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 Is Remission of Symptoms
Bipolar disorder is a life-long illness and no one in the medical community is suggesting bipolar can be “cured” (What to Do If You’ve Just Been Diagnosed as Bipolar). 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 do you get that normal life? 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.
What Does Bipolar 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 (Are Bipolars Crazy? I Am.). 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.
Should Bipolars Try to Achieve Remission?
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.
Tracy, N. (2010, July 19). What Does Remission Mean in Bipolar Disorder?, HealthyPlace. Retrieved on 2019, June 18 from https://www.healthyplace.com/blogs/breakingbipolar/2010/07/what-does-remission-mean-in-bipolar-disorder
Author: Natasha Tracy
I was Med free for 21 years after I recovered from my episode
Now 3 years ago had another manic episode and I’m having a really really hard time wanting or accepting medication
For 3 years I been to a few different psychiatrist all with different opinions
In my mind I feel like I created this negative/ obsessive thinking that made me go psychosis the second time.
Never did drugs or even drink at all
Always worked full time without missing one day except when I was hospitalized for the two times
Not sure what to do, any advise!
Episodes can be very difficult to work through and recover from and sometimes they do require medication. It's a personal decision as to whether you want to take it, but most people with bipolar disorder need it. But please keep this in mind, while it can take time to find the right medication, once you do, it can help your life immensely if you're still experiencing bipolar symptom (especially psychosis).
- Natasha Tracy
Ten years later, I've graduated college, hold a steady full-time job, and I'm married (he's wonderful). I have good relationships with friends and family. I've learned a lot over these ten years.
I take medications every day for bipolar and I track my sleep, emotions, exercise. I've restarted therapy, and I'm hopeful that I will learn more skills for when I get anxious, moody, or don't want to do what needs to be done.
But life is normal now, and has been for a very long time. Few people know how hard I work to stay well.
My illness came to a head about 5 1/2 years ago, I lost my job, a lot of my close relationships, and a lot of money, among other things. I guess you could say that I reached a rock bottom, and from there I couldn't go any deeper, so my only choice was to start over. It didn't happen overnight, and it didn't by any means come easy, but I stuck with the program, I took my meds, I changed my mindset, and I dedicated myself to the hard work needed to heal myself.
That brings me to something you said in your article, "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."
I used to think this way, in fact I thought this way for a very long time. I would have brief episodes of stability, but there was always something in the back of my mind telling me not to get too comfortable, that this is just a fleeting moment of normalcy and it's never going to last. But I am hear to tell you, THAT IS NOT TRUE! All that is is fear, and all fear stands for is, false evidence appearing real.
If you are willing to have faith, faith that there is a better life waiting for you at the other side of a bipolar diagnosis, than I promise you, you can feel "normal" one day too. I have been in remission now for over 4 years, and I can with confidence say that my bipolar is under control! I don't experience bothersome symptoms, side-effects and cycles anymore, and I no longer hang onto every insecure thought that this is something temporary, which is never going to last. Instead, now I am in check with my emotions, because even "normal" people have ups and downs. If I am having a "bad" day, or two, I definitely acknowledge it, but I don't jump to conclusions. I make myself aware of it, and if I am worried about it, I tell people. I talk about it with the people in my life, and also my doctor. The more people that are aware that I am struggling helps me to stay accountable for how far down the rabbit hole I let myself slide, and helps to keep things in check before they have a chance of becoming a problem.
But for all of you who are out there suffering, there is hope. Even if you think that you have destroyed all chances of being "normal", or happy, you haven't! When I started to do the things I needed to, to manage this b***h of a disease, I started to feel better and stronger with each passing day. With time, and in being honest with most importantly myself, as well as the people around me, that I had done a lot of damage because of my illness, I was able to repair a lot of my badly broken relationships I had with friends and family. As for the job I lost, I couldn't get that back, nor did I want to. I decided that that career, even though part of me loved it, was way too stressful and only helped to trigger my episodes. Instead I decided to start over and went back to school. I was never a good student, but I have been in college now for 3 years, and I am amazed to say, that I am at the top of my class. I take care of myself now, both inside and out, and sometimes I am even there to help others as well. And I, with 100% confidence, can say now, that things are definitely not perfect, but I like my life, I like who I have become, and I am happy to be alive.
If there is any advice I can give to anyone else out there struggling is;
Stay on your meds, and if you haven't found the right ones yet, keep trying!
Own up to the things you do, and the person you have become as a result of your bipolar, you will be surprised at just how much people will forgive if you are sincere in owning up to and resolving your faults.
Don't alienate yourself, bipolar is not something you can overcome on your own, build and utilize a strong support system, whether it be doctors, friends, or family.
Seize the day, if today was a good day then remember it and use it to motivate you to more days like today. If today wasn't your day, acknowledge it, understand it, learn from it, but don't dwell on it, tomorrow will be better.
Stay positive, one good thought almost always leads to another, and that is true for the bad ones too, so be careful.
Talk to yourself, at the end of the day you need to be your own best cheerleader. I talk to myself everyday, whether it is to keep me from overthinking, from getting upset, to stop me from being impulsive or from engaging in negative behaviors, and of course, to remind myself to stay positive and to continue moving forward.
And last but not least, DON'T GIVE UP! Life beyond bipolar is so worth it, and the best part is, for me at least, is that I appreciate feeling good so much more than the average person because I know first hand what it is like to have gone from hell and back.
Think - A perfect man is perfect but don't know cooking
On the other hand a man with many disabilities know cooking
Again think.. in situation of flood the disabled person saved himself and the healthy one starved.
Thanks for your question. Unfortunately, I am not a medical professional and I can in no way offer medical advice. What you should do is talk to your doctor about your plans and see what he or she thinks.
- Natasha Tracy
Now I am in court system and they are trying to either out me in Jail or make sure I never go to a hospital again. I asked my psychiatrist resident to put me on a mood stabilizer and she refuses. Most people believe I have no mental illness at all. I do isolate and get anxious and sad and stuff and I have psychotic breaks but I don't think its that serious. So basically is it okay for me to get off the meds since I have been better for 4 weeks now?
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.
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.
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.
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.
Really great comment, thanks so much.
That is all exactly what I would say. I'm glad to hear that is working for you.
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!!
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.
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.
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.
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.
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.
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.
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.
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. :)
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.
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.
Just because one bad man is bad, that doesn’t mean you have to deny yourself access to doctors and good care.
Go to ANY healthcare professional who is truly good, tell her what happened, and ask her to refer you to a GOOD doctor, ideally a psychiatrist who is a woman. Remember: 50% of them are.
You are precious. You are loved. You deserve a partner who can be your teammate and work on this annoying mental health condition with you together.
They chose this career because this is what they want to spend their entire life doing: helping people.
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