For two years I coordinated a project in Oregon trying to improve primary care physicians recognition and treatment of simple depression. Talking with more than a hundred of your colleagues, I am repeatedly struck by how many patients with mood disorders you see and treat. Many of you are effectively functioning as mental health specialists, often not by choice! Most of you are extremely frustrated at how hard it is to get a patient to a psychiatrist, even for evaluation.
At the same time, a new understanding of bipolar disorder has been evolving in Psychiatry. There is still substantial controversy about it, but the "new" diagnosis of Bipolar II has begun to change the way we think about the entire spectrum of mood disorders. Yet primary physicians have had no clear help learning about all this. So this site is designed to:
I have asked Abbott Labs, makers of Depakote (slow-release valproate), to fund this site. They provided a substantial grant with no strings. This was my idea, not theirs. I receive no regular funding from them.
Since that time I've also requested and received grant support from GSK, makers of lamotrigine. I liked lamotrigine long before they received FDA approval for its use in bipolar depression, so was singing its praises long before there was any money involved. Now, there is. See my essay on Funding re: how I use pharmaceutical company support for lecturing to pay for this site.
This site is not intended to substitute for evaluation by a mental health specialist. By learning more here, I hope you may develop a sensitivity to these bipolar variations; but if you are able, in most cases you should refer them to a psychiatrist. If you have a suspicion about this diagnosis and do not have access to a psychiatrist, often a good local therapist (Ph.D., MSW, or LCSW) can be helpful with a diagnostic assessment.
However, some of you may have access to neither, or the patient may be unwilling to go. Under these circumstances, Im sure you feel like you could use some help. That is the purpose of this site.
Hopefully you are asking yourself "Can you trust what I find here? Is this part of some sort of "bipolar bandwagon?" I hope you'll find those concerns addressed. Wherever possible this presentation will cite widely accepted expert literature, much of which you will be able to access directly on-line. Unreferenced statements can be regarded as my opinion and should be evaluated as such. Controversy in the psychiatric literature will be acknowledged.