this may be of some help:
http://www.vakkur.com/psy/mood_faq.htm
it seems the worst problem is a bipolar individual in a depressive episode. it's apparently just as bad as someone suffering from a major depressive episode but the use of antidepressants run the risk of triggering a manic episode. when i say "worst problem," i mean that from the point of view of the medical practitioner. the hope is that antidepressants when combined with a mood stabilizer (e.g., zyprexa, some form of lithium, tegratol, and depakote) will prevent a manic episode while reducing the severity of the depressive episode.
it's critical, it appears, that medication alone is not to be relied upon to relieve the symptoms. for example, if a bipolar person takes his mood stabilizer religiously but still does a few lines of ice to stay up for three days, then that's kinda like taking aspirin for the headache you get from banging your head against the wall. likewise similar to a person suffering from major depression religiously taking their antidepressants while still chugging the booze. btw, the depressive effects of alcohol last much longer than the initial buzz that lasts for only a few hours. often, one is not even aware of how depressed they are (or how manic they are, if bipolar).
depressed people who drink (in general, take depressants) and bipolar people who take stimulants (including even caffiene, sorry, but especially something like speed or cocaine) are simply playing with fire. I've heard bipolar people say that caffiene affects them the same way cocaine did before they were diagnosed with bipolar except that the high lasts much longer (caffiene has a half-life of eight hours!). the same would go for a schizophrenic who takes a hallucinagen.
another element in this is the distinction between thought disorders and mood disorders. there is such a thing as "major/minor depression with psychotic features" and "bipolar disorder with psychotic features." such people have elements of both a thought and a mood disorder. it can be difficult, sometimes, to tell the difference between someone who is bipolar or depressed with psychotic features from someone with schizophrenia. there appears to be a spectrum with pure mood disorder on one end and pure thought disorder on the other end. someone with a pure mood disorder never has hallucinations or delusional beliefs. i don't know much about how to characterize someone's mood patterns with a pure thought disorder. i suppose that's because it's hard for someone's mood to not appear irregular if they have a thought disorder.
i've heard two rough criteria for distinguishing between depression with psychosis and a thought disorder and between bpd and a thought disorder. for the first, the person usually knows that the hallucination is a hallucination while someone with a pure thought disorder wouldn't know the difference. being of the second variety, i asked my doctor if i had schizophrenia. he simply asked if i had any friends. since i said yes, he said i don't have schizophrenia. didn't seem very scientific for I've known schizophrenic people who've had friends (but my sample group has only n=2 and wasn't a simple random sample).
phoenix