untreated depression and leading a normal life

General Questions
#1

OK. I’m bipolar, I was diagnosed when I was 16 or so. For a few years I took a whole bunch of different drugs, Prozac, Wellbutrin, Depakote briefly. They made me gain a lot of weight, and made me unable to control my temper. I assumed I was just a loose cannon until that report on Prozac making people suicidal and prone to violent outbursts. That was me for a while.

I stopped taking all the drugs because I gained so much weight. I figured it was silly to take drugs to make me happy when the drugs themselves actually gave me a reason to be depressed.

I haven’t taken anything for almost 5 years now. I do all right most of the time, as it’s not very severe, but sometimes I just feel like absolute shit. Like right now. I have a great boyfriend, I’ve been doing well in school, I just started a new job that I like. And I feel horrible. And I know I shouldn’t feel horrible, that it’s all in my head, but I can’t change the way I feel.

So I was wondering, will I ever be able to manage this on my own? Will I get to a point where I can decide not to be depressed? Or are my only options taking medication forever or feeling crappy periodically?

Are there any other options besides drugs? And should I worry about occasional horrible thoughts like “I wish I were dead” or “Maybe Ben got in a horrific car accident driving home” or “I wonder what would happen if I stabbed myself in the stomach with this fork”? Does everyone have those, or am I crazy?

#2

Yeah there are other options.

Mindfulness meditation seems to work

http://www.edwardwillett.com/Columns/happiness.htm

SAM-e is an herbal supplement that seems to work. If you can’t afford it (its $200 a month) you can just buy trimethylglycine, its about $5 a month and does the same thing SAM-e does.

Regular exercise helps with depression too.

Read the book ‘dealing with depression naturally’ they cover tons of therapies from talk therapy to herbal therapy to exercise therapy to mineral deficiencies to hormonal imbalances. Its a really good book.

#3

IANAD, so I won’t try to advise you on your medications.

I dated an untreated, and for a long time, undiagnosed, bi-polar guy for several years. His highs weren’t very high and his lows weren’t very low, but I finally gave up in frustration because he did not take his treatment and therapy seriously. You see, it’s not how high or low your mood swings are, but how they affect the people around you, especially those close to you.

How does this make your boyfriend feel? I can tell you that if you feel like shit, he probably feels like the toilet bowl. How will this period of gloom affect your school work and your job? What about your own already out-of-balance self-esteem, especially if this downswing spoils your relationship with your boyfriend, causes you to fail your classes and/or lose your job?

Although exercise and sunshine can help with some types of minor depression, I don’t think bi-polar disorder responds to so-called “natural remedies” because the chemical imbalances in the brain are permanent, not temporary or conditional. You can’t induce your body to manufacture the missing substances because your body no longer can.

The bad part about medications for any chronic condition is that most of them do have side effects. Extra frustrating for sufferers of mental illnesses is that a lot of modern medications also take a period of time to kick in (6-8 weeks). So, you have to go through the discomfort for 2 months before you and your doctor can even guess at whether the meds are working for you. If they are not, you will often have to purge your system of those meds before starting new meds.

Once you do find a course of medication that controls your mood swings, you can strive to live a normal life. Taking your daily meds will be no more difficult than taking a daily vitamin. Untreated, you risk developing dysfunctional coping behaviors that will carry over and that you will require therapy for in order to correct and/or reduce their impact.

I urge you to resume treatment with your mental health care professional as soon as possible.

#4

I am Bipolar Type I (the major kind). I can give you some very basic advice that is agreed upon by most psychiatrists. That is as far as I will go.

  1. People that truly are bipolar have this condition for life.
  2. People with bipolar disorder are advised that they need to stay on maintenance medication for the rest of their lives.
  3. Many new psychiatric mood medications have been approved by the FDA in recent years. Some bipolar patients will find them a better alternative than older drugs.
  4. Most psychiatrists have little experience with correctly treating bipolar disorder. All bipolar patients should have a psychiatrist with significant experience treating bipolar disorder and should see that psychiatrist for consultation or medication adjustments whenever mood swings become unstable.

Also, Wesley Clark people with bipolar disorder are advised to never take herbal supplements such as SAM-e as treatment. That is a psychiatric drug, just not one that is under FDA regulation (which is even worse). Bipolar patients are treated medically very different from people with unipolar depression. The drugs used to treat each of them do not overlap much. In fact, most of the SSRI’s (Prozac, Zoloft, Paxil) are contraindicated for treating bipolar disorder. They can destabalize mood cycling and produce wildly unpredictable results.

#5

I am not bipolar, I’m unipolar, but I know lots of bipolars and I know the course of my own disease. Here’s what I’ve found:

[ul]
[li]Your Mileage May Vary. Most of the bipolars I have encountered would not be safe from themselves without medication. But, a few do without. The severity of the disease seems to vary.[/li][li]I have observed in myself, in other depressives, and in other bipolars that you probably won’t be able to manage it “on your own.” That is, you may be able to, but the chances aren’t good.[/li][li]But then again, why try? If I had heart disease or diabetes or cancer or even high blood pressure, nobody would expect me to “manage it on my own.” Even if I didn’t take medication, everyone would accept, perhaps even demand, that I get professional medical care and advice.[/li][li]This brings me to medication. Alas, I can’t give advice on that. It’s not that I’m afraid of the “liability.” I just happen to know that the medication situation is much different for most bipolars than it is for most depressives. Depression often responds favorably to anti-depressants. The current crop of anti-depressants, especially Effexor, has a very tolerable set of side effects. I certainly accept them. I perceive that this is not the case for medications prescribed by bipolars.[/li][li]I also observe that bipolars are much more at risk for suicide than even depressive. This is based only on my observations. Take it as you will.[/li][li]It’s hard to say what “everyone” has. Most people feel a bit depressed some time in their life. What is uncommon (except among depressives and bipolars) is prolonged (2-3 week minimum) periods of extreme depression resulting in an inability to perform basic life functions. Chronic suffering of this sort is an indication of a severe problem.[/li][/ul]

So can you handle it? I dunno. Do you like your life? Do you wish you could improve something, but can’t find the energy to do it? Do you constantly feel like you’re in a pit? Are you able to “love and work”?

In other words, you’re the only person who can really answer the question you’ve posed. You have to decide for yourself whether you’re satisfied with your life the way it is, or whether you’re really not but don’t like the alternative.

I don’t see anything wrong/shameful/weak about seeking professional advice and help, even if later on you decide not to take it. Go get some information!

My observations apply to others who might be reading this.

You may also want to check out a website/mailing list forum devoted to depressives and bipolars: Walkers in Darkness

#6

Crap, I totally forgot about SAM-e being known for sending BiPolar people into mania. But it was just a suggestion I doubt Obrien will take it w/o talking to a professional.

#7

Don’t use any psychoactive recreational substances. They are a threat to your neurochemical stability.

It might also be a good idea to meet regularly with a psychologist who specializes in Bipolar DO and/or a support group so that you develop some trusting relationships with people who aren’t your bf who can help you monitor when you’re swinging too far up or down. This may help you to evaluate whether you need medication to remain in the stable range.