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Impact of medicines vs impact of disorder


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I often wonder if all the medicine I take is really the answer to my problems.  I am very high-functioning, have always been except for some irratic behavior from time to time which could be excused as anxiety, over-tired, etc.  I do have problems with depression and had one suicide attempt, but it was in the late 80s and I was an undiagnosed BP taking an SSRI.

I have been in a long marriage, had a career of over 20 years in a professional position.....has does a bipolar do that???

My therapist says it is the structure.

So if I were to put some structure safeguards into my life, could I make it?  I would continue the sleeping medicine and anxiety meds PRN (I get in trouble if I don't sleep....have done that for decades), but would wean off the a/c drugs.  I take Lamictal (250) and Trileptal (600....a hang over from a previous cocktail). I have a problem with inappropriate anger and rage, but is that me or a reaction to the meds.  Certainly the meds aren't helping it.

What do you think??  I'm so tired of this fog and memory loss that comes from all the pills.

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Hi Crazyethel !

I know we BP'ers all tend to question our medicines and start to think that we don't need them.  And then we go off our meds, blow up and prove to all and sundry that indeed we need them.  (Everyone else already knew this).

Got that Tshirt, matching ones!    And I'm like you.  I made till I was 43 before I melted down, and was never swinging from the chandeliers (why can't I have the fun, too?). But I know my brain is bent, and I can't go back to doing what I did before.

Maybe you are at the shallow end of the BP pool and can get by without meds.  I wouldn't start attributing symptoms to the meds. There a number of other mood stabilizers that can be added or switched to level things out, including the depression. Remember BP'ers, especially BPII's may spend more time depressed than (hypo)manic.

Here is a link to a thread from a few days ago on the illness progression:

http://www.crazyboards.org/index.php?showt...ndpost&p=108241

A.M.

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What's your pdoc say? You mention that your "therapist says it is the structure," but what does you psychiatrist (or other prescribing doc) think?

Another factor to consider about not being on medication is the "kindling" effect. You don't want to get worse over the long run, either. http://www.psycheducation.org/bipolar/03_t...nchor-Does-2710. I know I have a better link on this topic, but I can't find it now. This will give you some idea, if you're not already familiar with this theory. (If you are interested in reading the rest of this excellent site, go here: Mood swings without "manic" episodes: Bipolar II -- more than plain depression, but never delusional or psychotic.)

You know there are plenty of high-functioning BPs who wouldn't be that way without their meds. I think questioning what meds you are on, or even your dx, is not a bad thing at all. Expecting that you can be med-free, however, can be a disaster.

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Actually....

I know a girl who's BP II. She has fairly bad depression and the odd bit of mild hypomania. When she was diagnosed, her pdoc told her she could be on medication for as little as 6 months, though there was the possibility she'd have to be on it for several years or even the rest of her life.

When I was diagnosed by the qdoc, who I only saw once, she said that after I got stable I would be on medication for a minimum of 5 years before they considered tapering anything down. She also thought I was likely BP II, because I hadn't been hospitalised for mania therefore could only go hypomanic. (Personally, I'm not convinced- following that appointment I've had some big spikes of psychotic mania where I've been screaming my head off about being experimented on by doctors and monitored by secret cameras blah dee blah etc etc, so I'm not paying too much attention to the dx until I see the new guy). Had she felt I was BP I, I'm not sure whether she would have felt I could ever try without meds, though she did mention some guy who'd been stable on lithium for 10 years so they were tapering him off.

Anyway, the point of all that was, that over here in the UK at least, our docs seem to think it is possible to be BP and med free (I assume they think this anyway- seems stupid to take a BP off their meds if they think they're eventually going to crash again). Then again I suppose this could be a yarn they spin to newly diagnosed BPs so we don't spin off into depression at the thought of the next 60 years or so on crazy meds...

Interpret as you will. I'm off meds at the moment because it's only a week until I see the new pdoc and I'm also doing the whole questioning is it me or is it the meds thing, so I wouldn't take my advice too seriously right now, especially as it's 3.40am here and I slept for two hours last night....

I guess it could be something for you to discuss with pdoc and tdoc.

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An anecdote:

After my first episode, and before being diagnosed and medicated, I managed to rack up two major breakdowns, two degrees with honors, a good internship, nine years of a successful professional career, nine years of marriage and two pregnancies.  So, I guess I spent thirteen years trying to go it alone.

While I think I could get back to that level of functioning on my own, I doubt very much that I could sustain it without mood stabilization.  Nor was it that great, under the surface.  I used to live from one self-imposed crisis to the next, and my one long remission coincided with a significant stress reduction. Structure was necessary, but far from sufficient.

That said, no one should be condemned to a fog, and you should talk to your psychiatrist about the Trileptal hangover, the possibly memory-harming anxiety drugs, and about new or fewer mood stabilizers, especially since you have symptoms that aren't being controlled.  (I like lithium for anger, personally.)

It does seem that if a person has mild symptoms and/or long remissions and responds well to treatment after onset of an episode, they might be okay without maintenance medication.  But, as far as I can tell from the literature I've seen, nobody knows for sure.

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AM: Hey, I'm 43 too, my meltdown happened last year. Let's >clink< our med cups in celebration!

Crazyethel: what I fear most is the *gradual* build-up/breakdown/whatever. Until I plummeted into my latest deep depression and was forced to seek help, I didn't realize what a dark world I was living in. I knew I was in an obsessional fog, but until the fog began clearing, I was unaware of how deeply it was impacting my life. If BP'ers *knew* they were going apeshit crazy, more would likely to be on meds. But they don't, so they won't until it's out of control. At least that's the way it seems.

Did any of that make sense? I just tried to watch "Hitchhiker's Guide..." and my brain is too fuzzy tonight. Okay, obviously I'm still trying to work out my own med kinks.

Not saying you can't do it without meds (nope, don't work for Pfizer); maybe if you feel the meds aren't helping, talk to your pdoc about switching?

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I'm a tender young 22.  MDD since the age of 7.  Unmedicated until the age of 19 (through 5 suicide attempts).  Don't even want to think about a week without my Crazymeds, especially Lamictal and Trazodone.  Interpret as you will.

PS - Rabbit37 - I LOVED the Hitchhiker's Guide books and movie.  Especially that robot, who, through his depression, neutralized the entire misfiring Volgon army through the point-of-view gun.  Comedy gold!

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I was in my mid-thirties before being diagnosed. I had several college degrees and a good career but life was hell. I went through a couple of years trying out different meds. I've finally found a great cocktail.

I cannot, in my wildest dreams, image going a single day without my meds. If someone took my meds away it would be my worst nightmare.

Why in the world do you want to put yourself through that? You definitely need to keep trying until you find the right combination of meds that have minimal side effects.

I know bipolars have a tendency to stop their meds. I guess some people have a real problem with the idea of taking meds. Not me. Before meds = unhappy. After meds = happy.

I *heart* my meds.

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My kids are grown, I'm retired, buit I haven't added much to my life.  How much does that weigh in on the scale? Is part of my floundering around a symptom of too much time on my hands?

I think that's probably a large part of it.  I've skimmed the rest of your topic, but I don't feel up to discussing everything right now.  What it sounds like you're describing here is a deficit in your quality of life.  It's not just "structure," although that's an important part of it; it's having things worth being and doing, on top of the motivation to do those things.  What do you have in your life that draws you?  That calls you?  That you feel you need to do?  What is important to you?  My overtired impression is that you're lacking this right now.  You are a worthwhile person, and you need a life. 

I hope you're successful in finding a med regime which will forestall degeneration and let you live.  I also hope you're able to construct a life you feel to be worth living.  I think you need both.  We all do. 

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Heya,

Well, ethel, I can't say what your *own* experience has been.

Like AM, I would consider tweaking the meds I was aready on before going off altogether.

FWIW:

But here are the reasons I came up with for why I should *not* stop taking my medication (I posted this journal entry on another thread, but can't figure out linking):

Oct 17/05

Medication

Things Lamictal has done for me:

-- sleeping through the night (even at homeopathic doses)

-- no more nightmares

-- improved concentration.  Vastly improved.

-- not raging anymore.

    -- typified by road rage, something tangible.

    -- feeling sad, disappointed, confused & frustrated but not angry.  Anger was simpler and had adrenaline in it.

-- interested in learning again.

-- sex drive, more than once a week, off the charts for me.

-- able to do this:

When I feel sad, hopeless, worthless, guilty, and like everything is my fault:  I can sometimes see that that's depression thinking and not me, not real.  And work against it a little.  Or, sometimes ignore it and wait for it to go away.  Sometimes.  A little bit.  Which is a thousand times more than before.

--less agitated, less of a startle response.

-- teeny wee bit less social phobic

-- more able to speak up for mself

-- calmer.  More able to calm myself.

-- not so pressured.

-- able to relax on vacation.

----

Without referring back to this, I would've gone off meds 20 times in the past 6 months.

My life has definitely been limited since I got diagnosed.  There are *so many* medical things I'd like to be doing, like delivering babies, surgical assists, emerg, b/c they would screw up my BP.

It's so easy to think I can't do them b/c Lamictal puts me to sleep around 10pm.

Your truth is yours alone, but this is mine.

--ncc--

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My husband used to go off his meds as soon as he felt better. After the last episode of no meds/calling the men in the white coats/into the loony bin/ etc....I told him the descision to take meds was his. But I get to decide if I want to live with an unmedicated bipolar.

Basically no meds = no marriage. I was not going to go through him waiting until he was so sick that only a hospitalization would help him and then fight me while I tried to get him admitted. (Ever try to do that with no insurance?!?!?! Way Fun!!) Love was not going to be enough to make me do that again and we have been married for 19 years.

I can easily see you wanting to get to the lowest possible therapuetic level of medication, but the "do I really need these meds?" question....well...ask your pdoc, ask your SO. My husband kept telling me, his family and himself that he didn't need the meds. He was very, very wrong.

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Thanks, wife, for your particular perspective.

As you suggested I asked my husband what he thought of all this and his feeling was much like yours.....take as little as you have to in order to stay stable, but don't think you can do without.

I would imagine the pdoc will say the same.

This thread is making me think more about taking responsibility for more of my problems/my health.  I think I've been very busy assessing blame.

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