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.
I have always felt it important to keep up with all points of view regarding Bipolar. If I am going to hold myself out as an expert in the field, it behooves me to be current with what everyone is doing. To that end I recently attended a video presentation made by someone from the anti-psychiatry camp. It was very well done and included many good points to consider. I better understand the anti-psychiatry point of view from having watched it.
At the end of the video, the young man who made it got up and made a few remarks. When he got to the topic of medicine I was relieved to hear that he had a more nuanced view than simply looking at all meds as bad. While he saw them beneficial in some instances, he proudly declared that he had been med free for the last year.
This was met with enthusiastic applause. The crowd became much more subdued when he stated that everything was going great until a month ago when he was hospitalized yet again for losing control.
Then the kicker came. He said he hoped to be off meds again as soon as possible and the applause was even more robust.
It all became clear to me at that moment. I decided that from now on my response when people ask my take on meds will be, “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 inadvertently 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.
If you visit the sites that are anti-med or anti-psychiatry it is mostly about what they are against and not about better outcomes. They are not talking about getting Bipolar IN Order. They are talking about their opposition to a set of tools. They are fixated on meds and psychiatry instead of gaining understanding about how to function while manic or depressed.
Meds can be a powerful tool for minimizing symptoms. They can help reduce the intensity during the Crisis and Managed Stages of Bipolar Dis-Order and help you to get to Recovery where the highs and lows are reduced and you can function. Meds can play a central role during all three stages of Dis-Order.
Medicine can help moderate the intensity during the Freedom Stage of Bipolar IN Order, but they cannot get you IN Order by themselves. 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.
The only way to expand your range is to increase your awareness, understanding, functionality, comfort, and perceived value in having highs and lows. You also need to understand how long you can function at each intensity level before it escalates. Medicine cannot do that for you; you have to do the work yourself.
Since medicine alone is incapable of getting people to Bipolar IN Order, the only outcome promoted by the pro-med camp is remission. And that is the worst thing about meds; those who advocate medicine as the solution to Bipolar Dis-Order can only advocate making Bipolar go away. They need the illness paradigm to make medicine the central tool and are unwilling to consider that remission is far below what we are capable of.
Once you understand Bipolar IN Order you see remission as an interim goal, but unacceptable and even foolish as an end goal of treatment. The central point of any discussion about Bipolar should be about moving from Bipolar Dis-Order to Bipolar IN Order. Medicine can be an important tool, but if it is the central topic it can relegate those both for and against its use to a life of Dis-Order.