I'd like to preface these remarks by first stating that I am neither a doctor, nor do I have any medical expertise. Second, I do not subscribe to any conspiracy theories regarding pharmaceutical companies or the psychiatric field.
That said, I'd like to pose two open questions:
1) How many people have been diagnosed Bipolar following their experience of a manic or mixed state subsequent to the introduction of an anti-depressant with no prior history of mania?
2) How many people have experienced a first incidence of psychosis while attempting to take themselves off anti-psychotics?
If either of these cases apply to you, I strongly urge you to complete an FDA Adverse Event Report. As I said I'm not a conspiracy theorist, but I do think that a certain intolerable state of ignorance about the nature and impact of these medications exists in psychiatry. You don't have to agree with what follows to submit a report, but an Adverse Event is certainly an Adverse Event, right?
There are a number of lines, soundbytes that the mentally ill typically hear from mental health practitioners:
"This is an illness like diabetes." This is an appeal to the pathos that the patient may feel a deep sense of inappropriate shame about their illness and aims at keeping someone on medication and fully compliant. I couldn't agree more. However, it is certainly NOT an illness like diabetes. My greatest objection to that statement deals with how people are diagnosed. "There is no bloodtest." That's fine-- inaccurate I'd think, if mental illnesses are in fact a 'chemical imbalance', but let's go with the idea that 'chemical imbalance' is a sloppy phrase and say that the illness is somehow neuroanatomic, as has been suggested with schizophrenia. I'd think it only fair to point out that there is a study of Macaques that yields clear as day that the anatomic changes associated with schizophrenia can be duplicated in healthy animals prescribed the medication currently given to schizophrenics.
Am I denying Bipolarity and Schizophrenia? Absolutely not. These are incredibly serious illnesses. They're so serious in fact that people would risk Neuroleptic Malignant Syndrome, Tardive Dyskinesia, and a laundry list of side-effects a mile long to treat them. My position certainly doesn't apply to folks who have experienced Bipolarity or Schizophrenia PRIOR to the introduction of psychoactive drugs.
What I'm suggesting is the following scenario: Depression, statistically a very common illness now that the associated stigma of 'mental illness' has been normalized statistically has a greater number of people going on anti-depressants, a not-insignificant percentage of whom will have a negative reaction to the drug whether impulse control or mania, these folks are placed on an anti-psychotic, loath the side-effects, try to withdraw and experience psychosis. If they go back on medication, psychosis goes away, psychiatrists are convinced they were correct in their diagnosis and everything's in its right place. . .
For most other physical ailments, you'd have little difficulty calling that a 'drug dependence'. With psychiatric illness, there's a trump card which says it has 'unmasked' the illness. Faulty logic, but when you've just experience a psychotic meltdown, it's easy to 'swallow that pill,' forgive the pun.
It doesn't require a 'conspiracy' to work this way, simply ignorance and self-interest. The sort of ignorance that's indicated in the line of thinking that a "classic symptom" of bipolarity is denial of the disease and desire to be off meds. Apparently bipolar people 'miss the highs.' It's absurd, but this is no joke, I've heard the line from mental health professionals before.
I suppose I'm saying that if either of the two conditions I'd listed in that second paragraph apply to you, or if the personal history I've hinted at sounds at all familiar, I want you to know the following:
1) You might well have been misdiagnosed, and led off down the psychopharmaceutical path. Do people experience grief at times? Absolutely--it's not the same thing as depression. Anti-depressants are, it seems, psychiatry's legal 'gateway drug.'
2) I haven't been able yet to successfully come off meds, but for someone who'd been deemed bipolar (actually, 'schizoaffective' at one point) down at 5mgs of Abilify and symptom-free (talking 'illness' symptoms, not side-effects which are of course still present), I'm thinking there's hope that an incredibly slow titration (talking over the course of a year, no less) might yet work. At the first hint of trouble--weird thinking, insomnia, get back to the dose you'd been on and wait it out. At least, that's the best guidance I've been able to find.
I am not advocating people discontinuing their medication, that certainly should be determined on a case-by-case basis. I am not advocating that people discontinue medications without the observation of a medical professional. I am strongly advocating that the FDA be made aware through reports of adverse events of the number of people who experience first episode psychosis in attempting to come off antipsychotics. These events do not appear to be reported by the psychiatric community, and yet it seems anecdotally to be a common occurence.
For my part, I can see no other means of initiating change.