Bipolar depression and meds

To be fair, I've been in much worse states than this years ago. In 2006 I was hospitalised for depression and was lucky to survive. Since then the meds and good lifestyle kept things mostly under control. There was frequent depressed mood, but never enough to seriously impact my generally high functioning life.

So for 11 years things were bearable, the meds, lifestyle, and CBT strategies kept things manageable. So I now sometimes struggle to understand why the depression has hit me so hard the last 10 mths and why no variety or amount of meds seems to be able get it under control. One of the meds has helped but I have also piled on 15kg of weight because of it, and sometimes I get these very unpleasant 'extrapyramidal symptoms' with muscle tension/tightening at night. If the dose is lowered, the appetite reduces but the depression spikes again.

My mood fluctuates like the wind. When I am feeling unusually happy, I have to unfortunately remind myself that this means I am still unwell, and the more un-naturally high I am the harder I will come crashing down. Overall the number of good days has increased, but the bad days hit me hard. Sometimes I think, how is it possible to cope with this agony of depression? But in the worse case scenario, I have a good safety plan to make sure I get whatever help neccessary before I ever became a danger to myself. I can smile and converse, and work apparently normal, but if only people could know what is really being felt inside.

When I feel like I can't cope, I often tell myself that I have to find a way to cope, there's no other option. And there are still some behaviours ('behavioural activation') that can help and provide at least some relief.