The question was submitted
21 May 2009
Subject: Being told that I'm in for the long-term
Years ago, in my teens, I was diagnosed with bipolar disorder and a personality disorder. It's been years since I first sought treatment, though unwillingly initially.
I'm now a young adult and recently, I have started talking to my doctor and psychologist about the duration of treatment required. Both of them has told me that it would take at least a few years for them to even consider tapering off the meds though my psychologist highlighted the possibility of me being on medications for a long, long time.
My current doctor, perhaps being unaware of my history (as she was standing in for my doctor who's away for this year till she's back) gave a general statement about the treatment being required for a few years. Her statement was also made in part due to the fact that she did not witness any bipolar mood episodes from me this year when she was seeing me though I had many such episodes last year (as stated by my psychologis and my own doctor who has seen me for years). My current doctor was also quite unaware of the fact that I had a family history of bipolar (my own maternal uncle had bipolar disorder and was told that he would have to be on maintenance medication for life).
My previous doctor who knows me well has told me that they are not sure how long I would need to be receiving treatment but that I would require long-term therapy due to the issues from the personality disorder and that the personality disorder affects negatively the mood episodes I may experienced and vice versa.
I'm wondering, despite discussions with both doctors and my psychologist whether the following:
1) Having a family history (albeit a weak one?)
2) Having a comorbid personality disorder
3) Having early onset of bipolar disorder (I had my first mood episode when I was in my teens)
4) Recurrent episodes that has at times landed me in the hospital (though symptom free for the last 5 months except insomnia)
means that its harder to get well? Recently, due to lack of compliance with medication, my doctor had to re-titrate lamictal, which was one of the meds I was taking. I was told by the doctor that one of the reasons for the increase in suicidal/self-harm thoughts recently may be due to the low/insufficient amount of lamictal that I have been taking as it is one of my main medications.
Is medications the only form of treatment for bipolar disorder? I'm aware that a healthy lifestyle can prevent relapses but I'm worried about being on the meds lifelong, given that my uncle had to be on meds because every time an attempt was made to go off the meds, the symptoms would reccur (for him, its marathon of sleepless nights). =(
Answer from DepNet
It does sound like you have had a very challenging time with your condition.
I would think it would be fair for you to discuss this with your treatment team and also highlight certain issues that your current doctor may not be aware of.
I would however say the following. Having a personailty disorder does make it more challenging, however it also depends which one you are diagnosed to have. With regards to issues with your personality, it is good that you are gettin help from a psychologist and changes in terms of the way you cope when faced with stress may augur well in your overall improvement.
The features you alluded to does suggest that your condition may need longer term care, but I think you may want to see things in a different light. I am glad that it appears that you have aknowledged that you have a problem and need help. Perhaps the stress seems to come from, wanting a "cure" and to be "free" of mental illness.
It may be alot more helpful for you to see how given the fact that you have a disorder, how you can maximise your life and live well despite the problem. Bipolar disorder is manageable and can be controlled. Medications are important in helping to achieve chemical balance and help psychological interventions which are also important work better.
Have a candid talk with your treatment team and discuss what your concerns are about medication and your treatment.
Take good care.
Regards,
Depnet
The answer was published on DepNet
25 May 2009