Many people say you should not discuss politics or religion with your friends because you might not be friends much longer. If your friends are Bipolar or associated with it in any way you might want to add meds to the list. The extremes both for and against meds give new meaning to the word Bipolar. The poles often seem further apart than the most intense debates in politics or religion.

I have been speaking with groups about Bipolar for almost ten years now and have tried my best to stay out of the debate. But many in the audience won’t let me. At the end of my talks I am frequently accosted by members of one camp or both. It is pretty clear that neither side even heard what I said and the only thing they listened for is whether I took their side in the only thing that matters to them. I didn’t validate their extreme point of view and they are furious with me.

In his song The Boxer, Paul Simon said, “Still, a man hears what he wants to hear and disregards the rest.” In my case they often hear things that were not even said. In their minds I gave a talk siding with the enemy.

I have always pretty much ignored the med controversy because it is not central to my message. Until now. I heard something recently that made me want to take a stand.

13 Comments to
Why I Am Against Bipolar Meds

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  1. Thank you for such an excellent article! I have shared it on my FB page with members as you make such important points. You literally did hit the nail on the head that the 2 camps, those against and for meds have completely missed the mark. I loved your ability to express this so well ““I would rather be on meds with Bipolar IN Order than off meds and still in Dis-Order.”

    For those of you paying attention I just made a pro-med statement. If that is how I feel, why did I title this article Why I Am Against Bipolar Meds? Because that young man inadvertantly hit the nail on the head – it is not about meds, it is about whether Bipolar is in Dis-Order or IN Order. The pro- and anti-med camps are so obsessed with medications that they completely miss the point.”

    It really isn’t possible to remain neutral on this topic, and I agree with you that the bottom line is to be in order and living a healthy, happy life.

  2. I operated in mania In Order for many years with
    peoridic crashes to recoop and start over again,
    all without meds..until I hurt my back and was forced to sit down and be still. It nearly killed me, but got through it and had to turn to meds to
    adjust and although I am walking again, it is not
    the same and I realize that the mania was killing me and wearing my body completely out.

    I am 61 years old now and still have ups and downs,
    wake up sick many days and just don’t feel good at all. When I do feel good, it may last one whole
    day but usually only 3 or 4 hours at most. I have
    a lot of sleepiness,depression and nausea.

    Sometimes my thoughts will be sharp and clear, but
    my focus is still limited, and I tend to feel like
    I am being followed or something. Also, I feel like
    everything people tell me or things I hear are in
    some way connected. I feel like I am being watched
    or something by someone or somebody but I don’t know who or why..it is disturbing.The medicine does
    help this but it is still there..

    I guess my question is how does one get In Order
    then? My version of In Order was awesome euphoric
    mania going from 4:00 AM until 10:00 PM non stop
    on full blast ahead loving every miniute of it…
    the only problem was, I didn’t know it was killing me. The only thing that saved me, I honestly believe, was hurting my back because it forced me
    to rest…but I have never really felt good since
    then. When you have lived for years on drugs from
    your own brain and then it abruptly comes to a halt..somehow you are never the same again.

    My Meds: Lithium 300MG 3X Daily
    Zoloft 100MG Once Daily
    Topamax 50MG Once Daily
    Strattera 40MG Once Daily
    MaxaltMLT 10MG PRN

  3. Interesting article. From what I understand, you are saying that bipolar sufferers can get themselves in order while on the meds. Once they understand themselves and how their highs/lows escalate and what is tolerable, they can be med free. Is that correct? I would like to know your thoughts on what bipolar actually is from a psychological perspective – no drugs. I have always wondered have the sufferers been through some type of childhood trauma that makes them high? What would a scenario be behind making them high and is it first a child pretending to be high then next time that high gets out of control – a bit like a tantrum? Does the child get themselves into such a state that they can’t unwind and need comfort? Do they then take this “learned behaviour” to adulthood and use it as a coping mechanism?
    I can certainly see the difference in my thought processes and ability to comprehend being off the anti-psychotics and mood stabilisers (even though I was not bipolar in the first place). A few years ago I could hardly string two paragraphs together to comment on your posts, it was pretty tough going but today I have a deep thought process and can comprehend a lot more. Glad you give my brain something to analyse and think about :)

  4. I was diagnosed with Bipolar 1 fifteen years ago. Spent a month in a hospital and got Haldol, Valproic acid (alternative for lithium). After getting out I slowly reduced the meds in partnership with my psychiatrist.
    Now I have Abilify and sleeping pills in the cupboard and use them when I notice that I am starting to get too manic (waking up at 4 am, etc).
    Meds are like a crutch you use when you’re having trouble walking.
    They really help, but you might not need them all the time.

  5. I have major problem when people call psychmeds “vitamins for brain” and talk of chemical imbalances and go great lenghts to deny psychmeds are indeed a mind altering substance… and I see nothing wrong with it. I personally find it amusing how in the USA there is this “war on drugs” and at the same time you see anti-depressants advertised on TV.

    But this attitude creates a false belief that you *need*, absolutelly *needs* psychmeds once you are diagnosed. I would never tell person for whom it works to go off their meds… At the same time… if somebody tried many meds and combinations and it’s making thing worse… why are doctors so reluctant to consider that the said person just may not react well to psychdrugs in general and they should try something else? Often doctors make it seem that if drugs don’t work for you… then you are screwed… and wanting more of life than 9-5 job is seen as symptom of illness, not as something that could help you.

    I think it’s about how you use your tools. As long as one is not stupid about it, it’s fine… psychmeds to help you take the edge off, so you can live and work on yourself… that is fine. Psychmeds taken in order so you don’t care your life sucks… that is bad.

  6. “I would rather be on meds with Bipolar IN Order than off meds and still in Dis-Order.” Tom, I love the concept. I did recently started cutting back on the medication (with my doctors disgruntled approval). I was fine for three months, I had my carbamazepine down 1200 mg to 400. That was working on weaning myself down also… All that changed this week after I’ve spent the last 20 days the depression… While I agree and applaud my peers ability to be able to run free, I don’t think it applies to everyone. Taking medications to rebalance ourselves than going off those medications over and over again is more calm than any good. FOR ME I have included with my wife’s consent that I do better and I’m safer when I AM medicated. It’s a necessary evil. But I will tell you this, I will not stop on trying to reduce the amount of poison I have to take to stay balanced.

    Still Tom love the article, was a nice balanced approach was very touchy sore subject.

    Chato
    http://blogs.psychcentral.com/humor/2011/07/psych-meds-a-necessary-evil-or-a-magic-pill/

  7. A refreshingly sensible view on the topic! Thank you. :)

  8. Quote’
    If your friends are Bipolar.

    You appear to understand a great deal about Bipolar yet you fail on the simple understanding that people are not Bipolar-They suffer from Bipolar.
    Just as people are not chicken pox-they suffer from chicken pox.

  9. Interesting article. I very much agree with the idea of person being in order or out of order so to speak, regarding bipolar. It is not about meds or no meds it is about what is working versus what is not working and everyone is different in this regard. One thing I would be very wary of – a person who is in a bipolar episode might very well believe he or she is “in order” despite the fact that he or she is way out of order! Certainly all of us with bipolar have had that experience? My point is that who determines order or disorder? Is it the consumer? Is it an outside person – a doctor, a family member, friend? We must be careful about who defines the order so that one who feels in order does not dismiss medication incorrectly and end up in dire staights. This issue is not a simple one indeed.

  10. This is definitely a sensible standpoint and I’d say I agree with it. It’s the same concept as treating symptoms as opposed to a label, bipolar disorder. Getting your symptoms under control so that you can manage your life should always be the goal. And this is only possible if you include medications in the context of the matter. Yes, there are some that can go without medication but for most with bipolar disorder the right medication treatment is a necessity. You can live a crazed and out of control lifestyle without meds or you can gain better control over your life with them. Ultimately, it is up to the individual but I do think bipolar medications are very much a good thing when prescribed the right way. So many with this illness would have no chance if it weren’t for modern medicine. I know I would.

  11. `Great article!! Mr. Wootten hit the nail on the head. Daily function, divded by (or x) happiness, less stress, less chaos, = Sucessful living .Meds ok! No meds ok! Diagnosed BP (don’t know I or II)24 yrs. ago, after 3 yrs. of therapy, with a great counsler,and thank God, before the loss of my teen Son, I went on meds. I am thankful for my Drs. and counsolers that have helped me through many health and emotional, crises’. I, like many’ I know, have,and still, hold on to the stigma that mental illness = CRASY… Knowing intellectlly, that is False! Emotionally it must be, that’s what everyone say’s. Family member’s ask.”.how long are you going to be on those pills?” I have accepted that I may be on “head meds” to facillitate “in-order” as opposed to living in chaos the rest of my life. I now believe I am bipolar, I was born that way, the same way I’m female, how I let that affect me and other’s is the only part I really have any control of. It’s the path I journey down in life and it’s great and it’s awful. NEVER NEVER boring or dull. Many desions, many choices! If what you’re doing works..do’nt change it..trust YOURSELF. If you are struggling *_reach out*_…talk to your friends, family, Doctor…stay open to any possible tools that can help you live a more relaxed, joyful life. Maybe, even Med’s.

  12. LOVE THIS ARTICLE AND ALL OF THE COMMENTS!

    Personally, I am not for or against medications but I am for people with the bipolar experience living lives of passion and however they determine success.

    I believe most people can be on little to no meds but that is with the caveat of doing the work and being courageous enough to not be married to any one system of belief i.e. taking meds again (if successfully off) when it seems dangerous not to. I’d rather be alive on meds that dead without them but I’s rather be off them and ‘in order’.

  13. WOW!! This article really resonated for me. In my work in the last few years as an Advocate, Educator on Mental Health and Human Rights issues, and Support Worker, I have always been open about my Bipolar diagnosis and the fact that I do not take medication. This, like you have experienced, puts me in a position also of having to “choose camps” regarding psychiatry and medication.
    This does, in fact, miss the point-my problem with psychiatry is that it is from an “illness” perspective (not holistic) and that medication is the “first line” (and often only) “treatment.”
    This does not promote building resilience and resourcefulness, characteristics which are definitely required to attain Recovery, and is based upon the notion that we never really get better, but MAY experience partial “remission.”
    When often asked what discriminatory attitudes I most often encounter, I always answer “that people automatically assume my abilities and potential are less than those not diagnosed with a mental illness.” This is the real point-whether someone takes meds or not, sees a psychiatrist/therapist or whatever, Bipolar is NOT In Order unless one is leading a full and fruitful life. For me, meds did nothing to “alleviate my distress” anyway, and that is when I began to question the effectiveness of psychiatry.
    I have met so many people that are medicated to the hilt and still have numerous breakdowns/crises, while others who do not take meds have been well and fully functional for years, as I have.
    I believe that this is because those constantly struggling have other complex issues that have not been resolved, and so these act as “triggers” that regularly jeopardise their wellbeing. I also believe that this is because the “illness model” attempts to “treat” the brain as a seperate entity to the rest of the person-an absurd proposition as the brain is an organ of the body just like any other.
    The Holistic model reintegrates ALL aspects of the person; spiritual, emotional, physical, cultural, and as such is about healing-not “symptom reduction” or “stability.” Don’t forget the importance of talk therapies either.
    There are numerous examples of historical figures who probably experienced Bipolar of some sort yet still achieved greatness in their chosen fields, and I often say to people that they should be shooting for the stars, not accepting the limitations imposed by others. I also believe that we have to get rid of terms such as “sufferers” from our vocabulary-this is extremely negative self-talk, and comes from a victim mentality.
    I say; if meds help, especially in the short-term, use them, BUT if your goal is self-mastery as proposed here and you put the work in, you will most likely have no need for them any more, as I don’t. The choice is yours.

  14. Hooray for the sane voices that advocating a nuanced view of medicine in the comments!

    Our discussion will not get anywhere until we get past false dichotomies: medicine/no-medicine, disorder/in-order, etc. What is with this black and white thinking? Aren’t we all intelligent enough to move past such a straw-man discussion?

    The author first states: “I would rather be on meds with Bipolar IN Order than off meds and still in Dis-Order.” This seems to imply an acceptance of meds. But later in the article, the author states: “The role of medication becomes more peripheral as one moves through Freedom Stage to Stability and is largely irrelevant once one reaches Self-Mastery. There is no point in taking something to lower the intensity when intensity is no longer an issue.” This seems to imply that the author considers an ideal in-order state to be one without medication.

    Why is the discussion medication or not medication? The reality is that there are hundreds of medications and each will have different effects and side-effects for each person. The human body is a wonderful mystery, and we cannot yet predict what drugs or combination of drugs will work or not work.

    I applaud anyone willing to try many different drugs in the hope of finding something that works. I caution people from taking dangerous combinations of drugs. If someone can live happily without drugs, all the better.

    We are all discussing methods of treating a ‘disease’ that science can barely even define and diagnose. To deal with such an ambiguous situation, we all need to be robust, try many things, and keep hoping. Most of all, we should support each others approaches, regardless of whether we would make the same decision for ourselves.

  15. TRIGGER ALERT!!

    I’ve been at this mental illness thing since my 1st suicide attempt at 15 (my mother committed suicide when I was 15 after many, many attempts & hospitalizations & a dx of schizo affective disorder) & was dxed as bipolar 1 after being dxed as being depressed & having anti-depressants like Prozac & many other prescribed sent me into hypo mania–I was seeing a GP & just thought, “Wow, these really work!” I only went to see the doc when extremely depressed so being thrown into hypo mania for 8 weeks was great until it wasn’t & back to a sudden deep depression.

    Anyway, finally changed to an internal medicine doc who had a relative w/bipolar & said w/my current symptoms of crying at the drop of the hat & extreme agitation & family history she thoughtbI had bipolar–started me on Depakote & sent me to a pdoc.

    Intensive outpatient program at the local psych hospital for 8 weeks–messing w/meds. Depakote helped w/agitation, but not depression. Lithium was like magic. I couldn’t believe how great I felt. I wondered if this is how other people feel? I had never felt like that before–the internal chaos gone, the wanting to cry all the time gone, the suicidal ideation gone…

    BUT my kidneys couldn’t take it & even on a low dose of Lithium after 3 mos. I was sent to the hospital for further testing to make sure I didn’t have a tumor causing the “bad” blood test results. So had to get off Lithium & even though it was only 3 mos. of a low dosage I have some kidney damage from it, BUT it did give me hope that I could feel & think differently & maybe have some kind if life that didn’t contain suicidal thoughts.

    So it was a year of trial & error to get me “stable”–though never got to feeling as good as I did on Lithium, but Abilify did take away my delusional thinking (I thought my husband wanted me to kill myself or he was going to poison me) & took Lamictal & needed Trazodone & Klonopin (low dose) to help w/sleep.

    Was “in remission” for about 7 years then took a trip to West Coast to visit friend & my coming from the East Coast & the excitement & time change made my insomnia come back in a major way–sleeping only 2-3 hours a night, but felt SO GOOD & energetic & didn’t realize anything was wrong. I stopped sleeping normally for about 5 mos. & then my husband made a negative remark about my weight gain on Abilify (when I 1st got on it, it said it was “weight neutral”–no longer, on the side effects is weight gain & metabolic syndrome, which I do have now). So I had a suicide attempt after his remark.

    And for 2 years despite working to change meds, I remained 296.62 (bipolar 1–mixed episode of moderate intensity). I could not get out of my suicidal ideation. Husband, of course, didn’t know I would react so irrationally & tried to repair the situation, but I could not stop ruminating on it.

    Finally, I heard a fellow at my DBSA support group say DBT was the only thing that helped his treatment-resistant depression. I sought out a qualified DBT therapist & explained my plight & asked if DBT might help me. She thought it could. Boy, did it ever! I also started individual therapy w/DBT therapist & within 3 mos. my bipolar meds provider couldn’t believe the difference in me (my ability to change my thinking–neuroplasticity of the brain at work) & agreed w/me to try getting off Abilify & Lamictal.

    Agreed to go back on meds if symptoms returned, but worked hard to use DBT skills. Got off Abilify & decreased Lamictal dosage by 1/2. When I got totally off Lamictal suicidal ideation returned, but I have also developed chronic pain issues that have contributed to my lower ability to cope (depression accompanies chronic pain).

    Did DBT weekly for 2 YEARS until therapist retired (not because of me!) & now w/chronic pain issues (3 surgeries last year; pain management doc; neurologist; surgeons, etc. trying to figure out what is causing my “nerves to go wild” & cause such intense pain that attacks several parts of my body). Mindfulness learned at DBT has helped tremendously but running out of options w/treatments for pain so probably heading to Mayo Clinic but docs also sending me to psychiatrist at hospital who treats cancer patients w/pain issues–coping w/the stress of a life w/daily pain.

    So I’m still struggling w/depression, anxiety, etc. but all those things are consistent w/chronic pain & bipolar 1–which is causing what? Still on low dose of Lamictal, sometimes take Klonopin, sometimes take pain medication (though not very effective as pain is not constant level but escalates very fast so pain medication is not as effective when taken in the throes of ER level pain)…

    Hope typos aren’t too bad–wrote on a tablet & tired. But I agree you don’t always need to stay on meds for bipolar treatment or on the same dosage–the neuroplasticity of the brain is amazing.

    Someone mentioned trauma. My meds provider said she does not have a patient w/bipolar who has not had some kind of trauma or neglect to “trigger” the bipolar, such as I did w/a severally mentally ill mother & alcoholic, non-caring father.

    Some friends I made in the IOP program when 1st dxed are appalled that I would even attempt to try to change my meds–get off them. They fear a relapse if they go off meds, but I had my relapse while being medication compliant–still went hypo manic & got extreme insomnia even when taking sedating meds.

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