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Ask the Mental Health Expert Archives 2001-2004

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Psychiatrist for Bipolar Patient

Q. Is there a website, organization or way to check the credentials of child psychiatrists to know if they have a specialty? My daughter was diagnosed with major depressive disorder and her psychiatrist tried her on Zoloft, Paxil and Lexapro since December.

Her symptoms became worse on each one and my husband and I even had to take time off from work. Her tempers became violent and prolonged. I read a book on "The Bipolar Child" by Drs. Papolos and see so many of those symptoms in my daughter. The book said that bipolar children have severe reactions to antidepressants. I hope she is not bipolar but would she have such reactions on antidepressants if she wasn't?

Is there any way I know if I chose a good psychiatrist? I don't want her to be a guinea pig for him to experiment with medication. Can you help me?

A. I believe that the questions you are raising about your daughter's diagnosis are important ones. The work of Drs. Nassir Ghaemi, Hagop Akiskal, Janet Wozniak and others suggest that bipolar disorder is often under-diagnosed or misdiagnosed in both adults and younger populations. While I can't comment on your daughter's case, a poor or paradoxical response to antidepressants is one warning sign of missed bipolar disorder.

You can probably find out about Board Certification of child psychiatrists via your state or county branch of the American Psychiatric Association. However, this will not tell you much about the special expertise of individual doctors, with respect to bipolar disorder. I personally would suggest one or both of these alternatives:

1. Contact the chairman of the department of child/adolescent psychiatry at a major academic medical center near you; be assertive and persistent! Ask him or her for the names of experts on bipolar disorder in children, in your area.

2. Contact your local branch of the Depression and Bipolar Support Alliance (http://www.dbsalliance.org or call 800-826-3632) and ask about local experts in childhood bipolar disorder.

If you don't get better results in the treatment of your daughter, be persistent--and, if necessary, consider having your daughter evaluated at a mood disorders clinic at a medical-school based department of child psychiatry. Make sure they are aware of the bad responses to antidepressants your daughter has experienced. Good luck!

Other Resources:

November 2003

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