Saturday, October 13, 2007

Long-Term Prognosis

I'll be writing a complete post about this over at BipolarConnect.

When I was in my diagnostic phase, knowing I had bipolar disorder, but not having been formally diagnosed, I was comforted to read that medicated, the progress of the condition was halted. I wouldn't get better, but wouldn't get worse, either. And at that time, medication was a necessity. People who know me may not believe this, but things were terrible. My family was terrified of me, my coworkers were leery of my moods, my temper was out of control, and alcohol and substance abuse was little changed over the years. It was a toxic environment in our home, and something had to give.

I never allowed myself to get on a long laundry list of meds, I have 1 main medication, and a couple of others to take when necessary for mania or sleep. But the one thing they don't tell you is that things not only don't get better, they get worse over time. That stuff about stopping the progression of the disorder is bullshit. Day to day does improve, but there is a steady, noticeable, long-term slide. I haven't yet decided if it's med related, or just the natural progression of the disorder. I suspect some of both.

I know people (family) still don't believe my diagnosis, don't like to talk about it, and blame my changes on medication and family stresses. Let me tell you folks, this is the real deal. Without meds, as imperfect as they are, I likely would have killed someone, and it might have been me. The high-energy life of the party fun hypomanias I used to get are mostly gone, replaced by pure mania, often with psychosis. This stuff is dangerous. But anyway, I won't function at this level forever. It may be 1, 5, maybe 10 years, but at some point I'll be forced to take a lower level career position. Perhaps disability won't be far past that. My wife works in admin for an excellent small investment company with excellent management and a kick-ass track record. She'll have to take up the slack, and will pursue her securities licensing in the near future. With her personality she'll do well enough for both of us. People just love her, and she gathers friends like the pied piper.

Enough for now, this medication may finally allow me to sleep. It's 3:30, so it's about time...


Carolyn said...

I have to agree with you... the symptoms seem to be getting more severe with time, regardless of meds...


Amanda said...

This is true. I think my father must have suspected this too because he tried saving every penny he could during his manic-productive years. He sure is glad he did this now.

Which reminds me...

Mark said...

"real deal" sure having experienced Mania/psychosis, it is real. Emotions being too powerful and overwhelming. I don't believe in forced-psychiatry though. Mania may be chemical due to food and environment. I PERSONALLY just don't have faith in the psych drugs as a solution, other than the tranquilizing effects. Long term use of any medicine/drug ends up with the body getting used to it, and the body producing counter-compensating chemicals.

BamaGal said...

I happen to think meds make you worse over time. This is why I have looked into alternative treatments, especially nutrition. A high fat, carb restricted approach as shown much promise. I turned myself into a lab rat this past year. I eat a diet very high in fat >70%. I have been able to decrease my meds dramatically.

Try reading a book by noted neurosurgeon, Dr Larry McCleary, The Brain Trust Program. It shows where a carb restricted dietary approach has made the difference in numerous brain disorders, like epilepsy, Alzheimer's, Parkinson's, even brain cancer.

Epilepsy has been treated by this dietary approach since the 1930's. It doesn't take much of stretch to know it would work well with Bipolar Disorder too. Since many of the meds used for Bipolar are anticonvulsants.

I would much rather treat my symptoms this way than be drugged up all the time.

Jon said...

Carolyn - thanks for checking in, and I have your blog "bloglined".

Amanda - I wish I could save some money, but it's impossible for me.

Mark - Do you feel forced hospitalization saves lives, costs lives, or is a push? I would think that for the potential downside, there is a net gain in saved lives. I have no evidence to back this up, but it seems common sense to me.

Bamagal - I'm agreeing with you on the meds. Some gains, but a lot of downside. And am starting to learn more about dietary impact.

Thanks all for your comments!

Just Me said...

I did some research a few years ago about the ketogenic diet that is used for seizure patients being used for us. There actually is a case report or two where it seemed to work.

Mark said...

"Mark - Do you feel forced hospitalization saves lives, costs lives, or is a push?"

If we are going to have forced hospitalization, taking away a persons freedom, then the same legal process for criminal action should take place. A judge, jury, prosecutor and defense lawyers. If we don't have this error checking process, forced hospitalization is preventative justice decided by one or two people. That's not democracy or freedom it's Fascism.

IMO All hospitalizations should be voluntary .
And then you need two hospitals one for the voluntary and one for the forced.

The media TV and movies have explioted the fear of altered states of conciousness. If you know it is wrong to kill, no matter what state of mind you are in, you won't kill.
The psych meds/drugs make the confused even more confused, and suffer side effects. This increases the chances of violent outcomes.

People cite the story of the mental patient going crazy in public and hurting and killing someone for insane/no reason. They then use this to explain the need for forced hospitalization. No one asks how did that mental patient end up that confused and angry.

Jon said...

Mark - I understand your stance on a loss of freedom, but you dodged my question. Do you feel that potential lives saved are secondary to individual freedoms? By lives saved my first thought is suicide, but it could be a person who is a risk to others.

Mark said...

Commiting suicide from the pain of addiction/withdrawl effects from psych drugs? Suicide from the failed promise that mental illness is a (fixable)chemical imbalance? I believe in personal freedom. Most people don't think to make smoking illegal, as it is a choice to do the slow suicide or not.
There is all kinds of suicides at all ages. You have to be specific in your imaginary suicide case.
If we had the right to any drug we want (as adult) without doctors, we could get opiates to stop the need to suicide. There are alot of possibilities.
A person who is a risk to others? Like a Pedophile? yeah they lock them up in psych wards next to the schizo and bipolar.

Anonymous said...

I've actually been trying to research this very question for the past while now. At 28 years of age it's become very apparent that even on medication, it's a slow decline. I can't keep dodging the inevitable. What happens to people after suffering for twenty years or more? I don't come by their stories too often which only makes me fear the worst.

Jon said...

Anonymous - As far as where you find people who have been diagnosed 20 + years, a quarter have suicided. Isn't that terrifying? 25% of our peers won't die naturally.