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Doctor Kevin
Doctor Kevin, Ph.D.
Category: Mental Health
Satisfied Customers: 1482
Experience:  25 years in private practice
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My boyfriend lives in South Africa. After the death of his

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My boyfriend lives in South Africa. After the death of his grandfather he was grieving (worst time ever to give someone a diagnosis) and they immediately started him on Lithium (Camcolit 1200) for bipolar. That was way too much so it went down to 400mg but he still has never felt comfortable on the drug. It has not fixed any of his depression issues and before they even "diagnosed" him he had never had a manic issue in his life. I myself am bipolar and can say with a great deal of certainty that he is NOT bipolar. We did a little research and compared the symptoms of major depression and bipolar and he fits under the major depression far more than bipolar. None of the doctors in SA talked to him about the side effects of the Camcolit nor did they ever do any sort of blood tests. He suffers from terrible migraines and he still has suicidal thoughts from time to time. He will not ever follow through with them and he knows it's not what he wants but he has a difficult time controlling that feeling of dread. Plus he seems to suffer a bit of anxiety but that may be more because of the dangerous environment he is living in. (Johannesburg is not the safest place in the world) Anyhow - since I'm writing a book here - he wants to wean off the Camcolit and try an antidepressant instead. The problem is that health care in SA isn't the same as it is in the US. The doctors take no time to discuss concerns etc. and they pretty much just give you what you ask for. So can he safely wean off the Camcolit and start an antidepressant at the same time or would he have to be totally off the Camcolit before he starts. We were looking at options and thinking either Lexapro or Welbutrin XR may do the trick. I say Webutrin because he shows a lot of signs of ADHD but then I say Lexapro because of his anxiety issues. Any suggestions or thoughts?
Submitted: 2 years ago.
Category: Mental Health
Expert:  Doctor Kevin replied 2 years ago.

Dr.Kappler :

thank you for choosing just answer. I'm sorry to hear about your boyfriend's professional mistreatment. As you know lithium does nothing for depression and without proper blood tests can be extremely damaging to the kidneys and even cause psychosis or death if it is a high enough level in the blood. Anyone who's monkeying around with the amount of lithium is getting and not doing blood tests should be sued for malpractice and I'm concerned that your boyfriend is in mortal danger. Too many times I have seen the grieving response be misdiagnosed as a mental illness and that which is a natural process for all of us degraded to a disease. Not only that but the mental stigma and the side effects of the inappropriate medication may delay the grieving process or sidetrack it altogether as the patient become so involved in being a mentally ill that they cannot perform a function common to all human beings.

Dr.Kappler :

I am always surprised by people who are diagnosed as paranoid when they live in a very dangerous area. I am reminded of the T-shirt that says "even paranoids have real fears."Your discouragement about the medical community and its lack of empathy is real but that approach is unhelpful. Your boyfriend needs to take a more proactive approach to his mental health. His decision to stop lithium make sense and he should let his doctor know. I would advise against an antidepressant since that will slow down the grieving process. Too many times people start out in the stages of grief as outlined by Kubler Ross and end up stuck in a major depression because of the iatrogenic nature of psychiatry. As R.D.Lang so clearly points out people need to be educated in the fact or myth that they have the depression before they will buy antidepressants. This is especially true when the drug companies started to market in Japan where the concept of depression is totally foreign. Japanese can feel shame but they never understand the selfishness involved in calling yourself depressed despite the millions of dollars the foreign drug companies poured into media to try to educate them on the need to buy their drugs.

Dr.Kappler :

if you insist on an antidepressant I would strongly recommend you look into the latest literature and research on the efficacy of anti-depressant medication.

Customer:

Thank you for validating what I believed. Not only misdiagnosed but giving a drug like lithium for the "first try" scared me to death. His grandfather died a year or so ago so I think the grieving is over but he still has the symptoms of depression. It's quite possible though, that he may not need to be on anything at all.

Customer:

He asked the doctor about weaning off the lithium and they guy actually shrugged his shoulders and had to look it up on line.

Customer:

So now he has been cutting the pills in half for the last couple of days and it hasn't been as bad as he thought it would be.

Customer:

Being in South Africa is some of the issue. I am constantly reminded of how lucky we are here in the US. I told him that the next time he goes to the doc if he is not satisfied then he needs to demand another doctor. He is on a medication he does not want to be on and wants to get off. Not sure why it's so difficult to get help but that is why he is trying to do it on his own. I've been sort of monitoring his moods and such but I think he is being careful. Thanks very much for your answer. I makes me feel better knowing my concerns were valid.

Doctor Kevin, Ph.D.
Category: Mental Health
Satisfied Customers: 1482
Experience: 25 years in private practice
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Expert:  Doctor Kevin replied 2 years ago.
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Expert:  Doctor Kevin replied 2 years ago.
I have switched out of I & R mode is requested
Expert:  Doctor Kevin replied 2 years ago.
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  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
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  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
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