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Bipolar Treatment: If I’m Doing Everything Right, Why Am I Still Sick?

If you’ve followed your doctor’s bipolar treatment suggestions, and tried every treatment for bipolar, why are you still sick? Is it your fault? Breaking Bipolar blog has an answer.

Once you’re on a magical medication cocktail, see doctors regularly, have done years of talk therapy, cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), tried shock therapy (ECT), exercise, have social contacts, a support network, a support group, eat well, tried light therapy, dark therapy, and a series of awful tasting herbs and you find yourself still unwell; the question must be asked:

If I’m doing everything right, why am I still sick?

I’ve been in treatment for bipolar disorder for 12 years and have been asking myself that question for most of them.

What Doctors Tell Us

Here are a few of the things we hear in the doctor’s or therapist’s office:

  1. Most bipolars respond to treatment
  2. Most bipolars lead happy, normal lives
  3. Electroconvulsive therapy is the “gold standard” of depression treatment and almost always works

What We Know

According to research and science, here is what we know:

  1. Technically, this is true. “Most” is more than half, and yes, it seems that more than half of bipolars respond to treatment. Between 10 and 25 percent of people (depending on who you ask) are “treatment resistant” and in spite of bipolar treatment will remain sick. No one knows why.
  2. This is highly debatable. I have yet to hear from a person with a severe mental illness who says, “Yup, I lead a normal, happy life”. The people I hear from are hugely impacted by their disorder and while some have spent part of their time being successfully treated, normal, and happy, these periods can be brief and often are the exception, not the rule. There may be people who lead “normal happy lives” but I wouldn’t say it’s “most”.
  3. ECT really is the gold standard of depression treatment and works better than any known antidepressant. However, to suggest it almost always works is ludicrous. In a chart review in 2005, only 65.8% of those with bipolar depression were shown to remit*. That’s a pretty generous use of the term “almost always”.

And Let’s Talk About What Remit Means

In medical literature, doctors have to come up a quantifiable scale on which one can be considered depressed and one can consider having remitted – getting better. The bar for depression or bipolar remission is often a reduction in symptoms of 60%. That means people in “remission” still have up to 40% of their symptoms after treatment, and this is considered successful.

And, as a person who has experienced extreme depression and mood disorder I can say, 40% of my symptoms is still enough to ruin my whole day.

Let’s Reset Expectations

These numbers aren’t to depress you or make bipolar treatment seem hopeless. Even for me, with almost every treatment for bipolar disorder under my belt, and doctors giving up on me, it’s not hopeless. The idea is to grasp some reality here. There is nothing wrong with you for not getting better. You are, in fact, in great company. You did not fail. It’s not your fault. You are with so many of us that struggle every day.

Honestly, if cancer patients can accept the real number on their chance of survival, then so can we. We’re adults. We can handle the truth, slimy though it may be.

The truth is that most of us will have to fight and struggle for the rest of our lives. I think it matters that we know this. I think it matter that we accept this. I think this helps us realize that not getting better is not our fault. We can do everything right and still be sick. Doctors don’t understand this disease. Doctors are treating this disease with a spiky sledgehammer because it’s the best they can do right now.

Part of your life will probably be not getting better. But that’s OK. It’s not your fault. It simply represents a medical ignorance at this time. The good news is, even though we don’t understand why; part of your life will probably be getting better too. Remember that. Keep trying, keep fighting, keep auditioning medication cocktails, and just know that the failure is not yours, it is simply our lack of understanding.

*Journal of Clinical Psychiatry, 2005
You can find Natasha Tracy on Facebook or GooglePlus or @Natasha_Tracy on Twitter or at the Bipolar Burble, her blog.

Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate and author of Lost Marbles: Insights into My Life with Depression & Bipolar.

Find Natasha Tracy on her blog, Bipolar Burble, Twitter, Google+ and Facebook.

42 thoughts on “Bipolar Treatment: If I’m Doing Everything Right, Why Am I Still Sick?”

  1. Nothings working,meds,life,I can’t get a job,I have beautiful kids and a beautiful girlfriend,but I’m hitting a wall I don’t know how to live or act to other people they are all like aliens to me,my docs say its just depression and put me on different drugs but it never works,I only feel relief when I’m isolated and in nature away from the idiots I can’t cope now how do I get help?

  2. I am having issues with being able to get my meds right. Been going to a psychiatrist for about 3 years since being diagnosed with bipolar. I’ve been on so many things, but the mood stabilizers have always helped the most. My problem is that I have had to go on and off meds cause of the dangerous side effects some have given me. For instance, I was on Lamictal and Lithium and ended up in the emergency room from toxicity issues with the Lithium. Just the other day, I discovered I have the beginnings of the “Lamictal rash” or Steven-Johnson’s syndrome. I was put on Depakote in conjunction with the Lamictal I was taking and it ended up triggering horrible bumps all over my chest and back that were working their way up my neck. The skin was getting red and starting to itch. Had to go off the Depakote quickly!

    So, yeah. That kind of stuff bites, but there is always hope though. Just gotta find the right combo. My doc told me not to feel bad because I am so resistant to treatments. It’s like it’s one step forward and two steps back on some days. But, what choice do I have? I have to get better somehow. All I can say is to not give up. There are many of us right there struggling with you. We may not know each other on a personal level, but we are never truly alone in our daily struggles. Find hope and hold on to it with a vice-grip. It doesn’t matter if it’s finding hope in a dear friend’s encouraging words, in family, a pet or a talent you have. Grab on to it and never let go.

  3. So this is my wish list to help improve things and maybe help the people on this.
    1.Remember when things are not great,they’ll pass eventually.
    2.Keep eating as healthy as possible and exercise,upping the tempo to lose some weight.
    3.Talk.keep talking it out,go to the depression group,see the therapist,talk to my mam,cousin,whoevers good to chat with.
    4.Stop isolating myself,this is the hard one,as im hiding away.
    5.To aim to get back working and feeling more productive,as at the moment dont feel that i am.

  4. Hi everyone.just been reading some comments there.one guy spoke about wanting to ripping someones head off,know that feeling.someone else spoke about not holding down work for too long and having short lived good experiences.i can relate to all that.i was feeling pretty downhearted sitting here feeling concerned about what life has in store for me.theres lots i can do if i want,but the brain knowing what is good things to do,struggles due to the force of nature of this thing that dictates or tries hard to stop you from doing anything productive.the fight at the moment is with me exercising,the demon keeps trying to stop me.

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