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Page 1 of 4  Carol Watkins, M.D., our guest, is board certified in adult and child psychiatry. She has written numerous articles on the treatment of Bipolar Disorder, Manic Depression and Depression in children and adults.
David Roberts is the HealthyPlace.com moderator.
The people in blue are audience members.
online conference transcript
David: Good Evening. I'm David Roberts, the moderator for tonight's conference. I want to welcome everyone to HealthyPlace.com. Our topic tonight is "Depression and Bipolar Medications." Our guest, Carol Watkins, M.D. is board certified in adult and child psychiatry. She is a clinical assistant professor of psychiatry at the University of Maryland and maintains a private practice in Baltimore, Maryland. She is the author of many published psychiatric papers and a frequent lecturer at workshops and seminars. Dr. Watkins has also written numerous articles on the treatment of Bipolar Disorder and Depression in children and adults, and maintains an active online resource site dealing with those subjects:
http://www.ncpamd.com/Bipolar.htm,
http://www.ncpamd.com/Adult_Depression.htm
http://www.ncpamd.com/cadepress.htm.
If you are looking for information on a particular depression medication or medication for bipolar disorder, you might want to try the HealthyPlace.com psychiatric medications area.
Good evening, Dr. Watkins and welcome back to HealthyPlace.com. We appreciate you being our guest tonight. Lately, we've been hearing a lot about children with depression, teens with depression. What do you think about children under age eighteen receiving antidepressants?
Dr. Watkins: In some cases, medication can be useful for depressed children and adolescents. Depression in young people is often overlooked, sometimes with tragic results. We are generally more cautious when using medications in those under eighteen. In the past decade, we have gotten more safe and effective antidepressants for young people.
David: What makes an individual "qualified" for medication for depression?
Dr. Watkins: It varies depending on the severity of the depression, the individual's medical condition, and the individual's preferences. For milder depression, we are more likely to recommend psychotherapy first. For more severe depression, antidepressant medication is more likely to be necessary.
David: We've heard a lot about "brain chemical" depression, an imbalance in a person's brain chemicals. Are antidepressants the only way to treat that?
Dr. Watkins: The term "chemical imbalance" is misleading. Many things start with a chemical abnormality and become much more. For example, type 1 diabetes seems to be a simple chemical abnormality. The pancreas does not make insulin. The disorder is treated by insulin. However, living with diabetes is much more complex. It involves lifestyle issues, and many behavioral and emotional issues.
David: I was under the impression that antidepressants were primarily used to balance the brain chemicals. Is that not true?
Dr. Watkins: Yes, they are. However, we do not completely understand how the brain chemicals get the way they are. I suspect that there are still a number of factors that we do not yet understand. Non-pharmacological things that make you feel better may themselves alter brain chemistry.
David: We also have a very large Bipolar Disorder community here at HealthyPlace.com. So, I want to touch on that too, before we start taking some audience questions. Can Bipolar Disorder be effectively managed without medications?
Dr. Watkins: I think that Bipolar Disorder is one of the conditions that usually requires long-term medications. Fortunately, we have more and better choices in that area. However, other factors can help the medications for Bipolar Disorder be more effective. For instance, getting the right amount of sleep is very important to a person with Bipolar Disorder.
David: Let's get to some audience questions, Dr. Watkins.
Dr. Watkins: O.K.
Wende: My son does not seem to have the "depressive" traits usually associated with bipolar. It's the manic side that we see more often. What meds do you recommend?
David: Wende's son is four years old.
Dr. Watkins: I can't really recommend specific medications without evaluating your son. It can be difficult to diagnose bipolar disorder in a preschooler. He should have a complete physical, neurological and psychiatric evaluation. Psychological testing may also be useful. You need to be very thorough in a preschooler with manic-type symptoms.
David: We've had a lot of doctors on talking about bipolar in children and many are hesitant to classify a young child as having bipolar. What are your thoughts on that?
Dr. Watkins: I have seen a few that did seem to have bipolar disorder. I feel more confident in making the diagnosis if there is a strong family history of bipolar disorder, and I have had a complete evaluation. I may try to hold off on mood stabilizers for a few years if I can manage things behaviorally. I might get a second opinion if I really thought that a four year old might need a mood stabilizer.
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