Sunday, May 17, 2009

May Madness: How Many Pills From Normal?

Hopefully as the month progresses my readers will learn more about bipolar disorder and its treatment options. Although I appreciate that Mental Health Awareness month includes awareness of other mental maladies I have the most expertise on bipolar. Soon I may choose to move on to different subjects, as my interests are varied and unpredictable, much like my mood. Today's subject: "Crazy Meds" is a term I first saw at this great web site devoted to the topic: .
I have conflicting opinions on whether these meds cause more harm than good. Are they creating a world of moodless, overmedicated zombies trying to keep up the status quo, or are they saving lives (including my own). Furthermore, are they really necessary and effective for everyone with bipolar?

Two questions I have been asked as someone with bipolar: "Is there a pill for that?" and "Can't you just do some yoga?"

Good questions... The answer to the first one is an almost definite no. For most of us there is no magic pill, but "cocktails" of four all the way to--I don't know that there's a limit to how many pills they will prescribe. I am 5 pills or so from normal, and several of those pills are to counteract the side effects of others, which include, early waking insomnia, weight gain, and oddly, depression. Each pill has a veritable encyclopedia of side effects, some of which can be dangerous or deadly.
Being on no meds and trying yoga and positive thinking has its own drawbacks. If one's mood in unstable, beginning positive work on one's body or mind can be severely hindered. Suicidal ideation may creep up, or hypomania or mania can rear their ugly heads. Mania and its slightly less severe sibling, hypomania, can lead to anxiety, anger, irritability, elation, hypersexuality, and a level of hyperactivity that can burn a person's mind and body into ash. Bank accounts can be emptied, credit maxed out, relationships ruined, and lives endangered. At worst suicide or psychosis can occur. The crash from mania can be a devastating plummet into despair and depression. I don't think yoga or positive thinking can begin from those extreme emotional states.
There are theories about an effect called "kindling" which may occur in the bipolar brain. This theory posits that when a bipolar brain experiences stress, the stress reaction continues long after the event. The brain literally smolders with past stresses. For me stress is the biggest trigger that I face, and its effects are long lasting. Medication is supposed to prevent this reaction.
The trouble with these flawed medications is that they don't work for everyone, the side effects can be terrible, the combos have not been safety tested, and the adjustment of dosages and drug types are a fine pseudo-science; some people require an almost constant tweaking of their meds to remain stable.
There is also an enormous amount of stigma attached to taking psychotropic medications. Yet who would judge a diabetic for taking their insulin?
As a person who takes these medications I can attest to the fact that I hate taking them. I'd like to believe if I stopped them I could deal with my haywire emotions or the burning fires in my brain. Maybe one day I will be able to deal without them. For now though, I am scared of the mercurial nature of my brain, the way the neaurotransmitters dopamine and serotonin teeter totter back and forth, in a sickening motion beyond my control. The illness is real, the treatment imperfect, and the question of the lesser of two evils is right there: staring back at me in the mirror every day.

1 comment:

  1. I've been to the pharmacy getting meds for a loved one and been asked by the pharmacist "are you sure they want to take these two together? They cause fatal heart failure." My answer was "no, I'm sure they don't." Deadly combinations of drugs have been prescribed to my loved one on three different occasions. It is definitely a difficult balance to strike, taking dangerous meds or being in an already dangerous mental state. BTW, I think kindling is an actual phenomenon. It seems to fit with behavioral patters I have witnessed (and possible felt myself).