Aa
Unsure About What to Do
I have having a dilemma regarding my treatment and it is advice from more experienced sufferers of bipolar disorder, or from other medical professionals, that I seek. First some background of my situation:
In May of 2006 I was diagnosed with Bipolar Type I after having a manic episode resulting from a combination of stress and marijuana abuse. I was sleepless for a week and neither me nor any of my friends (who were with me and helped me through it) knew anything of bipolar disorder or mania. As such no one knew what was happening to me. I did however recognize that I could not sleep and so read about sleep deprivation (surprisingly nothing linked to any information about bipolar disorder or mania, or perhaps I just missed such information) at which point I learned that after awhile hallucinations occur and eventually insanity. So when I eventually started hallucinating (only auditory and delusions of grandeur) I was prepared and was thankfully safe in my apartment with close friends. After almost a week of sleeplessness my thoughts were getting so distorted (not violent but I thought I was Jesus incarnate!) that I realized it was time to go to the hospital. We knew that insanity wasn't far away though no one knew exactly what that might entail, though I was about to find out. I won't go into details about what happened once in the ER but, after feigning sleep (in my psychosis I felt I had to) and subsequently being stripped naked and laid on the exam table, I went into a fully blown violent psychotic state. After many days of confused hospitalization I finally began to think rationally and had it explained what had happened and that I had this disorder.
I was then put on 15 mg of olanzapine (Zyprexa) and for 3 months I was alright. Then, in September, I went back to school and became very depressed at which point my doctor prescribed lamotrigine (Lamictal), which seemed to curb my depression. And so I was quite stable for nearly 10 months on the same 2 medications, during which time I graduated from college and got a full time job.
After getting said job in July my insurance information changed and I needed to find a new doctor. At the time I was busy with work and moving into a new apartment so I put off finding a new doctor. Because I was unable to see my old doctor he was unable (or unwilling) to continue to prescribe my medications and so, when they ran out in August, I simply ceased taking them. I experienced no withdrawal symptoms, which is surprising since I have been reading now that stopping both medications can cause them.
Very soon after I stopped taking the medications I actually felt much better, a better mood in general and more stable. The short periods of slight depression were gone and I found that I didn't need so much sleep (I could and would sleep 15 hours) and it was much easier to get myself out of bed in the morning (though still unpleasant as I have always been a night owl). So here I am 4 months later, still very stable and feeling better than I have since before I knew anything about bipolar disorder. I would like to say at this point that going off of my medication like that was careless at best and utterly foolish at worst and I would not necessarily recommend it to anybody without consulting your doctor. However I reasoned (perhaps falsely) that if depressive or manic symptoms returned it would take days of sleeplessness before developing psychosis and so I would have had time to seek emergency help. Furthermore my roommates/friends we fully aware of what was going on and so were able to monitor my behavior and report any strangeness.
That brings me to my present situation. Last week I finally had my first appointment with a new doctor and, after hearing all about my past and present situation, he prescribed ziprasidone (Geodon) and oxcarbazepine (Trileptal). I filled the prescription but do not know if I am going to begin taking them. My view is that if it isn't broken (not experiencing any mood swings or depressive/manic symptoms), don't try to fix it. I discussed this with him and he informed me that with bipolar disorder it is best to attempt to maintain stability throughout rather than medicating only from crisis to crisis. I didn't think of it when with the doctor but I have since wondered what is wrong with medicating only when needed (experiencing symptoms), especially if stability is maintained otherwise. After all one doesn't take antibiotics unless there is an infection present. (This may be a bad example as I know little about medicine)
I would like to mention here that I am not in denial about having this disorder given my family's history of mental illness, nor do I believe that I will never again have another episode with or without medication. I do however feel that I am now self-aware enough to recognize the signs of another episode very early and will not hesitate to seek help. I am merely questioning whether or not constant pharmaceutical treatment is necessary or even beneficial. I would generally prefer to not be on any medication unless it is necessary since it can produce side effects (I gained a lot of weight from olanzapine), imposes restrictions (like no alcohol, which I admittedly enjoy), is expensive even with insurance, and I feel better without it (though I have yet to try the newly prescribed medications).
Aside from that there are other things that encourage me to question my current treatment and which diminish my confidence in the psychiatric paradigm in general:
-After doing some reading it seems as though physicians and scientists are still very much in the dark about why and how these drugs work, only that they alleviate symptoms in certain patients.
-My present doctor prescribed totally different medications than my previous doctor and I think he mentioned that he never prescribes lamogtrigine despite the fact that it is the only drug besides lithium to be granted FDA approval for treatment of bipolar disorder. While I have no doubt that he has perfectly valid reasons for not prescribing that particular drug (likely his experiences with patients), it just seems like treatment is very much a matter of the doctor's personal preferences and biases. Perhaps it is just the nature of the beast at this point, but treatment seems very much a trial-and-error process rather than the exact science it is sometimes perceived to be.
-Drug companies, while definitely providing a great service to humanity, are after all large, profit-driven corporations who spend extremely large sums of money marketing their products to doctors and consumers (turn on the TV or look around any medical establishment at all the drug-branded office supplies). While some may think it paranoid, I can't help but wonder what influence these wealthy companies might have on the current methods of treatment.
I apologize for the length of this post but I just wanted to detail my exact situation in case anyone has had similar experiences. Any thoughts or advice would be greatly appreciated.
In May of 2006 I was diagnosed with Bipolar Type I after having a manic episode resulting from a combination of stress and marijuana abuse. I was sleepless for a week and neither me nor any of my friends (who were with me and helped me through it) knew anything of bipolar disorder or mania. As such no one knew what was happening to me. I did however recognize that I could not sleep and so read about sleep deprivation (surprisingly nothing linked to any information about bipolar disorder or mania, or perhaps I just missed such information) at which point I learned that after awhile hallucinations occur and eventually insanity. So when I eventually started hallucinating (only auditory and delusions of grandeur) I was prepared and was thankfully safe in my apartment with close friends. After almost a week of sleeplessness my thoughts were getting so distorted (not violent but I thought I was Jesus incarnate!) that I realized it was time to go to the hospital. We knew that insanity wasn't far away though no one knew exactly what that might entail, though I was about to find out. I won't go into details about what happened once in the ER but, after feigning sleep (in my psychosis I felt I had to) and subsequently being stripped naked and laid on the exam table, I went into a fully blown violent psychotic state. After many days of confused hospitalization I finally began to think rationally and had it explained what had happened and that I had this disorder.
I was then put on 15 mg of olanzapine (Zyprexa) and for 3 months I was alright. Then, in September, I went back to school and became very depressed at which point my doctor prescribed lamotrigine (Lamictal), which seemed to curb my depression. And so I was quite stable for nearly 10 months on the same 2 medications, during which time I graduated from college and got a full time job.
After getting said job in July my insurance information changed and I needed to find a new doctor. At the time I was busy with work and moving into a new apartment so I put off finding a new doctor. Because I was unable to see my old doctor he was unable (or unwilling) to continue to prescribe my medications and so, when they ran out in August, I simply ceased taking them. I experienced no withdrawal symptoms, which is surprising since I have been reading now that stopping both medications can cause them.
Very soon after I stopped taking the medications I actually felt much better, a better mood in general and more stable. The short periods of slight depression were gone and I found that I didn't need so much sleep (I could and would sleep 15 hours) and it was much easier to get myself out of bed in the morning (though still unpleasant as I have always been a night owl). So here I am 4 months later, still very stable and feeling better than I have since before I knew anything about bipolar disorder. I would like to say at this point that going off of my medication like that was careless at best and utterly foolish at worst and I would not necessarily recommend it to anybody without consulting your doctor. However I reasoned (perhaps falsely) that if depressive or manic symptoms returned it would take days of sleeplessness before developing psychosis and so I would have had time to seek emergency help. Furthermore my roommates/friends we fully aware of what was going on and so were able to monitor my behavior and report any strangeness.
That brings me to my present situation. Last week I finally had my first appointment with a new doctor and, after hearing all about my past and present situation, he prescribed ziprasidone (Geodon) and oxcarbazepine (Trileptal). I filled the prescription but do not know if I am going to begin taking them. My view is that if it isn't broken (not experiencing any mood swings or depressive/manic symptoms), don't try to fix it. I discussed this with him and he informed me that with bipolar disorder it is best to attempt to maintain stability throughout rather than medicating only from crisis to crisis. I didn't think of it when with the doctor but I have since wondered what is wrong with medicating only when needed (experiencing symptoms), especially if stability is maintained otherwise. After all one doesn't take antibiotics unless there is an infection present. (This may be a bad example as I know little about medicine)
I would like to mention here that I am not in denial about having this disorder given my family's history of mental illness, nor do I believe that I will never again have another episode with or without medication. I do however feel that I am now self-aware enough to recognize the signs of another episode very early and will not hesitate to seek help. I am merely questioning whether or not constant pharmaceutical treatment is necessary or even beneficial. I would generally prefer to not be on any medication unless it is necessary since it can produce side effects (I gained a lot of weight from olanzapine), imposes restrictions (like no alcohol, which I admittedly enjoy), is expensive even with insurance, and I feel better without it (though I have yet to try the newly prescribed medications).
Aside from that there are other things that encourage me to question my current treatment and which diminish my confidence in the psychiatric paradigm in general:
-After doing some reading it seems as though physicians and scientists are still very much in the dark about why and how these drugs work, only that they alleviate symptoms in certain patients.
-My present doctor prescribed totally different medications than my previous doctor and I think he mentioned that he never prescribes lamogtrigine despite the fact that it is the only drug besides lithium to be granted FDA approval for treatment of bipolar disorder. While I have no doubt that he has perfectly valid reasons for not prescribing that particular drug (likely his experiences with patients), it just seems like treatment is very much a matter of the doctor's personal preferences and biases. Perhaps it is just the nature of the beast at this point, but treatment seems very much a trial-and-error process rather than the exact science it is sometimes perceived to be.
-Drug companies, while definitely providing a great service to humanity, are after all large, profit-driven corporations who spend extremely large sums of money marketing their products to doctors and consumers (turn on the TV or look around any medical establishment at all the drug-branded office supplies). While some may think it paranoid, I can't help but wonder what influence these wealthy companies might have on the current methods of treatment.
I apologize for the length of this post but I just wanted to detail my exact situation in case anyone has had similar experiences. Any thoughts or advice would be greatly appreciated.
My meds prevent bi polar I feel great and I have a normal life now. Held my job for 8 years and that is a record for bi polar me.lol when you star the med e sure to give 4-6 weeks and go from there.Let me know how it works out for you.
That's exactly the thing though: I am experiencing absolutely no symptoms and thus I am presently "beating this thing" without the aid of medication or therapy. I have decided though that I am going to start the medication after the New Year's and see if it makes me feel better (don't see how this is possible) or worse, as I want to be able to drink over the holidays. My only goal presently is not to alleviate symptoms (since there are none) but rather to not have another episode, and if the medication does that then I will use it. Speaking of which, in your experiences, does medication indeed prevent episodes or make it easier to deal with them?
As far as therapy goes I did it for awhile with my old doctor and, while I had some issues with which it helped, we eventually ran out of things to talk about. Though I am quite happy, I lead a pretty normal, uneventful life presently and as such I don't have many of the issues that I think many other sufferers of mental illness have (substance abuse, anxiety, etc.) I will say however that I think group therapy is very neat as I had to do that while still an outpatient after my hospitalization. As such I may at some point join a support group but I don't have enough free time to do all the things that I want as it is.
As far as therapy goes I did it for awhile with my old doctor and, while I had some issues with which it helped, we eventually ran out of things to talk about. Though I am quite happy, I lead a pretty normal, uneventful life presently and as such I don't have many of the issues that I think many other sufferers of mental illness have (substance abuse, anxiety, etc.) I will say however that I think group therapy is very neat as I had to do that while still an outpatient after my hospitalization. As such I may at some point join a support group but I don't have enough free time to do all the things that I want as it is.
bi polar need to be treated with a mood stabilize and an anti depressant. also therapy will help you maintain a good balnce in addition to the meds. it really takes both to beat bi polar and it can be beaten.I am proof of that I take my meds and go to therapy and I have a great life for 7 years now My husban brought the point home when he asked me how badly I wanted to be better and I decided I wanted to better so I take my meds and live very well now. you can beat this thing. take your meds exercise and eat healthy.
Love Venora
Love Venora
First off if you are not comfortable with your new doctor find a new one, one that will talk with you and answer why he/she is giving you something different.
As for your "don't fix it if it ain't broke" theory. It's the nature of the beast. When we are within normal mood ranges we don't feel we need the meds. And yes the side effects of the meds can be a *****. "I gained a lot of weight from olanzapine" (Lamical is weight neutral no gain or loss, which is why I'm on it after Lithuim put 70 lbs on me, and am now trying Topomax to try and lose weight) But remember the meds usually take a month in your system to be at max. working. (like birth control pills) and along those lines, you can't just take a BCP after sex for it to work. It's called maintance.
As you described your first episode. Do you think that by the time you figured out (if you even did) your manic was coming on and you took the meds they would take effect in time to help. You stated you were in the hospital for days, and I suppose that they gave you high doses of meds in a controled enviroment.
You stated also the you don't like the restrictions like no alcohol. Me either. lol. But that's another off shoot of bipolar that a lot of us have substance abuse to go along with it. And many before being diag. used the "drugs" to self medicate so to speak. Or so they say.
I still go out once in a while and have a few drinks and luckly have not had any problems other than I get drunk faster...lol. for 2 reasons I think. Tolerance is down and the meds increase the effect. I don't advise you to do it, but if you do make SURE you have a friend to watch out for you and don't drive.
-Drugs to treat bipolar are also used for other problems many times. In my own words I call them cross-overs
-Drug Company's will get away with it until the government stops them.
As for your "don't fix it if it ain't broke" theory. It's the nature of the beast. When we are within normal mood ranges we don't feel we need the meds. And yes the side effects of the meds can be a *****. "I gained a lot of weight from olanzapine" (Lamical is weight neutral no gain or loss, which is why I'm on it after Lithuim put 70 lbs on me, and am now trying Topomax to try and lose weight) But remember the meds usually take a month in your system to be at max. working. (like birth control pills) and along those lines, you can't just take a BCP after sex for it to work. It's called maintance.
As you described your first episode. Do you think that by the time you figured out (if you even did) your manic was coming on and you took the meds they would take effect in time to help. You stated you were in the hospital for days, and I suppose that they gave you high doses of meds in a controled enviroment.
You stated also the you don't like the restrictions like no alcohol. Me either. lol. But that's another off shoot of bipolar that a lot of us have substance abuse to go along with it. And many before being diag. used the "drugs" to self medicate so to speak. Or so they say.
I still go out once in a while and have a few drinks and luckly have not had any problems other than I get drunk faster...lol. for 2 reasons I think. Tolerance is down and the meds increase the effect. I don't advise you to do it, but if you do make SURE you have a friend to watch out for you and don't drive.
-Drugs to treat bipolar are also used for other problems many times. In my own words I call them cross-overs
-Drug Company's will get away with it until the government stops them.
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