Infrequent episodes

I have been stable for around 4 months. I realize that's not a very long time but it already has me wondering if I even have Bipolar Disorder. I have had an extremely unstable couple of years but I was pregnant and postpartum most of the time so there were problems with hormones.

Before this (other than postpartum depressions), I hadn't had any major episodes in about 10 years (and that is all I've ever had before the last 2 1/2 years--about 4 years of instability). Do you think lithium is necessary for someone who has had infrequent episodes? Could just taking meds as needed work? My doc insists on lithium (she is weaning me off my other meds) for life and so does my husband but ultimately it is my decision. I just wonder if everyone would agree that meds are always needed.

I don't think meds are always needed, but I think you would be most familiar with yourself and what works for you. I don't understand using mood stabilizers or antipsychotics as PRN (as needed) just because they don't work immediately, it takes some time for them to work, and it can be hard to recognize the beginning of an episode, so by the time you realize you need the medication, you're already compromised, and might even be in a place where you won't take the meds. The only time I've ever had antipsychotics as needed have been a very low dose of Seroquel (25 mg) and that wasn't for psychosis, it's only for sleep. I can understand using meds as needed for anxiety or sleep, because the meds usually used for those work immediately.

I think it depends on the person, their living situation, lifestyle and other their issues. It's a personal choice but I feel its a family decision. Do you have a therapist you can talk to about the pros and con's of medication for you?

I think you have answered your own question. Just because episodes are infrequent does not mean anything. Talk to your pdoc. How important is your relationship with your husband? (rhetorical question)

I went 10 years stable also. Totally stable, I refused to believe I had bipolar.

Then I went through an extremely stressful year, and it triggered an epic manic episode that climaxed with me thinking I was literally GOD, I had to be restrained with a straight-jacket and knocked out with thorazine in the emergency room.

Anyway, the point of this story is that YES, you can go years without symptoms, and still have bipolar disorder....I was stable and didn't have ANY bipolar symptoms for 10 years, and then BAM! I had a manic episode so extreme, it was manic type 1, psychotic super-mania. After I was released from the mental hospital, I went into a depression for two ****ing years. Now I am medicated and stable again.

I hope this helps.

I remember wondering exactly the same thing after a couple of months' "stability". Maybe I wasn't bipolar after all---maybe I was just going through an existential crisis and had finally snapped out of it.

I was rewarded for this thinking with one of my worst manic episodes followed swiftly by a hard crash. So much for THAT idea!

If you were stable for 10 years on lithium, have you thought that maybe it's because the medication was keeping you that way, and to go off of it might de-stabilize you? You've logged four months this time.....that's not long enough to consider coming off meds. Of course, it's ultimately your decision but your loved ones, friends, co-workers etc. also have to deal with you, medicated or unmedicated. Just saying.....

A member here, Sierra, takes meds on an as needed basis, with the blessing of her pdoc.

So she's proof that it can be done.

Actually, four months stable does not equal infrequent episodes. If a person has more than four episodes a year, it make him a rapid cycler, which is not as common as a non-rapid cycling, as far as I know.

Plus, diagnosis of bipolar is for life. If you had at least one full blown manic episode, you will technically always be bipolar.

Now, saying all that, it doesn't mean that bipolar person can not stabilize for a very long time. Even without medication. I was taken off my lithium two month ago, but only after I was stable on the very low dose for three years. Before two years my pdoc would probably hospitalize me on the spot if I even mentioned getting off my meds. He is looking at me as a ticking bomb now still lol.

If I were you, I would have enjoyed my stability, made peace with the fact that I was not a plain boring neurotypical person and did not look for trouble when I didn't need to. If you continue to be stable for several years getting off your lithium will become very clear possibility. But that is after years, not months of stability.