Here are some of our experiences with quetiapine for reducing depression, hypomania, anxiety attacks/flashbacks (it’s hard to tell the difference for us), and obsessive thoughts:
One of the biggest things quetiapine did for us was to make it easier to release thoughts. By making it easier to release thoughts without acting on them (ie. “we should look up information on x” or “we should send an email about x”), it made it easier to lie there and do nothing. Before, when we had a thought like that, we always went and acted on them immediately or fought hard to be able to do nothing. After, it was much easier to put the thought aside and to come back to the task two hours later if the thought still feels important. This made it much easier to set aside an hour or two for lying in bed and relaxing.
Another thing it did was to make it easier to fall asleep, to sleep for longer, and to maintain a regular sleep schedule. For us, quetiapine knocks me out about an hour after we take it every evening. For most of my friends, this happens about 2 hours after they take it. Before, we would often wake up early after only ~7h in bed and feel we had to get out of bed to do something. Afterwards, it made it much easier for us to continue lying in bed until we spent the full 10h in bed I need to maintain our mental state.
In the model we am currently working under for myself, hypomania is dealt with by making a conscious decision not to do things we want to do because it would be bad for our mental state. For example, we recently started wanting to play more video games. Unfortunately, playing more video games consumes spoons we do not have and takes us into hypomania territory. We had to consciously come to the conclusion that playing video games was not something we could do while maintaining our mental health and had to remove it from the list of things we consider ourselves able to safely do. Quetiapine helps immensely for this because making it easier to release thoughts without acting on them makes it much easier to say “we want to play video games, but can’t because it would threaten our mental stability” and to not play video games.
We haven’t actually tracked how quetiapine affects depression. For us, depression is just something which exists and which we don’t feel the need to actively do something about. Lying in bed suicidal most mornings is simply a part of life and any attempt to fix that would run the risk of making us more manic. We consider depression to usually only be dangerous when it chains into the post hypomania crash and so focus almost entirely on reducing hypomania and using our depression and suicidal thoughts as a chance to look at our life in a more self aware way.