Q:  Have a Serious Problem & Uninsured

I am reaching out because I know I have a serious problem.  I have been unable to find help because at this time I am uninsured.  My problem is this: these past few months I have been getting extremely emotional (psychotic) the day before and during my period. I feel extremely out of control, my kids are nothing but a nuisance to me during this time, and I have considered trying to end my life.( I love my children so much) All of these feelings subside as soon as my cycle is over, and I realize how irrational my thoughts were. My husband notices that I am sometimes out of control, but he isn't worried. I feel disconnected during these times, and I am terrified of my next cycle and what I might do. I don't know what good it will do to send this off to you, but I am desperate to find help. Thank you


Dear Sonya -- 
This sounds really rough.  Your husband is either thick-skinned or very patient or you're doing a very good job coping while having these symptoms.  I wish there was an easy, cheap medication I could steer you toward.  If you asked some of the OB-GYN doc's you might well be given an antidepressant like Prozac or Zoloft or Celexa.  

However, here you are writing on a bipolar website, so something has made you think about bipolar disorder (perhaps someone in the family with something similar and diagnosed as BP, or looking more truly "bipolar").  Or maybe you read my musing about the relationship of bipolar disorder and premenstrual symptoms on my Hormones and Mood site, which remember are just opinions and speculation at this point.  But in any case, I'm glad you're thinking about the "bipolar" angle, because that may be warranted and thus antidepressants might actually have some risk -- but the information we have to go on there is extremely limited.  

And thus I can't recommend something simple you can pursue, even though if there was one I'd have to be trying not to do that because somebody might say I was diagnosing or treating, which is a no-no still at this point on the internet.  So instead, I'd recommend that you try to scrape some money together and see a primary care doc' (they're cheaper and easier to get to than psychiatrists) and see what she/he recommends (people use to work a second part time job to pay for therapy, so I suppose you could take that approach here too).  Often doc's have samples of med's to try so you can find out if something works before having to pay for it; and there are programs to help there too (e.g. see NeedyMeds.com, a remarkable resource).  In any case, and especially if this gets any worse, the most important thing is to get treatment and often a medical system will offer that first and figure out the money later (e.g. most emergency rooms operate like that, and that would be the place to go if things are no longer in control). Good luck to you. 

Dr. Phelps