Being bipolar and taking medication...or not

[electra]

I have had a very rough time in the last few months which I did post about here. I was prescribed cipramil and quetiapine (mood stabaliser). I took this for a while but recently stopped. I know it might sound wreckless but I am afraid to be dependent on drugs for the rest of my life. I haven't taken them for at least 3 weeks and I am not depressed. I can look after my children again but my family have noticed that I am hyper lately. I also am finding it difficult to settle at night and take codine to make me sleep. I know this isn't good.

The thing I want to know is

Have I always been bipolar or can it be triggered? Is there a way for me to cope with this without needing drugs?

When I was very ill I was self-harming regularly and was extremely depressed but experiencing highs at the same time. I am not like that now but recognise that I still have porblems.

Anyone have a pov on this?

Therapy definitely can be worth it, electra, but it does make you worse before you get better, and I've never made it through the worse bits before crying off.

I was very 'blunted' each time I was started on lithium but the effect did wear off and I am functional. So I guess I do feel that not taking it is a luxury I cannot afford. I just thought I would share the story of that particular medication effect lessening.

Thanks MLP How long have you been bipolar if you don't mind my asking?

I don't know if you will read this expat but for me my therapy consists a lot of me not talking about anything because I don't know what to talk about! I obviously have things to say or else I would not be in therapy but that does not mean I can talk about them! Its not all talking about feelings.

I am not bi-polar so no idea on the thread but therapy has worked well for me in the past.

I had quite a bit of CBT in the early days of my bp/md diagnosis, the focus was more on recognising that I had the illness and, eventually, learning how to respond to early warning signs. I went once a week for about 9 months and finally gained a bit of insight.

From what I hear good CBT is not on offer everywhere and there is often a waiting list, but the other non-medication route (although it works best for most people in conjunction with meds) is the MDF self-management course. Last I heard there were plans to deliver the materials online, so it might be worth calling them and finding out if this has happened or is still planned to happen. Some of their self-help groups are very good too, I've been involved in setting one or two up and there's usually a library of self-management materials, books and dvds to borrow.

As for meds, every time I've tried to go without I've ended up in hospital and then on far more than I started with! Currently on lamictal, quetiapine and reboxetine all of which are pretty much side-effect free for me, and a huge improvement on lithium and the older anti-psychotics.

I think if you're asking for point of views, then my point of view is that you need to be extremely careful.

I can understand your fear of being on drugs for the rest of your life but I wonder whether you have thought that you can manage now and are feeling OK because of the medication you have only just stopped taking?

It's a horrid thing, bi-polar and I do think there are different degrees that people get it (in our family alone we have one person who has it very severely and one person who has it quite mildly if that makes sense) but PLEASE go and speak to someone about your future plans before another low comes along and hits your hard.

Anyway, whatever you decide, please take care of yourself. Keep talking to your friends and your husband and don't be afraid to ask for help if you need it.

I have never understood the 'drugs for life' thing, I just take them each day with a view to maybe or maybe not managing my way out of the condition altogether.

Electra, I hope you get to see your doc soon, as you do sound down .

I am not bi-polar, but I have had PND twice and now on AD's again after missed miscarriage, so I'm afraid I do not understand the manic part of bi-polar disorder, having only ever been depressed.

But it's not a nice place to be so I hope you get to feeling better soon.

Vacua - can I ask about the quetiapine - were side effects bad initially? I am having real problems loading onto it at the moment.

Electra - I was diagnosed in May 2006, just before I conceived my dd. The clincher was psychotic depression - my hypomanic states which had occurred previously were not severe enough to land me in hospital. Apparently psychosis with depression is quite common in bipolar disorder. I have since had another community managed hypomanic episode, and a recent/ ongoing psychosis, but the beast is never that far from the door, iykwim. Sorry about the essay . I'm sorry things are a struggle - do you have much IRL support?

I know that bi polar can be triggered by something happening in that person's life. But has it always been there in some way, ie are you born with it? And will it always be there, or can it ever disappear like other types of depression?

mylittlepudding - I started on a very low dose, about 25mg and at the same time had an antidepressant introduce but it was all during a period when my daughter was critically ill so it was very difficult to know what was what.
Every few days it was increased and with each increase I was knocked out for about 12 hours at a time until I adjusted to it, and then it went up again! I just take it all at night now, and am definitely a bit more sluggish in the morning but otherwise ok. I'm still on a lowish (200mg) dose, originally the plan was to go up to something ridiculous like 600mg! If you can persevere it is well worth it, it's the only med of its kind that I've been on that hasn't made me fat. Have you ever tried olanzapine? Each pill is like having 12kg of houmous I like the fact that quetiapine can bring my mood down to an ok level without pushing it too low, the whole combination is great for me.

frankie3 - I think the current consensus is that people are born with a genetic predisposition that external events may or may not kick into life. We've got an extensive family history of it so I shouldn't have been so surprised/insulted to be diagnosed with it myself but of course by its very nature most people are totally unaware there is anything wrong with their manic behaviour. It tends to emerge whenever pressures are at their greatest, which sadly is often when people are on the very threshold of realising their academic, professional or personal potential - such as going to university, qualifying into their chosen career or having a baby.

Also, medal please for talking about it so openly in such a public place! I was terrified for years of people finding out, and it's not exactly something you can hide easily, but I kept my illness self and my how-I-would-prefer-to-be-perceived self quite separate for years. This is despite doing lots of work behind the scenes with media campaigns, peer-support movement and developing and delivering self-management material. After 7 years of being officially diagnosed I'm finally grasping the idea that stigma busting begins at home.

frankie - I think the average is about 5 episodes in a lifetime, although lots of people spend time being quite depressed between their periods of elation. Others 'rapid cycle' which means they will have 4 or even more episodes every year and I believe the prognosis is more uncertain in that case. Broadly speaking it is supposed to get better with age but so much depends upon access to appropriate treatment and support and also the extent to which the person concerned is willing and able to recognise and respond to early warning signs of relapse. Each episode of mania is believed to increase the likelihood of another, something known as the 'kindling effect', so it's important to take action immediately one's mood begins to rise above a normal level. It's incredibly difficult to do this, because unlike the depressive phase the early stages of hypomania or mania are powerfully seductive and alluring and it is all too easy to forget where it ultimately leads.

Has anyone found that quetiapine makes them put on weight?

Electra- it might be worth talking to Donna Williams about it. Or reading some of the stuff she's written-there's some on her website- just thinking she's written quite a bit about bipolar and autism and their links etc. She's obviously not medically qualified but might have a different perspective that you could then ask someone medically qualified about.She's also very well read in this area so could pehaps point you in the right direction for further reading.

She's talked to me quite a bit about ds1 possibly having rapid (very) cycling biploar. It was certainly interesting and I am going to talk more about this sort of thing to the paed when we next see her.

link here by Donna Williams about rapid cycling bipolar in childhood and autism- so not entirely relevant to you but given family history perhaps of interest. There's some more if you follow the links on the left.

I can understand your concerns about medication - I think she takes tiny amounts of certain drugs- tiny doses- but don't quote me on that.

haven't gained weight on it yet electra, in fact am about 2 stone lighter but multiple possible explanations for the weight loss - I think of its kind (anti-psychotic) it is as close to weight neutral as possible, poss. exception being aripiprazole (abilify) sp?

Thanks, yurt - hope you're ok

Thanks to everyone else too xx

just read this..

clearly i am up at this time and so are you and we both should be asleep

i emailed u back

Yes Santa - know what you mean! I am currently wide awake. I was shocked to see the time and realise that I am not even tired. I have again been drinking to make myself sleep but I have decided not to drink at all now because of the awful side effects the next day...hense why I'm still up now. Thanks - just off to check email.