Jump to content
CrazyBoards.org

Progression of Symptoms When Left Untreated


Recommended Posts

I've read in a lot of places that untreated BP leads to a progression of symptoms; however, the thing I'm not clear on is whether the same is true with those who remain unmedicated because life is stable without meds.

I stopped meds for various reasons with the approval of my pdoc. Aside from a horrible 2 weeks of misery caused by tramadol completely fucking up my neurochemistry, the worst I've experienced are "the blues" and light elevation of mood. All of which seem to be partially influenced by external events, though not solely.

So I wonder, with my brain not crashing into depression or overheating into mania, has anyone read any research on what the dangers are regarding BP progression in someone who can be defined as "stable"? My symptoms are probably 90% depression, 10% everything else. I'm pretty sure the mixed episodes were caused SOLELY by taking SSRIs and related drugs. I can't think of any time I was like that where I wasn't being medicated. Hypomania seems to be the MO for my brain in terms of non-depressive symptoms and I have experienced "mild" psychotic symptoms at times--generally when under a great deal of stress.

I know this site is extremely pro-medicating, but I'm asking aside from that, is there research on brain damage occurring in BP people even when they're stable that anyone's aware of?

I fully intend on getting back on meds if (when) things start going bad again. The depression is where the danger lies for me and I'm pretty good at spotting when things are going beyond the blues. Plus I have feedback from my BF which is a big help.

Link to comment
Share on other sites

No, that is getting to far down in the weeds.

What would you do with a number like: "For patients ill more than 2 years who cease medication, the relapse rate is 74.5% within six years" (completely fictional). *Shrug*'

We have the well documented works of Dr. Emil Kraepelin from the 1890s thru 1920's. Significant because this was an era before any medication, and he was able to follow many patients for a majority of their lifetimes. From his life charts we can see the natural progression of the illness. I'll try to find a link.

From the modern era of medication (really 1970 in the US with Lithium) there are numerous studies showing the high rate of relapse following discontinuation, especially going cold turkey. Jamison and Goodwin's 'Manic Depressive Illness' is probably the best ready source.

Link to comment
Share on other sites

If your bipolar diagnosis is correct, it is extremely unlikely that you will not relapse, off meds. That's such an uncontested reality I wouldn't even know where to go to support it. It's kind of like looking for research supporting the statement, "The sky is blue."

Link to comment
Share on other sites

To clarify: I would have just kept it as "when I relapse" instead of "if (when) I relapse", but I was trying to be an optimist. I'm not kidding myself about the nature of the BP and know it's likely only a matter of time.

I'm just curious as to if there is any real damage done if you're BP, stable, and unmedicated. I'm definitely not against meds; just trying to understand it all.

Anyone know of any super secret magic ways of getting to read peer-reviewed articles without a subscription? :)

Thanks.

Link to comment
Share on other sites

Well, staying on meds would most likely prevent a relapse. I'm not bp but I do have recurrent depression and can be almost 100% assured that if I go off half my meds I'll have another major depressive episode. I've accepted that I'll need to be on meds for life to prevent repeatedly becoming disabled for several months as I suffer through episode after episode.

As I understand it, with both bp and depression, the more episodes you have, the more likely you are to have another one and the harder the next one will be to treat. With each episode brain cells are killed off and you are left less functional than you were prior to the previous episode.

Your goal, IMHO, should really be to do everything you can to try and never have another episode if you can and to make sure it's as short and mild as possible if you do.

Link to comment
Share on other sites

VE,

I don't like the statement: "With each episode brain cells are killed off and you are left less functional than you were prior to the previous episode." I believe that damage to the brain in one region may be compensated in another region. We just don't know enough at this point and loss of functionality may be individualistic. The brain is highly plastic after all.

This is not to say that I don't think episodes should be avoided. And, I totally agree that a healthy regimen needs to be maintained [drugs, diet, exercise, having good doctors, having good pets, watching good movies, reading good books, masturbating just enough but not too much, oh -- you get the picture (or maybe it's better that you don't)].

(Edit: And Sasha, the sky is not just Carolina blue. It is Rebel red sometimes also.)

(Edit again: I need to shut up. Ya'll tell me when to shut up PLEASE. I think my time might be better spend polishing a tile.)

Link to comment
Share on other sites

I found some stuff on decrease in brain volume between persons w/ BP. A few teeny studies:

http://archpsyc.ama-assn.org/cgi/content/abstract/60/12/1201

http://onlinelibrary.wiley.com/doi/10.1002/gps.2285/abstract

http://www.biologicalpsychiatryjournal.com/article/S0006-3223%2804%2900350-6/abstract

From what little I understand about the brain, it may be more losing connections than brain cell loss. But I don't know jack about the brain.

I do know that untreated BP will fuck up your life - make you miserable at best and dead at worst. I'd stay on meds. You don't know what will trigger you - could be a death, could be something great like a marriage or new job. Any stress can trigger a mood episode. It'd be best to prevent it.

Link to comment
Share on other sites

I'm not at all sure there's sufficient research to back up the statement that brain cells are killed off by mood episodes. I've looked before and not found it, but maybe I'm missing something.

I have been wondering about that too, and what makes the most sense to me is the kindling theory from epilepsy (each seizure makes one more susceptible to more, more severe seizures) being applied to mood episodes and assuming the result would be identical, which it might be and it's just easier to induce seizures in test animals to test that theory as opposed to mania and depression.

Link to comment
Share on other sites

I keep trying to type a furious response to VE's cite and I keep coming up with something that looks like word jello. So, indeed, we must all be doomed. I'm so pissed I'm going to have 1 O'Doul's.

Link to comment
Share on other sites

I'm not at all sure there's sufficient research to back up the statement that brain cells are killed off by mood episodes. I've looked before and not found it, but maybe I'm missing something.

I was thinking of stuff like this, just to use a random example off google.

http://www.emaxhealth.com/112/14510.html

Without a link to the original study being discussed, it's really impossible to know how to interpret the findings.

As Rowen said, reductions in volume aren't necessarily caused by cell death. And, at least as far as what I've seen, no one seems to be all that clear as to whether the reductions in volume are an effect of biolar, or a cause.

As, again, from what I've seen, no one's really established a consistent link between volume/density reductions, and reduced functioning.

Link to comment
Share on other sites

I had at one time a nice (and recent) powerpoint-type presentation prepared by a prof at a major US research university dealing with the high incidence of bi-polars, not only in the arts, but also in the sciences. If I can run it down again I'll link it. Point is of course that you shouldn't romance this stuff, but it is no reason to quit either.

Link to comment
Share on other sites

I'm not at all sure there's sufficient research to back up the statement that brain cells are killed off by mood episodes. I've looked before and not found it, but maybe I'm missing something.

I have been wondering about that too, and what makes the most sense to me is the kindling theory from epilepsy (each seizure makes one more susceptible to more, more severe seizures) being applied to mood episodes and assuming the result would be identical, which it might be and it's just easier to induce seizures in test animals to test that theory as opposed to mania and depression.

I don't know if it even needs to be that complicated. The more practice the brain gets at doing anything, including being manic, the better at it it becomes, and the more likely it is to do that thing again in the future.

Link to comment
Share on other sites

That's right Sasha. In a discussion with a former pdoc 20 years ago, I analogized it as feeling similar to memory in some respects. (The more you recall it, and all that.) He was interested but not terrribly impressed with my analogy.

My BP kid just says my pathways are well burned and he wants to avoid that. The wisdom of youth.

Link to comment
Share on other sites

To clarify: I would have just kept it as "when I relapse" instead of "if (when) I relapse", but I was trying to be an optimist. I'm not kidding myself about the nature of the BP and know it's likely only a matter of time.

I'm just curious as to if there is any real damage done if you're BP, stable, and unmedicated. I'm definitely not against meds; just trying to understand it all.

Anyone know of any super secret magic ways of getting to read peer-reviewed articles without a subscription? :)

Thanks.

PubMed is the US medical archives. It has the abstracts for all peer reviewed research. It is a good source for info. If you want the full text, then you need to search elsewhere.

Link to comment
Share on other sites

To clarify: I would have just kept it as "when I relapse" instead of "if (when) I relapse", but I was trying to be an optimist. I'm not kidding myself about the nature of the BP and know it's likely only a matter of time.

I'm just curious as to if there is any real damage done if you're BP, stable, and unmedicated. I'm definitely not against meds; just trying to understand it all.

Anyone know of any super secret magic ways of getting to read peer-reviewed articles without a subscription? :)

Thanks.

PubMed is the US medical archives. It has the abstracts for all peer reviewed research. It is a good source for info. If you want the full text, then you need to search elsewhere.

Abstracts are spam.

Link to comment
Share on other sites

To clarify: I would have just kept it as "when I relapse" instead of "if (when) I relapse", but I was trying to be an optimist. I'm not kidding myself about the nature of the BP and know it's likely only a matter of time.

I'm just curious as to if there is any real damage done if you're BP, stable, and unmedicated. I'm definitely not against meds; just trying to understand it all.

Anyone know of any super secret magic ways of getting to read peer-reviewed articles without a subscription? :)

Thanks.

PubMed is the US medical archives. It has the abstracts for all peer reviewed research. It is a good source for info. If you want the full text, then you need to search elsewhere.

Abstracts are spam.

Whatever. It's your issue. Equating abstracts to spam is absurd. Support what you have to say.

Link to comment
Share on other sites

To clarify: I would have just kept it as "when I relapse" instead of "if (when) I relapse", but I was trying to be an optimist. I'm not kidding myself about the nature of the BP and know it's likely only a matter of time.

I'm just curious as to if there is any real damage done if you're BP, stable, and unmedicated. I'm definitely not against meds; just trying to understand it all.

Anyone know of any super secret magic ways of getting to read peer-reviewed articles without a subscription? :)

Thanks.

PubMed is the US medical archives. It has the abstracts for all peer reviewed research. It is a good source for info. If you want the full text, then you need to search elsewhere.

Abstracts are spam.

Could you maybe share your definition of spam? Because I think of spam as crap I don't want that shows up somewhere I don't want it. Abstracts are things I find, by looking for them, in places they're supposed to be. Their purpose is to give you the general gist of the reaearch done, and to give you enough information to decide whether or not you want to go to the trouble and/or expense of obtaining the full text.

I also think of spam as likely to be in some way misleading which abstracts just aren't. They aren't the whole story, but they're fairly representative of the content.

This idea that abstracts are spam just kind of seems like it's maybe something you heard someone say, and just accepted, without a lot of critical thought, which isn't like you.

To clarify: I would have just kept it as "when I relapse" instead of "if (when) I relapse", but I was trying to be an optimist. I'm not kidding myself about the nature of the BP and know it's likely only a matter of time.

I'm just curious as to if there is any real damage done if you're BP, stable, and unmedicated. I'm definitely not against meds; just trying to understand it all.

Anyone know of any super secret magic ways of getting to read peer-reviewed articles without a subscription? :)

Thanks.

PubMed is the US medical archives. It has the abstracts for all peer reviewed research. It is a good source for info. If you want the full text, then you need to search elsewhere.

If a free full text version is available, there's usually, though not always, a link on the pubmed page.

Link to comment
Share on other sites

Could you maybe share your definition of spam?

Spam is unsolicited advertisements that are forced on you when you're expecting actual content. Abstracts might have once served and actual informational purpose but since the rise of pub med and full text articles for sale individually they mostly are nothing but advertisements to get you to purchase the full text article. They leave out most of the meaningful information you need to actually use them as a solid citation or reference so if you want to reference the research in writing a paper you have to buy the full text article. They don't provide enough information in which to solidly ground any further conclusions and they used to.

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.

×
×
  • Create New...