Bipolarlife Newsletter May 2017

issue 92  (our 8th year)

May 2017

Bipolar Life Victoria

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Articles

Making Medication Changes

Suddenly stopping your bipolar disorder medications can cause your bipolar symptoms to worsen.
Learn about the right way to make medication changes.

By Debra-Lynn B Hook

There may come a time in the treatment of your bipolar disorder symptoms when you feel your drugs are no longer working. You may be tempted to stop taking one or more of your medications altogether – without consulting your doctor.

While there are all kinds of good reasons for wanting to stop taking a particular bipolar disorder medication, doctors agree it’s almost never a good idea to do so suddenly and on your own.

The Rebound Effect of Halting Drugs

“Sudden major changes in a treatment plan can cause all kinds of changes in the patient’s biochemistry,” says Melvin G. McInnis, MD, director of psychiatry programs at the University of Michigan Depression Center in Ann Arbor. “It’s much more beneficial for changes to be calculated and gradual, in a situation that’s not acute.”

Stopping psychiatric medications suddenly can cause a range of symptoms – from the dizziness and ringing ears associated with abruptly stopping certain antidepressants, to the actual withdrawal that you could experience from going off an anti-anxiety medication. If you suddenly stop taking lithium, one of the drugs most commonly prescribed to stabilize bipolar disorder moods, you can experience “rebound,” a worsening of your bipolar symptoms.

“Long-term use [of some drugs such as lithium] causes brain cells to compensate – like water building up behind a dam,” says Gregory Simon, MD, a psychiatrist and researcher at the Group Health Center for Health Studies in Seattle and chair of the scientific advisory board of the Depression and Bipolar Support Alliance in Chicago. “If those drugs are stopped suddenly, symptoms can come back even more severe than they were at the start.”

Sound Reasons to Stop Medications

This is not to say that wanting to stop one or more of your bipolar disorder medications is unwarranted.

In fact, there are many justifiable reasons to stop a bipolar medication, including dangerous side effects. Sometimes several drugs have to be tried before the right combination of drugs is found. After a period of treatment, the efficacy of a drug sometimes seems to wear off, although researchers aren’t sure whether it’s actually the drug in question or something unrelated that’s going on in the patient’s environment that is bringing an escalation of bipolar symptoms.

It’s also the plain and simple fact, Dr. Simon says, that drugs for bipolar treatment are not always that effective to begin with.

“Although the drugs make them better, people may still experience some degree of depression and some periods of feeling speeded-up or racy. It’s understandable that a patient would want to quit, more so than would the patient who is taking blood pressure medication or medicine for high cholesterol,” Simon says.

Going for Gradual, Monitored Change

If you feel as if your medications aren’t working, your doctor will most likely prefer that you work with him on a series of steps that may include:

Keeping a diary of symptoms, if possible, for a week or two.

Being honest with your doctor about those symptoms and your frustrations and concerns.

Working with your doctor on options, including increasing your dosage, decreasing your dosage, and changing medications.

Making a gradual, monitored change from one drug to another.

Bringing your family and loved ones into the conversation.

Family members can be particularly valuable at this time, providing your doctor with additional insights about your response to particular medications.

“The management of bipolar disorder is a collaboration between the treatment provider, the patient, and the family,” says Dr. McInnis. “The individual bears the burden of the illness. His responsibility is to adhere to the treatment regimen and report back to the doctor with a degree of fidelity on the symptoms and the severity of life stressors. The family is the sounding board for observations and perspective. With that trio in place, one can really effectively manage the treatment through all kinds of storms.”

Announcement

Bipolar Life was asked to let people know about this research in the hope that you might volunteer to be part of the study.  Please read below and do consider taking part, especially if you think the research results may help other people with Bipolar Disorder in the future.

Story

Jerry’s Story / Interview

  1. What is your diagnosis?
    Bipolar Schizoaffective
  2. How old are you now and when did you get diagnosed?
    I am 57 now.  When I was 15 I had racing thoughts when I got stressed.  Deep depressions started when I was 19.  At age 27 I was diagnosed with Bipolar Disorder 6 months after a serious motorbike accident.  9 months after that I was diagnosed Bipolar Schizoaffective.
  3. How many episodes have you had?
    15 episodes.  Some episodes lasted 6 months before I got to hospital.
  4. Have you anything to say about suicide?
    I’ve attempted suicide once.  I wanted to use a gun but could never get my hands on one.  I’ve felt suicidal many times and sometimes have had fleeting thoughts about it.  Now I’ve got to the stage where my mental health is so good that I don’t think I’ll ever attempt suicide again.  I no longer have even fleeting suicidal thoughts.
  5. That’s great.  How have you managed to get healthier?
    • I was a heavy drinker and smoked marijuana but I gave these both away to help myself be stable.
    • Getting stable accommodation.  In the past I lived in various group homes.  I’m now in a stable and affordable home.
    • Keeping busy.  My social life is good.
    • Getting good sleep.  I was taking 5 Valium a night (not recommended).  Now I take melatonin and it really helps me sleep.  At first I felt it caused a hangover but now it doesn’t.
    • Financially, I am starting to work on a good budget.  I’m an impulsive spender and I believe this is due to my illness.
    • A good social worker.  The social worker helps me with transport for food shopping and has a social chat to check how I am going.
    • Listening to music.  I find it better than watching TV.
    • Taking medication.  I’m scared to miss it!  Medication helps me sleep.  I also have an injection once a fortnight which helps me keep stable too.  It has taken a good 20 years to be on the medication regime that works for me.
  6. Tell me more about your social support.
    I have the best group of friends.  In the past I’ve given them a ride for their money with abusive phone calls when I was manic.  They coped with it all and they even came looking for me when I was psychotic and living on the streets.  In the past I’ve had a few friends discriminate against me but they are not in my life now.  I have 5 amazing friends and they’re real good support.  My mother has given great support and she started off COPES.  COPES was set up for parents of children with a mental illness.  She’s retired from that now.  If I want to, I have access to social agendas run by EACH with other people with mental illness.
  7. What did you think about living in group homes?
    You live with more than one person, maybe up to 3 people.  They also have a mental illness.  In my experience, it never works out.  For me, I was a “goer” and the people I lived with weren’t.  I don’t think group homes work.
  8. Have you anything to say about E.C.T?
    I’ve had E.C.T. twice.  In those instances, it was the only thing that worked on the psychosis (medication was not enough).  I would recommend E.C.T. if you get offered it.  I originally fought it but I realize now that it was the best thing for me.
  9. Any final thoughts?
    After my journey to now I am quite confident that being on medication I will:

    • Not breakdown/have another episode
    • Feel good 95% of the time (everyone gets bad days)

      I’m very happy now.

We’d love to hear from you

Do you have a story to share?  Please feel free to send it to us and we may use it in a newsletter in future.  Want to tell your story to us in an interview?  Let us know.  We can interview you and put the interview in the newsletter. Do you have any topics or questions you’d like discussed in the newsletter?  Let us know.  Email us at editorbipolarlife@outlook.com

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