Hi T. Paul,
Your experience is why we need a new way of looking at the issues. Our approach is the opposite of what you have been told for forty years – we are not trying to make it go away. Please read Bipolar In Order on our website or buy the book. I guarantee that it is a completely different way of looking at depression, mania, hallucination, and delusion.

I really like this article and the insights that it offers. I don’t think that anyone can really understand the points made and not feel somewhat better on account of it.

It is my own personal experience that I have been at my unhappiest when my bad mood, whatever that may be, is made worse by a mind of non-acceptance thinking “it shouldn’t be like this.” Acceptance takes away the non-acceptance and consequent feelings of despair.

Pavel Somov is making the same point in many of his articles, and that is all well and good too. Most of us have come to believe in the doctrine of how things ‘ought’ to be, and need plenty of reminders that there is a better, easier, and more intelligent way of leading life based upon an acceptance of what is, conjoined with sensible and informed planning for what we would like to see in the future.

Pepper–

The text you link to is lovely. I believe there is a ground shift occurring among those who experience powerful moods and depression. We are collectively realizing that rather than being an illness, depth of feeling is a gift. I see signs of this new understanding all around. We have good cause to rejoice: the answer we have sought for ages is now at hand. It takes courage, but if we allow our hearts to flow in the open current of our emotions, we will find that sorrow is endurable, and needless suffering ends.

–Will Meecham
WillSpirit.com

what about a seriously debilitating mood problem, like suicidal depression? acceptance of that could lead to suicide. Or a mania which causes a person to think s/he is being called to break into the White House to deliver a message from God? These are extremes but they do exist within the parameters of manic-depression/bipolar disorder. Acceptance is good if your disorder only takes you from “normal” levels of depression to non-extreme manias. But we need to be aware that medication can help people whose moods sway wildly.

Will,
your distinction between acquiescence and acceptance is so important and critical! So often this distinction is exactly what is missing in these conversations about acceptance. Thank you so much. I will now know how to respond to so many who I’ve not been able to clearly communicate with on the issue of acceptance.

Hi Colette–

Thank you for taking an interest in my writing. I will offer some opinions about medication, but please understand that although I formerly worked as a physician (an ocular plastic surgeon, to be exact), I have had no formal training in psychiatry beyond what comes with basic medical education. Long ago I did some graduate work in neurophysiology, and I try to educate myself about the brain and mental illness, but I am not qualified and do not intend to offer advice about whether any particular person should take medication.

Those disclaimers aside, I will say that in my opinion you are fortunate to be free of drugs. There are plenty of ways to prepare a safety net that don’t require pharmaceutical agents. One can learn to discipline thought, pay attention to behavior patterns, eat well, get enough sleep, exercise regularly, etc.

The internet and media are flooded with messages that imply medications are essential to the mental health of everyone with mood disorders. However, the research evidence is not persuasive for the following reasons:

1. The pharmaceutical companies have blocked publication of studies that fail to show effectiveness. This biases the literature to increase how useful drugs look, when if we knew about all the studies, we might be less convinced.

2. Even when research does show benefit, the effect size is usually small. In general, when you subtract out the strength of the placebo response, only about one person in five is demonstrably helped by medication. Even those who are helped often just score a little better on a questionnaire; they seldom become symptom-free.

3. The research protocols are almost invariably of short duration, usually about six weeks. Logistical and financial barriers have made it impossible to determine effectiveness in the real world situation, where people take drugs for years. So although it is reasonably certain that medications help some people in the short run, the support for long term effectiveness comes primarily from what is known as anecdotal evidence: doctors see patients who do well on medications. But they have no reliable way of knowing whether those patients are in fact any better than they would have been if they had never been started on drugs. Many medical and psychiatric conditions improve with time even without treatment.

4. Doctors sometimes cite the fact that people deteriorate when they stop their drugs as supporting the usefulness of the agents. There is no question that once a person is habituated to psychiatric chemicals, negative consequences follow discontinuation. But that does prove the person is better off than if drugs had never been started in the first place.

5. Mental health clinics are packed with people on numerous medications, saddled with terrible side effects, who feel as bad as ever. These drugs are not miracle cures.

6. The drugs affect neurotransmitters in the brain, and naturally that changes how people feel. Sometimes the drugs alleviate psychiatric symptoms, but there is no evidence that they are correcting a so-called chemical imbalance. Some differences in certain transmitter levels have been seen in people with psychiatric conditions, but the oft-cited comparison of psychiatric drugs with insulin is inappropriate. There is no demonstrated chemical abnormality in mental illness, and the drugs do not in any way restore normal balance.

These statements may be open to different interpretations, but they are factual. I am sure medications have a role to play, but it seems inescapable to me that their huge popularity is a consequence of marketing, not miraculous effectiveness.

–Will