Bluemoonfairie - In my years of study and clinical experience I have found that all people who are unfortunate enough to be afflicted with bipolar disorder must take a mood stabilizer or combination of mood stabilizers to prevent recurrences of manic &/or depressive episodes. Studies have shown that 98% people who have had at least one manic will have another. The main problem with subsequent manic episode is the occurence of a phenomenon known as the "kindling effect".

Each manic (or depressive) episode that someone with bipolar disorder experiences "kindles" the next episode. That is, the time interval between each episode becomes shorter, and each subsequent episode lasts longer and is more intense than previous episodes. We use mood stabilizers to prevent kindling by (hopefully) lengthening the time period between subsequent episodes.

Unfortunately, even if someone finds the best combination of medications for their particular situation, the likelihood of eventually experiencing another episode within their lifetime is close to 100%. We just cannot predict when that episode will occur. The best we can do is try to keep the time interval between episodes as long as possible.

The way to do this is to try figure out what events or situations have triggered episodes in the past. This is definitely not easy, as some episodes do happen for no apparent reason at all. By consciously being aware of what types of stressors have seemed to precipitate past episodes (eg. certain types of social situations; recreational substance usage; certain emotional states, etc.) one can minimize the amount of medication needed to control kindling, but unfortunately almost all people afflicted with bipolar disorder do need to take some sort of mood stabilizing medication for the rest of their life. This is a well documented fact; and coming to terms with this fact is the greatest accomplishment and biggest step one will ever make in the battle against this incidious (and cruely unfair) disorder.

I'm sorry if I seem blunt and cold, but that is the reality of this disorder. I am not one who believes in the adage of "better living through chemistry", but bipolar disorder is a disease that requires one to take medication for life, very much the same way that someone with diabetes needs to.

As I have said, medication is just one component in the assault on this affliction; as important is the lifestyle on has to adopt. The choices that need to be made aren't easy, but they are necessary.

Sincerely - Cam