Local doctor advocates for people with bipolar disorder

Psychiatrist Thomas Jensen empathizes with people with bipolar disorder.

His Scandinavian family tree is “genetically loaded” with relatives who suffered from the disorder that affects an estimated 5.7 million Americans and 222 million worldwide, causing extreme shifts in mood, energy and functioning, with a high incidence of suicide.

Jensen, 49, was recently appointed medical director of the California Bipolar Foundation, a not-for-profit organization founded two years ago by Rancho Santa Fe resident Muffy Walker after her young son was diagnosed as bipolar.

After several doctors had misdiagnosed her son, Walker recently said, it was Jensen who first considered and ultimately diagnosed her son with early-onset bipolar disorder.

In 2007, Walker and her husband, Dr. John Reed, president and CEO of The Burnham Institute, along with other parents of bipolar children, founded the California Bipolar Foundation (CBF).

CBF is dedicated to the eventual elimination of bipolar disorder through research, support services and public education to erase the stigma associated with the disorder, also known as manic-depressive illness.

Jensen served on CBF’s scientific advisory board for the past year. The advisory board reviews grant applications from researchers. Last year, CBF funded two $50,000 grants for bipolar research.

As medical director, Jensen will be the “medical voice” of the foundation reviewing and ensuring that all information issued by CBF, including educational brochures, videos, webinars, blogs and live Webcasts, will be medically factual and user-friendly.

Many of Jensen’s patients are children. One room in his office is devoted to an array of toys on the floor.
“What I tell the children is: I have the best job in the world because I get paid to sit on the floor and play with toys and then tell their parents what to do.”

Jensen’s office is decorated with black-leather chairs and matching ottomans and a low side table, also occupied by toys and a laptop computer. No desk. “I don’t like to set up barriers between myself and my patients,” he said.

Jensen is board certified in child psychiatry, adult psychiatry, behavioral neurology and neuropsychiatry.

He devotes about half his time to treating patients with mood disorders, both depression and bipolar disorder. In addition, he treats a variety of biologically-based mental illnesses in children and adults, such as Tourette Syndrome, OCD (obsessive compulsive disorder) and panic disorders.

While bipolar typically develops in late adolescence or early adulthood, and usually lasts a lifetime, first symptoms can emerge during early childhood with symptomatic rapid mood swings between depression and destructive tantrums sometimes many times within a day.

Although there is no known cure as of yet, bipolar disorder can be managed with various medications (mood stabilizers, anti-seizure meds, antidepressants and others), psychotherapy, and, in severe cases, when all else fails, with electro-shock (ECT) therapy and hospitalization.

“One big misconception that many have is that folks with bipolar disorder are somehow dangerous,” Jensen said. “And they base this [misconception] on a very limited number of cases in which people with bipolar disorder, often under the influence of wrong medications, became violent.

“I’d like to erase any theories that still remain that this is somehow a psychologically-based disorder. It isn’t, although psychotherapy is an important part of the treatment.

“We have identified now five of the genes responsible for bipolar disorder and decoded what those genes code for, which is a huge breakthrough. The search for additional genes continues. We’re pretty sure we don’t even have half of them yet.

“Additionally there may be what we call gene environment interactions that can trigger a mania. We know in animal models of bipolar disorder exposure to certain agents can trigger a mania, amphetamines or cocaine being the two most common. We think there may be in some people a role that severe stress may play in turning on some of these genes.”

“Also,” Jensen continued, “I’d like to erase the stigma that exists in the workplace towards people with bipolar disorder. The reality is that, well-treated, the vast majority with the disorder function extremely well. Many are CEOs, general counsels, and senior scientists.”

Jensen was born in Peoria, Illinois. His father was an IBM salesman and executive. Growing up, Jensen lived with his family in Europe and various U.S. cities.

In Baltimore, he recalled, he was the poster child for “the intelligent, extremely hyperactive ADHT child” and was given the then-relatively new drug Ritalin “without which I wouldn’t be where I’m at today.”

The family eventually moved to San Diego where Jensen earned his B.A. in chemistry at the University of San Diego in 1982 and went on to earn his medical degree from UCLA School of Medicine in 1986.

After earning his medical degree, he launched his specialization training at UCSD with a pediatric internship, an adult psychiatry residency, and a child psychiatry fellowship; followed by a child psychiatry fellowship at Stanford University, 1990-91.

He and his attorney wife, Karen Boudreau, moved to Lewiston, Maine, in 1991, where he opened a private practice and his wife commuted to Boston to practice law.

“I was drawn there because I was a young guy with educational debts and Maine was a cheap place to live and I could make a good living there … and it was my best financial deal for a medical directorship at a nonprofit hospital (St. Mary’s Regional Medical Center).

“And,” he added, “in those days, the for-profit hospitals were in the news every week for unethical behavior, so I wouldn’t go to work for one.”

Between his medical directorship and a running a thriving practice, he paid off his student loans and built up his finances, but he was also working 80 hours a week and, after eight years in Maine, he and his wife decided it was time for a change. They returned to San Diego in 1999.

Jensen joined the Kaiser Permanente medical group as an outpatient psychiatrist, with a subspecialty in difficult-to-treat mood disorders, including bipolar disorder and depression.

He soon ran into conflict with the HMO over Kaiser’s policy for psychiatrists in its San Diego area facilities that stipulated when they receive a request for a prescription for a patient from nonphysician staff psychologists, social workers or family therapists, they, in keeping with Kaiser’s “multidisciplinary team-based approach”, should write the prescription without the necessity of scheduling a visit with the patient.

“At the time, psychiatrists were prescribing psychiatric medications based solely on the evaluations of social workers and social work interns,” he said.

Jensen objected, arguing that the policy was illegal and placed patients at risk. “I was fired,” he said, “and then I sued them, not for money, but for an injunction to force them essentially so that the doctors would actually see patients before they prescribed psychiatric meds.

“The story hit the front page of the LA Times and became national news,” Jensen said. “Ed Bradley [broadcast journalist] flew me to New York to do a 60 Minutes special which never aired because there was a settlement and essentially the result of it was that psychiatric patients at Kaiser are now seen by the psychiatrist personally prior to being prescribed medications.”

“I actually feel in terms of my career accomplishments that did more for people than anything else I’ve done.

“And that’s why I did it. My wife asked me why I wanted to do this. What I said to her was, ‘I’m afraid I’m going to open up the newspaper one day and read a story that some high school or college kid shot up a school after a missed bipolar diagnosis and having been given a prescription for Prozac.

“It was one of the worst times of my life, but it was good decision that I made, although to this day among some people in town, I’m quite controversial. There’s essentially a rule in medicine. Ed Bradley called it, ‘The White Wall of Silence.’ It’s that doctors don’t tell on doctors. And so, there will always be people in San Diego in the psychiatry community who will never forgive me for what I did.”

More information on bipolar disorder is available at the CBF Website: www.californiabipolarfoundation.org

Tags: Bipolar disorder, California Bipolar Foundation, SDNN, Thomas Jensen

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