My family is very frustrated - I continue to try to manage things on my own (through meditation, diet/omega 3s, exercise).
About 6 weeks ago I had a manic episode that was very scary. I was close to having to go to the hospital because I simply could not sleep! After several days I even tried sleeping pills, but I might as well have been taking a sugar pill - it did nothing whatsoever. The good thing that came out of it is that I have been able to pin down how mania begins for me. For days prior to the episode, I would awaken at 3 am every night like clockwork, and be unable to get back to sleep. At the beginning of the episode, it was actually very, very exhilarating, euphoric even. Despite getting little sleep, I would hop out of bed in the morning feeling like I had been given a shot of meth. But a few days later, the lack of sleep and feeling of helplessness was very distressing - I began to wonder how much more I could take before psychosis began to set in. It was like the switch in my brain that controls my adrenals was stuck in the "on" position. My doctor put me on lithium (900mgs) and I immediately went toxic. It was at that point that I decided to try and manage on my own.
My question here is has anyone been able to manage bipolar disorder on their own? Am I stupid for trying to do this? This was my second major manic episode (the first was 6 years ago), but I am sure that I have probably had smaller one since then.
Lastly, is it true what so many professionals seem to believe...that bipolar disorder, if untreated, will only get worse? Has anyone noticed that their episodes of mania have become more frequent? Is hospitalization at some point inevitable?
Boy, the euphoria of mania can be very, very seductive!
Yes although I was on a full regimen of medication I wasn't on a mood stabilizer that worked well (Lovaza, which is an FDA approved medication that is a synthetic version of fish oil used off label for bipolar and in clinical study for this use) and I was up until the early morning hours and rapid cycling and in some ways starting to lose touch with reality. Sleep disruption is a common trigger point and warning sign of manic episodes. Lithium is one of many mood stabilizers and there are other options and they don't all have the same side effect profile or potential concerns as lithium but you could speak to your psychiatrist about this:
>>>Has anyone noticed that their episodes of mania have become more frequent
indeed they became so unfortunately.
to try to go on your own is risky because you can never know the consequences. pdocs are not angels of mercy but still better trained than us. The pdpoc who put you on 900 is in panic because when the symptoms return back they become more ferocious so he was trying to stop it fast. perhaps you can reduce the lithium to 600 this is the average. OR try abilify or seroquel after the pdoc consent of course
"Lastly, is it true what so many professionals seem to believe...that bipolar disorder, if untreated, will only get worse? Has anyone noticed that their episodes of mania have become more frequent?"
Our adult son has chosen not to accept treatment for his bipolar disorder, and I can tell you that his behavior over the last two years has gone from anger (over our many past failures as parents) to obscene name calling to--most recently--confusing my personal history with his own and, in uncontrollable rage, physically attacking his father. I do not know if his psychiatrist feels that our son's condition has worsened, but I can tell you that without treatment, our son has become a dangerous stranger to us.
ILADVOCATE - I actually was on lithium a couple of years ago and tolerated it very well. Yet this time things were completely different. Your comment regarding the fact that lithium is not the only option is very helpful and I'll consider this if I start to struggle.
adel - I do remember that my last time on lithium, my pdoc brought me up gradually (I was up to 1200mgs eventually, plus lamictal). Perhaps it was that the dose was too high.
yarrow - I do hear from a lot of people that things got worse rather than better. I haven't ruled out just going back on the lithium. The thought of increasingly more drastic manic episodes is rather scary!
Some people just can't tolerate lithium, unfortunately, although it's strange that you were fine on it before and had the bad reaction the second time around. Did your doctor taper up the dose and monitor your blood levels to make sure that you were reaching the target serum concentration, but not going any higher than the normal range? If not, maybe a more careful try at lithium again might be worth a shot. If he/she did follow that protocol, then it might be wise to look into a different medication. The website the ILADVOCATE posted is great for comparing mood stabilizers, and nowadays there are some very effective alternatives to lithium for maintenance treatment. Do you experience depressive episodes as well as manic episodes, or are you just more of a "manic type"? This could guide which medication to pursue.
There is a belief held by some in the psychiatric community that untreated bipolar disorder will get worse over time. This is sometimes referred to as "kindling theory", something that's also applied to epilepsy. I don't think there's a total consensus on it just yet, but I think most doctors approach bipolar disorder treatment as if this theory was true. Kindling theory could also be applied to bipolar disorders triggered by antidepressants, where the first manic episode is medication induced, but the person then goes on to experience spontaneous manias without antidepressants.
Your manifestation of bipolar disorder seems to be more classic (that is, not rapid cycling, mixed, etc.), where you have periodic manic episodes and then long periods of more or less normal mood in between. Lithium is a great medication for this type of BP, but it also might be worth looking into alternatives and discussing this with your doctor. Lithium was okay for me, but I'm on lamotrigine (Lamictal) now and I feel good, pretty much back to normal. There's no harm in at least exploring the options, because you never know what might work.
My last comment is that you're already on the right track by recognizing your mania triggers. This is a really important thing to do, and a lot of people struggle with it.
I have struggled getting treatment actually and I have had to go off and on lithium due to being ill, but before last year I was never treated for my bipolar. I jumped from job to job, made rash decisions at the drop of the hat, such as one day I decided to drop out of school for no reason. Racing thoughts, paranoia, delusions of persecution for a while there... Yeah, it has not been an easy road for me without treatment. I always was mad no one ever helped me. When I was feeling good of course I wasn't looking for help, only when depressed, but it was when I was feeling good that things were actually worst for me and I was just a kid.
Well, now I'm an adult and I'm trying to be treated so I can get well because I have noticed I am worse. I cycle more and more, or I'm mixed more and more. Not sure which exactly, but that's how I feel. I would say talk really seriously with your doctor. You probably need a different medicine or something.
I'm surprised your doctor didn't taper you onto the Lithium this time. As others have suggested, that could have been the simple issue.
That being said, I have been on Lithium twice myself. Both times, the doctor's tapered me onto the med. The first time, it worked quite well, though I did have some low level reduction in thyroid functioning that was successfully addressed with the addition of Synthroid. I only went off of the Lithium the first time because I changed doctors (a necessity after moving from one state to another) and the new doctor simply refused to treat me with Lithium based on his belief that there are better (read newer) meds out there and that Lithium was too risky.
After working my way through many other options of medication, some having very serious side effects, some having very rare side effects, and some simply no longer being available to me due to lack of health insurance, another doctor decided to place me back on Lithium. The second time through, my thyroid functioning totally destabilized swinging from one extreme to the other even while attempting treatment with Synthroid. Add to that the fact that it wasn't helping my mood swings really and that my hair was falling out (not breaking off, literally falling out) and the doctor decided that I simply wasn't tolerating the med well that time. Apparently, there are people for whom a med will work once, and not work if you try to go back on it again later. I am one of those people, maybe you are too...
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