Pdoc' Overwhelmed by Family
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Q:  Pdoc' Overwhelmed by Family

Dear Dr. Phelps,
I have been seeing the same psychiatrist for two years and have been treated for ADD with Metadate, Neurontin and Effexor XR. I have not had a rage during that time and have functioned better than I ever have, but still had high anxiety all of the time.  I had one of my rages on Nov. 1st and have not washed my bed linens, dishes or kept my grandchildren since. I normally keep them almost daily and enjoy it. I prearranged with my doctor's receptionist to have my adult daughters attend my last session with my psychiatrist. We could all tell he resented this and he refused to answer any of our questions and left the session as soon as possible. He did prescribe Depakote and stated he thought it was bipolar.  I am so confused an hurt that he treated us this way.  I am still not responding to the Depakote after 3 weeks.  Any advice you can give will be greatly appreciated.                   


Dear Brenda -- 
First, you'll need to learn more about
Bipolar II.  Sounds like your psychiatrist got overwhelmed and may have felt blamed for not coming up with this diagnosis sooner; but you can use that website to learn more you might have learned from him. 

You shouldn't have to take care of your doctor's ego, but on the other hand, we're human and we can get overwhelmed (like maybe he had three other episodes of frustration that day before you got there and your family was just a "last straw" for him that day).  So you could remind him that you value his efforts to help you and tell him you've been trying to learn more about bipolar disorder; and then note gently that so far you're tolerating the Depakote okay but that it doesn't seem to be helping much so far (you get the idea...).  

If you're still taking Neurontin and Effexor, that might account for the lack of response to Depakote so far, so remember you won't get a fair evaluation of Depakote until you don't have antidepressants on board (DON'T stop taking them though; they have to be tapered, and your psychiatrist needs to lay out that plan); but there are other mood stabilizers to consider, as you can see.  

Dr. Phelps

Published January, 2003 


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