Can bipolar disorder become treatment refractory?

I was diagnosed with bipolar disorder approximately 3 years ago, after about 15 years of mostly untreated episodes. My current doctor has been very good about monitoring medication and trying various combinations of ADs and mood stabilizers, as well as tracking thyroid function and other blood tests--all of which have been normal. Current medication is 1200 mg Neurontin, 300 mg Wellbutrin, 20 mg Celexa, 10 mg Ambien and 1 mg Klonopin PRN (which is seldom), and I've been working hard in psychotherapy for two years. Despite all this, I've only experienced about 4 months euthymia in that time, with a tendency mostly toward depression and occasional euphoric mania. I was recently stable for 6 whole weeks, but now feel myself slipping back into depression.

Okay, so the question part... I had hoped to enroll in the college of Nursing this fall--but now wonder if I'm *ever* going to be sufficiently stabilized. Can bipolar disorder become treatment refractory? Or is there still hope of getting it under control? Does nursing school seem like an unrealistic goal? Please don't hold out false hope--what I'm really looking for is a reality check.

Thank you so much for taking time to read and respond to my question.

marcia

[HFHS-M.D.-HG]

Dear Marcia

People with bipolar disorders are able to function at different levels depending upon the severity of their condition. Unlike Schizophrenia, which is considered as a chronic deteriorating condition, bipolar disorder is considered to be different with periods of exacerbation and remissions. Even though going to a nursing school doesn

[HFHG-M.D.-HG]

Dear Marcia

People with bipolar disorders are able to function at different levels depending upon the severity of their condition. Unlike Schizophrenia, which is considered as a chronic deteriorating condition, bipolar disorder is considered to be different with periods of exacerbation and remissions. Even though going to a  nursing school doesn