One year medication-free with bipolar disorder

Although he doesn’t recommend it for others, Philip over at Furious Seasons describes what kind of year it’s been since he’s been off of his medications for bipolar disorder: I’m comfortable saying that if I were going to crash and burn and wind up back at square one, it likely would’ve happened by now. Things haven’t been perfect–there was a bout of depression/seasonal affective disorder a few months back, and my metabolism went haywire after I got off Lamictal and I put on 20 pounds–but I did come through an extremely cold, gray winter (one of the worst ever in Seattle), have been under loads of professional and life stresses and so on. And, yet, things are pretty good. This isn’t supposed to be happening, not by the standards of medicine and psychiatry. Bipolar disorder is a lifetime diagnosis and you take medications pretty much forever. If you don’t follow through, you are dangerous, a person best kept at arm’s length by one and all. I know I am lucky, but luck only accounts for so much. The rest is all questions: Did I ever have bipolar disorder? Was my initial diagnosis wrong? Am I a false positive? Did I cure myself? Am I simply a bipolar who does well without meds? Am I in a lengthy remission that will crumple on me someday? Is the diagnosis of bipolar disorder bullshit to begin with? Does the disorder ebb with time? Or am I just a medical freak show, the lone exception that proves the rule? In his followup post, he describes what led to his decision to try his psychiatrist’s advice to get off of medications altogether, after trying a number of combinations of medications that didn’t seem to be helping him all that much. I don’t think bipolar disorder has to be a “lifetime diagnosis” — people can and do get better with it over time. And while I don’t think going off of meds for bipolar is for anyone to try on their own (Philip did it with his psychiatrist’s help), it may be something to discuss with your doctor if you feel like you’ve hit a treatment wall. The problem with medication compliance in bipolar disorder is primarily when a person is in a manic phase and feels like they no longer need the medication, and discontinue it on their own, without consulting their psychiatrist or doctor. The conventional wisdom is that for someone to be successfully treated with bipolar disorder, they must be on medication for a very long time. Sometimes the conventional wisdom is wrong. Congratulations, Philip! We hope you have many more fruitful years to come. Read the first post: Losing my religion Read the followup post: How I got off meds (Source: World of Psychology)

How i got off-meds

I wanted to clear up a few misconceptions that seem to have cropped up around my posting on being off-meds for bipolar disorder for one year. First, it is not a path I am suggesting others follow. There's no way I could make that kind of suggestion from a distance for other people (I should note that if I did pro-meds advocates would likely call me irresponsible and a murderer, but one wonders what I should call them when they press people to take medication, especially when it's medication that isn't working, without knowing much about the person they are suggesting it for. We see this all the time, don't we? Paging Fuller Torrey, paging NAMI). If there's any implication in my own experience, it's that others should be open to this possibility for themselves or others, regardless of where they stand on the on-meds/off-meds divide. Doctors and other mental health providers should have an open mind as well. Second, some people think this is a path I chose for myself. Not really. My doctor pressed it upon me, two times in separate appointments before I agreed to give it a go. Yes, psychiatrist haters, a psychiatrist did this. That said, my own case and my own choices about what I would and wouldn't take certainly backed my psychiatrist into a clinical corner. I didn't do this wittingly. It was the by-product of my frustrations with anti-depressants and antipsychotics, and in the end that's what guided my treatment. When I began seeing a new psychiatrist in 2004, I was taking Depakote and Wellbutrin. I wasn't doing very well, but I wasn't doing very badly either. I was very clear with the new doc that Wellbutrin wasn't working for me at all and that I was tired of Depakote. Did I want to try another anti-depressant? he asked. I told him I didn't think that made much sense since I'd already been on six different ones, none of them had worked and several of them had fucked me up. Why would a new one be any different? He took me off those meds and I went onto Lamictal and a low dose of Seroquel. He also gave me a small scrip of Ativan to take as needed, and I promised him I wouldn't let myself get addicted to benzos (the scrip was small enough to where that wouldn't happen). One thing I should mention is that after years of bouts of suicidal ideation--largely driven by anti-depressants in my opinion--I hadn't had a suicidal image in my head for about a year. I'd driven them out somehow. Or maybe being off anti-depressants ended them. Who cares which? The next year, I lost my patience with Seroquel--the weight gain, the bad dreams, the agitation, the fifth of whiskey head in the morning, the TD and so on were too much to tolerate--and I took myself off it before visiting my doctor to discuss the situation. He felt I should be on a low dose of an atypical and I told him I'd give it a try and so I took Geodon for about three weeks until I was so agitated and hypomanic that I couldn't sleep (lost a lot of weight though). I took myself off that particular poison pill on my own also. And so, in late August of 2005, there I was talking with my psychiatrist and he said, "What do we do now?" I was on Lamictal and taking Ativan perhaps twice a month. "Nothing," I said. I was sick and tired of polypharmacy and my gut hunch was that I wanted to simplify things and see what happened. I already knew how more meds and more meds worked out. "Let's see how I do on Lamictal alone." And when I did very well on Lamictal only over the next 18 months or so that's when my psychiatrist started pressing me to get off meds altogether. That's how I got off-meds. I hope other patients can work out a similarly beneficial relationship with their docs. And, I hope I cleared things up instead of muddying the waters further. (Source: Furious Seasons)

Judge weinstein : fda: eli lilly: accountability!

(Source: soulful sepulcher)

What about lithium for bipolar disorder?

Often overlooked in the conversation about things that work for bipolar disorder is the old stand-by, lithium. Lithium is a naturally occurring salt that was, prior to the past decade or so, the medication treatment of choice for bipolar disorder. It is now seen more as a secondary treatment with doctors instead preferring the pricier atypical antipsychotics. That’s because lithium has some unpleasant side effects (but hey, what medication doesn’t?). Our new blog, Bipolar Beat has a great entry about lithium that’s worth a read: Bipolar Medication Spotlight: Lithium. It’s a great informational piece about this medication and how it’s regaining some renewed interest and prescribing popularity as the downsides to the newer atypical anti-psychotics are becoming better highlighted and understood. (Source: World of Psychology)

Here kitty kitty

C, the feline here-recently informed me she purchased Bipolar for Dummies. We had some quality phone time and some needed laughs that afternoon as she read excerpts from it. She plans on reviewing it here…possibly in a series…soon. *ahem* here kitty kitty…. *waves …arm* Well, now they have an on-line advertisement blog. You can read about [...] (Source: bipolar chicks blogging)

Feeling, not thinking in pediatric bipolar

In this study from Chicago, researchers compared the responses of children to negative words. As a group, children diagnosed with bipolar affective disorder had more activation in their emotional limbic areas, and less activation in prefrontal (executive function, cognitive control) areas. Responses to positive emotional words were exaggerated in dorsolateral prefrontal cortex, an area known to be important for attention, working memory, and response inhibition. Feeling vs. Thinking in Pediatric Bipolar Disease Eide Neurolearning Blog (Source: Eide Neurolearning Blog)

Losing my religion

Yesterday was the first anniversary of the last day I took a psych med--Lamictal--after 18 years of being in the mental health system, taking meds with a 99 percent compliance rate after being diagnosed with bipolar disorder in 1989. Today is the first anniversary of my first meds-free day--one sanctioned by my own psychiatrist--since I was 26 years old, excepting 3 months back in 2003. In the year since, I have had fellow bipolars tell me--in emails usually--that my chances for success were slim to none. One told me I'd wind up dead. I'm in too generous a mood to get into who said this and, besides, I am doing quite well and were I to get into who these Nostradamuses of the mental health world are, then I'd have to point out how poorly some of them are faring despite being "experts" in bipolar disorder. I'm comfortable saying that if I were going to crash and burn and wind up back at square one, it likely would've happened by now. Things haven't been perfect--there was a bout of depression/seasonal affective disorder a few months back, and my metabolism went haywire after I got off Lamictal and I put on 20 pounds--but I did come through an extremely cold, gray winter (one of the worst ever in Seattle), have been under loads of professional and life stresses and so on. And, yet, things are pretty good. This isn't supposed to be happening, not by the standards of medicine and psychiatry. Bipolar disorder is a lifetime diagnosis and you take medications pretty much forever. If you don't follow through, you are dangerous, a person best kept at arm's length by one and all. I know I am lucky, but luck only accounts for so much. The rest is all questions: Did I ever have bipolar disorder? Was my initial diagnosis wrong? Am I a false positive? Did I cure myself? Am I simply a bipolar who does well without meds? Am I in a lengthy remission that will crumple on me someday? Is the diagnosis of bipolar disorder bullshit to begin with? Does the disorder ebb with time? Or am I just a medical freak show, the lone exception that proves the rule? There are likely other questions worth asking as well. They are worth asking because I suspect that what's going on with me isn't restricted to me alone. There's recent research indicating that 50 percent of diagnoses of bipolar disorder are wrong and I've had psychiatrists tell me they've been saying the same thing for a decade. Let's assume the 50 percent figure is on the high side and use 25 percent. With anywhere from 6 million to 12 million American adults diagnosed with some flavor of bipolar disorder (the low number is from NIMH, the higher number is from pharma ads), then we are talking anywhere from 1.5 million to 3 million bipolar diagnoses that are in doubt. I suppose I could be deeply bitter about my own experience--18 years of meds I may not have needed is enough for a sea of bitterness, as is all the lovely social discrimination around being tagged with the disorder--and declare psychiatrists body snatchers and psychiatry a thought crime. That's not going to happen. I'm not into the whole anti-psychiatry, identity politics thing. I've seen enough true positives in my life to where some things about psychiatry make sense, but perhaps for shorter periods of time than doctors think. I've also seen enough people being pounded by treatments that aren't working for them--or are flat out injuring them--that you have to wonder how humane some doctors are. I've also seen a fair number of false positives. I've had almost 19 years of seeing my life and experiences through the lens of a disorder. And, now what? How do I reconcile and correlate who I was when I was 25 and 26 with who I am now? I don't know because I cannot even remember who that guy was, but it is like losing my religion in a way. Replacing it with I don't know what. This all raises several issues for the practice of psychiatry. I'll get to those in a later post. For now, it's almost a birthday and I deserve a drink. (Source: Furious Seasons)

Rampage

My heart is breaking guys. I hate to hear of anyone becoming acutely ill. I’m just hoping for the best. That he gets the care he needs and comes out of this as Quinton; and not some damn medicated zombie or someone forever lost. He seems like such a good guy. Dana White, on “a little” about Rampage’s mental [...] (Source: bipolar chicks blogging)

My diabetes journey has moved on to insulin injections

It was no surprise when, after reviewing my latest blood glucose monitor readings, my HIV specialist prescribed insulin injections. (He’s been working on me about this.) Diet was not doing enough and the pills could only do so much for so long (approximately five years). I had already been to a diabetes [...] (Source: My journey with AIDS)

Nice? f*ck nice! i’m sick of the drama

 Beginning To The End Of My Niceness An update to an update on my journey of trying to be a good person. That’s what this post is about. Wanna know where my phone is at the moment? Buried under a mound of pillows to stiffle the ring. Wanna know why? Because, I was nice to a person [...] (Source: bipolar chicks blogging)

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