Expert: Ivan Goldberg, M.D. - 10/21/2007

Question
Hi

I am looking for understanding into my "bipolar" illness which i have battled with for many years.

Are you someone who thinks that it is a chemical balance or not?

I have always tried to combat my condition without drugs but now am trying st. johns wart to try and stop me having all these very negative thoughts.

Could you maybe advice me on how to treat this?

Thanks

Toby

Answer
Hi Toby . . .

Bipolar disorder is a disorder that has biological, psychological and social etiologies. To treat such a complex disorder with just one modality of treatment, for example with medications or herbs, without dealing directly with the psychological aspects such as the morbid thoughts is usually much less effective that a multi-modal approach.

When I see someone with bipolar disorder who is having negative/hopeless thoughts I usually start them on Lamictal as a psychopharmacological treatment for the bipolar depression (See: http://www.psycom.net/depression.central.lamotragine.html) and refer them for cognitive therapy to deal with the negative/hopeless thinking (See: http://www.depression-guide.com/cognitive-therapy.html).

Best regards . . .
Ivan
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