bipolar no meds, anyone?

[MitchyInge]

am keen on the idea of treating episodes rather than taking long term maintenance meds, or that is my excuse, actually I just hate taking meds and have never fully accepted my diagnosis even though it is probably sound

but what do you do if mood sinks? is obviously 'easier' to treat impending elation as those drugs kick in quickly, and the newer ones seem better at averting the resulting depression

Not on mood stabiliser here MI, but when the mood sinks, I HAVE to go onto anti depressants....otherwise the suicidal felings overwhelm me and I can't cope with it.
Don't get elation..am Bipolar II so get the crippling depression instead.

Used to be episodes meds as and when, but they have already upped the dose and am looking at long term for now...

You can't treat episodes if you are rapid cycling. A stabiliser med is prob much better than having a crash and taking months to recover, then putting all the pressure on your family n friends IYSWIM.

Please go and talk it over with your GP, or your friendly psych at CMHT if you have one.
Take it easy.

thanks purpleone, I am loath to crawl back to the cmht having pestered to be discharged to GP care over the last 9 years but have started taking my 'stabiliser' again (lamictal, it's not v good at preventing a high but as a stimulant it starts to lift mood immediately, for me anyway). Lithium was much much better but it made me fat and scabby and ended up in hospital with dangerously high levels so that's off the list.

what's happened over recent years is that I've needed increasing amounts of anti-psychotic meds to stop my mood from going up, and as I refuse the serious weight gain ones (like olanzapine) have ended up on absolute shedloads of seroquel which still didn't work earlier this year. Luckily my cycle is long (1-3 yrs between episodes) and v few bouts of depression (am supposedly bpI on basis of hyperthymic traits) but I have a really poor tolerance of any dip in mood, panic and think I am going to kill myself if it slips even half a notch below baseline

it is officially 5 yrs since I last had an admission so have probably got complacent and imagine it has gone away

You poor thing. It sounds awful. I don't have much experience - my sis was diagnosed as bipolar around 2 or 3 years ago and she really didn't want to be on Lithium or anything else really. She has a history of abusing her meds which she is aware of when she is OK.

She has managed to ward off any episodes so far. Tries to stick to a routine of bed at same time and up at same time. We all tend to notice when she is doing too much so kind of warn her. She now notices that herself and basically tells herself out loud "I must calm down, I must calm down". Then she takes herself off to sofa with a good book.

Her speech goes funny too sometimes which we warn her about. She sounds like Kerry Katona did on that This Morning interview.

She was also exercising which really seemed to help.

She is now 34 weeks PG with twins though so we are all worried it will all kick off again. It was PND that seemed to 'trigger' hers.

Buda, your sister sounds like she is doing very well - it took me years to learn that bed at same time, up at same time was the cornerstone to it all! Has she been on an MDF self-management course? I really think it is a disorder of sleep rather than mood (that is not my own original idea but something a research fellow at the institute of psychiatry told me). My active, outdoor lifestyle working with various animals definitely helps too.

PND triggered my eldest sister's first episode and she has never recovered, 21 years later, but this is v v v unusual. She has schizoaffective disorder though, among other things. Hopefully everything will go smoothly for your sister, there have been lots of advancements since then. The advent of home treatment teams is especially helpful.

there are far worse things to contend with in life, but I do think it is a bit grrrrrrr to have a depressive disorder and be unable to take anti-depressants!

Hi Mitchy. She didn't do a course no. Basically I think she was just happy to have a diagnosis for how she was and she really didn't want to be on meds. Also our Mum is prone to depression and sis is very like her so she doesn't want to end up like her if she can help it!

I think she did some reading and spoke to the psychiatrist at length and just went for it. And it really seems to have worked.

Just hoping that she stays ok after babies are born.

I hope so too, though it might be good to have some sort of Plan in place in case of relapse as it's a major trigger for most women with bipolar. Doesn't mean it's inevitable though!

Am really glad nobody has told me off for ditching my meds - family are not very pleased with me but they don't have to take them!

I think self awareness helps hugely if you ditch your meds. And being completely and totally honest with yourself that if people tell you they can see changes that you take that onboard and make any changes necessary.

My sis figured out some of her triggers. Christmas and holidays were huge ones. She came here for Xmas one year and had packed all the presents for her DCs - obscene amounts - and Xmas clothes but no everyday clothes. She would do the same if they were going on holiday. So she avoided holidays for a couple of years. With Xmas she and her DH set a budget and he takes a day off in November and they do most of the shopping. Then she does a Xmas clothes shop one day.

She has already seen the psychiatrist at the maternity hosp (she is in Dublin) and they have a plan in place. He actually has twins himself so says he can give her lots of advice on that! And they have plans for weekly telephone consultations to see how she is doing. Also her DH is much more aware now.

they sound very well prepared, twins though! how exciting for you all! I caught something on Woman's Hour about perinatal psychiatry last week, might be worth a listen if it's still on their website?

seem to be something more like my normal self again, which is lucky. Wonder if future generations will have something better than drugs to push mood down, others to drag it up and ones that make you fat but do little else to choose from?

Hi - major breakdown 16yrs ago - thought that was it as no meds for 15 yrs - now find I have bi-polar diagnosis on system after starting with a new gp practice - queried but dr refused to remove - bit upset as think inaccurate diagnoisis - not sure how I could have stayed well so long if really had this? Have 3 small children and no probs with any - more upset about finding out about this than can say - no one gave me this diagnosis years ago - now quite worried about contact with any health-profesional as think this is all they will focus on........hope this is'nt hijacking your thread!

1 or more episodes of mania = bipolar, regardless

do you remember having/being treated for an episode of hypomania or mania, could that have been your 'breakdown'?

think the average is 5 episodes a lifetime or something quite low like that, so that leaves an awful lot of time to be well even if you account for our shortened life expectancy

Hi Mitchyinge - thanks for your reply - no one discussed this with me at the time or later and I don't have a psychiatrist to discuss this with so I honestly don't know. Do find it very bizarre that someone can meet out a dignosis on my records and never mention it to me.........so essentially have more illness to look forward to at some unspecified occasion? - feel like a walking time bomb now - terrific! sorry to be so thick but what is hypomania?
How does anyone else deal with the uncertainty of all this?

the most anyone could tell you is that you have a vulnerability to this sort of mood instability, I know what you mean about walking time bomb, that sums it up all too well

do you remember what medications you had during your major breakdown, or what it felt like at the time?

hypomania is a less severe mania, it doesn't impair functioning to quite such a serious degree and (I think) generally means no loss of touch with reality - usually no need for hospital unless this mildly euphoric state heralds a full blown manic episode and has to be nipped in the bud

copied from wiki: "In the hypomanic state, people may feel like they can't slow their mind down, and that the speeding thoughts are crafted exceptionally well. Some examples are speaking or writing in rhyme or alliteration without planning it first; quick responses to people talking; or the ability to improvise easily on the spot.

People in hypomanic episodes do not have delusions or hallucinations. They do not lose touch with reality in the sense that they know who they are and what is real. What can be a problem, however, is that people in a hypomanic state can sometimes overestimate their capabilities and fail to see the risks involved in their ventures. For example, someone may suddenly decide to expand their business in a way that is not really practical or set up schemes for which they are ill prepared.

Other forms of less inhibited behavior include reckless driving, gambling, spending sprees and sexual adventures. They may also have lots of new ideas but do not follow them through. People who are described as hypomanic are often very jolly to be with but may quickly become very impatient or unpleasant if they cannot get what they want.

It is unknown to what degree hypomanic symptoms can occur without a depressive component. Patients may be relatively unlikely to seek psychiatric treatment for hypomania alone. However, many hypomanic patients also experience:

• obsessive behavior, whether mild or severe
• poor judgment relative to a particular situation's judgment call
• uncontrollable, or only partially controllable, impulsivity
• excessive sexual activity

plus other out-of-character behaviors that the person may regret following the conclusion of the mood episode. A more mild form of elevated mood which has fewer negative behaviors is hyperthymic temperament."