So patients are left to their own devices …
JOHN MCMANAMY: And fortunately we’re getting smarter. That’s what LIVING WELL WITH DEPRESSION AND BIPOLAR DISORDER is all about. Getting smarter. All of us need to become expert patients. Yes, we need to partner with our clinicians, and they have the professional expertise, but if we’re the passive and stupid ones in the relationship then our path to recovery is problematic.
What do you mean by recovery?
JOHN MCMANAMY: Return to where you were before your illness, namely no symptoms and full functioning. This may not be possible in the early going, but I don’t care how hopeless we may appear, no doctor has a right to give up on us. We shouldn’t have to settle for anything less than recovery. Mind you, your doctor isn’t going to wave a magic wand for you. As patients, we have to take responsibility for our own recovery
A lot of patients complain of side effects …
JOHN MCMANAMY: And being turned into stupid zombie eunuchs and metabolic catastrophes shouldn’t be regarded as a fair trade-off for getting our moods under control. We are entitled to feel better, period. Mind you, many side effects are temporary. But if they persist, patients need to work with their doctors on finding the right meds at the right doses. It is my belief that doctors tend to err on the side of overmedicating us, but if we don’t inform them that this is going on, then two things can happen: We can stay miserable on meds, or we quit on our meds and throw ourselves to the tender mercies of our illness.
So what is the correct medications strategy?
JOHN MCMANAMY: Every patient is unique, so what works for one individual may not work for another. Moreover, my MD stands for manic depression, not doctor of medicine. But a couple of general observations: One -meds get us maybe fifty percent better. The rest is up to us. Most days, I operate at about 80 or 90 percent, which is doable. Two - when you’re in a crisis, medications overkill is justified. But there is a huge difference between medicating a patient out of danger and medicating a patient into recovery.
