Treatment Is Not Simple: World Bipolar Day 2019
This year, I want people to really try and understand that treatment for Bipolar Disorder is complicated.
The simple trope is that if all of us with mental illness would "just take your meds," we would be fine. That’s not true.
I recently looked through my notebooks of medication notes (I have taken everything from SSRI's to antipsychotics since I was nineteen years old) and found these notes:
“Extreme dizziness, fell.”
“Unable to stand. Had to call Dad to come get me and my son because I couldn’t drive.”
“Testing shows 30% cognitive decline.”
“Tardive dyskinesia in legs and right arm. Driving is unsafe.”
“Extreme fatigue and brain fog, can’t get my son to school.”
“Suicidal. Wanted to crash car into tree.”
“Extreme anxiety, feel like I am unsafe and could die at any minute.”
“Shaking and can’t stand.”
“Constant blood and diarrhea for my son. He’s crying all the time and can’t keep milk down.” (This was when my son was a baby and they put me on “safe” medications for nursing mothers.)
“Can’t feel any emotions. No sadness, no happiness, don’t even feel anything for my family. Just numb. It’s not possible to have medicine make you not love or care about your family, is it?” (FYI, the doctor said: “Even if you can’t connect with your family anymore, you are at least stable and that is better for them.”)
And those are just a few of the side effects. The worse physical ones are too personal and sometimes gruesome to share publicly. When people ask me what it is like to take all of these medications, I often refer them to the song from the musical Next to Normal, called “Who's Crazy / My Psychopharmacologist and I.”
So, if you always thought that therapy and/or medication just works for all people (remember, I had been taking medications and also seeing a therapist 1-2 times a week from nineteen years old to thirty eight years old (I am now forty), then please open your mind to that fact that this assumption is just not true for many, many people.
It is absolutely fantastic when people find a medication and/or therapy intervention that works for them. However, getting treatment is not easy for most of us. Even when the most common route of trying medication and therapy works, it still takes most people years to find a combination of meds that work for them.
If you are someone who is trying to find the right treatment, never give up hope. After the first five years of medication and therapy not working, I wish someone had told me about other options. You can often combine medication with many of these options to help the medication work better.
If you want to talk to your doctors about other things to try or to add to your treatment plan, here are a few options that we don't often know about.:
EFT (Emotional Freedom Technique): Lowers cortisol levels and can help calm anxiety, reduce or control manic episodes. It is a non-invasive body practice.
Somatic Experiencing or Somatic Therapy (especially good if you have trauma): From Dr. Peter Levine’s website “The Somatic Experiencing® method is a body-oriented approach to the healing of trauma and other stress disorders...Offers a framework to assess where a person is “stuck” in the fight, flight or freeze responses and provides clinical tools to resolve these fixated physiological states.”
Ketogenic Diet: A low carb, high fat, and moderate protein diet that gets the brain and body into a state of ketosis- using ketones instead of glucose as a form of fuel for the brain and body. In small studies and many anecdotal experiences has led to stabilization of mood. One very small study found that it worked better than the commonly used drug, Lamictal. I can say that for me it works 90% better than Lamictal, and I was on Lamictal for 5 years.
Mindfulness Based Cognitive Therapy: “It integrates elements of cognitive therapy and mindfulness-based meditative practices with the goal of developing a capacity for awareness of distressing thoughts and feelings and the ability to disengage from them without taking countermeasures to try to change, replace, or fix anything about them.”
High Intensity Exercise: Still being studied, but exercise does at least release endorphins and help people feel less depressed. However, high intensity exercise does have more specific changes in the brain that they are just starting to study and see if it is beneficial for those of us with bipolar disorder. I can say that doing CrossFit for the last nine years has been something that saved me when I was still figuring out medications and therapies- it made me stable enough to not be at risk for death by suicide. One study says: “Specifically, evidence suggests that exercise is neuroprotective at least in part by increasing brain derived neurotrophic factor (BDNF; Sylvia et al., 2010).”
EMDR (Eye Movement Desensitization and Reprocessing): "Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapy treatment that was originally designed to alleviate the distress associated with traumatic memories (Shapiro, 1989a, 1989b). Shapiro’s (2001) Adaptive Information Processing model posits that EMDR therapy facilitates the accessing and processing of traumatic memories and other adverse life experience to bring these to an adaptive resolution."
Transcranial Magnetic Stimulation (TMS): "a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS is typically used when other depression treatments haven't been effective." It needs to be repeated and is often called rTMS or Repetitive TMS. The Bloggess talks about her experience with TMS and it has really helped her.
Remember, this blog is not medical advice, it is just sharing information. NEVER do anything without your medical team supervising you. All forms of treatment, whether they are medication or not, need to be monitored by a mental health professional. And, to be clear, I am not saying medication does not work and if we all took a walk in the woods and ate kale we would be cured. I am saying that treatment is not simple and the voices of those of us for whom medication does not work have been lost in this conversation.
Also, while you can share information with people, don’t tell people what treatment you think they should try. Every body is different. Every mind is different. We are all on our own journey. Sharing information is powerful. Telling people what they should do is destructive.
* This blog provides general information and discussion about medicine, health, wellness, and related topics. The content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. The content is for informational purposes only. If you have any medical concerns, you should consult with a licensed physician or other health care worker.