[Tucson]

I expect the right med cocktail to put me into remission. I have accomplished this for a year. But my life situation was different back then. I had structure in my life. I was highly motivated to complete a job. I interacted with people on a daily basis both professionally and personally.

So now that I am isolated with allot of stress, my meds are not working as well. My doctor has been fine tuning my med cocktail. He has even tried my original cocktail that worked. But I still struggle every day. There was one month earlier this year I was at my baseline. The only thing that I can remember is I hiked out in the desert on a semi regular basis, sometimes with my daughter. But I thought I was doing this because I was already feeling better.

What do you guys think? Are meds not enough for remission?

PS: Recently I have had a downturn during an already bad month. I just remembered that I have run out of Olanzapine. But what I said above still holds to be true.

[Victoria'smom]

For me I feel meds are maybe a quarter of what's stabilizing. I need a calm organized life with a therapist to help me learn when I need to ask for extra help. I can't deal with working and my family life so I'm not going to attempt work for at least another 6 years. A lot of things that I have fun with I have to force myself to do. I've thought differently all my life I'm not nor will I ever have the "right" response to anything. My goals for remission is not to scare myself or others, be functional to keep house, enjoy going out, and stay out of jail and the hospital.

Originally Posted by Tucson

I expect the right med cocktail to put me into remission. I have accomplished this for a year. But my life situation was different back then. I had structure in my life. I was highly motivated to complete a job. I interacted with people on a daily basis both professionally and personally.

So now that I am isolated with allot of stress, my meds are not working as well. My doctor has been fine tuning my med cocktail. He has even tried my original cocktail that worked. But I still struggle every day. There was one month earlier this year I was at my baseline. The only thing that I can remember is I hiked out in the desert on a semi regular basis, sometimes with my daughter. But I thought I was doing this because I was already feeling better.

What do you guys think? Are meds not enough for remission?

PS: Recently I have had a downturn during an already bad month. I just remembered that I have run out of Olanzapine. But what I said above still holds to be true.

Well, Tucson, I'm certainly no expert on this stuff. But what I do believe is "circumstances alter cases", as the saying goes. Also, it is amazing how quickly one can go downhill when one becomes isolated. This has certainly been true for me.

Personally, my experience has been that the SNRI I'm on helps to "keep a floor under me", as I like to say. It keeps me from sinking so low I can't climb back up. But it won't, by itself, keep me afloat & on-course. To accomplish that, I have to work at it every day. So, I would say, based on my experience, it takes more than med's to achieve a successful remission. From what you've written, it sounds like, previously, you had the "extra" you needed. Now you don't. So it may be you're going to need to find that "extra" something again somewhere. My best wishes to you...

[LastQuestion]

I believe medication can help a great deal, especially during a severe episode, but cannot substitute for proper self-care such as regular and sufficient sleep, a healthy whole foods diet (no sugar and avoiding gluten), abstaining from the chronic use of stimulants and depressants (caffeine, alchohol), and exercising at least three times a week.

Things like vitamin supplements can be very useful if one has deficiencies - some medications can actually interfere with how the body interacts with nutrients and cause one to be deficient. I personally believe people with bipolar have a greater need for certain vitamins relative to their mood episodes and life stress, such as magnesium, vitamin c, and b vitamins to help mitigate oxidative stress and the damage caused by excess glutamate.

I have integrated certain amino acids and Ayurvedic herbs to great effect in my own treatment. However, one must be careful and work with a competant doctor familiar in using them as they can interact with medications, such as enhancing how effectively benzos bind to receptor sites, or inhibiting glutamate (which might not be beneficial while on a high dose of a mood stabilizer). Ironically, those same interactions could be quite beneficial when taken into account as it may reduce the need for high dosages, which has the potential to reduce the severity of side effects, and could be used as needed to intervene during a mood cycle, perhaps even prevent them from progressing beyond control.

Unfortunately, these substances will require further study before the majority of Psychiatrists feel it necessay to familiarize themself with their pharmacology, although I believe it is negligent that they currently do not as some of these substances are already part of the diet many of their patients have.

Everyone has different needs and will have to find out what works best for them. What is important is to keep in mind that medication is not the only way to cope let alone the most effective prophalactic treatment. There are many ways to maintain stability and relying primarily on medication to do this increases the potential for destabilizing and then having to deal with the fallout.

More importantly, the neuropharmacology of withdrawal from psychotropics is poorly studied and when someone has developed dependance on a
substance its withdrawal can be destabiliziing and even manifest as symptoms of the diagnosed disorder and even disorders the patient does not have (such as a psychotic state, hallucinations, and intense anxiety). As such, whether or not a patient requires a medication to be stable is unknown. It could be that after medications have helped stabilize someone that they then cause more harm than good as their side effects can make it more difficult to cope.

For example, weight gain can make it harder to exercise or lead to developing sleep apnea. The ravenous apatite caused by certain meds may lead to stronger cravings that make it very difficult to maintain a healthy diet. Cognitive deficits from meds can make it harder to deal with challenging problems. All of these things lead to elevated levels of psychological and physiological stress which are in themself quite destabilizing and can accumulate into problems so large that they become disabling. Such life problems routinely keep people up at night for which a Psychiatrist tends to prescribe more medication.

I know this is a long post. The point I am making is that medications are one of many tools which are available. Relying primarily on just one set of tools limits what can built and maintained. So expand the toolset so as to make it easier to weather through the storms.

[~Christina]

Meds are never enough. Bipolar needs to be hit from all sides . Coping skills, Mindfulness, Meditation, exercise, routine,healthy diet, good sleep hygiene, etc etc etc

Sometimes even when you have done all the self care possible ... Bipolar can jump up and give you a ride... Just have to learn to surf the waves.

[hamster-bamster]

Originally Posted by Tucson

I expect the right med cocktail to put me into remission. I have accomplished this for a year. But my life situation was different back then. I had structure in my life. I was highly motivated to complete a job. I interacted with people on a daily basis both professionally and personally.

So now that I am isolated with allot of stress, my meds are not working as well. My doctor has been fine tuning my med cocktail. He has even tried my original cocktail that worked. But I still struggle every day. There was one month earlier this year I was at my baseline. The only thing that I can remember is I hiked out in the desert on a semi regular basis, sometimes with my daughter. But I thought I was doing this because I was already feeling better.

What do you guys think? Are meds not enough for remission?

PS: Recently I have had a downturn during an already bad month. I just remembered that I have run out of Olanzapine. But what I said above still holds to be true.

Structure in your life is key. That you identified it means that it is especially important to you.

There is a type of therapy for bipolar, called "Social rhythm therapy". It is not supposed to replace, but to supplement medication. For some people it may be sufficient without medication. Look it up - structure is a big part of this approach.

your cocktail seems well-balanced, so it is now up to you to put structure into your life. If there is no external structure, such as a job, you need to find ways to put the structure from within. Once you have that structure, you would feel much better.

You ran out of Olanzapine - what will you do to prevent this from happening to you in the future? Are you getting the drug from a brick-and-mortar pharmacy or a mail order pharmacy? What reminders have you put in place to avoid running out of the medication?

These would be some q's to ask in the aftermath of the incident with running out of meds

[Tucson]

Thank you all for your replies. I see that other aspects of self-care are equally or more important than meds. Also I always have thought structure was an important part of my previous success. But this is always been a major hurdle for me.

BTW I ordered Sensoril and L-Theamine. I will give this a try. Maybe I can have pdoc reduce or eliminate my Buspirone.

[venusss]

No, meds are never enough.

Pills cannot teach you have to make good decisions. They don't give you sense of purpose or fullfillment. They don't fix matters that are spiritual or existential. They aren't substitute for healthy eating and healthy habits.

[Creative1onder]

I know a lot of people take medication for their illness or think they have to. But i take none. And no, i'm not doing well, im not managing things well but at the same time i don't want to be on drugs for long time. I dont have professional help or support with it. No one understands what its like for me.

[Trippin2.0]

Meds never brought me the remission I craved, I actually experienced my first remission 3 months after quitting my meds.


Meds water down the bipolar experience but doesn't equate remission...


I've been less symptomatic sans meds, things still get really rough every 2 months or so though, so I'm gonna try medicating on a PRN basis with Ativan. My T thinks its a good idea and I'm not ashamed to admit that a lil something to take the edge off during times of crisis would be a Godsend.


Wonder which camp that puts me in now though, I'm not traditionally medicated, but I'm not purely med free anymore either... Meds PRN will have to do I guess


Anywayyy, I rambled :0


Meds working alone effectively is very rare, and when it is effective, its more likely for those patients who welcome being zombified, the walking dead cant exactly have emotional and mental turmoil.


Exercise, good sleep hygiene and a toolbox full of coping skills to assist the meds is imperative.


As mentioned above, this beast has to be tackled from as many angles as possible. The fact that it affects us on so many levels, and bleeds out to affect different aspects of our lives is evidence that monotherapy is a longass shot.


Looking after the body, mind and spirit is important to everyone, probably more so for us folks.

[Creative1onder]

I think hardest thing is battling alone with this illness whethr on or not on drugs

[Curious651]

Meds are not the answer for me. I am the answer and what I do. I forgot that the other week. Someone here reminded me that I need to take care of self. Keep to schedule, exercise, sleep (at least try), eat right, and move each day outside for some time. Hope this helps. Please don't think I am saying no medication. I feel it is a start.

[Creative1onder]

It isnt easy coping with challenging illness on own. I see that way i am and my life is severely affected by illness. Sleeping difficulty is part of it.