Mental Health Blogs

What Does Remission Mean in Bipolar Disorder?

I mentioned what remission means for a mental illness in a clinical setting: reduction in specific, empirical symptoms by a given amount. In other words, you are given a depression “score” and remission means reducing that score by a given number.

But does that number mean anything at all to the patient in question? If you achieved it, are you “better”? If you suffer from mental illness, what does remission really mean?

A Cure for Bipolar Disorder

Bipolar disorder is a life-long illness and no one in the medical community is suggesting bipolar can be “cured”. The best that can be hoped for is a suppression of symptoms through treatment. In the best case scenario, the person with bipolar disorder would take medication, attend therapy, build relationships, get a job, be happy and live one of those normal lives everyone seems to talk about.

How Often Does That Happen?

Well, I can’t say. In my experience, almost never, but that’s probably because I only hear from people who are experiencing difficulties. Those who don’t struggle as much probably aren’t reaching out to bipolar writers.

triumphant woman

What Does Remission Mean?

Every person with bipolar disorder, or any mental disorder, is different. Some have more mania, some have more depression, some self-harm, some have anxiety, some can’t hold down a job, some are homeless. All of these people have “bipolar disorder,” but in every case it manifests differently.

And not only does it manifest differently, but an individual’s tolerance to each symptom is different. Some people have hypomanias that are euphoric and not problematic; some have anxiety but control it through meditation; some have a history of self-harm but have found a support group that helps suppress that behavior. And in other cases, mania, anxiety, or self-harm is completely unacceptable.

In each case, bipolar remission means something different. For a homeless person without a job, remission may be the ability to hold down a job and pay rent. For someone else, it might be having stable relationships and a happy home life with a wife and children. And for some it might be enjoying their previous hobbies and interests. We all have different goals and different levels of illness that we are willing to accept.

What is Remission for My Bipolar Disorder?

Personally, I never think of bipolar remission; all I think of are levels of symptoms. I never get to the place where I can just say, yes, my bipolar disorder is under control. I never get to the place where I don’t have fairly bothersome symptoms, side-effects and cycles. All I think about are temporary periods of stability. Times when I’m feeling OK. I’ve come to accept that these times will never be great and likely won’t last long. But that is my experience and certainly not everyone’s.

So Should Bipolars Try to Achieve Remission?

Absolutely.

Yes, I think most of us will have to accept that bipolar disorder will never really go away, but I think striving for an acceptable level of treatment is important. I see people give up when their symptoms have only improved 20% and they are still much debilitated. This shouldn’t be enough for your doctor and this shouldn’t be enough for you. You deserve better and you should aim higher. Remaining sad for the rest of your life is not good enough.

Yes, accept that your life will likely never be what it was before bipolar disorder, but also know that with bipolar treatment you can do better. Call it remission, assign it a number or don’t. It’s better than being sick.

You can find Natasha Tracy on Facebook or GooglePlus or @Natasha_Tracy on Twitter or at the Bipolar Burble, her blog.

This entry was posted in Achieving Remission, Bipolar Treatment, Desire For Remission, Understanding Mental Illness and tagged , , , , , , , . Bookmark the permalink.

32 Responses to What Does Remission Mean in Bipolar Disorder?

  1. Pingback: Mental Disorders 101

  2. heather says:

    i was diagnosed with this bp.disorder several years ago, i no longer see a psychatrist, due to sexual assault from my former one.i rely on god to help me when i get extreemly depressed and cant get out of bed.my general doctor prescribes intidepressants but they dont seem to help much. my family is so proud that i dont take 13 different medications now, i think i would rather suffer than to let them know how irealy feel.plus i dont want to let god down. or my family.i pray for strength and motivation every day to just get the most simple of tasks done.

  3. Natasha Tracy says:

    Heather,

    Medication decisions are always personal, and if you’re satisfied with the outcome now, then that’s all that matters.

    I do feel compelled to say a couple of things to you:

    1. Many people find strength through a faith and if that works for you that’s great. I have to say though, in my humble opinion, a deity wouldn’t have any interest in you suffering. Some believe that god helps those who help themselves so there’s nothing wrong in getting help to feel better. You can still have as much faith as you have now. Medicine and doctors doesn’t take away your faith.

    2. Some people are judgmental about the treatment of mental illness. This is very common. Please don’t let these people make treatment decisions for you. You are the one that has to live with the illness, no one else.

    Obviously I can understand that if you’ve been abused by a psychiatrist you would be tremendously leery of seeing another, but psychiatrists are the ones most able to help you. If you’re scared (and I completely understand if you are) have a person come with you. Have multiple people. There is no reason why you should have to do that alone.

    And I hope you’re getting therapy for the abuse. That can of thing can affect you for a long time if you don’t deal with it.

    As I said, all these decisions are yours and yours alone to make, what I’ve said is just my opinion. Your satisfaction with your life is what matters most.

    - Natasha

  4. Lucía says:

    I’m 17 and I have bipolar disorder too, and I didn’t knew of the existence of the term “remission” till’ know, but i think that is what i’m experiencing right now, an estability, i’ve been on remission for a week now, it sounds a very short period of time, but it feels like years, it makes me feel as if i weren’t ill anymore, like i don’t really need all the therapy and the meds, as if everything that i went through before was only a dream, all the self-harm, all the euphoria, anxiety, depression, suicidal thoughts. But i know that one day, all this will be back, maybe tomorrow, maybe within a month, but right now i’m really calm, I am more me. And I’m happy to know that everyone’s bipolar is diferent, because I thought because of TV programs and stuff my personality should be like, Very Extroverted, all the time. But I’m actually a really chill person most of the time, regardless of how I behave when I have my episodes, when I have them of course I’m more much extroverted than I usually am, but that’s not the everyday me.

  5. Lucía says:

    I’m 17 and I have bipolar disorder too, and I didn’t knew of the existence of the term “remission” till’ know, but i think that is what i’m experiencing right now, an estability, i’ve been on remission for a week now, it sounds a very short period of time, but it feels like years, it makes me feel as if i weren’t ill anymore, like i don’t really need all the therapy and the meds, as if everything that i went through before was only a dream, all the self-harm, all the euphoria, anxiety, depression, suicidal thoughts. But i know that one day, all this will be back, maybe tomorrow, maybe within a month, but right now i’m really calm, I am more me. And I’m happy to know that everyone’s bipolar is diferent, because I thought because of TV programs and stuff my personality should be like, Very Extroverted, all the time. But I’m actually a really chill person most of the time, regardless of how I behave when I have my episodes, when I have them of course I’m more much extroverted than I usually am, but that’s not the everyday me.

  6. Natasha Tracy says:

    Hi Lucia,

    Are you getting help? Therapy? A doctor? You are very young and what you’re experiencing may not be bipolar, per se, and you may be able to be helped by some targeted therapy.

    The good news is the sooner you are diagnosed and treated, the better the chance is that you will get better. Just make sure you’re seeing really qualified professionals and getting therapy.

    And yes, remission is wonderful. Although a week normally isn’t considered remission, it’s good, and I say, call it whatever you like.

    - Natasha

  7. Lucía says:

    Yes, i have been diagnosed with bipolar disorder, rapid cycling, I’m getting therapy and meds, the meds specially have been helping me a lot, cause, well, i’m not very consistent, so at first i didn’t follow the therapy the way the told me to, but now i’m getting on track… so, how time shall pass to say i’m on remision?.

  8. Lucía says:

    Yes, i have been diagnosed with bipolar disorder, rapid cycling, I’m getting therapy and meds, the meds specially have been helping me a lot, cause, well, i’m not very consistent, so at first i didn’t follow the therapy the way the told me to, but now i’m getting on track… so, how time shall pass to say i’m on remision?.

  9. Natasha Tracy says:

    Hi Lucia,

    It’s great to hear you’re getting on track.

    Remission? I don’t know of a specific time. It sort of depends on the person. Some people cycle a lot (like me) so if I have a good day, I don’t call that a remission. For me, I would say a month, maybe, but like I said, I think that’s individual.

    What you call it is up to you. What matters is that it’s good. :)

    - Natasha

  10. laura says:

    Natasha- I am 32 and have been diagnosed with bipolar NOS, ADHD, PTSD and an anxiety disorder. I have a great psychiatrist and therapist who work very closely with me. I have gone from non-functioning living on disability to working full-time for the last 4 years. I even started my own business in March. Sounds great but its not. I still constantly struggle. Yes I have made leaps and bounds but often times I find myself wondering if its even worth it. Sick of the roller coaster ride. How can I find “remission”?

  11. Natasha Tracy says:

    Laura,

    Hon, I’m sorry, I don’t have the answer. If I had the answer I would feel a lot better myself.

    The only thing I can tell you is that if you’re not happy, don’t settle. Your meds aren’t right. You can do better. Get more therapy. Try a different doctor.

    All I can say is that if it’s not good enough for you, then it’s not good enough. I know where you are. I know the functioning-miserable-daily-slog. It just means you’re persistently unwell. If you want that to change, then you have to try something different.

    - Natasha

  12. Tracey says:

    Hello Natasha,

    I just wanted to write because I believe I am one of those individuals who has reached bi-polar remission. After 7 years of unstability, I have had over 6 months of wellness to date. I am on a very minimal amount of medication. I can say that I work every day at maintaining my wellness. I don’t talk about it much but I do assess my emotions, eat right, exercise and monitor my sleep patterns. I figure, if a diabetic has to monitor themselves with food and blood sugar levels, then I am no different. The hardest part to wellness has to be “feeling” again. I have been so medicated and numb for so long that certain feelings are unusual to me. However, with a great support network, I have been able to realize that my emotions are completely in line with the events in my life. This confirmation is extremely helpful and relieving. I could go on and write so much more but I would mainly like to tell every bi-polar person not to give up hope. It is the one thing we all have and it is what kept me going when I was ill and brought me to a place of wellness.

    Thanks for writing about bi-polar.
    Regards;
    Tracey

  13. says:

    Natasha…
    Thank you very much for writing this piece. I’m bipolar and have been in remission for close to a decade with the exception of one six-month hiccup. You wrote that in your experience almost no one achieves remission because your experience mainly involves hearing from people not yet there. To realte, in my experience, the collected Internet also seems to think that remission is rarely achieved given the lack of writing, blogging, etc on it. Similarly, it’s rare to find support groups and the like for those of us in remission, the so-called High-Functioning. Not all of our symptoms go away, though they may minimize. We deal with finding ways to rebuild the trust we lost from our friends and family. We go through new worries that one day our brains may crack or some stress will be too much or we’ll exceed out respective limits and find ourselves sick again. We bend over backward, contorting our lives, to avoid all triggers. I’m yet to find a productive, supportive forum for discussion on these issues. So, last month, I started one. I’d really appreciate your thoughts and feedback on this nascent project. It’s the website linked to this comment.

    Thanks again for this post.

  14. Natasha Tracy says:

    Hi Tracey,

    Thanks for sharing your story.

    “I have been able to realize that my emotions are completely in line with the events in my life.”

    That’s an amazing thing. Congratulations.

    Thanks for sharing your hope.

    - Natasha

  15. Natasha Tracy says:

    Hi E,

    This is something I can relate to as well:

    “We go through new worries that one day our brains may crack or some stress will be too much or we’ll exceed out respective limits and find ourselves sick again. We bend over backward, contorting our lives, to avoid all triggers.”

    It’s a good point that those in remission need support, lots of support, too. Congratulations on taking the initiative to get the support you need when you couldn’t find it elsewhere.

    I can’t promise I’ll take a look, but I will if I have the time.

    Thanks for sharing.

    - Natasha

  16. Dolores King says:

    I have left a verbal relationship, but after separation it continued, he did whatever he could to hurt me. He placed the blame on me, and lead my eldest son that it was all my fault and that I was crazy.
    My family doctor doesn’t listen to me and just keeps prescribing medication. Tells me to go to the hospital if I continue thoughts of suicide. I feel helpless and alone and that maybe I would just be better off dead. I am fighting this every day, but feel I will need to go to the hospital if I am going to survive.

  17. Natasha Tracy says:

    Hi Dolores,

    You would not be better off dead and your children certainly would be better with you dead.

    If you are suicidal you have to get help. Get help now. If that help is a hospital, then that’s OK.

    If your doctor isn’t giving you what you need then you need to try something else. Is this a psychiatrist? If not, then see a psychiatrist. Look into getting therapy for yourself. You are working through a lot of issues and you need professional help right now to get you through them.

    You are not alone. Do what it takes to survive because it will get better.

    Here are the numbers of hotlines and resources. Use them.

    http://www.healthyplace.com/other-info/resources/mental-health-hotline-numbers-and-referral-resources/menu-id-200/

    - Natasha

  18. Sarah Rosenberg says:

    Natasha,

    I am also one of the bps who found remission. It comes from conscious, regular use of meds and talk therapy. Exercise helps, too. Keeping a consistent mood chart is the best way to get here. It helps you learn the patterns of your mood ups and downs, and helps you learn to handle the waves when they do come. Find the right doc for you — and trust your own judgement about what works best for you, then speak up to your doc. If they don’t listen, they’re not the right person to be seeing. Don’t let your family or internet forums talk you off meds. If you need them to calm the waves, do it. Your own experience is the best indicator of what you need to achieve remission. Hang in there, fellow bp’ers! Remission is achievable!!

  19. Hi Sarah,

    Really great comment, thanks so much.

    That is all exactly what I would say. I’m glad to hear that is working for you.

    - Natasha

  20. Claire says:

    To Deloris, Get Help For Your Son-Do Not Commmit suicide. Get a sleep study done. Ask your regular doctor to perform one and log your sleep hours, have your broken nose fixed (if you have one). The brain needs oxygen and sleep or you will go insane. Check your surroundings, check your sleep and oxygen, sleep apnia, broken nose etc. Have surgery, get an auto pap machine for oxygen. Take meds while your doctor says. YOUR SON NEEDS YOU. Life Will Get Better!

  21. Susan millin says:

    I have bipolar and have had three psychotic episodes, which where very hard to get over.
    I am now in remission without any drugs or therapy.
    I do strudle in the mornings, when my thoughts are very erratic, so i just get up out of bed and keep myself busy, so I can’t have damaging thoughts.
    Each day for me is a massive task, but the evenings are good, when I can relax after getting through without depression.

  22. Sherry says:

    I am bp and ahve reached remission. My doctor feels we have finally found the right medications. I think that is a big contributor, but more important is daily exercise, a strict sleep regimen, and disciplined positive thinking. My lows are suicidal, and I’ve learned not to dwell on the bad or jump to the conclusion that the worst will happen. There is hope, fellow bps!
    Sherry

  23. Amanda says:

    I have been diagnosed with bp type I for 15 years. Honestly I don’t remember a time in my life when I didn’t feel like I had it (even preteen). You’re right, it never really goes away like you think about remission in terms of cancer or something. I have more issues with mania than depression thankfully. I feel if you can call something in bipolar “in remission”, I’m there. Cognitive behavioral therapy has done wonders for me and given me the ability to look at myself and say “I need medication now”. I don’t have to take it all the time, or even most of the time anymore. (I would not recommend this as a standard, I’ve had years and years of therapy). I’ve even gotten to the point that I accept this disease as part of me and something that I don’t want to go away. It’s made me a stronger, better person. You can live with this and through it.

  24. Pingback: Removing the Labels of Mental Illness | Recovering from Mental Illness

  25. Caroline says:

    Remission happens. I was diagnosed at 15. I was extremely symptomatic throughout high school, despite different medications. In college, due to no car and no consistent university psychiatrist I quit therapy, drug and talk, quite abruptly. I do not recommend this. I suffered off and on for four years, eventually tried a new medication, which didn’t work, decided drugs didn’t work, but continued talk therapy and figured out a strict exercise regimen and solid support group worked best. I still hold a highly physical job, and try to maintain a good support system. Sometimes I think about trying to find a medication that works again. But for the last several years I’ve had minimal symptoms. As close to a remission as someone with bipolar can get.

  26. Erica says:

    I came across this blog while looking up what life was like in remission. I have been in “remission” for quite a while. I guess what it means to me is living almost symptom free. Life will never go back to the way it was before diagnosis but I have adjusted to my new norm. I work full time and am getting my master degree. I go out with friends and have fun with family. I have had to make some adjustments to get here. I go to be earlier. If I am tired I rest. If I am feeling very hyper I reign it in before it gets out of control and if I am feeling down I tell someone. I have had some severe symptoms in the last year but none have turned into a full blown episode. I occasionally have symptoms but just enough to remind me that I have to take care of myself.

  27. Megan says:

    Great blog on remission. I was dignosed with bipolar at 18 after several misdiagnosis. After a lot of different therapies, medications, and self-education I was able to cope with my illness. I have been able to stop destructive behaviors and able to cope without medication. my therapist has listed me as in remission for several years now and we are dicussing discharge from treatment.

    I would have to agree that remission is different for everyone. While my illness has taken a major turn for the better there are still days when coping with symptoms is difficult. Never try to achieve 100% normalcy, because in reality normal does not exist. The key to coping with bipolar is to surround yourself with positive situations and supportive people. Know your red flags and educate your self on the illness. Always have a plan of action for when things become unmanageable.

  28. Banana says:

    I will never be normal again. Meds, therapy, sleep, eating well, supplements. Nothing works. I hate this. This is no way to live. And I see symptoms of how I was as a kid in one of my kids. It’s terrible to see the monster lurking in your beautiful child. All I can do is wait.
    I go to work. I come home. I try not to yell and snap at people. Or cry, or get so hyper that others raise their eye brows at me. Repeat.
    I can’t tell my Pdoc. I want to separate eventually, and my medical records can be subpoena’d if the DH says I’m an unfit parent. I can tell no one what I’m going through.

  29. Anonymous Bipolar in Remission says:

    I would consider myself a person with bipolar in remission. Bipolar remission to me means fully functioning on a daily basis with symptoms mild enough that they are not noticeable to those closest to me. After reaching stability through cognitive behavioral therapy and medication, I was able to titrate off daily medication 7 years ago. Please know you should never attempt to go off medication without both the approval and the close supervision of both a psychiatrist and a psychologist. In order to remain stable, I work hard. I am vigilant in my self-awareness and well-versed in the first signs that my stability is wavering. I utilize CBT strategies daily and reintroduce medication when necessary, usually anti-anxiety medications. By introducing these medications at the first signs of depression or rapid cycling, I have been able to maintain stability. I closely track my sleeping patterns, because I know that when my sleep patterns change, rapid cycling follows. I keep tabs on all the symptoms I know are precursors to depression and rapid cycling for me. I believe I am fortunate and that as hard as I have worked to reach this place, much of my ability to manage my symptoms sans medication is due to plain old chemical luck.

  30. Kate says:

    I was diagnosed with bi polar at 22 and am now 33. Three years ago I got the right medication, a helpful and respectful psychiatrist and I kept going to my psychologist (8 years). I’ve had my current full time job for two years, I have savings for the first time in my life and a lovely fiancee. This is better than I could have imagined was possible.

  31. Tabatha says:

    Hi Natasha,
    I am saddened to hear your views about remission in bipolar. I feel free of ‘symptoms’ of the condition most of the time, and rarely have episodes of full scale unwellness. The one thing about mental health conditions is that they effect the underlying reasons we make decisions. Given this, everyone on the earth differs in their reasoning for making decisions on a wide ranging scale. There are actually no ‘acutely unwell’ symptoms in a person with a bipolar condition to speak of. You cant actually notice a person feeling more or less emoitional on a given day if their moods are in a period of fluctuation or not. As in all areas of life, we are subject to our social circumstances and the resulting pressures these apply to our emotional state, whether we become more or less emotional reacting to losing a job or a place to live or a friend does not even necessarily dictate us as having an abnornmal “bipolar” reaction as such. The anyone reacts to given stressors in their life is unique to that person and at times,everyone is a little over-emotional during different circumstances. I had a child at age 37 and since then my whole outlook “settled” significantly that I have not had significant issues with my emotional reactions to stress, I have effectively been in a “remission” from my bipolar symptoms. I am not sure if this is due to hormonal processes through having a child, or due to my age, or lifestyle but I am very thankful to not suffer with frequent bouts of illness and am convinced this is my true remission. Having a child necessitates a stable steady lifestyle of daily routines and eating and sleeping patterns all of which are beneficial to stabilising mood and ability to cope with stress. I have never considered myself as a person who suffers with a “chronic” condition or chronic symptoms ever. Even though I have had several episodes of illness, I am always able to return to a stable and very boringly normal ‘self’. I feel sorry that your experience of bipolar is so chronic and constant.

  32. Courtney says:

    Remission for at least a year. Perfect med package, therapist, and psychiatrist.

Leave a Reply

Your email address will not be published. Required fields are marked *

*

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>