Not always manic. I was on Elavil for 2 years before I got suicidal. Finally, they put me on Lithium. It made all the difference. AD's are bad if you're an undiagnosed beeper.

I've been on Seroquel for about four months now. It's working well for me overall. Best of luck in your search.

I have been on psych meds for over 30 years. I think I have been on every psych med known to man at some. point. But the meds have gotten better over the years, more effective with fewer side effects. There are a few things that I have learned over the years: 1.) You may get on a certain regimen and it will be effective for a while, but it may stop working at some point or new symptoms may present themselves, necessitating a retooling of the meds.
2.)Do not change dosages. self-medicate, or go cold turkey off of any medications because it could kill you.
Working closely with your psychiatrist and having good communication is key to good med management and good symptom management.

It's a trial and error process. I was diagnosed w major depression, gad, and panic attacks. Just got diagnosed w bipolar 2. Antidepressants did not work for me, in fact some made it exponentially worse. I just started lamictal and vistaril (for sleep and anxiety). I was already taking Xanax tho I foresee coming off it eventually. The lamictal will take weeks to months to work. The vistaril thus far has done nothing-I should be asleep right now. Trial and error. Everyone is different. Good luck!