totally agree with ya chris. pain takes so much from us physically and emotionally that i think the inevitable is that we fall into depression. and when it is ongoing that can then manifest itself into clinical depressions like PND that require extra help and support. i guess the only advice i can offer (from my own experiences) is maybe instead of trying to change meds while your body is still undergoing MASSIVE changes with the mirena is to take out a few extra sessions with your counsellor through the really bad moments. i know that it can get exxy to do that, but i reckon it is less of an hormone assault at a vulnerable juncture ITMS. then, once you feel in a groove on the mirena then do a revaluation of the meds...just a thought of course!