Where Else Can I Turn?
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Q:  Where Else Can I Turn?

Dear Doctor Phelps:

I was diagnosed with bipolar II shortly after experiencing debilitating anxiety attacks. I was put on Paxil and then referred to the County Mental Health organization (I have no insurance) The Psychiatrist diagnosed me and put me on a combination of Depakote and paxil. Shortly after that I became pregnant, stopped my meds and all my symptoms went away until 3 months post partum. After reading extensively about BPII (there is little research available mostly) I knew that this was not uncommon to BPII. Now my dilemma is that I am breastfeeding and a stay at home mom with no support system and no way to seek treatment. Coutny Mental Health could not "fit me in" for two months after I became pregnant and stopped taking my  medication-their version of a crisis line consisted of a 20 year old 3rd year undergraduate with no life experience. I feel unsafe using them as a resource.  I talked to my family doctor at the clinic and he told me that there are virtually no resources in my area for BPII patients and good luck. This is the abbreviated version of my story.  My life is falling apart, I feel isolated and unable to help myself or to seek help. My husband is wonderful, but barely able to cope. I am afraid that my family will fall apart if this coninues any longer. So far I can take care of the baby without freaking out, but it takes every ounce of self control I have. Is there anywhere else to turn?

Your response would be greatly appreciated.


Dear Andrea -- 
Some people including the American Academy of Pediatrics feel that breastfeeding while taking Depakote is safe for the baby.  Even paxil is thought by some to be safe as well, as not much (though some, just like Depakote) gets through.  I can't tell you from here what to do while you wait for your county appointment, but I can give you information.  In many doctors opinion, even taking a medication that has a small or unknown risk to the baby (as above) may be justified if the mother's health is really compromised by being off her medications: the assumption is that the kiddo will be better off in the "big picture" if she's much better off.  I suppose you could even discuss this perspective with your family clinic doc'.  Have you read from my site about
basics of treating what you have?  You'll see there that I've encouraged primary care doc's to learn how to do just what you're after.  There's even a letter there for your doctor, you'll find.  Good luck with that. 

Dr. Phelps

Published November, 2001


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