Expert: Ivan Goldberg, M.D. - 8/3/2006

Question
Thank you! If we can get her to answer the questionnaire truthfully and she scores in the bi-polar spectrum range, what do we do then? Can one of us bring her and the results of the questionnaire to a regular doctor and have them refer us somewhere or do we try to find a psychiatrist on our own?  
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Followup To

Question -
Dr. Goldberg,  I am a 43 year old female with 5 female siblings and 1 male sibling.  My family believes that our sister, 41, has bipolar disorder, though she has never been diagnosed (that we know of). She has been diagnosed in the past with depression, but has never stayed on any medication.  I do believe she has been on lithium which we believed helped her, but she removed the medication when it "slowed her down", i.e. she stopped running marathons.  She has been unable to keep a job in the US and has recently returned from China after several years (and jobs) teaching abroad.  We have all seen the BPD lists of symptoms and she has or does display at least 5 or more of the behaviors.  Do you have any advice on how we can help her recognize her disorder (if it is indeed BPD)?  She is very smart and manipulative and we believe has lied to many professionals in the past.  We feel that without some family input, she would likely do the same in the future.  Thank you.

Answer -
Hi . . .

Unfortunately many people with bipolar disorder would rather be untreated as they fear that treatment will cause them to lose their manic "edge." As it is said "There are none so bland as those who refuse to see."

You might try to sit down with your sister and maybe a few of the other members of your family and help her complete the bipolar screening scale to be found at:
http://www.psycom.net/depression.central.bipolar-screening.html

While she might insist that sh does not have any of the behaviors listed, it might help reduce her denial if the family points out to her how they would answer the questions if they were her.

Best regards . . .

Ivan
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Answer
Hi . . .

What you might do is take your sister to a psychiatrist with special interest in diagnosing and treating people with mood disorders. You might fill out the scale as you think your sister would no it IF SHE WERE BEING 100 honest and bring that along to the evaluation.

A list of psychiatrists who specialize in working with people with mood disorders may be found at:
http://www.psycom.net/depression.central.psychiatrists.html

Best regards . . .

Ivan
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