When Bipolar Medication Doesn’t Work – Disappointing Your Doctor

I am a very difficult case of bipolar to treat. Believe me. I have been on more bipolar medications than anyone I know and finding an effective cocktail is akin to walking on water. It’s possible, but it’s pretty darn rare.

And recently I made a medication change from one antipsychotic to another. It went very badly in a whole host of ways. In fact, I terminated the medication trial early and went back to my previous medication.

I see my doctor this afternoon and now I have to tell him the bad news about how it went. And I feel guilty about failing another bipolar medication. I know he will be disappointed and I feel bad about it.

Failing Treatments

Yes, some people will correct me and say, “The medication failed you.” Well, use all the wordplay you want, it still feels like I failed another medication treatment.

Disappointing Doctors

And, if you have a decent doctor, the doctor is disappointed when treatments fail. They’re not disappointed in you, of course. They are disappointed in the failure. But it’s easy to feel like this is a disappointment in you. It’s easy to read this like you’ve done something wrong.  It’s easy to feel like it’s your fault.

And it’s hard to see the look of disappointment on your doctor’s face – especially if you like him. And this look gets more and more pronounced the more treatments that fail.

It’s Not Your Fault

But, as I said, it isn’t your fault. I admit that it feels like it is but we need to remember that this is a depression thing. Depression looks to make us feel bad about everything regardless as to whether there is any actual blame to be had. And in this situation there is no blame. Your chemistry just didn’t match with the chemistry of a drug. That’s no one’s fault.

Scientists see a negative result as favourably as a positive one. This is because a negative result is still a result. It’s still data to take into account. It’s still one step closer to the answer you seek. So we can view medication trials in the same way. If a medication doesn’t work then it’s just one more data point. It’s just one more medication to cross off the list. Yes, because we have personal skin in the game, we would have preferred that it work, but if nothing else, we still got a data point out of it and that data point can help get us to the answer we seek.

Because something will work. It takes time, patience, persistence and a good doctor, but it will happen. If nothing else, this I have learned. Eventually neither of you will be disappointed. But it can be an agonizing wait getting there – and that time will be hard enough so try not to spend it beating yourself up too.

You can find Natasha Tracy on Facebook or GooglePlus or @Natasha_Tracy on Twitter.

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14 Responses to When Bipolar Medication Doesn’t Work – Disappointing Your Doctor

  1. Andrea says:

    We could be medication sisters, Natasha. Sometimes it’s not only disappointing and frustrating the psychiatrist. With a violent, life-threatening allergic reaction to Saphris this week, which is new and hadn’t crossed my radar, didn’t connect the dots that it was the introduction of the new drug that made me so sick, not the head cold going around the house. When I begged the doctor to put me back on Geodon, she refused and wants to try Zyprexa since my antipsychotic seemed to plateau as I was rapid cycling way too much. I am PETRIFIED to try another antipsychotic. Psychiatric “cocktails” are admittedly hard to tweak, and it takes time, but if we know one thing about bipolar disorder, it’s that there is no cure and no magic bullet, which is rough.

  2. Charles Mistretta says:

    Lets say the large pharmaceutical companies met and came to the conclusion that only one of two generation anti-psychotics worked. The battle is still raging, and in some circles dosage seems to make a significant difference. Personally I have found that dosage, auxiliary drugs, and the time of day medication is taken works for me. Two many variables to juggle? I spent a year in Atlanta looking for the right doc. the right med. and the right phd. Conclusion – a new socio-economic environment changed me more for the better than words of wisdom and industrial excrement of the Rx kind. Conclusion: “Know thyself.”

  3. Judy R. says:

    So sorry for those who struggle with finding workable meds. Lucky for me I am not having that problem. I just have a hard time GETTING what I need without INSURANCE. Psychiatrists Aren’t exactly County Clinics’ Specialty.

  4. Clara Koblosh says:

    I went through a couple of years of depression then mania before we got the meds right. In the meantime I was diagnosed with Schitzoaffective disorder which is a combination of bipolar and schitophrenia. My last hospital stay was where I was put on the “right meds”. Even though I still get depressed at times for the most part my head is clear and I have control of my mind well most of the time. I guess this is the closest thing to sanity that I ever got to. I complain a lot sometimes but that passes also. It is worth the wait for the right coctail to be made just for you.

  5. Michelle says:

    I’ve been struggling with this for years. I do consider it a personal failure. I guess because when I say years I mean over 2 decades. Part of the problem is I have an ok head doc but there are no good pill docs in my area. Add in the health insurance problem & my weak will, I never see to gain traction. I took myself off everything a week ago because I swear the newest cocktail just made me dwell on ‘not wanting to be here’ (not active suicide, just apathy) all the time. I don’t know what to do anymore.

  6. Malissa says:

    Hello, I myself was diagnosed with bi-polar II back in 2010 when I was definetly going through all the signs of mania like staying up for days and days, talking very fast and rambling, shopping and getting myself in severe debt,etc…but then I broke my left femur in a freak slip and fall and was bed-ridden for 6 months unable to even wash myself,etc. I fell into such a depression and mind you back when I was only 12 years old was the first of many mant suicide attempts that stopped in my 20′s when I met my husband and had a child. I just couldn’t consider that an option as far as doing that to them although even today right now as I am typing this I can’t help but pray that one day I will just not wake up. Aside from my mental illness I also suffer from chronic migraines, fibromyalgia, insomnia, and heart issues. I knew from birth I had a heart murmur and always had a rapid heart rate anywhere from 110-140 all the time. Finally saw a cardiologist and after an echo-cardiogram and a 24 hour holitar monitor found out I have high blood pressure, an enlarged and over-worked heart, and three leaky valves. So again in the depths of my sick mind I was almost happy about this news. Which brings me back to this diagnosis of bi-polar II, in the years since my leg broke I seem to be depressed or anxious all the time and yet every in-patient psych stay, I had three seperate stays in 2012 alone, I have been given Lithium,Depakote,and now I’m currently on 300mg a day of Lamictal for the past 7 months or so and have had NO improvement. For my anxiety I take 2mg of Klonopin twice daily and then 2mg of Ativan as a PRN when I’m having a panic attack and I take about 2 of those a day on top of the Klonopin, for the insomnia I take 3mg of Lunesta and was put on Saphris 5mg at night but had too many side effects I stopped taking it. Lastly I was on Wellbutrin for a few months I don’t even remember the mg because it did absolutely nothing for me and so I keep asking my psychiatrist to get me on something strong and works quickly for this depression cause I can not get out of this funk and my family is paying for it severly. My husband doesn’t believe in mental illness, he sees it as a weakness and excuse for not doing anything and he resents the fact he is pretty much a single parent most of the time. He is only staying with me at this point because I need his health insurance since I’ve been on disability for the last 10 years or so for the migraines, and deep down I know he must still care for me or at least due to me being the mother of his child…but its scary to think about being better and then losing him. As far as my 10 year daughter goes she is old enough now to know that when Mommy isn’t well its not just a migraine that its something in her mind…I mean she has known why I was hospitalized last year, she sees the bottles and bottles of medication I must take, and worst of all when I have had severe side effects from some meds. that the ambulance was called to the house she is actually afraid to be alone with me and I can’t blame her. I just wonder if this diagnosis could be wrong since these days it seems like evryone is bi-polar and if it is wrong maybe the right diagnosis followed by the right medication can help my life become an actual life…at the end of my rope…Malissa

  7. Hi Malissa,

    Obviously, I can’t diagnose you but what I can tell you is that the presence of mania and the presence of depression in the same person indicates bipolar disorder. Is it possible that it could be something else? It doesn’t sound like it if you primary symptoms are mood-related.

    As for bipolar depression, only three medications have been approved for it and it doesn’t sound like you’ve been on any of them.

    There is:
    - quetiapine (Seroquel)
    - lurasidone (Latuda) (fairly new)
    - olanzapine/fluoxetine combination (Symbax)

    If you haven’t tried those, then you absolutely should talk to your doctor about them.

    Also, in really intractable cases ECT is an option, but you probably want to try those drugs first. (ECT works quickly when it does work though, and that’s its advantage (plus it’s highly effective for most). It’s disadvantage is some memory loss.)

    - Natasha Tracy

  8. Oh, and you can see all the approved drugs in the table at the end of this page:

    - Natasha

  9. Angel Ziegler says:

    I know how hard it can be as well, I have been on every kind of medicine and none have worked. Because none have worked I can’t find a doctor to keep trying to get me better. I’m scared what my future holds. My moods are getting worse, not able to sleep for days on end, not able to eat, having more and more panic attacks. And to be honest the thoughts are getting sadder is a way to put it. Is there anyone out there that has any ideas on what I can do. I’ve been looking up on line for options for treatment without medicine and i’m not getting any where and I really need help. PLEASE HELP IF YOU CAN.

    Desprite Angel

  10. Natasha Tracy says:

    Hi Angel,

    You haven’t said what your diagnosis is, so I can’t really tell you much.

    You haven’t mentioned therapy. Have you tried that? Have you tried cognitive behavioral therapy? Dialectical behavior therapy?

    Is repetitive transcranial magnetic stimulation (rTMS) treatment an option for you?

    What about electroconvulsive therapy (ECT)? It can be very effective even when other medications have failed.

    In short, there are options, so please don’t give up. Get a consult from a specialist. Go to a mood disorder-specific treatment center. There are people who will help you.

    - Natasha Tracy

  11. catsrgreat says:

    Angel’s situation is unacceptable. I wonder if she has few choices due to insurance?

    I’m out of treatment options, but my psychiatrist sees me anyway since I do have serious depression problems and want a psychiatrist who knows me so I could get lithium if I needed it. It bothers me that Angel can’t get a doctor. Heck, my husband has no more treatment options for his eyes (macular edema) either, but the retina doc still wants to monitor him. Seems negligent, if Angel has serious problems, doesn’t it?

    I will repeat here – in my case, the treatments greatly worsened my mood problems, and gave me a bunch of behavioral and cognitive problems. So now I’m off the meds, and 4 years later, back to the original bipolar (it took a LONG time) and I wish I’d given up treatment sooner, because at least I can think and I’m a pleasant person again. But if a person is going to go off the prescribed drugs, they should still have a doctor.

    A lot of bipolar doctors (probably most, maybe all) think bipolar is many different disorders, and maybe that’s why some people get good results, and others have a long running disaster with the drugs.

  12. catsrgreat says:

    Sorry, my last sentence wasn’t clear – the second part was MY opinion

  13. Angel Ziegler says:

    Sry 9 didn’t say what it Is I have bipolar. the last time I got a doc to look at me was 6yrs ago that when he gave up.

  14. Caroline says:

    Angel, Good quality sleep is imperative for good mental health — there is melatonin which you can try (over the counter — talk to your doctor of course for his/her suggested milligram and ok to take it). Have a relationship with your pharmacist ask him or her what time of the day to take your medications, I was practically a zombie being on medications in the am and pm and then I asked my psychiatrist if Ii could take my meds at night — then I could sleep soundly and was able to function better in the day (I was unable to drive I was so sleepy). There are also meds for sleep but for me most of these meds had the opposite effect on me and made me manic. I found trazadone helpful for quite sometime, You say you gave not seen a doctor in six years there are new meds now, perhaps try to see one. Also meditation, drinking water, practicing gratitude, also if you are interested in something simple you can do for your self try EFT or tapping therapy. Try also local peer support drop in places you can find these in most counties. You are not alone. I am also a fan of Sleepytime Tea before bed (Celestial Seasonings). I have bi-polar and have had seven major hospitalizations for mania and have gotten better despite the odds.

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