Dear Dr Phelps
1st I would like to tell you how much information your website has given me and hope that someone will eventually help my daughter.   My problem is that my daughter's psychiatrist does not seem to agree with the treatment approaches you have mentioned for bipolar (II).  I printed off and gave her your website info. so she could see your findings and maybe try a new approach for my daughter but she told me to stop reading and just let her be in control and let her be the boss (pretty much exact words).  She has my daughter on Effexor 375mg , Seroquel 100mg and wants to try another mood stablizer -Tegretol.  I asked her if we could start to lower the Effexor since my daughter's depression is not the problem now.... it is the poor concentration, and memory, irritability, anger, and poor sleeping.  She said no.   She does not seem to know anything about bipolar II. I guess my question is... Are there many doctors that acknowledge bipolar II and treat it in or around the western Pennsylvania area???   By the way, Western Psychiatric does not seem to know much about bipolar II either. (I noticed it was on your referral database.)   I am so close to just coming out to you to have my daughter evaluated but thought I would see if you knew of any doc's near me.  Thanks for the time.... let me know info. you have.      

(ps. my daughter is 16 y.o.)
 

Dear Ms. R' -- 
For those others besides Ms. R' who read this, let her experience serve as a warning:  this is an unfortunately common outcome of handing to a doc' something you found on the internet.  Doc's are not well-socialized to accept this practice, as you may have seen, and as evident here.  It's a threat to their need to run the show, and when you're prescribing medications with substantial risks sometimes, maybe that "need" is understandable to some degree, but it would be nice if the usual response was more open-minded.  (could take up a fair amount of time, however, which many doc's do not have or feel they have). 

Anyway, sorry you had that experience.  What to do now?  Well, you might start by paying privately for another opinion right there in Pittsburgh, which I presume is where we're talking about.  Ironically, the Western Psychiatric Institute and Clinic there is world famous for the treatment of mood disorders and is a major participant in the Stanley Foundation Bipolar programs, e.g. something called STEP-BD, a bipolar research program, and other Stanley-funded programs.  So it's ironic to find a closed mind to your suggestion there, and should be relatively easy to find an opportunity for a second opinion.  You could start by posting on the BPkids message board for a child psychiatrist in that area someone thinks is good, or try ditto on this site (the CABF site comes to mind because the director is in Pittsburgh!)  Even just casting around within the WPIC ought to yield another psychiatrist who's possibly more open to your point of view, I'd think.  Good luck with that. 

Dr. Phelps
 

Published July, 2003