What's the scoop on slow metabolism and BPII.Is it thyroid related? I'm getting so much info on this(only recently diagnosed after5 years treatment for GAD)that my mind is exploding.My new DR. is Really slow to tell me much.Old School I think. Oh well--Do no harm.In the meantime, I'm trying to do as much as I can with safe vitamin supplements.I've got him to reduce Wellbutrin to 100mg daily,but he still gives me doxepin or hydroxyzine(?) to sleep.Zombie,no doubt. What's next? I'm having pretty severe anxiety/stress related,episodes,sleeplessness,if I want to get up before 2pm.Too many questions--so little time. Thanks for your site and all the help--Wes

Dear Wes -- 
The way you write and apparently -- on that bit of evidence -- think, you're on the right track.  That is, you're asking very good questions here.   You arrived at the thyroid question just as I have begun to have some success treating people with thyroid hormone after the pattern one can observe is used at the NIMH.  If you haven't already found my new update on thyroid and bipolar disorder, that will tell you what I know so far on this clearly important subject. 

As for what's next, if you're stuck with your Old School doctor (how kind of you to recognize and invoke the "do no harm" concept as an explanation for "old school" behavior -- very fair and appropriate), you seem perhaps to be having some luck over time bringing him along.  You could direct him to my site for the provider's version of a rap on bipolar II -- would he go?  Or print some of it for him to review?  

The "open mind" approach you seem to be describing as your own experience is the key to progress in this murky area; if you can induce some of that in him, you'll have done well, as well as hopefully getting access thereby to some different approaches, like a trial of T3/T4 or other "mood stabilizers".  Good luck to you in this process. 

Dr. Phelps