Inappropriate to Call Her Doc'? BP II & Mania & Psychosis
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Q:  Inappropriate to Call Her Doc' ? BPII & Mania & Psychosis

Dear Dr.Phelps

My mother has been told after fighting depression for over 20 years that she has Bipolar2 disorder.  I have a problem with her DX because from my understanding Bipolar2 patients do not become outright manic only experiencing hypo-manic symptoms and do not suffer from psychosis.   My mother admittedly see's things ,hears things I have tried to get her the help she needs but she flatly refuses to tell the doctor the truth about her Other symptoms and I believe her doctor does not realize the full extent of her illness because she fails to disclose what is really going on .I know that she has full blown mania and have witnessed her actions my whole life. I have been Dxd Bipolar1 myself and know the warning signs. I think she is Bipolar1 or suffering from schizophrenic disorder I have set up an appointment with my doctor for her in hopes of getting her help with someone who has a clue as to the disorder as her doctor is only a Gp . Is it inappropriate of me to let my doctor know what is really going on with her so he can help !her? Or do I just keep sitting by and hope she will tell him on her own.  Am I right in thinking Bipolar2 patients do not become frankly manic or psychotic?
Concerned Daughter Whos mom has Fallen through the cracks....

Dear Concerned -- 
In the way my colleagues and I practice medicine in Oregon, it is not at all inappropriate to call her doc' and let him know what you see in your mother in terms of symptoms (you can ask the staff to just let you leave voicemail, or put it in a letter; that way you won't be told "I'm sorry, we don't have a release of information to talk with you").  When families do that for me, when I'm not seeing some symptom they're seeing, I usually appreciate it (as long as it's done nicely, not "you clod, how could you miss blah blah"; or as long as it's a symptom that really shows up all over the patient's life, not just in the context of dealing with that family member -- which happens). 

Her doctor may be only a GP but if he figured out bipolar disorder, that's doing pretty good (which kind is less crucial, as you'll see in a moment).  Try to give him some encouragement, reinforcement, and appreciation while you're working on letting him know about the other symptoms, which you can do gently ("here's some stuff that as you've been working to help my mother you may not have been in a position to see...." and focus on what you observe, not what you interpret, that will get you listened to better).  

Finally, you're right all right: bipolar II is basically defined as bipolar disorder that doesn't become manic, i.e. doesn't get the psychotic symptoms (not that there's all that clear a line between psychotic and not psychotic; sometimes people who look like "bipolar II" can get some pretty hefty paranoid thinking without really getting overtly psychotic, so there's a spectrum there that makes these distinctions a little fuzzy sometimes -- though not in your mother's case, it sounds like).  

Dr. Phelps

Published August, 2002


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