Mental Illness

[Nigel]

I was diagnosed with bipolar disorder about 7 years ago. For the past 4 years I had not had any bipolar episodes or any issues. Two months ago, I had a manic episode. It was not necessarily a bad episode, but I was manic nonetheless. As a result, the doctor put me on a medication that makes me extremely tired and impairs my cognitive functioning. This medication was chosen because it has worked for me in the past, and we knew that it would work quickly. The problem is, the doctor would like me to stay on this medication to prevent possible future bipolar episodes.

In the past, to counteract the mind dulling effects of this medication, I had taken a stimulant (like adderall). But stimulants will no longer work to counteract the effects of the medication. As a result, I have become very frustrated and agitated, as I think anyone would if their cognitive functioning were suddenly limited. I talked with my psychiatrist about this and she was insistent that I stay on the medication.

I have serious issues with the logical reasoning here. Yes, without medication I will eventually have another episode. However, these episodes can be easily fixed in a short amount of time. It took less than two weeks to get the last episode under control. Furthermore, I have never hurt others during the course of a bipolar episode, and I have never hurt myself. The only time that things got seriously out of hand, I was able to seek out medical help prior to any adverse decisions. Also, during this one instance, I had not yet been diagnosed with bipolar disorder, so the racing thoughts and mania were quite scary. Being older and more knowledgeable about bipolar makes a significant difference.

I guess my question is, is it logical to impair my cognitive functioning to prevent something that is very treatable. I value my mind. I don't see how inhibiting my attention and cognitive processing could benefit me, particularly if the concern is my mood. Am I right in demanding that my doctor take me off this medication?

*as an after thought, last time I was put on this medication, I simply stopped taking it. I did not have a bipolar episode for 3 years after I stopped taking it.

Edited July 4, 2011 by Nigel

[mmmcannibalism]

I would say that if the effects of your illness are ultimately* minor; it is probably better to suffer the occasional episode.

One thing I would bring up with whatever medical professional you would be talking to is the possibility of a lower dosage or alternative medication. I have very limited understanding of the medical treatment here, but minor symptoms with bad side effects sound exactly like a situation where you would consider a lighter treatment.

*the way you describe it, it sounds like off medication you have a normal life with rare bad days.

[bluecherry]

If your psychiatrist really won't consider any adjustments to your medication, you may also want to consider seeking out a second opinion from another psychiatrist.

[Eiuol]

If anything, you make it sound like the impaired cognitive function from the medication is bothersome enough that it may as well be a mental illness. When the side effects of the meds are just as bad or worse than the illness itself, then that's a good time to stop that particular med. From what I know about bipolar disorder, it can be more notable once you're in your twenties, so if you are around that age, there may be good reason that your psychiatrist doesn't want to try other meds. Of course, some doctors have poor justification for using certain meds and just choose one just because it works well enough with plenty of other people. In a whole other field of medicine I was suggested I should take one certain medication, but the research behind it for people like me was mostly absent on top of potential side-effects that were worse than the medication itself. There wasn't much information on long-term effects, so no matter how much the doctor thought the treatment was fine, I found little scientific justification. If the side-effects really are severe, you certainly should ask for specific objective standards that are being used to determine that the med is really the absolute best one for you to take *and* is necessary to prevent severe episodes. If you already requested that information and you were given poor or weak justification, you would be right to ask to be taken off the medication and switch to another, or maybe even see another doctor.

[Erik Christensen]

Nigel, hope your day is going well. Have you considered psychotherapy? You may want to seek out a psychotherapist (preferably cognitive if you can find one) I don't think I would solely rely on medication. In fact, I would use the lowest and least psycho-impacting drug as possible if you are going to use medication.-ask your Dr. Anyhow, Dr. Michael Hurd and Nathaniel Branden (both Objectivists) have excellent writings on the subject of mental health.

http://drhurd.com/index.php/Life-s-a-Beach/Published-Columns/Pills-cant-cure-Victim-Think.html

[VcatoV]

Nigel,

To be honest with you, I would give up on psychiatrist and psychologist 100%. I don't want to get too much into it, but will safely say that they are bunk "Dr.'s" who attempt to use medication and mind games to normalize your condition to their view of a healthy population.

This is not to say that mental illness is a fantasy, but rather that "psychosis" has become an excuse for quacks to dress up and hide behind the sanctity of the medical community. Bring your problems to a real Dr.--trust your PCP over them any day of the week.

[Grames]

The dosages of drugs are set to get a statistical effectiveness for 95% of the people who take the drug. (I forget the reference, and it is not immediatley obvious to me what to search on. I recall there was a popular book on the topic a few years ago.) Anyway, the result is some portion of the treated population are guaranteed to be getting an overdose. Overdose levels are highly correlated with side effects. The point of all this is: if you haven't yet experimented (in conjunction with your doctor) with smaller doses you should commence doing so immediately.

[Eiuol]

This is not to say that mental illness is a fantasy, but rather that "psychosis" has become an excuse for quacks to dress up and hide behind the sanctity of the medical community. Bring your problems to a real Dr.--trust your PCP over them any day of the week.

I don't deny that probably many psychiatrists over-prescribe medications and a variety of psychologists are involved with little more than mind games, but I think you're overgeneralizing here. What do you mean by a "real doctor", anyway? These are doctors that deal with the brain, so I don't know what you could mean by real doctors. Medications absolutely do alter brain functioning, so if used properly, can be beneficial in dealing with problems that are the result of your brain not working in an efficient way (based on what I know about psych meds, they are something to only take if they are absolutely *required*). Also, methods of thinking can cause problems as well, so altering those can make a person feel better and more productive. I've experienced plenty of non-brain related doctors, and plenty of those don't know what they're doing either. Or they do, but barely *think* in a scientific way.

[volco]

I don't deny that probably many psychiatrists over-prescribe medications and a variety of psychologists are involved with little more than mind games, but I think you're overgeneralizing here. What do you mean by a "real doctor", anyway? These are doctors that deal with the brain, so I don't know what you could mean by real doctors. Medications absolutely do alter brain functioning, so if used properly, can be beneficial in dealing with problems that are the result of your brain not working in an efficient way (based on what I know about psych meds, they are something to only take if they are absolutely *required*). Also, methods of thinking can cause problems as well, so altering those can make a person feel better and more productive. I've experienced plenty of non-brain related doctors, and plenty of those don't know what they're doing either. Or they do, but barely *think* in a scientific way.

Eiuol is not overgeneralizing, there is a difference between psychiatrists, psychologists, and medical doctors (even though they may overlap). The difference is that "real" doctors deal with parts of the human body, psychiatrists don't not yet. It is neurologists that deal with the brain. Psychiatrists and psychologists deal with the mind.

While it is true that some advances have been made to show objectively how applied science can actually identify and balance some disorders, namely schizophrenia, the rest vast scope of diagnosis are try and guesses with the patients being the guinea pigs. present psychiatric drugs are to future comprehension and treatment what alchemy used to be to chemistry. the one mystical pseudo science is needed to advance toward hard science. unfortunate how many lives are destroyed on the seemingly inevitable process.

maybe counteract the input from your psychiatrist with some of dr methodius bonkers's Institute for nearly genuine research.