well, they don't seem to all the way recover from the major depression. That's always hanging over their heads to some degree. The key with double depression is that it's difficult to treat.