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Bipolar Treatment and Risk Tolerance

March 24, 2011 Natasha Tracy

Every medical treatment comes with risk. If you have a headache, you could take ibuprofen or you could have a craniotomy looking for brain cancer. One has considerably more risk than the other. (Of course, if you have brain cancer, then the reward could be quite great.)

This means every time you undertake a bipolar treatment knowingly, or not, you weigh the risks vs. rewards in your head. And one of your doctor’s main jobs is to manage that risk vs. reward scenario. Doctors, for example, almost never prescribe barbiturates anymore due to the fairly large risk of addiction. Instead, they prescribe benzodiazepines (or nonbenzodiazepines; very similar) which do not carry such an increased risk. In both cases, they carry the reward of managing anxiety.

But some people don’t want to take benzodiazepines either, because some people tolerate more risk than others.

Skydiving is Dangerous

In my fairly short skydiving career I did 150 skydives. I obtained various forms of licenses, jumped out of multiple types of aircraft, jumped in formation and jumped from a helicopter. Good times.

But, the thing about skydiving is, when you jump from a plane you will die unless you take evasive action (i.e., deploying your parachute). That comes with a certain inherent risk. (The risk is not nearly as high as most people believe. About one death per 133,928 skydives.)

But I was willing to take that risk because for me, the reward of skydiving outweighed the risk. Some people think skydiving is crazy. They are adverse to that level of risk.

[caption id="attachment_2111" align="aligncenter" width="332" caption="This is in no way me. Photo by by Ori Kuper."]This is in no way me.[/caption]

Bipolar Treatment and Risk

When one gets medical treatment there is an inherent risk also. And each treatment carries different risks. So, for example, an SSRI that has been prescribed for 30 years might be less risky than an antidepressant that has been available for 1 year as the former’s effects are well-known thanks to the hundreds-of-thousands of people who came before you.

When you start treatment, your risk tolerance (and your doctor’s) is likely very low. You will pick the safest treatment because there is no reason to pick something riskier when you don’t have to.

Risky Bipolar Treatment

But the longer you’re unsuccessfully treated for bipolar disorder the more risk you are likely to accept. That’s because either you’ve tried the lower-risk options and they haven’t worked, or the severity of your illness has reached the point where you need help immediately.

This increase in risk tolerance is pretty typical. There are many things I wouldn’t do when I started treatment that I do all the time now. (Sometimes we learn the things we perceive as risky aren’t as risky as we thought.)

Bipolar Treatment and Risk Tolerance

But, make no mistake; I can jump off this ride any time I like. I can decide a drug has too many side effects and work with my doctor to get off of it. I can decide to work with them to get off my meds altogether perhaps due to new information. Risk tolerance can change, I (and you) can change your treatment strategy any time you like.

Tolerating Risk Tolerance

So clearly some people consider some treatments too risky, and others don’t. Both of these people are “correct” as both are assessing the level of risk for them, personally.

It’s important to remember though, risk tolerance is personal. You cannot look at someone and tell them to tolerate more risk just like you can’t look at someone and tell them to tolerate less. Both sides need to respect the assessment of the other.

I don’t drive people to a drop zone and tell them to jump out of a plane because the risk of death or injury is real, but that doesn’t mean I don’t think jumping is OK for me.

Photo by Ori Kuper care of the USPA National Skydiving Championships for Canopy Piloting.

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

APA Reference
Tracy, N. (2011, March 24). Bipolar Treatment and Risk Tolerance, HealthyPlace. Retrieved on 2019, August 18 from https://www.healthyplace.com/blogs/breakingbipolar/2011/03/bipolar-treatment-and-risk-tolerance



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 BurbleTwitter, Instagram and Facebook.

r
says:
July, 25 2015 at 9:03 am
The thing I worry about most is the possible side effects of long term use of antipsychotics primarily for depression, ie Abilify as an add on to help with Lamictal's antidepressant properties. I worry most about the weight gain antipsychotics are notorious for. While I take my lamictal religiously, I can't say the same for the Abilify. While Abilify is suppose to be 'weight neutral" for me I have not found that to be the case. I can NOT afford to gain anymore weight. It also causes some muscle weakness, can make me tired and lethargic which also makes it harder to concentrate at work, especially when I am too groggy to focus on the task at hand. For these reasons sometimes I cut back on the prescribed dosage. I've tried almost all of the other atypical antipsychotics and on Abilify I've had by far the best outcome so I don't want to rock the boat with anymore med changes. Too much stress (and anxiety) is my biggest downfall so when that becomes a problem that can't be resolved with the usual methods such as meditation, mindfulness, etc I go back to the full dosage and it seems to help calm me down
Julie
says:
July, 22 2015 at 10:15 am
Many years ago, I did a tandem skydive. I wasn't especially afraid; and when we finally touched ground I was glad, but not especially relieved.

Other than concern about the intense throbbing in my ears from the stress to my very weak Eustachian tubes, I felt very little... and that's how I knew for sure that there really was something wrong with me. I got my MDD diagnosis soon afterward.

So, in that sense, perhaps skydiving could be considered a diagnostic tool. ;-)
Natasha Tracy
says:
June, 3 2014 at 11:46 am
Hi Jennifer,

Well, I can't say how it'll affect you definitely as I don't know you or your particular symptoms. What I can say is it will alter you body chemistry with a hit of adrenaline and likely increase your anxiety dramatically.

And it'll be really, really fun. I never met a person who came down from a skydive and didn't want to go again.

So it's a personal choice. Be careful and be prepared for fallout, but I say, go and have fun. (But that's me. I did 150 of them, so I'm biased.)

- Natasha
Jennifer
says:
June, 3 2014 at 10:33 am
Hi my name is Jennifer and I am bipolar type 1. I have always wanted to skydive. I made the decision to do it this summer for my 30th birthday. I am just curious as to how this may impact my illness. If it is a risk worth taking. I know I ultimately have to decide just wanted to know what you thought.

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