"i experienced only adverse reactions to ssris and tcas thanks in part to being bipolar, but tramadol has been a god send for my depression. i was sick and tired, literally, of trying different medicines only to have my mood get thrown around crazily. tramadol worked when nothing else could touch the depression. i take it twice daily. could not live without it. i am so thankful that my psychiatrist is open to new ideas and tried this, i only will encourage others to try this also. because of the tramadol i am now recovered from any form of self injury - i am free for over 3 years.  it works. simple."