July 16, 2007

I've Earned The Right

For the last 18 months or so, my psych doc and I have discussed the prospect of my coming off meds altogether. His opinion has been that I've done remarkably well since getting the low-dose, long-term atypicals out of my life two years ago. So why leave me on Lamictal alone? He's told me that I may be one of those bipolars who does just fine without medication.

After 18 years of playing by the rules 98 percent-plus of the time, I've earned the right to find out the answer. I should stress that I've had no problems with Lamictal aside from the cost. It's one of very few meds I would openly recommend to people. Obviously, I am aware that others have had different experiences on the drug.

Anyhow, I've tapered from 200 mgs. a day down to 25 mgs. a day and will be on 0 mgs. a day come this weekend. So far, so good.

Of course, if this works out long-term, I then have to ask myself if I am even bipolar. For several years, I've met none of the criteria for bipolar disorder I, my original diagnosis from 1989 (although it was called manic-depression then). But then I have been mania free for many years. I haven't met the criteria for Bipolar Disorder II for the required time period in ages. I've not even met the standards for unipolar depression.

Forget about whether those facts are even clinically interesting. What interests me is what do I call myself in the future? Formerly bipolar? A bipolar off-meds? A psychiatric survivor? A bipolar survivor? Or, as the fine folks at TAC might have it, lacking insight into my serious debilitating disorder?

Maybe I'll just call myself by my name and leave it at that. I've earned that right, too.

Posted by Philip Dawdy at July 16, 2007 12:24 AM
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Comments

Good luck, and why not call yourself recovered? Why should recovery mean you were never ill? If we or psychiatry say that everyone who stops having psychiatric symptoms must have been misdiagnosed to start with, we are saying that there is no hope of recovery and we are stealing people's hope. Even E. Fullofit Torrey said on a phone call to NAMI family members that 25% of folks who experience psychotic episodes will fully recover with or without treatment.

Congratulations and enjoy!

Posted by: Alison Hymes at July 16, 2007 06:08 AM

I'd be curious to know why you would recommend lamictal. Is it purely the lack of side effects? I ended up on lamictal after endless med trials and thought it was great because it didn't make me feel crappy. I interpreted lack of side effects as "good" medication that was "treating" me, but now that I'm off of it, it's clear it wasn't actually doing anything...I was just doing fine anyway.

Posted by: undiagnosed at July 16, 2007 06:15 AM

Call yourself anything you like mate. If you CAN manage OK off meds you will probably be called misdiagnosed, or maybe Munchausen's syndrome (faking a mental illness to get attention). Whatever, I call you a hero!

PS I'm still off meds.

Posted by: Magi at July 16, 2007 06:51 AM

You sound so much like me! I have been on many, MANY meds in the past, but recently, I decided to try weaning off them to see how I would do. Of course, I did this with the help of my psychiatrist. There were times though, years ago, when I would just get so sick of the meds and their side effects, that I'd just flush them all down the toilet, but this time, I decided to recruit the help of my doctor, and do it the "right way."



I have been diagnosed with Bipolar Disorder NOS (among other things.) But, truthfully, for quite some time now, I don't fit *any* psychiatric diagnosis. It feels SO good to be able to say that! I don't know if that means that I was misdiagnosed, or if I DID have Bipolar and somehow I am cured now? Whatever the answer is, the important thing is that I am better now. I feel that I have grown so very much emotionally (with the help of therapy), that I have "outgrown" the depression. And whatever mania and psychoses I had, have disappeared. I don't know why, but I don't really care why either, I'm just glad.



I went off Lamictal this past February (I think.) I tapered down, like you did. I never noticed a single thing coming off the med. It was great. I was coming off the last of my meds, and I was still doing fine! (Not bad for a chronically mentally ill person, huh?) I was still taking Xanax and Adderall though, and had a much harder time getting off those than Lamictal. But the good news is that I'm now off of everything, and it feels so darn good!



So, now how do I define myself? That is a tough question! I am not "mentally ill." I don't identify with that label anymore. I don't call myself bipolar, or formerly bipolar. I call myself by my name. When I am talking to someone, like my husband, for instance, and I need to refer back to some time in the past when things were bad, I just say..."back when things were bad" or "when things were crazy." He knows exactly what I'm talking about, as he lived through it with me.



So anyway, You are going to do wonderfully off the meds. A huge part of it is your attitude toward going off them. Best of luck to you, but I don't think you'll need it!

Posted by: onlylife at July 16, 2007 08:42 AM

Please-you know how much I commend you for your efforts but you will carry the stigma forever. Everytime I think about applying for a job or trying to explain why I am a 33 year old "retired cop" though I have never been manic, hospitalized or whatever stigmas society has labeled me with are stuck forever.

I know a guy who is a level 3 sex offender (the most likely to reoffend) who has had an easier time finding a job than me, making more money than me and I have more education and training than him.

Good Post/Rant Over.....Anyone think I need some serious therapy?

Posted by: Angie at July 16, 2007 09:26 AM

Congrats. I like to think that Lamictal is a harmless medication with little to no side effects that causes me to THINK it's helping me. Either way, my symptoms are "in remission."

Maybe it's possible for some people that as they get older, their symptoms become few and far between.

So did any of the meds REALLY help you then? :)

Posted by: Marissa Miller at July 16, 2007 11:35 AM

Congrats Senor Philip! Recovery happens!

Posted by: Gianna at July 16, 2007 02:21 PM

Yay.Philip.

Posted by: Stephany at July 16, 2007 05:12 PM

I have been med free since last Thanksgiving (after having tried just about every med and combo out there). I just got sick of all the side effects and the more meds/longer I was on them, the side effects seemed to be getting worse and having more permanent effects.

Four years ago I was coerced into ECT. Bad bad stuff. Ruined my life, gave me brain damage, lost my career/friends/family.

While I'm glad I'm off meds, I really have no idea whether I'm any better for it as far as my mental state goes. I know that physically I am better off without them.

I haven't had a manic episode since I quit but I also have not come out of the depression. Every day I have thoughts of wishing I were not alive. Not every waking moment, but much more than anyone should.

I truely believe it would be a different situation for me had I come to this decision to go off meds without having had the ECT. I really feel I would have been able to go back to work and deal with it all again like I had for so many years.

But now my brain is damaged to the point that every day is a challenge. Everyday tasks can be monumental, just to remember how to do them. I can't help wonder how much of my present feelings of depression can be attributed to that.

Posted by: SallyT at July 16, 2007 07:33 PM

I wouldn't worry too much about your former diagnosis or being a "survivor" unless you wish to be an advocate? Or you wish to personally share your story? But it sounds like you question whether or not you even had Bipolar in the first place?

I'm not sure...I haven't had a chance to look at your blog enough and am only reading this post (eek!)

Actually, I just came by to thank you for the blogroll!

Bipolar is funny as it's a chronic condition so I'm wondering if you were somehow misdiagnosed? If not...have you been stable so long to be able to go med free? Then if so, give it shot. We are all in control of our own bodies and health.

There are some transient forms of Depression that are not chronic. I've never heard of someone with Bipolar that can go off meds but I find the prospect very interesting. Following you should be quite a good and enlightening read.

Take care,
PA

Posted by: patientanonymous at July 16, 2007 08:20 PM

Off-label?

Posted by: Ruth at July 16, 2007 08:45 PM

Good for you, Philip! I wish you all the best.

I was diagnosed with depression in 1987 and upgraded to bipolar in 1988 (after tricyclics and electroshock). After a horrible couple of years, I walked away from all that (no meds, no shrinks, bliss!) in 1990 and was fine until 2002.

When I went back into that hospital (due to a lame suicide attempt), it was like the intervening 12 symptom-free years never happened. My medical records are filled with references to my "long psychiatric history." Nobody, not one medical professional, asked what I learned about taking care of myself in those 12 years.

Anyway, after being treated with SSRIs and electroshock in 2002, I went manic again and had another horrible few years. I think any reasonable person would conclude that bipolar was actually a misdiagnosis. What I do have, however, is a sensitivity to psych drugs. As with many other psych patients, the cure is worse for me than the disease.

My solution? I told my doctors to shove their pills up their asses. I've been drug-free and out of the psych system for over a year now and it's a truly glorious feeling. I'm looking forward to another 12 year hiatus. For me, and thousands like me, psychiatry brought nothing but pain. Psychiatrists are vermin. I'll never talk to another one without a lawyer present.

As for labels, you don't need one. You're a writer, a fine one. Your medical history doesn't need to be categorized. Labelling is the whole problem with the psych system. You are who you are. Profound some days, aren't I? :)

Posted by: Francesca Allan at July 16, 2007 11:55 PM

yes you are francesca. and the rest of you, thanks for the kind thoughts. but PA where the heck have you been? it's been a wild ride around here for two years, zyprexa documents, banging on seroquel and the bp kiddos and such. fun times.

Posted by: Philip Dawdy at July 17, 2007 12:16 AM

My son has been off atypicals for 8 months. I started treating him for Pyroluria (a nutritional deficiency) and whammo! He was 'cured'. Unless he doesn't take his vitamin. Studies show that up to 75% of schizo/BP patients may have this to some degree - but our pysch, family doc, and ped never even heard of it.
We both take choline and inositol for mania and anxiety.
Coming from a family full of BP people... our supplement program works better than meds and doesn't cost $200 a month out of pocket.

Mama Says

Posted by: Milehimama at July 17, 2007 01:35 PM

Eh, bang on this BP kiddo if you want. If that's what you're referring to? Hey, I have a boatload of crap going on in my bean so I'll prefer to stay on my meds--that may not go over well here but again, we all have a right to what we need or want to do. Different opinions make the world go 'round. But yes...nightmares with some doctors absolutely! I'd just manage my own care and make my own med suggestions whenever possible. If not, I'd move on.

For me, it was just the insanity (no pun intended?) of finding a good combo.

I mean, at least I'm seizure free now? And the migraines are gone too. That means half of my issues are dealt with.

Posted by: patientanonymous at July 17, 2007 04:54 PM

no no PA. banging on the bp kiddo refers to banging on the silly bp child paradigm

Posted by: Philip Dawdy at July 17, 2007 05:33 PM

The childhood bipolar diagnostic criteria based on a few self-appointed elitists is not exactly in the silly category, Philip is being to kind. Banging down the one-sided myth of childhood bipolar disorder created by a few self-appointed fearmongers and Pharmaceutical companies sounds more like the Harvard crew. Hey after all they are published. Let's believe every word they say.
Also yes, I agree vitamin B-3 and B-12 are imperative to mental health and more people like Mind Hacks--should be researching why B-12 shots are popular with older manic depressives. Ask one. Bet they used to go get those shots. I know a relative who did and never understood why they felt better and calmer later.

Posted by: Stephany at July 17, 2007 06:57 PM

Angie, I'm sorry. It pisses me off to no end when I drove in White Center behind a SPD Recruitment vehicle with ads all over the back window. I wanted to call the number and go ripshit on em. You should be working here.

Posted by: Stephany at July 18, 2007 12:47 PM

They just call me epileptic now;(oops sorry, D) but it doesn't matter, It's not as if they burned the old medical records. I still cannot explain the "missing years" of my life on a job application...and I'll never get that life back.

Posted by: ~d at July 19, 2007 10:49 PM
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