Expert: Ivan Goldberg, M.D. - 10/30/2006

Question
Dear Dr Goldberg,
I am sorry my mail was quite rightly very unclear, I sent it very late and did not check it before sending it. I suppose I'm trying to say that I think I may be bipolar, I don't have big extemes of highs and lows but my moods do fluctuate a lot. Would you have any reccomendations for anyone I could ee in Dublin? I've just started taking seroxat 20mg a couple of days ago and would hate to think that I'm yet again on another ad when I shouldn't be. I'm sorry if my mails are slightly rambling but I am just about keeping it together at the moment.
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The text above is a follow-up to ...

-----Question-----
Dear Dr. Goldberg,
I'm a 39 year old female and my first depressive episode was age 7. Although I was not diagnosed until I was diagnosed with pnd after the birth of my daughter who is now 20. Over the years I have had on and off episodes of depression. I spent time in a treatment Centrex 8 years ago after my mother died very suddenly. (She had Schizophrenia) I believed for a long time that I had an addictive personality but honestly think now that they my be more to it. I thought I might be looking for a label to let me off the hook but in my gut it just feels like something else, something I can't pin down. Please help me to shed some light on this, I'm so fed up, I'm doing a degree in Ireland as a psychotherapist and really want to progress in this field but despite intense personal therapy, group work and supervision I still feel like a fraud, what worries me is that I could probably sail through my exams with flying colors. I'm already seeing clients. I don't want to be unethical. I would truly appreciate any advice you could give me

Kind regards

Sandra
Dublin Ireland

PS
Sorry this is so long

-----Answer-----
Hi . . .

I am a little confused by your message as I am not sure what you are asking. If you doubt the diagnosis of bipolar disorder, you should have a full psychiatric evaluation done by a psychiatrist with more than average experience.

If you wonder if someone with a bipolar diagnosis can do good clinical work, I can assure you that I treat many psychologists and psychiatrists who have bipolar disorder and that they generally do an excellent job of treating their patients.

If I have totally missed the point of your query, please get back to me and I'll see if I can do a better job of answering your questions.

Best regards . . .

Ivan
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Answer
Sandra . . .

If, in fact, you are bipolar, paroxetine by itself might just make things worse.

I do not know anyone in Dublin but as far as I can tell, the psychiatrists at St. James's Hospital seem to have the most experience diagnosing and treating people with bipolar disorder.

Best regards . . .

Ivan
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