Rely on psychologist, neurologist or (heaven forbid) psychiatrist?

Q: Dear Dr. Phelps, I recently read an article concerning neurologists versus psychiatrists versus psychologists and their views towards bipolar disorder. This seems especially relevant in my case- a history of (multiple) head trauma, child abuse and clear manic and depressive episodes with rapid cycling (and family history). I don't want to start a turf war between my specialists (who all genuinely seem to care about my welfare), but I'm confused about who may help me the most and their conflicting views. You seem so objective with your answers, I respect your opinion in this (despite being a psychiatrist, and I certainly don't mean that negatively). I also want to thank you for your hope essay, I came across it during a very difficult time. Sincerely, Judy P.S. My tendency is to lean towards my psychologist simply because I loathe taking medication, first because it doesn't really help and second, of course, the side effects.

Dear Judy --
First of all, I appreciate your feedback and especially to be accorded such confidence -- as a psychiatrist!   Actually, I think I understand that comment entirely and it makes your praise all the more ego-swelling, so thanks; I can use it just now, having recently been raked over the coals by a colleague for writing answers like these. 

All right, on to the matter you raise: you are wisely sensitive to the "turf wars" issue, and to treading carefully around doctors' egos.  There may be a relatively simple answer, unless your symptoms press for a relatively rapid treatment approach, namely the "proof in the pudding" method (this is too obvious to mean much as advice, really): pick one, rely on her/him, see if you get better, and if not, pick the next one. 

Not that simple, surely; what do you do with the others' advice in the interim, e.g.   On that I can't comment as I'm not sure what they're offering you.  At minimum you could keep a mood chart so as to be able to evaluate the "treatment" each offers.  Your perspective and humor ought to help you hold course.  I hope so for you.

Dr. Phelps


Published February, 2001