Thoughts on Treatment and Recovery from Bipolar Disorder

Hi.Merry Christmas to everyone reading this I certainly didn't think I would be doing this on Christmas Day one year ago,but my life has changed so much in the past year that replying to someone from DBSA is part of my new life.  I was diagnosed with bipolar 23 years ago. My story of my first manic episode is on the New website of DBSA (facing off) it is Sue from Oakridge Tn.under personal story videos. I not only have bipolar but am also a victim of childhood sexual abuse.  I know there is a big difference between my bipolar illness and whether I am reacting to my childhood abuse.  How I know the difference is because I have a Vagus Nerve Stimulator implant. I had it implanted in December 2005.  It started working in April 2006.  My God what a miracle the black cloud had lifted!!!!   Then in August I was reminded of my childhood abuse by a trigger and I was depressed but in a diffrent way. My dr. called it Post Traumatic Stress Disorder.  I have since had therapy and have forgiven my abuser(he is dead)  I never thought I could ever forgive him but what a weight was lifted from my heart when I did. I still am bipolar but thanks to the implant the deep dark depression is gone. I still worry that I might have a manic episode but so far since the implant I haven't. I have a good doctor and I know he will help me if I do have an episode.  I could go on and on but I won't I just wanted to say that there is a difference between bipolar illness and childhood abuse.  Sue

You have touched on many topics - perhaps you can go in depth with a few of them another time.

 

If I could be "cured" of this illness, I'm not so sure I would want that.  My illness is a small part of who I am.  The challenges are enormous, but we grow through our difficult obstacles in life.

 

Yes, every individual's illness is unique, that's why this disorder it's so hard for doctors to treat.  Psychiatric doctors have their work cut out for them.

 

Genetics AND environment "can" play into our diagnosis...there are so many variables.

 

If you can form a partnership with your doctor, all the better key to getting well and staying well.  It works for me.  If someone has a doctor that will not work with you, leave and go find one that will.

 

I believe I have this illness for life, no qualms about it.  But I have learned not to fight the illness, but rather to accept it and get to know it well, I'm stuck with it, so I may as well get over it and win some battles.  It takes time.  And even then, bipolar issues will rear that ugly head now and then.  But I can and WILL survive it.  Bipolar is not a terminal illness.  We are lucky that way.

 

A farorite poem, by Henry David Thoreau:

 

If a man does not

keep pace with his companions,

perhaps it is because he hears

a different drummer.

 

Many of you dance to your own drumbeat, and that can be a very good thing when you are doing well.  Count your blessings.

 

Now I will try to go out there and have "even one good hour" in an extra-ordinary bipolar day.

 

 

 

from what i have learned, and wholly agree with-- and i have been through countless days, weeks and even twice, a month+ in a psych hospital and outpatient-- learning all about this, how to cope and etc... there is no cure.

if one is struggling, medication dependent, needing regular therapy, etc.  they absolutely have the chance of improving to the point they can manage life with less and less outside help. it totally depends on the person and their particular situation and how good their self-care is. symptoms will never completely go away, even with all the best outside and self care. unfortunately.

 

as to being born bipolar or not, i was told by my pdoc that everyone is born with the genes/capacity that may lead to bipolar (or many many other diseases, even cancer.) it is just a matter of nature/nuture, traumatic events or some other trigger being there to "activate" it.

 

 

i have to respond to your comments about medications as well. I agree that the pharm. companies are trying to over-medicate the population. i have been fortunate enough to have responsible doctors in this area. My GP, OB and OB specialist all said to go ask your pdoc, i don't want to be wrong.

my first pdoc treated me as competent. he trusted my judgement when i said i was doing very poorly, but didn't need to be admitted. i was also asked if i agreed with the med changes he was doing. 

 

currently, i am on 4 meds for my bipolar. from 5 yrs ago and for the following 2-3 years, i was on a whole lot more. at one time, i remember taking a total of 16 pills a day. it wasn't 16 medications, but probably around 9 because of the high levels. at that time i felt i truly needed those different types of meds. after a time, as i reduced triggers and improved my self-care, i was able to reduce the number of meds. 

i'm not saying i was in no way over-medicated, but i feel that for a while, it was needed for me to get through that hard time (self-injury was a huge concern as well.)

Thanks for these comments.  We have some new commenters, and I want to thank everyone for taking the time to share experiences.  I'll be personally responding to each comment in the next day or so, but I just wanted to quickly jump in here and say thanks. 

 

How about others?  Any input, opinion, or experiences to share?  Leave a comment and let us know.

I was told by my psych that group therapy would not help my bi-polar but it might help me!  I don't see the difference.  If stress triggers cycles than you need to learn how to react to it.  Because everyone has stress.  One of those ways is to attend group therapy.  I'm not saying it has cured me but it has helped.  Hope this helps some people. 

 

Thank you for such a wonderful post...you bring up much food for thought. I personally don't believe that people can be "cured" of bipolar disorder and tend very much (given my background in genetics and biomedical research) to follow the paradigm that there is a medical basis for the illness. Having said this however, I do NOT think that everyone responds equally well to (or necessitates) the same treatments. Some people such as myself simply cannot function in society without medication, while others can do fine without them. Who I find disturbing are the people unwilling to acknowledge that the treatment spectrum is as diverse as the manifestations of bipolar disorder: there are med freaks (including not only patients but healthcare providers as well) who think that pharmaceuticals are the only way to go, while there also exist anti-med freaks who feel that no one should be allowed to consider this route. I think I am equally frustrated by both categories. Prudent self-care tailored to the INDIVIDUAL under the guidance of a well-matched doctor (communication is key) is the best way to go.

I've said so many things on my blog I'm not going to repeat here, but you hit on one thing I haven't.  I strongly think pharmaceuticals should not be advertised directly to consumers unless they are available OTC.  Right now I'm staring at 2 enormous ads for Geodon, and Geodon is a med with a number of potentially really serious side effects.  But these ads would never let you guess.  Besides that, there are nuances that make one drug preferable to another that are not shown in these ads. 

 

I also think there ideally should be some form of limitation on non-psychiatrists prescribing heavy duty psychotropics.  I won't let anyone touch mine except the psychiatrist.  I had a family doctor flip because I was taking low dose ativan once; he wanted me switched to low dose Seroquel.  I don't think he considered that the Seroquel would sedate me too much to work.

 

Anyway, I've said too much already.  (www.masterofirony.blogspot.com)

 Hi, it's just me Emma,   I also think your born with bipolar, and it manifest itself in different ways at different times in people lives. I think when you've been diagnoised,or at least when my husband was diagnoised, I could look back and see so many things he had done, that were finally explainable.     I have learned over the last couple of years that the two most important things we've done was to educate ourselves about bipolar disorder and about the meds. I do think physicians and psyciatrist tend to over medicate, at least my husbands pdoc does. He went to see her last month and told her he had changed some of his meds time and amount and she did't like it at all. We both tried to explain that he shook so bad he couldn't do his job,plus he was self consious of it, which made it worse. I don't think she liked it ,because she acted like we were questioning her. She told him he was headed for a major depression, and added more meds. Actually he's been doing so much better the last couple of months since I switched some of his meds to him taking them at night instead of mornings.   Some of the meds do the same thing also. She gave him Xanax for his shaking ,as many as he wanted. This is the list of meds he is suppose to be taking, please tell me what you think. Geodon, Seroquel, Lamictal, Lithium, Zoloft, Ambien and don't forget the Xanax. Do you think he could possibly be over medicated?  If she adds something new she never takes away any. We stay with her because we live in a rural area and pdocs are few and far between. I know from researching all these meds, that several of them cause shaking, why does she not know it?  I'm the one in this house who has researched bipolar and the medicine and the bipolar husband has finally started listening to me.  Bipolar is alot like other illnesses, you educate yourself about it ,and you learn what to watch for everyday ,and if your lucky you can catch yourself before as we say you get really weird(with him it's depression). You have to live life in the best possible way you can with bipolar ,and it's alot easier on everybody, if you kindof know what you're dealing with. I'm sorry for rattling on so .        Thank You, Emma.

These are the things that I believe regarding Bipolar, Schizophrenia, and other Mood Disorders:

 

1) We are not born with them but have the genetic makeup for them to be triggered into "being".

2) Childhood abuse, trauma, environmental surroundings, behavioral skills learned and accepted by those in our surroundings while young all can set the disorders in motion.

3) I do not believe in meds for each & every symptom.  I do not believe in medicating young children UNLESS it is absolutely necessary and/or literally life or death.  Their brains are developing, hormones play a part.  You are hard wiring their brains to think as the drugs want them to think and not what they naturally are.  You mess with the brain while it is developing - you get what you get when they are older and yet, you'll never know who they would've been.  Plus, they can't voice whether they want their brains re-wired.  Agree or not, don't care (I suffered mercilessly as a teen, I'm still glad I wasn't medicated with high powered anti-psychotics)

4)  Bipolar is a life long chronic and often debilitating illness.  I know folks who have been diligent with their meds, diligent with sleep, go to every meeting when the door cracks - they still at times become suicidal and at times manic - even on meds, even sleeping on schedule, even going to therapy.  Stress of any kind, grief over a loss, anything that throws a curve - can cause the most stable of folks to relapse.  Heck, it doesn't even have to have a curve thrown.

5)  Not all with Bipolar are killers, lack conscience, lack empathy, lack sympathy.  Not all with Bipolar are violent, aggressive, or abusive.  This is a behavioral trait learned and accepted while young.  Bipolar mood swings feed this behavior and unless the individual learns a different trait - it continues.

6) And lastly - not every single solitary individual person on earth has Bipolar.  It can't just "happen", it takes time to develop.  Just cause your "other" displays hypersexuality and gambles till the cows come a mooing - doesn't make a Bipolar person.  Just cause your "other" raises the vocal cords, agitated, and ill mannered - doesn't make a Bipolar person.  Oh, and each person in a relationship needs to own up to their own individual responsibilities if the relationship turns sour.  You aren't so easy to live with neither. 

 

 

i feel that with bipoolar you only need up to three meds and one prn to only help you deal with the illness.  the meds can't do it for you but can aide in subsiding some of the symptoms and while the meds are doing their job, you can cognative restructure your mind, your self, your soul in order to live better.  when you cognative restructure yourself, you change things.  when things have changed, you have a better sense of self, a better way of living with bipolar--it becomes like its not there at all!:)

This has been fascinating.  Thanks to all for your comments, and I hope we get more.  Everybody is right, of course, as each person's opinion is based on their own experience.  This illustrates the total lack of a comprehensive body of knowledge about this disorder, and that's disturbing.

 

More opinions?  Keep 'em coming. 

Hmmmmmmmm…what’s my take?

 

Well I used to think I was special having the illness until it became as I put it, the flavor of the moth illness.

 

Ø      If a person were caught cheating on their partner (hypersexuality)…they must be bipolar.

Ø      If a person had a drinking or gambling problem....bipolar again.

Ø      If the person didn’t understand the concept of how to manage or budget money and continually over spent on credit cards…gosh that person needs to be treated for bipolarism.

Ø      If a person went on a rampage killing people…again bipolarism is brought into play

Ø      If a child is acting out because parents feel dropping their kids off at a day care center all day and not really spending time with them in the evening is called parenting, we again dope them up with medications because of our failings as parent…god forbid if we actually had to take any responsibility for how our child turns out.

 

I can continue with this list but I think you get the point. So many are misdiagnosed now as being bipolar to explain behavioral problems that could for the most part be fixed aka cured. So why not medicate everyone so that none of have to take any responsibilities for our actions.

 

This point and time will be known as the “Generations of Excuses” of why we don’t need to take any responsibility any more because we can lay blame to a mental illness and not just do the right thing. Instead we can just take a pill for every issue in our lives instead of owning our failings and making the necessary changes to get us back on the right track.

 

It is genetic and you are born with it and if you look back through your family tree, there should be markers of family members having the illness. There are no cures that I am aware of, just medications to help control the symptoms.

 

Maybe I’m not even bipolar and really suffering from menopause? Don’t seem to have any hot flashes unless the wife turns up the furnace because she cold. Have to remember to talk with the doc about the possibility of a hormone patch on my next visit.

There appears to be a dearth of information on the subject of a cure for organic and/or situational bipolar. There are some published documents available from highly credible agencies, universities and portal websites. These include Johns Hopkins, The Mayo Clinic, Harvard, Yale, Medlineplus, Pubmed, NIMH, WHO, Black Dog Institute (Aust), HealthInsite (Aust), Australian Institute of Health and Welfare, Bipolar Depression and Support Alliance, Department of Health and Ageing (Aust), WebMD, Medscape, University of Oxford (UK), University of Cambridge (UK).

 

It is my understanding that none of these researched sources indicated that we are presently in possession of a medical cure. Some stated categorically that there is no cure. Others spoke in terms of attempting to stop and/or halt the progress of symptoms.

 

Having lived with bipolar disorder and a psychotic illness for 37 years, I can categorically say that I've never reached a point of total recovery - let alone a complete end to symptoms. So, in my opinion, having looked at some of the professional published documents (both now and previously), and from my own anecdotal experience, I must come to the irrevocable conclusion that a cure does not exist at this present time.

 

As someone who has pursued the concept of ‘superior illness management' (a term I made up all by my little self), I have utilised most of the available and recognised treatment regimes on a long-term basis. I have strived to obtain and maintain the best possible health within the parameters present in having a mental illness.

 

Please, please don't interpret this as me "patting myself on the back" as I have resoundingly and spectacularly failed more times than I care to think about.

 

If I was required to strive for a level of recovery that meant by definition no more symptoms, ever, I would at least be tempted to stop trying. If that is the definition, hypothetically, then it is an impossible mission without a cure. Personally, I think for "recovery" to mean a state where symptoms are eliminated, it is far too restrictive. It does not automatically follow that for a definition to become broader, or more inclusive, it will then lose some of its strength, clarity and meaning.

 

For example, if the academic and on-the-ground medical professionals viewed recovery to mean an end of all symptoms - just imagine how that might affect you and me as we interact with our psychiatrists and GPs, and hospitals for that matter. Possibly, the expectations imposed upon us would result in a detrimental effect rather than a positive one?

 

Anyway, I don't believe there is a cure for bipolar disorder or psychotic illnesses. I believe that we can and should strive to manage our illnesses to the degree that we are able, at any given time, considering the severity of those illnesses. You see at present I am at a stage in my life and illness where I would be considered (both by my doctors and peers), to be in recovery.

 

But I'm currently making my way successfully through a time of depression that can only be described as a ‘horror'. Also, even when I'm not experiencing significant symptoms - that are intruding on by ability to function and my quality of life - there are still discrepancies and deficits that are happening both internally and externally. In my very strong opinion the idea that we experience episodes of illness, and in between there are no symptoms at all, is a total myth.

 

Peter

Hi

I just read all the oppinions about bipolar. I thought it was interesting to see all the differences....and it spurred me to think how I would like to see the same posited for the "variety of symptoms, triggers, what "your bipolar looks like".  Could you do that?

 

feather

...me again

 I have never heard of the term "situational bipolar".  what does that mean?  Is this another "form" of bipolar, now?  (that expression fits me, right now.)

 

Thanks for any insight on the new vocabulary, as I have not heard this, as of yet.

 

raku

I guess I'm one that you would consider "over medicated" because I do take 6 different meds for bp & one winter had to add Wellbutrin (so 7 meds).  I was able to get off it in the spring.

 

My doc says that I am one who will have to take meds the rest of my life due to suicide attempts (plus my mother was bp & did commit suicide).  I have had delusions & paranoia.  I still had a relapse 1 1/2 years ago & overdosed despite having been stable on these meds for 5 years & it was brought on by a situation that was very hurtful to me.  I'm still reeling from that relapse & having cycling despite meds.  I'm in close contact with my doc & have returned to therapy.  I had been doing so well that I discontinued therapy during those 5 years.

 

As as aside, what do you do in therapy? I'm not sure I'm getting any better with the therapy.  I'm not sure how I'm supposed to get help from it.

 

I did haver abuse when I was a child due to my mother & father both being alcoholics, plus my mother's bp.  So that may have "triggered" the bp to rear its ugly head when I was 15 (1st suicide attempt then).

 

I have 2 children & asked my doc how to protect them from developing bp.  She said to raise them in as stable an environment as possible would help.  Well, with my bp I guess it was difficult to have a stable environmnet, though my husband was an excellent father & picked up the slack when I was unwell.  (We've been married for 34 years--he's a saint).

 

Unfortunately, both my kids have gone through periods of depression where they needed meds.  They are off them now, but I think my daughter needs to go back on them but she fears the stigma if anyone found out (she's a lawyer).

 

So I definitely think bp is highly genetically based & that situations can trigger the onset or relapses.  I participated in a study that is looking at the genetic component of bp.

 

Anyway, despite Trazodone & klonopin at night I haven't been sleeping except a few hours a night for a couple months.  My doc wanted to add Seroquel (sp?) but I refused as it can promote weight gain & I've already gained 50 lbs. on my meds which is causing some depression & hopelessness.  

 

Today's a new day & I am attempting to practice good self-care & exercise & eat a healthy diet, journal, have a balance between doing chores & hobbies (reading & knitting) & not isolate myself too much (a problem with me).  Even when I don't get together or talk on the phone with one of the few friends I've made in my support group or through NAMI (don't have any "normal" friends), I'll take a book & go to a coffee shop just to be around people so I don't feel like such a loser. 

I have a friend who is Manic-Depressive.  She is now on medication.  But she won't stay on it and she is actually worse because it is a mental illness that tells you that you aren't mentally ill.  So, she goes off till someone tells her to go back on them.

 

Her biggest problem with the pills is that she feels "normal," not grandiose, not lower that pond scum.  Not suicidal and not homocidal.  But what the pills do seem to hightlight in her is that she does not have empathy, sympathy, or any kind of conscience at all.   When not on pills it doesn't seem to bother her at all, she says, "I AM WHAT I AM," And I think this really bothers her the most, not having a conscience.  She is a bright person, computer technician, and is considered high functioning.  Meaning she holds down a job. 

 

I no longer speak to her, at all, I learned how cruel she could be a couple a months ago.  I don't believe that a pill can give you a conscience.  So I don't believe she would consider it recovery till it did. 

 

What I have witnessed in the last two years of my best ex-friend has the same behavior with/without pills, and I don't even feel like she is the same person when she is on medication.  It is like talking to a black/cold hole.

 

 

 

 

I have a friend who is Manic-Depressive.  She is now on medication.  But she won't stay on it and she is actually worse because it is a mental illness that tells you that you aren't mentally ill.  So, she goes off till someone tells her to go back on them.

 

Her biggest problem with the pills is that she feels "normal," not grandiose, not lower that pond scum.  Not suicidal and not homocidal.  But what the pills do seem to hightlight in her is that she does not have empathy, sympathy, or any kind of conscience at all.   When not on pills it doesn't seem to bother her at all, she says, "I AM WHAT I AM," And I think this really bothers her the most, not having a conscience.  She is a bright person, computer technician, and is considered high functioning.  Meaning she holds down a job. 

 

I no longer speak to her, at all, I learned how cruel she could be a couple a months ago.  I don't believe that a pill can give you a conscience.  So I don't believe she would consider it recovery till it did. 

 

What I have witnessed in the last two years of my best ex-friend has the same behavior with/without pills, and I don't even feel like she is the same person when she is on medication.  It is like talking to a black/cold hole.