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Dr. Michael
Dr. Michael, Psychologist
Category: Mental Health
Satisfied Customers: 2177
Experience:  Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
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Hi, We are in xxxxxxx . My husband had xxxxxx xxxxxxx

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Hi, We are in xxxxxxx. My husband had xxxxxx xxxxxx (II) before we were together. When I first met him he was recovering from what seemed like normal depression. During our time together, his well regarded psychiatrist agreed that he could stop taking Valproate as my husband felt his condition was fine. The psychiatrist reluctantly agreed. This was maybe 3 years ago (guessing, can't remember). Anyway, since then he has been fine, however his mother died last July and he got what seemed to be a bout of reactive depression. He was also just into a new job with much greater responsibilities than his past role, but enjoying the challenge enormously. Our daughter turned 1 in July also. I identified the depression as he was (too) tearful, and he was terribly vague and forgetful and not functioning that well. His xx put him on xxxxx (knowing his xxxxx xxxxxx), and consulted with someone else who agreed that was reasonable. His depression became full scale xx, with high levels of aggression and irritabilty. He went back to the xx to say it was not working out that well for him after maybe a month (felt he couldn't think properly among other things) , and the xx said to give it 6 weeks. He lost his job. He is now with a xx experienced psychiatrist who put him on Olanzapine to calm him down and help him sleep. My question is this: My life has been horrible throughout all this with his horrible demeanour, and if it weren't for the toddler I would definitely give up on the relationship due to the constant conflict. Do you think we have a case for medical negligence against the xx please?
Hi, I’m a moderator for this topic and I wonder whether you’re still waiting for an answer. If you are, please let me know and I will do my best to find an Expert to assist you right away. If not, feel free to let me know and I will cancel this question for you. Thank you!
Customer: replied 5 years ago.
Hi I have not had an answer yet. I'm actually asking for a psychiatrist of any nationality (i'd assumed American) to say is this a legitimate or incorrect and hazardous way to treat a patient with these circumstances, more than from an Australian law perspective, as only an expert psychiatrist can determine that. My view is that prescribing this anti-depressant without a mood stabilizer was not ok, he should have known, and it directly caused the mania. Thanks
Customer: replied 5 years ago.
Hi it seems an Australian solicitor has the question. I don't see how she would be able to answer it except to say what constitutes medical negligence which isn't the question. It is completely about whether a psychiatrist thinks its an appropriate or inappropriate treatment. Bipolar meds are specialized.
Hello. I believe I can be of help to you with this issue in the event a psychiatrist doesn't step forward.; I'm a clinical psychologist, university professor and know the research literature well enough.
Customer: replied 5 years ago.
Hi Dr Michael. Thanks for your offer of assistance. No psychiatrist has answered which does not surprise me. Will anyone stick their neck out (for $25) to help me to say a GP did an indefensible thing?! I would be very grateful for your thoughts. With thanks
Yes, you can likely find an academic or medical researcher in psychopharmacology who understands this research literature, i.e., there is reasonable evidence that SSRI and possibly SNRI antidepressants should NOT be knowingly administered to persons with known bipolar disorder. For example, read the Abstract of this competent article and then, read through it. If there are specifc studies you want to read from it, let me know and I'll try to dig up .pdf files for you and stick them on an external server for you to download.

Here is more information, written in lay persons terms by a lay person, that alludes to this topic as well.

You don't need a practicing psychiatrist to testify about this; in fact a researcher or professor in psychopharmacology or who does bipolar RESEARCH would be more credible. I'll pause here and solicit your reaction. I need to run off to meetings for a few hours so it may be some time/delay before I get back to you, but I will respond.
Customer: replied 5 years ago.
Dr Michael, Thanks for your very helpful perspective. I had not considered the (of course!) large body of published research which of course states that anti-depressants given in the absence of mood stabilisers can lead to mania. I think you are right - it is not necessary to ask a practicing psychiatrist. I am very grateful for your pointing me in the right direction, and the links are interesting. To be honest, I don't know where I'm going with this or why I'm doing it. It's not going to turn back the clock and change our quality of life, and I feel no satisfaction from the mere fact of being right. I'm not even angry and looking for retribution, or to sue someone and get money. I'm just so sad that this is where we are left when we sought help in a legitimate way, and they so lightly made our problems so much worse. I thank you again for troubling to provide an answer, it's a good service.
Customer: replied 5 years ago.
I just realised that all of these answers are publicly posted. Can my name be deleted from them please?
Customer: replied 5 years ago.
BTW, I just realised that the site is posting this all publicly (I wish it wouldn't). Can my name be deleted wherever it appears please?
It was a pleasure hearing your story. I can empathize with your statement, "....I feel no satisfaction from the mere fact of being right". Well, you are most probably, right.

You do need a physician who is well-trained about this issue and is highly patient in trying out types and does of MOOD STABILIZERS, first and foremost. And, I can also tell you, bipolar disorder can be tremendously affected by quality, cognitive-behavioral therapy i.e., good data exist on decreases in rates of episodes, durations of episodes going forward. I share this with you because you are young---only about halfway through your lifespan and some months of consistent work with a clinical psychologist who practices cognitive behavioral therapy or a variant of it (dialectical behavior therapy, acceptance and commitment therapy) can help. The combination of the medication and therapy is the 'way to go'. And from time to time, consideration of couples therapy can help. The #1 factor accounting for relapses or new episodes involves a combination of stress, not 'taking care of yourself' (skipping medication, disruption of your circadian rhythms through sleep deprivation) and lack of social support. The social/emotional support is huge, and hence, I would consider marital therapy, so you are on the same page about managing conflicts, stress, working to keep life on an even keel, etc. But all in all, medication + cognitive behavioral therapy is the 'way to go' here, IMO.

I hope this interaction has been helpful to you. Please let me know if I have overlooked any aspect of your original question. Please click on the green Accept button at the bottom of the screen. Thanks.

I got your last post about privacy. You can have the question and all responses removed by checking with customer service. They have no problem doing it. I can't access the system to do it myself however.
Dr. Michael, Psychologist
Category: Mental Health
Satisfied Customers: 2177
Experience: Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
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