Category: Medication

I have experienced some frustration when discussing the role of my medication in the treatment of bipolar disorder to people who do not have the illness. Bipolar disorder is a physical illness which has physical and psychological symptoms. Bipolar disorder is not a psychological problem. Sometimes, I hear the sentiment that I am using medication as an easy crutch rather than face my life problems or sometimes people question if I even need medication. I have had people say, “Well, if it works for you that’s great,” with the emphasis on the “you.” Sometimes, people suggest yoga, exercise or meditation as a preferential solution to the issues bipolar causes in my life.

If I did not take medication I would be acutely ill frequently and I would likely require extensive psychiatric care on a daily basis. For me, the distinction between the symptoms of bipolar disorder and the regular ups and downs that everyone has is very clear. There was a time that I did not have bipolar disorder. The onset of my illness occurred in 1995. I was living in Japan and under a tremendous amount of stress which triggered my first manic episode. I had never had any symptoms of bipolar disorder before this happened.

At that time, I was experiencing psychosis. I was having delusions that made me believe I had reached enlightenment, could heal people with my mind, gain enormous wealth in a short period of time and that all my friends and family would quit their jobs and join me to live a life of endless joy and prosperity. Of course, none of that was true but bipolar disorder made it seem 100% real. I barely slept or ate any food. I am sure I was talking fast and a lot and I couldn’t sit still.

I returned to Canada and spent three months on the psych ward in Calgary and I saw multiple specialized medical doctors called psychiatrists. They were able to find the right medication to bring me down from my manic episode.

The depressive episode that followed was the worst level of anguish I have ever experienced in my life. The fatigue was so extreme that I had to use two hands to brush my teeth. I could only spend a few minutes away from my bed before being completely drained of energy and forced to return to the covers. I could intellectually recognize flavours, smells, colours and sounds but there was no human element of that perception. My body could recognize all of these but it was incapable of deriving pleasure or any meaning from any of it. My thoughts were stuck on negativity and suicidal ideation.

After I left the hospital, my psychiatrist worked on getting me the right medication and my depressive episode ran its course. I felt better and went back to work. After a few months, I started to wonder if I had bipolar disorder. After all, I had never experienced symptoms of the illness until my first episode. I thought that maybe it was just a one time thing so I decided to stop taking my medication. A few months later, I had another full blown manic episode that decimated my life. I have never stopped taking my medication since then.

There is no cure for bipolar disorder. My medication gives me a chance to live a positive life but it does not free me from my symptoms completely nor does it guarantee that I will never have an acute episode again. My last full blown, psychotic manic episode was in 2010 and I was taking my medication at the time.

I still have depressive episodes but they are milder than if I wasn’t taking medication. I occasionally have mild hypomania, a less severe form of mania, but I have a routine that prevents them from getting worse. I have learned that if I get too excited about my own ideas and I am experiencing a lot of stress I will likely have a manic episode even if I am taking medication. A high level of stress will trigger a depressive episode for me.

In addition to taking my medication, I have to make lifestyle choices to maintain a level of wellness that allows me to enjoy my life. I limit my activity level to what is within my capacity. I rarely consume alcohol. I have firm boundaries in my relationships. I try to stay active. I monitor my thoughts and I attend a peer support group. I see my psychiatrist regularly and we make adjustments to my medication if necessary. If I did not maintain this routine I am sure I would have another manic or severe depressive episode.

For me, the key to finding the right medication has been playing an active role in decisions when working with my psychiatrist. There is no imaging or blood test that a psychiatrist can use to assess your symptoms. They rely on us to give them the information they need to treat our bipolar disorder. Any information about your symptoms, side effects and current stressors in your life is helpful. Taking a notebook with this information and any questions you have to your appointments can be helpful.

For friends and family, the most supportive thing you can do is show compassion by understanding we suffer from a real illness with real physical symptoms. They are not made up in our head. When you imply otherwise it makes people blame themselves for their symptoms which is demoralizing and produces unnecessary feelings of shame. This in turn drastically reduces the chances of people regaining a positive life.

I am extremely grateful that I have medication that I respond to in a positive way. This is not the case for everyone. The side effects have been difficult and have contributed to other health problems I have and the day may come when my medication will not be effective in treating my bipolar disorder. But for right now, I am fairly content with my life and psychiatric medication has made that possible.