July 18, 2008

From The New York Times: Voices Of Patients With Bipolar Disorder

The New York Times has an interesting feature up on its website wherein about 10 people diagnosed with bipolar disorder detail their experiences. It's not really possible for me to sort all of this out since the audio interviews are short and I really don't know the life stories and such of the people involved, except for one. That would be Randy Revelle, who was diagnosed with bipolar disorder in 1977 while he was a Seattle City Council member. He was later elected King County Executive. He didn't go public with his condition until he was running for that position and somehow won election. Randy, who is a friend, is a true pioneer, and one of the few bipolars I've ever encountered who's done well on Lithium alone for all those years.

One other person among this group is a reader of this site. That's Steven Morgan, who's been off-meds for three years and is doing well. On his clip, he describes himself as the impossible patient. I know exactly what he means.

The one thing that makes me pause is that a few of the patients on here are late-diagnosed bipolars, a trend that's all the rage like the bipolar child business, and for reasons I don't completely understand myself, I am suspicious of this late DX business. But that's just me. I've become skeptical about everything. But, then, I've earned the right.

Ironically, this bit on the nytimes.com site pops up two days before my one-year anniversary of being off-meds. Ironically, I am planning something of a major post on Monday about my own thoughts on where being off-meds for a year puts me. Like Morgan, I feel impossible somehow and I mean that in as sane and sober a manner as possible.

See you Monday.

Posted by Philip Dawdy at July 18, 2008 12:03 AM
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Comments

I quit taking all psych drugs - five years ago this upcoming August. For me it all started 14 or 15 years ago when a doctor gave me Paxil. Until I started looking into all of this it never occurred to me that I might have had withdrawal symptoms over the years when scripts ran out and I couldn't afford docs.

The chemical imbalance theory has been debunked. No one is bipolar though apparently some people find that they like the feeling of taking lithium in spite of the renal problems it brings on. I'm watching a friend die early from lithium. Of course he thinks it saved his life when he was dx'd manic depressive years ago. What really happened was that he got a couple of dui's close together when he was a hell raising high school kid, people who did the same thing a few months before were fined, but with the law change, his lawyer came up with the manic depressive thing, he bought it and it's become an integral part of his identity.

I have another troubled friend who loves her bipolar dx. She blames tragically in appropriate choices in sex partners on the dx when her problem is low self esteem brought on partly because she really looks not too good due to her psychotropic drug cocktail. She declared bankruptcy blaming it on mania and recently had her meds adjusted because she couldn't figure out how to housebreak her dog. I've never seen a worse case of drug addiction, in complete denial fostered by incompetent, dishonest doctors and therapists.

Congratulations on being clean almost a year.

Sad, tragic that people buy into this crap, but then no one can blame you for believing your doctor even if he's knowingly lying. My five years off meds have been good years.

Posted by: Sally at July 18, 2008 03:00 AM

Peter Breggin has been writing extensively on medication spellbinding in the last year or two. It's really an interesting concept and most people who believe drugs are helping them are actually victims of this phenomenon and in complete denial about the adverse effects they are experiencing. I think his newest book Medication Madness is probably his best and most compelling book ever and he gives lots of specific examples of this phenomenon in it.

I just want to say that I can only imagine how difficult it must be to adjust to life without medications and with a diagnosis that may be a complete sham after living with both for a decade or two. It has got to take a good long time to accept the new reality and to realize that there is no magic bullet out there to make one's life happy and productive. It takes work, effort, practice -- empathy for others and an acceptance of one's identity. It takes challenging one's fears and limitations and coming to believe in something that's bigger than one's own self interests. It's darn hard but at some point hopefully rewarding.

Posted by: Sara at July 18, 2008 11:59 AM

It is difficult to tell if these 10 people who say they were diagnosed as "bipolar" actually had manic depressive illness or were instead suffering from a stressful life, etc. Very little background is given for their lives.

One woman had a son who was an alcoholic and refused treatment. He committed suicide. Suicide among alcoholics [alcohol is a depressant] are not all that infrequent. The mother believes her son had "bipolar" disorder. I wonder if there is any scientific evidence to this effect.

www.SSRIstories.com has a Journal Article that shows that 45 out of 100 alcoholics increased their drinking while on Zoloft. It would be crucial science to know if the increase was due to the Zoloft causing some kind of 'mania' or if the Zoloft was increasing the "depression".

As far as smoking goes, about 80% of schizophrenics smoke, compared to about 50% of "bipolars" and 22% of the general population in the U.S. I came across this article on schizophrenia & smoking. The Website address no longer works so I am putting in a copy and paste of the article which does have the Journal Name and Date & Number. If this article is true that smoking can prevent some people from ever DEVELOPING schizophrenia, than this is pretty heavy stuff.

Here is the article:

Smoking May Protect Against Schizophrenia

NEW YORK (Reuters Health) Dec 29 - Cigarette smoking at age 18-20 seems to be associated with a reduced risk of subsequently developing schizophrenia, according to researchers. However, they say, any possible benefit is greatly offset by the harm of smoking.
"Many case-control and cross-sectional studies have observed an association with cigarette smoking after the onset of schizophrenia, and there is evidence to suggest that smoking may improve symptoms in people with this disorder," Dr. Stanley Zammit from the University of Wales College of Medicine, UK, and colleague write in the December issue of the American Journal of Psychiatry.
In a longitudinal study, the researchers examined whether smoking alters the risk of subsequently developing schizophrenia. Included were 50,000 Swedish conscripts who were followed up by record linkage to the National Register of Inpatient Care from 1970 to 1996 to determine hospital admission for schizophrenia.
A total of 362 (0.70%) subjects were diagnosed with schizophrenia by 1996. After adjustment for confounders, the team observed an association between smoking cigarettes at age 18 and a lower rate of developing schizophrenia.
A linear relationship was found between the number of cigarettes smoked and a lower risk of schizophrenia (adjusted hazard ratio for linear trend across smoking categories, 0.8). The adjusted hazard ratio for heavy smokers was 0.5.
While the investigators caution that the harmful effects of smoking outweigh any possible benefits, they note that further investigation may lead to important findings about the etiology of schizophrenia at the molecular level.
Am J Psychiatry 2003;160:2216-2221.

Posted by: Rosie C. at July 18, 2008 01:07 PM

Looking forward to another person's definition of what I've always called myself: impossible.

Have a great weekend!

Posted by: Stephany at July 18, 2008 07:08 PM

Philip:

I simultaneously gave you a shout-out in my comment on the Times multimedia project (#132) and expressed my profound concern for your friend Steven Morgan, and indirectly for you, about non-medication.

Still, given your voluminous detailing of the ills of Big Pharma, you have earned the right to carve your own path -- period, never mind questioning from the likes of me.

Alas, I choose instead to go your friend Randy Revelle's path. "Two roads in a wood diverged ..."

Posted by: Larry Parker at July 22, 2008 06:43 PM

Shades of Robert Frost here? -

"...I shall be telling this with a sigh
Somewhere ages and ages hence:
two roads diverged in a wood, and I --
I took the one less traveled by,
And that has made all the difference."

I think the therapeutic power of poetry is often under-appreciated.

Posted by: Kent at July 22, 2008 08:11 PM

Still think the first drug for bipolar disorder is the best choice, which is lithium- a 60 year old medication. It is of particular benefit with the mania associated with the condition, and may prevent depressive episodes, or augment antidepressant meds taken by a lithium patient. Suicide risk is low as well.

All drugs have side effects. With Lithium, it is weight gain. Also, blood monitoring of those taking this drug is required to maintain therapeutic levels and avoid toxicity possible with Lithium treatment.

Bipolar disorder, as with other mood disorders, is rather mysterious and are not always easy to diagnose. There are those who, when manic, are able to achieve exceptional accomplishments mentally. And how does one's personality factor into such disorders?

Posted by: Dan at July 23, 2008 07:29 PM
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