Does anyone know why depression seems to get better in evenings?

Q.Evenings are so much worse for me. It's when I stop and start thinking about how useless I am and how my existence means nothing... I usually sit there in the shower for like 3o minutes crying. Then go to bed and cry myself to sleep - never before 2am. Just to wake up the next morning exhausted. But at least college seems to keep my mind busy. Anyway, what does it mean? I mean, not displaying a "classic sympton"?

A.I think this is probably the most common. ("Simple mood-reactive depression" is what it is sometimes called.) Most people probably don't clearly fall into either of these categories. I seem to have a mixture of symptoms of both (awkward bugger, aren't I?) To answer the original question, I've found that during my last episode I tended to be worst very early in the morning (combined with insomnia), quite bad in the morning to midday, then finally not too bad in the evening. My doc said this was "typical" of depression, but didn't say which type. Is it working? If so, stick with it (assuming you are tolerating it okay). I should correct my statement on this subject; tricyclics do seem to work better than placebo for atypical depression in some studies. However, they are definitely not nearly as effective (i.e., are not effective as frequently) as monoamine oxidase inhibitors, either in studies or in clinical experience. Clinical experience has also suggested that SSRIs are more effective for this presentation than are tricyclics, though I know of no head-to-head studies comparing drugs of these two types in atypical depression.

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