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Ask the Experts

Question:

I am a 53 year old woman with bipolar I disorder. Although I had my first episode at 15, I was not diagnosed until 7 years ago.

Over the last 7 years, I have been treated with all the available medications and protocols, but have found no lasting relief. My current doctor says he has nothing else to offer me and suggests I just wait until new medications become available.

I do not know if this is possible. I have attempted suicide in the past, and with no medications on board now, I am feeling really bad and hopeless.

Do you have any other suggestions besides just waiting?

Answered by: David Kahn

Often a doctor or series of doctors may believe that all available options have been tried, but on a re-evaluation, an independent expert may find that some particular combination has not been used, or that even an obvious class or type of medication has been avoided. In addition, electroconvulsive therapy may not have been discussed with you, and for severe depression this should definitely be on the table. It can also be used as a maintenance treatment to help preserve the gains achieved during acute treatment.

In this reply, I am assuming that your diagnosis is correct, and that there are not any overlooked medical problems, or ongoing substance use problems that could complicate the picture - those are crucial issues of course and may also need a fresh look.

We would strongly recommend a consultation at a teaching hospital or major university department of psychiatry.