James R. Phelps, M.D.
Samaritan Mental Health
Corvallis, OR

"... at least half of patients with psychiatric disorders make their only contact with the health care delivery system through the general medical sector."
Wells KB: Depression in general medical settings. Psychosomatics 35:279-296, 1994.

What is this site all about?
This site is about a new conception of bipolar disorder, appearing for the first time in the DSM-IV but under discussion for more than 10 years. This new conception is almost certainly applicable to some of your patients. Here you will learn how to "rule in" such variations as Bipolar II, Bipolar Mixed States, "cyclothymia", and Rapid Cycling Bipolar disorder. Other variations not recognized by the DSM are also addressed here. All will be viewed as they inform the treatment of patients with depression.

This site seeks to serve as a single, "one-stop shopping" locus for accurate, up-to-date information on bipolar variations, especially for primary care physicians, who see many patients with this disorder.^Manning  Most of the pages have the date of most recent changes at the top. 

The focus here is on diagnosis and treatment, as reflected in the outline you see at left, including a step by step guide to the use of lithium and valproate in a primary care setting. If you feel like you know nothing at all about bipolar disorder and want some basics, try this 8 page summary of expert opinion ^Frances, but beware: it does not address the "new" variations. That is the purpose of the site you’re reading now.

Now you can continue to the next page or use the outline at left to navigate.