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Mental Health (Expert Forum)
Can bipolar disorder become treatment refractory?
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.
Can bipolar disorder become treatment refractory?
by marcia, Feb 26, 2000 12:00AM
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
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
Doctor's Answer
by HFHS-M.D.-HG, Feb 28, 2000 12:00AM
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’t seem to be an unrealistic goal for a bipolar patient, it depends on your motivation and mental condition. I would recommend that you discuss your concerns with your doctor because he would be able to help you the most since he knows your situation. Ongoing psychotherapy and medication adjustments would be helpful. There is a good chance of getting it under control.
Sincerely
HFHS-M.D.
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’t seem to be an unrealistic goal for a bipolar patient, it depends on your motivation and mental condition. I would recommend that you discuss your concerns with your doctor because he would be able to help you the most since he knows your situation. Ongoing psychotherapy and medication adjustments would be helpful. There is a good chance of getting it under control.
Sincerely
HFHS-M.D.
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’t seem to be an unrealistic goal for a bipolar patient, it depends on your motivation and mental condition. I would recommend that you discuss your concerns with your doctor because he would be able to help you the most since he knows your situation. Ongoing psychotherapy and medication adjustments would be helpful. There is a good chance of getting it under control.
Sincerely
HFHS-M.D.