Living with Bipolar Disorder
Frequently Asked Questions

I'm Worried About Medications for Bipolar or
I Don't Want to Take Bipolar Medications

It is quite reasonable to be concerned about taking medications. They are going to change the way you feel. They might be an admission that you might really be manic depressive. They may make you nauseous or sleepy or have other side effects that interfere with your work or leisure activities or sleep. You might worry whether you want to be taking medication for a long while. Or you might just not like pills.

But let's start at the beginning. You didn't end up on my bipolar website or at the psychiatrist's office because your life was fine. Something is going wrong or went wrong somewhere and you are trying to find the problem(s) and resolve it. You've been told that perhaps you are bipolar and you've been given some pills.

Well okay, you might not feel you are manic depressive. But are you sure of it? It might be worth checking to find out if the pills do make your life better? Remember you can always stop taking them later on if you so choose to. I agree that you probably have other options of trying to sort your life out, but at the moment you do have the bipolar medications and now is as good as any other time to try to see if they work. If they don't, then you can explore your other options.

I am not saying that the medication is a cure all, or inherently a good thing, because it isn't. But you owe it to yourself to know all the options you have available.

To be honest, I am not one of the people who thinks you should take medications for bipolar because your psychiatrist prescribed them and you should follow her/his advice. You should, at least, be able to satisfy yourself that medication works somewhat in making you feel better and more able to handle your life. I do spend a fair amount of time arguing with my psychiatrist about this (luckily for me, she supports my view and I haven't experienced the horror stories that some people have written me about).

Here are two reasons you might want to take bipolar medications for awhile.

You want to find out if the people around you notice a difference when you are on medication.

I remember when I started up on medication, I got comments that ranged from my parents saying that I looked and acted so much calmer than before to friends telling me I was less obnoxious because I did not butt in on conversations any more. The classic comment is from a close cousin who told me "...and now you can even finish your sentences."

Apparently, the differences were not all that subtle either because some people I never told I was on medication volunteered their information without my asking.

The funny part was that I never realised that these problems (a) existed or (b) were problems. But those around me did. And we all thought that they were inherent parts of my character, except the problems disappeared abruptly when I went on medication.

It's a rather sobering experience to suddenly have some of your faults disappear by taking a pill when you have spent years trying to get rid of them or control them.

Of course some of my cuter quirky habits disappeared too. I didn't magically become a better person.

The point is that some of your problems may have an underlying medical cause and the medication does help deal with them. I grant that the medication is no magic bullet, but if you don't try it, you'll never know if it will help.

Bipolar Medications can help you see the goal you are trying to attain.

It is worth trying medication for bipolar disorder at least once. While getting yourself into the mess that you probably are in, your might have lost the ability to remember what "normal" or "calm" or "happy" might mean. I don't mean it as an abstract concept either, but as the actual sensations of happiness or calm. Most bipolar medications will help you to calm down or perk up over a two to three week period and allow you to feel again what it could be like to be somewhat normal.

Before I went on medication I used to be hyper or depressed continually. When I started taking carbamazepine (Tegretol), it altered my behaviour to something approaching 'normal'. That was an eye-opener because I never realised how odd I really was and how many of the little things that I did and took for granted were NOT normal. I would never have believed that life could be so calm or easy until after I went on medication. I would never have been able to even imagine it since I had never been that way ever before.

So if you stop the medication, for whatever reason you have, you can at least remember what being calm was like and try alternative methods to achieve the same calmer state.

How you feel when you go on medication usually can provide the convincing evidence that there is actually an underlying medical reason for your mood swings. But you might not feel convinced, or you might just not want to be on medication. That's your choice. If you do decide to stay off the medication for now, remember you can always change your mind later. Don't let embarrassment or false pride get in the way.

There is one reason that you might not one to be on medication.  Just about all the mood stabilizing drugs have cautions against taking them while pregnant or while you are trying to become pregnant. If you are considering having children or if you are pregnant talk with your psych about the drugs and pregnancy.

If you have chosen the no medication route...

I've found the following to be helpful in trying to ward off stress, mood changes, anxiety, and mild mania without medication. I have found no good wards against low moods or depression.

1. If you find that you are tense, or are being stressed out, or things are happening too quickly, or it is all too much, take a few deep breaths slowly in and slowly out and try to relax your muscles. It provides partial relief.

2. When things get overbearing, take 2 minutes out to decide what you are going to do for the next hour. There is nothing in the world that cannot wait for 2 minutes and the planning of the time relieves you of some stress. Write down what you intend to do if necessary.

3. Over the next month or so, pick one or two things you don't like and want to change. Then try working on it to prevent it from happening. The feeling of control makes you feel better. You can pick odd things. I've picked on driving less than 80kph (instead of at 120-140kph) as one of my goals. It makes me calmer overall to do so.

4. Do the following every day: Relax more. Stop feeling guilty for the things you did not achieve. Stop feeling anxious about the things that you are not achieving. If you have a partner, spend 10 minutes lying quietly relaxed or cuddling with him/her every day. (It's therapeutic for them too.)

5. If you can make the time, exercise. Whatever you like. Exercise makes you feel better. Don't forget to have fun doing it and don't feel guilty if you skip a day or ten. Just smile and start again. Don't let the gung-ho exercisers make you feel inadequate. I've found swimming, walking on a treadmill or medium intensity aerobics to be fun, and stretching at the end of them to be very relaxing. With the aerobics I felt really stupid for the first 4-5 classes until I got the hang of it, but after that it was fine. Whatever you choose, make sure it is something that you can still achieve even on a bad day. With swimming, I set the minimum number of laps to an amount I can achieve even if I am feeling lousy. That way even on bad days I feel as if I have have accomplished my goal anyway.

6. Monitor the signals that warn you that you are becoming stressed or overreacting. Calm down using deep breathing or anything else that works.

7. Try to overcome the guilt/stress/embarrassment on the things that have not been done. Start over afresh. Get the people close to you to just lay off on your case and tell them it will take you a while before things are back to normal. Don't overwork trying to get things back to normal - things will happen when they happen.

8. Get your partner and those people close to you to tell you - often - that they love you. I'm not exactly sure why this works, but it makes me feel better.

9. Talk to other people. It is the only way to let them know how you feel. Find a few close people and tell them how you honestly feel. This is a therapeutic thing (but remember that relationships are on line here, so still be tactful in what you say).

10. I have no recommendation for diet. My experience is that diet follows mood. I would suggest that you try anything you feel as long as it is sensible.

A warning. If you really are bipolar, all of the above will be very useful, but may not be enough to prevent you from destabilising. Please hold that at the back of your mind if you stop taking your bipolar medications, and please be aware that you may have to go on mood stabilizing drugs to stabilise.

Whatever you do, keep in touch with your psychiatrist. That way in case things go wrong, your psych knows how to handle the situation. If you don't want to tell your psychiatrist, tell someone close to you so that if anything goes wrong, they can pass on the necessary information.