Right now, more than ever, it is important that we are taking extra care of our physical and emotional health. For those of us living with Bipolar Disorder and taking medications we need to be especially mindful we are staying on top of our treatment. Before I continue I want to emphasize that medication for mental illness is a very complicated topic and I’m not advocating it for everyone as it’s not a one size fits all treatment. It is a choice that every person and family gets to make with the guidance of their doctor. However, I am approaching this topic as some who has been taking at least two medications for Bipolar Disorder for twenty six years. I don’t take this subject lightly. I know how difficult it is to accept that you need to take medication, find the right ones, take them consistently, live with the stigma, deal with insurance, and the cost as well as suffering from life-changing side effects. But all that work has been worth it. I have no doubt in my mind that because I have stayed on my meds and taken them consistently I am still here today living a stable and healthy life.
Major Misconceptions about Medications
Although medications work for mental illness treatment, they do not cure you or make you happy. That is a common misconception. For me, the medication stops me from experiencing highs that are too high or lows that are too low. They help me stay in a normal range of emotions. I still have my ups and downs just like anyone, but those ups and downs aren’t so extreme. Medications give me a solid foundation and the ability to pursue happiness, to provide for myself, and to have good relationships. Am I happy all the time? Heck no! Like not even close. I still struggle with emotions, but I can work through them. And more important, my moments of happiness are worth all the effort.
Treatment grounded in science
When I was first diagnosed with Bipolar I Disorder at age sixteen my family and I made the choice to go with the doctor’s recommendations which meant I would start taking medications. I didn’t know it then, but at the age of sixteen I made the choice to believe in science and right now from my perspective medications are the best that modern science has to offer. This is the same science that created lifesaving vaccines, modern-day living, and amazing technology. Why don’t we accept scientific achievements that have to do with mental health treatment? Medications are not perfect by any means, but they are what is available for now. The cool thing is that they are only getting better.
Consistency During the Pandemic
These are difficult times for everyone. Right now may not the best time to be experimenting with reducing or going off medications. Experimenting with dance videos, bake-offs, and drive-by birthdays are a yes, but medications, um, maybe not. I am not talking about all people living with Bipolar Disorder as not everyone needs to be taking medications, but there are many (like myself) that do. I have gone off and on medications as well as decreased the dosage, but with the guidance of my doctor, and most important at the right time.
Dealing with the Stigma
The stigma surrounding mental health medication is unrelenting. Nobody talks about it. Medications for physical illnesses can be part of common conversations, but it’s not normal to talk about medication like anti-depressants openly. This makes the journey of treating a mental illness incredibly lonely. I have to work even harder to stay committed to my own treatment.
In addition, the jokes and insults about medication are everywhere. If I got offended at all the insensitive, ignorant, and flat out hurtful things that everyday people say about psych meds I’d be upset all the time. I am doing things like writing this article to try to help people understand how important medications are, but the ignorance is deep. I’ll keep trying, but what I mostly do is ignore it. I have to rise above it. I’m not going to let someone’s small-mindedness stop me from living my best life. They don’t know. Taking medications is nothing to be ashamed of. In fact, it’s commendable. It shows that you are being responsible and taking care of yourself. We all have to do what is right for us.
How do you know if you need to be on medications?
I am an advocate for medications if you need them, but it doesn’t have to be the first step. If you are struggling with emotional issues you can start with cognitive talk therapy and see if that helps. You can also make changes to your outer environment. Creating a less stressful life, eating right, exercising, meditation, and getting enough sleep can make a big difference in your mental health. If you have exhausted all other avenues and you are still struggling, that is a good time to talk to your doctor about medications.
I also think the degree to which you are struggling could help determine if you should try medication. Sometimes it’s hard to determine what the “normal” level of emotions should be. I like to use similar factors for when to know to get professional help. If your emotions are affecting your daily life, consistently damaging your relationships or your job, then medications could be helpful. If you just want to avoid uncomfortable emotions from time to time, medications might not be the answer.
Finding the right one and the right dosage
Unfortunately finding the right medications can be very time consuming and in some ways is not a very advanced process. Let’s be honest: this part is really difficult. It comes down to trial and error. Yes, I know its 2020 and we are talking trial and error. People react differently to medications and you don’t know what will work until you try it. At sixteen they put me on all kinds of things until they found the combination that worked best. And even when I settled on the right combo, it wasn’t an immediate fix. It took some time for me to recover and start doing activities again that brought back to my (for the lack of a better word) normal life.
It is essential is to stay on a new medication for as long as the doctor recommends to see if it will work. Some drugs take weeks to actually have an effect. You need enough time on the medication to know if it works or if it doesn’t. And if it doesn’t you can truly cross it off the list. If you choose to go off a medication work with your doctor. There is a process to go off medication slowly called tapering, and your doctor should teach you how to taper off a medication properly.
Finally, just know that finding the right medication and dosage can be very challenging and frustrating. It could take weeks, months, or even years. Be patient with yourself. Don’t give up just because one or two or even ten don’t work. There are a lot out there. And as I mentioned before, the medication might not bring the happiness that you were hoping for. However, it could provide that mental stability and clarity that will allow you to do the things that could create happiness.
The Power of False Hope
Be very careful about the power of hope (that sounds bad but just wait). I talked in my last book about how those of us living with a severe mental illness secretly dream that we don’t need meds. Like it’s all been a huge mistake and in fact, we never needed medications. It’s like this weird fantasy. This affected me when I have tried to go off an anti-depressant. That strong sense of hope that I didn’t need it took over my rational brain. For the first few weeks, I was “fine.” I was overjoyed that I was doing okay… but it was a false hope. As soon as things in my life started going badly the depression hit like a vengeance. I went back on the antidepressant before it got to a serious situation. That’s why it’s good to work with a professional so that you have a plan for when going off a medication isn’t working.
Dealing with Side effects
Let’s face it, side effects really suck! I mean really suck. They are annoying and unpredictable, but they are not insurmountable. First of all I must mention that many side effects can be are temporary. For some medications, it takes a while for your body to tolerate all of them. I speak from experience. When I was first put on medications I felt sick all the time. I threw up almost every day. I remember my mom pulling over on the way to school so I could throw up. One time, I ran out of math class and just barely made it to the bathroom in time. Not only that, my skin broke out. My hair started thinning. I gained weight. I was a hot mess. Eventually, my hair grew back, I stopped throwing up and my skin improved.
In addition, over the years I have dealt with even more side effects as I have tried new medications. Some went away within a few weeks, some lasted a few months, and some I still deal with. One of my current medications causes weight gain. I have had to get creative and find ways to manage that (that is a whole other article that I need to write). In general, the result of taking the medication motivates me to deal with the side effects. I know how bad I have felt off medications so I stick with them no matter how difficult. It’s good to find something that will motivate you to deal with the side effects. Why are you taking this medication? What is your goal? Focus on getting better.
In addition, talk to your doctor before you start Googling your medication side effects or even reading them in the prescription description. Your doctor can tell you about the most common ones. The internet will list every possible side effect under the sun that may never happen to you. You will freak yourself out and you may miss out on something that could help you.
Medication Education 101-ish
How medication works is extremely complicated! Mental illness has to do with “brain stuff” like neurotransmitters. And when the levels of our neurotransmitters serotonin, norepinephrine, and dopamine are off-balance it can cause mood issues. Medications for mental illness target these neurotransmitters to correct the imbalance. I don’t totally understand it, but you don’t have to completely understand something to enjoy the benefits. I don’t understand how the internet works but I still love watching cat videos.
We are also not very educated about the different types of psych medications. We know more about what type of flat-screen TV we have than we know about the drugs that we take every day. Doctors usually just tell us what they are prescribing. Many try their best to explain why they are choosing a certain type of drug, but it is extremely complicated.
According to the NIMH, Bi-polar medications usually come from 3 different types of medications: mood stabilizers, Anti-depressants, and Anti-Psychotics. It is also common for those with a dual anxiety disorder to also be prescribed Anti- Anxiety Medication. In addition, it’s likely for those living with Bi-polar disorder to be prescribed multiple medications from all categories. NIMH gives a great overview of the most common mental health drugs- https://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml
Here is a list of generic and name brands. I am in no way recommending these drugs but listing them to help identify the different kinds and categories. There are so many it’s hard to keep track, but it good to have a general idea of what category they are in. This not a complete list, but some of the most popular brands.
- Mood Stabilizers
- Valproate (Depakote)
- Carbamazepine (Tegretol, Carbatrol, Epitol)
- Lamotrigine (Lamictal)
- Oxcarbazepine (Trileptal)
- Bupropion (WellButrin)
- Citalopram (Celexa, Cipralex)
- Sertraline- (Zoloft, Lustral)
- Paroxetine (Paxil, Seoxat)
- Escitalopram (Lexapro, Cipralex)
- Venlafaxine (Effexor)
- Duloxetine (Cymbalta)
- Fluoxetine (Prozac)
- Anti- Psychotics
- Chlorpromazine (Largactil, Thorazine)
- Haloperidol (Haldol)
- Perphenazine (Trilafon)
- Fluphenazine (Prolixin, Modecate)
- Atypical antipsychotics
- Risperidone (Pesperdal, Zepidone)
- Olanzapine (Zyprexa, Ozace, Lanzek, Zypadhera)
- Quetiapine (Seroquel)
- Ziprasidone (Geodon, Zeldox)
- Aripiprazole (Abilify)
- Paliperidone (Lullan)
- Lurasidone (Latuda)
- Clonazepam (Klonopin)
- Alprazolam (Xanex)
- Lorazepam (Atavan)
How you can help a loved one with Bipolar Disorder
I try not to preach too much about medications since it’s not always the right fit for everyone, but I guess I sort of am in this article. I am doing this now because I have seen some things on online that have concerned me. Over the years I’ve seen people post that they are decreasing their meds like anti-depressants or stopping them all together to try something more natural. Every time, people in the comments are cheering them on. I know friends want to be supportive, but for some, medications are keeping them alive. If someone with Type 1 Diabetes said online, “Hey, I’m feeling good so I decided I don’t need to take insulin anymore.” You would be like, What?! No!
So what do you do then? If you are in that person’s inner circle like family or close friends I think it’s okay to get involved. I know my family did with me. You can start by asking if they are working with their doctor. Unless you are a psychiatrist you are not an expert. If they aren’t working with their doctor, then tell them to talk with their doctor first before they do anything. If you are close enough you can even talk to their doctor as well. If you are just friends, think before you post. Maybe send a message to the person, like “Hey, I want the best for you, but I’m not educated on medications. I hope you are working with a doctor on this. I am here if you need support”. If you are just Facebook or Insta friend maybe don’t post unless you absolutely know what you are talking about (a novel concept these days!).
Medication key takeaways
The point of this article is to hopefully help those that may be struggling with the fact that they need to take medication as well as to educate others. Acceptance for me comes when I look at the big picture. So I take two pills a day to help my moods stay consistent. So what? That’s my life and I accept it. I keep it moving. I’m taking advantage of modern medicine and science when it comes to mental health. Again, I am not advocating meds if you don’t need them. But, don’t let stigma and ignorance stop you from finding lifesaving medication. The side effects are tough but I too am hopeful for better meds to come. In the meantime, it gives me the ability to create my own joy and the life I want.
So final thought, drugs are good, m’kay!