If You Are Bipolar Stay On Your Meds

If the answer is "no," then you are categorically unqualified to make the decision to take yourself off your bipolar medications.

And yet, it's very, very common for bipolars to exclaim, "I'm off my meds!!" or "I'm going off my meds!" Interestingly, you rarely hear of patients deciding to simply stop treating their blood pressure, ulcers or asthma.

Hmmm. Think this could be mental illness at work???

It's no easy trick to manage the ups and downs of a bipolar brain. The treatment goal is to help you function within a normal range -- not too up, not too down, but just right.

If you're feeling pretty good, pretty balanced, congratulations! That means your meds are working!!! It means your doctor has gotten your cocktail of mood stabilizer/antidepressant/antipsychotic/anti-manic/anti-anxiety just so for your particular symptoms.

A word about side effects

It's true that some medications come with some rather unpleasant side effects. Some, like Thorazine, are notorious for being pretty hard to swallow.

But with the vast array of meds available today, there's undoubtedly a substitute you'll be better able to tolerate. Talk to your psychiatrist about alternatives.

So, I bet you miss being manic, don't you?

Some patients complain that they miss the energy rush and wild exhilaration of their "high highs" once they're medicated. But I can't say I've heard of anyone nostalgizing the "low lows" of their depressive moods!

As a bipolar, your brain suffers from a major chemical imbalance. One way or another, it needs to be rebalanced, it craves to be rebalanced. This is why, without even knowing they're doing it, so many bipolars turn to "self-medicating" with alcohol and drugs. They are naturally obeying their brain's command to please, please stop this roller coaster and give me some peace!

How common is substance abuse in bipolars? According to some sources, 50- 60% of bipolar disorder patients abuse alcohol and drugs at some point during their illness.

If you used alcohol or drugs before you got diagnosed, it's highly likely you will turn back to what "worked" for you in the past. But alcohol and other depressants will only make depressive episodes worse. Cocaine and other stimulants can also produce abnormal mood swings. And withdrawal can produce symptoms of mania or severe depression -- so really, you're going "out of the mental frying pan into the fire" if you give up prescribed drugs and try to medicate yourself.

Assuming your meds are effective, there are two concerns specifically about quitting them.

1. If you're hell bent on experimenting, make sure you read the literature that came with your meds. These are not aspirins we're talking about. They are serious psychotropic drugs. If you're supposed to taper off and you stop abruptly, you risk going into seizures. (And obviously, this would be 1000x worse than any side effect you might be experiencing now.)

2. Once the drugs are out of your system, you're a blank canvass. Getting back on them may not be a simple matter of refilling your old prescriptions. There's a good chance your old scrips won't work. You can become immune to them (at least that's how it was explained to me). Your psychiatrist will have to start all over again -- trial and error with dosages and even drug types. Thus, if you crawl back in, miserable and desperate for relief, you may not get it, at least not right away.

Don't be fooled. Bipolar is a chronic condition. Its symptoms can be managed, and you can live a normal life. But it doesn't go away.

And the best predictor of future behavior is past episodes. As it was explained to me by a psychiatrist, if you've had one depressive episode in the past, you can expect to have more in the future. Same goes for manic episodes.

Try to remember the worst experience you had before you got diagnosed. Did you go on a spending spree that left you in debt? Did you spend two weeks holed up under the covers, unbathed and alone? Did you end up in trouble with the law, or under observation on a 5150 (involuntary psychiatric hold)? Whatever unpleasant memories you can dredge up -- amplify them by at least two. That's what's in store for you if you persist in this plan.

Still not convinced?

I'll share with you a true story of a friend of mine, a bipolar who did exactly what you are contemplating. He didn't feel anything unusual so thought he'd made the right decision. Until about three weeks later. Out of the blue he decided it would be a good idea to kill himself. He set out to drink himself to death (after being sober for three years). Luckily, he didn't succeed. The cops found him on the side of the road puking his guts out next to his car. He lost his license for a year. But he gained an important lesson -- and a new respect -- for bipolar disease.