Hi everyone,

I went to my T yesterday to discuss with her the potential for medicating me for depression. This has been a particularly bad episode for me, but it's the first I've really had since I started seeing this T a year ago. I've been really resistant to RX meds for my depression because of a few bad experiences with them in the past (total apathy on one - everything was flat, and the other didn't seem to have any impact on me whatsoever). As a rule, I don't really put chemicals that are not absolutely necessary in my body. She asked about my past history with depression, and during the course of that conversation, asked me how I felt about checking me out for bipolar. She and I ran through a bunch of things, got through major parts of my history. At the end, it seemed pretty clear I was BP, and she also said that her experience of me over the time we've worked together agrees with this.

She could tell I started to panic a bit. I'm used to thinking about myself having depression. I have 2 relatives with BP; one (a great aunt who has died) was universally disliked in my family and labeled 'crazy' - she was blunt & abrasive, seemed to enjoy making others uncomfortable, was extremely creative. I don't know if she ever medicated or not, but everyone was aware of her mental illness. She was generally avoided (my dad particularly disliked her - they had a very antagonistic relationships). It's hard for me to tell how much of the discord had to do with her illness, and how much might have just been her personality outside of BP. My aunt (one of my dad's sisters) is also BP. We all love her, but she seriously struggles with keeping a job, making rent, affording life. She has low expenses, but work is an issue. She's a lovely person, thoughtful and caring. She medicates off and on, I think, and has for much of her life. I see how much she struggles to handle the basics of life, and between that extreme and my great aunt who made her way just fine but alienated everyone, I don't feel positive about my future with this.

While I was looking at my answers relative to questions about the manic side of BP, I was floored. I just assumed that the things I experience when I'm not depressed are 'normal.' There are bits I don't care for too much: impulsivity, doing/saying things that are socially embarrassing, undertaking big efforts that are left undone when I start to get depressed, speaking too fast for others, having to get all my rapid thoughts out quickly while talking, anxiety (one of the things I started seeing this T for...she thinks it might be my physical experience of the hypomania), and irritability. I just felt like I was maybe a little socially awkward (a source of a lot of self judgment when I'm in a depressive episode), have a very quick mind, and am quick to strong emotions.

On the plus side, though, I love how productive I am when I'm in what I guess is a hypomanic state. I thoroughly enjoy the activities I undertake, feeling like I'm accomplishing a lot, the general feeling of being energetic, enthusiastic, socially engaging/engaged, creative, excited, etc. I really don't want to let go of any of this...I feel like its the only time I'm really happy.

So back to the issue of medication. I don't know what to do. My T understands my aversion to RX meds, though she does have a relationship with my GP's PA, so she can talk to him about my past experiences with meds and maybe try to help guide that path a little bit. But if I start on meds, will I always have to be taking them? For the rest of my life? And my understanding is that they would help smooth out the cycles - the big downs and ups. Does that mean I have to give up the good stuff...the productivity, the creativity, the energy? What happens when that goes away - what's in its place? Do I just not experience the world as intensely as I do? Will my mind slow down (I realize for some this is a good thing, but I like how my mind makes so many quick connections and speeds through analyses of things/situations so that I don't have to plod through things)?

My T did say she has experience with others of a more natural alternative being effective...EMPowerPlus from TrueHope. I've checked around a little bit, and it seems there is some controversy about effectiveness. I'm used to that, though, with most of the natural alternatives I've found to things in my life. I know we don't live in a society in the US that values it much. If it works for me, I can live with that - but it's also very expensive & won't be covered by insurance, and I'm again worried about having to take it forever...

Does anyone have any success with not medicating their BP, or have any other methods for managing it?

(Sorry this ended up so long...I'm still trying to wrap my head around it all - how I feel, what I'm concerned about and why, what I think I should do next. Thanks if you made it through all this.)