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What Does Remission Mean in Bipolar Disorder?

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?

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.

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.

43 thoughts on “What Does Remission Mean in Bipolar Disorder?”

  1. I’m sorry, but I have to strongly disagree with some of what you are saying. I have been battling bipolar disorder for almost 30 years now. I suffered each extreme, from deep dark depressions, that only by the grace of some higher being I made it through, despite every close attempt I made to end things. I also suffered from episodes of extreme mania, which led to legal issues, hospitalizations and a whole host of damaging behaviors, that even now will forever affect my life. Because of my extreme highs and lows, at times I struggled to even function. At times I lacked the skills to take care of myself both emotionally and even in the basic things we do to physically maintain ourselves. I struggled with relationships, with myself, my family, my friends, and at times with anyone. At times I was able to keep it together to some extent, enough to start a career and to even keep and succeed in a very stressful and demanding job from almost a decade.
    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.
    STAY STRONG!!!

    1. Simply put, I completely agree with you Alex. I never thought I would know how it feels to be present in my life, have memories that are real and an ability to see that I bring something to this world that is strong and caring not “crazy and dysfunctional”. Life truly is good. Its amazing to be able to say that whole heartedly.

  2. A person may feel helpless, but they are never hopeless. The so called worker tolls me upon my dx there may be a new drug developed tomorrow that will change everything. And now at 60 years of age. Being undermedicated, overmedicated, my Psychiatrist announced my remission. 40 years later. Trust yourself. Trust your own body. Pull back back and be mindful of it. Attend every mental health group you can find. If they aren’t for you, move on. Try try and try some more. Never give up. The biggest shortcoming of mental health patients is lack is insight. I had a Doctor once say to me after something behavioral had happened… what Are you you going to do with me? She said, what I’ve always done. Nothing. And it clicked. If I was going to find my way out of this darkness I would find it alone. It was my responsibility. Responsibility. The key. Never be whined. And never become absorbed in symptoms. We are so much more than they are. I am. Not a survivor. I’m a Thriver. You be too!

  3. I was diagnosed with bipolar and phycosis and schizoaffected disorder , 15 th Dec 2016 was told that I’m in remission. I’m on a tablet and injection. I feel lost at mo not having to fight my illness each day is that normal????

    1. Be hopeful. God is always with you.
      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.

  4. hi natasha im 30 years old and diagnosed with bi polar disorder i wonder if temporary not using of medication would took effect for a while.. i really hate the side effects. i am planning to follow the meds religiously for a while and then stop it if the doctor dont give me another prescription. i am also planning to wothdraw from medication and live cleanly.. if there is no follow up medication..would that be ok?

    1. Hi Michaelj,

      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

  5. Also I have been on disability for about 9 years but always try to work full time and get off disability but then I have a psychotic break or get suicidal and end up at the stupid ER and then they send me to acute in my state hospital. My question is how do I not self harm or threaten to kill people when I am stressed out? I am in remission now fr 3 weeks or 4 weeks. Also do drugs cause a healthy person to become bipolar?

  6. I have been in and out of hospitals from 21 diagnosed for the first time at 24 and am now 35. I keep having my diagnosis change from bipolar to Schizoaffective to a “mood problem” plus BPD. It is frustrating they (social workers and nurses) tell me everything and can’t just leave me alone they grill me constantly about stuff I can’t and don’t need to understand.
    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?

  7. It is not true that remission happens “almost never”. Read the book “Unquiet Mind” by Kay Redfield Jamison. It is an autobiography about a PhD Psychologist who gets diagnosed with bipolar and then goes to work as a researcher for Johns Hopkins. I myself have been diagnosed with bipolar disorder and work as a functioning member of society. It has been 12 years since my last manic episode. There was one major depressive episode 2 years ago after a doctor took me off an antidepressant and lowered the mood stabilizer. I am a working professional at a job that could be considered stressful to the general public. Recently I got promoted to a management position at my job. I am also considering going back to graduate school and pursuing a doctorate level of education. People would not guess that I suffer from bipolar disorder unless I disclose the information. I take my meds every day, follow with a psychiatrist, go to therapy and keep myself healthy. I am careful to get enough sleep, rarely drink alcohol and have never done drugs. These are all things I do to maintain a healthy balance. Mostly I struggle from the stigma of the disease and am working to maintain a healthy self esteem. I live completely independently, have a bachelors degree and don’t struggle with symptoms on a day to day basis. This is manageable disease and there is hope for people who suffer from it to be able to live a productive life.

  8. 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.

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