ISPP 2015

Career Opportunities in Pharmacy
Can You Stop Your Bipolar Medication? – Maybe Here’s How

can you stop your bipolar medication that's what I'm gonna talk about today I'm dr. Tracy Marx a psychiatrist and I published weekly videos on mental health education and self-improvement please subscribe and press notifications if you don't want to miss a video today's topic is based on a viewer question from the bee man and he asks dr. Tracy can you please do a video on stopping bipolar medication or can it even be possible to stop taking your bipolar medication thanks thanks bee man and there were also two more requests for the same topic as well bipolar disorder is a serious mental illness that involves recurring episodes of depression and either hypomania or mania it normally requires medication to treat the acute episodes as well as keep them from coming back once they resolve but there are people who go periods of time without medication so let's break that down in a classical picture of bipolar disorder the episodes alternate you have an episode of depression that comes and then it goes and how long the episode last depends on the individual the average amount of time is six to nine months then this is followed by what we call the intereseted this can last weeks for someone who's rapid cycling or months or even years before you have another episode in this period you're usually back to your regular functioning the next episode would be mania or hypomania the mania tends to last for weeks it's hard to sustain mania from for very long but you can have a buildup of increasing energy and goal-directed activity that lasts for weeks before you actually go into hyperdrive now this is the classic picture not everyone is classic in 2007 the National Institute of Mental Health published a study called the step BD study where they followed people with bipolar disorder in an outpatient setting to see what treatments seemed to work best and it's a great reference study I'll have it in the description for you that studies showed that only 58% of people with bipolar disorder types 1 and 2 fully recovered that is the majority but that's not everyone it also showed that 49% of those people had another episode within two years and twice of twice as many of those episodes were depression in a previous video that I'll reference on the corner and in the description I talked about the differences between bipolar 1 & 2 plus bipolar two disorder we've seen that over time people tend to have more and longer depressive episodes than they do the hypomania so how can we use this information to answer the question about getting off medication well if you're someone who fully recovers in between episodes and your episodes are separated by years then you may be able to manage without medication until the next episode comes the key here is recognizing when the next episode is coming with mania it can just slip up on you quickly often people don't seek help during the mania especially hypomania because it can feel good or you could have the irritable form of hypomania where you just figure you're going through a bad patch right now and it'll pass the danger of watching and waiting is once you've sunk into a depression or escalated into mania it's harder to get things under control we can do it with medication but it's much easier to tweak what you're already on if you have a relapse on medication but if you're off meds the process of onboarding with a new medication regimen takes more time and if your doctor tries to do a fast taper upward we call that a titration where you increase the dose stepwise to get to a therapeutic dose you can get more side effects like sedation or feeling like a zombie also if you go too long without meds while you're having an episode the period of time you spend in those episodes without treatment makes future episodes harder to treat it's called the kindling effect let me say that again going long stretches of time in an episode without treatment has the cumulative effect of making your future episodes less responsive to the medications this may play into the concept of treatment resistant depression also you really want to see a video I did on how untreated depression shrinks your brain cells I know that sounds dramatic but unfortunately it's true so am I saying that you can't treat bipolar disorder with therapy and no medication yes actually I am saying that there's been bunches of studies on this and I I have references in the description psychotherapy can be a good addition to treatment but it's it's not been shown to be effective as an only treatment and in the studies they'll use the term mono therapy to mean only treatment one thing therapy can be helpful for is in delaying the onset of future episodes so this can be useful if you're trying to stay off medication in your inter FSO period a therapy developed for bipolar disorder is called interpersonal and social rhythm therapy this therapy focuses on the problems in your relationships and helps you establish regular daily routines mania tends to be more destructive interpersonally in the manic state the person can do all kinds of things that hurt them or others like having affairs run up credit cards ruin business deals embarrass themselves at work or school because they're acting bizarrely and scaring people in contrast depression tends to be more of a silent personal pain that others don't necessarily see the person who live with you may see how dysfunctional you are but they still may not appreciate the depth of despair and darkness that you feel so interpersonal therapy focuses on the problematic areas in your life that involve how you relate to other people in your environment in the therapy the therapist would help you identify some of these problems and help you troubleshoot solutions as for the social rhythm part of the therapy mood disorders especially bipolar disorder are very sensitive to changes in your body clock and overall body homeostasis which you can think of as your body's overall rhythm early signs of a manic episode approaching is the decreased need for sleep with social rhythm therapy you keep close track of certain daily routines like when you wake up and when you go to bed and when you eat your meals and it's been shown that people who keep a schedule with these things and they don't vary it very much they recover faster during an episode and lengthen the time in between episodes that's kind of a big deal let me say it again following a daily routine helps you recover faster and lengthens the time in between episodes now I realize your schedule may not always be entirely under your control but if you can adjust your life so that you can keep a regular sleeping and eating hours you can do better overall with your bipolar disorder this doesn't mean you have to eat three meals a day however many meals you eat in a day they just need to be regular people using this therapy will sometimes use the social rhythm metric to track your activities there's a longer version of it which is 17 items and then there's a shorter one that's five items for the SRM five the items that are tracked are the times that you get out of bed have your first contact with another person start work housework or volunteer activities have dinner and go to bed if you use that metric you would track the times for these activities over two weeks the goal is to keep them as constant as you can last thing just to be complete I mentioned earlier that in the step BD study they showed that only 58% of people have a full recover recovery in between episodes so what about that other 46% those are people who get better from their episodes but they still have some lingering symptoms so they're better but they're not quite right so if that's you it's not a good idea to stop your medication if you're not at a hundred percent so getting back to the original question can people with bipolar disorder stop taking vacation my answer is some people can for a while but for the best treatment and best chance that your condition won't get worse over time you probably shouldn't stop your medication please share this video with others and let me know what you think in the comments I'll see you next time

33 thoughts on “Can You Stop Your Bipolar Medication? – Maybe Here’s How

  1. I’m on meds … genuinely makes me like I’m on drug .. my head is too heavy and pain inside … nothing works if you have genetic…my Dad and my Sis …

  2. Anyone struggling with bipolar disorder, I want you to know just how fucking strong you are. You’ve got this.

  3. I just got out of a 4-month stint in a state hospital after going through serious episodes. This video felt like exactly what they were telling me about how if I stop my medication and end up back in the hospital how bad it will be getting back on medication and the long process it will be. Thanks for reinforcing keeping track on taking my meds.

  4. are there rare cases that you consider cured from bipolar? if so what are the criteria they should meet?

  5. You've mentioned that some prescribed drugs/dosages give a sedated/zombie effect on the patient which affects their cognitive function in a negative way. Some people with Bipolar Disorder thrive in mentally challenging work, software engineering, academic research per se. Putting them on meds for a long period of time, blunts their skills and they get frustrated about their lost sharpness which can lead to depression which can lead to more meds or increased dosages. But, you've also mentioned that there can be a time in between episodes
    where a patient can stop medicating, is this a standard in the mental health care system in your country?

  6. What are your thoughts on the weight gain side effect some people experience when taking mood stabilizers? In my country, the dosage should be in proportion to the patient's weight. Weight loss is more challenging to people who became fat because of drugs than food I once read in PsychologyToday

  7. Thank you for explaining everything so concisely. I really needed to hear this. I really battle with this topic. I want to turn to holistic remedies instead of prescribed meds, but I've been on meds for so long that I am afraid to fully go off of them. When you talk about getting off for short whiles, that makes sense because I am pretty good on the SR-5 Metric… I really want to live my life without meds. I really do.

  8. Thank you doctor for your video. I am suffering from Bipolar Disorder type 2.. ive encountered severe depression when i accidentally not taking my medicine.

  9. I haven't taken medication in years on top of that I suffered the loss of a child. A child that I constantly tried to get help for to keep his medicine regulated. Try to make this short. After asking for help for myself and my kids and not getting what we needed and losing him in the process I've lost all Faith and Hope in this process. If anything is to work you first have to have the right people and environment. And that is hard to find from professionals to your family and friends. I see the benefit and tracking and maintaining a daily routine but that still goes back-to being in an environment that you can be successful in. With all that said where do I start I'm sure my brain has shrunken to a pea-sized by now

  10. Thanks for the video! I guess there is no way to go without meds for the rest of your life if you have Bipolar right? Have you ever heard of Dr. Peter Breggins, and any opinions of him. Is he just a well meaning delusional quack?

  11. I was diagnosed bipolar in 2013 at the age of 23 after a suicide attempt. I was hospitalized in a mental hospital for 9 days and left on multiple meds. Over the next year I never found a treatment that worked. I eventually went into denial about my diagnosis and quit all treatment in 2014. It’s been over 5 years no meds and I’ve RUINED my life!! I have experienced so much loss, lost jobs, lost relationships, lost experience and opportunities. Nobody told me going untreated could make my illness worse. I believe I’m now rapid cycle my mood fluctuates multiple times a day I go from ok and at some times even happy setting goals, wanting to change my life drastically to 30 mins later crying uncontrollably feeling hopeless like I’m ruining everyone’s life around me. I’ve convinced myself I’m the negative denominator in the butterfly effect around me and if I just didn’t exist the world would be perfect. I’m going in as a walk in tomorrow at my local mental health clinic, I pray I find something that works:(

  12. I have bipolar 1.. At age of 25 I was diagnosed with it with manic psychosis in 2010. Then again after 5 years in 2015. Second episode was quickly cured compared to first. I want to get off meds because I had episode even though I was on meds. So I'm in the year long stable category. I also believe scheduling and setting specific goals help me slot. I'm on 300 mg qutuapibe n 100 mg limotrogine

  13. What do you know about tapering off of meds and then substituting with CBD oil? This is what I have been considering as an alternative.
    (Bipolar 2 and Anxiety Disorder.)

  14. Was the Kindling Effect Research funded by the Pharmaceutical Industry. My experience is that at no time was the full horrific side effecte of “ Bipolar Medications” told to me. From being a fit athletic personnel within months you could become a fat zombie with no colour in their life. The constant experimentation with medications seems too experimental to show there is a clear pharmaceutical. treatment for Bipolar. Being given antidepressants when manic and heavy tranquillisers mainly used for schizophrenia, did not inspire confidence in my Doctors. Coupled with patronising recommended Cognitive Behaviour Therapy delivered by Sleep Inducing Psychologists! Bipolar is chemical in nature and very fast so thinking a talk therapy will work is nonsense. I control my Bipolar better without experimental chemicals by an exercise regime. The exercise helps with any low and high moods and creates physical activity which needs sleep to recover. If I do have bad days I avoid situations likely to cause stress and realise I am better off those days avoiding people who irritate me. It is extremely difficult to talk to non Psychiatrists about this condition as the Training only provides a superficial stereotype of the Disorder.

  15. Going of meds is like fighting for your freedom.  It requires standing up for yourself in ways you would have never imagined.  You will get beat down and fail before you ever succeed because no one has laid that framework for success.  I have been medication free for 6 years even with a high susceptibility for bipolar I / schizoaffective episodes since 2008 with 6 manic episodes and 4 hospitalizations.  I got to where I am with a lot of hard work.  When others say, "I have tried everything."  I say, "Oh! I haven't tried that yet!"

  16. I'm 63 years old, and was only diagnosed with BI-Polar Disorder in 2010. I did some really crazy thing before I got medication. It has done wonders, but had to try several different ones before it was working! I wish they had videos like this back then, I probable would have noticed I was Bi-Polar!

  17. Dr. Tracey Marks, I would like to tell you, I personally enjoy your videos immensely! I find them informative, personable, and easy to understand. Thank you for sharing this educational content, I've been using your tips in your videos to help manage my bipolar disorder, such as suggested in your other videos: Writing down triggers and in this video: keeping track of daily routine, and trying to keep the consistency. I do believe the medicine, and the participation of myself, and your information are all helping me make the best possible decisions to become better overall. Oh, I even told my therapist about you and she was delighted that I'm being as involved as possible with the recovery process by watching/using your videos to understand what's going on and tips on taking action, and I just wanted to say THANK YOU. =D

  18. I've been off my meds for a few months, I think I'm going to set up an appointment with my psychiatrist

  19. I have Bipolar and can’t sleep without Xanax. I would really love to get off of this drug. Good sleep hygiene practices haven’t helped.

  20. you da best. i definitely need this as detailed and as professional as you present it.. if i could pay you for these classes i would.

  21. Hi Tracey, I've recently subscribed to your channel and find all of your information very helpful and truthful – not opinionated! I'm wondering if you have any videos / knowledge on the medication Lithium for treating Bipolar disorder. I am about to receive my diagnosis and wishing to start medication. Is it possible for someone to take 'low-dose' Lithium (i.e 300mg or below) to treat Bipolar? I have seen the research on neuroprotective benefits, and its overall efficacy for Bipolar, but I'm scared off by the possible side effects that come with (usually) larger doses. Is it possible to be treated effectively with these 'lower' doses?

    Thank you so much.

  22. I enjoyed the video on should I stop my medication with bipolar. Definitely not for me. Mania has crept on me many times. Anyway when some of my treatments are diagnosed I always have lingering symptoms and new symptoms sometimes,

  23. I have been a treatment for bipolar 35 years. It has been hard to cope with the disorder. I am always seeking help. Your video is very helpful. Thanks.

  24. Can you do a video about the benzo problem with benzo meds for anxiety & bipolar patients. My mom tried to come off a benzo (lozepram) and it was hard for her we had to go to ER. jesus why is this given to mental health patients had I known this I would of never allowed this. She likes the med but I think shes addicted. 😣😔 now dr lowered her lithuim and she has mania I'm crying and losing sleep trying to get my mom back to herself.😣 not going back to work till mom is back at 100. We trying a new dr in 2 days.

  25. As someone who is still working on accepting my BPII diagnosis, yet taking medications to get my symptoms under control, I had seriously thought about discontinuing meds and therapy. This video helped to tip the balance of whether I should discontinue my medications or see the process through; I’ve decided to take the medications & therapy route. Thank you very much for what you do

  26. I was a Mormon missionary and every hour of every day was tracked. I knew when and where I was going to eat I knew when I was going to sleep. I knew who I was going to visit, and what I was going to do during that day.

    In two years time I had about 12 depressive and hypomanic episodes give or take. I recovered 100% through every one of those.

    But when I got off my mission that whole dynamic changed I did not schedule sleep or eating or any other part of my day except work.

    My hypo manic and depressive episodes became more and more regular as well as the destructive behavior that comes with it.

    My condition deteriorated and my ability to function as well my self-control also decreased Substantially

    15 years after that I finally got on medication and at is been so much better. It took a very long time for me to find out that I had bipolar disorder. I wish I had known sooner.

  27. In my case, type 2,  psychotherapy is more effective as meds. I do not have mania, only rarely 1-2 weeks hypomania but not every year , than I take few days some meds to get asleep.  I stay long periods (months or longer) stable without meds, the psychotherapy helps me to stabilize without the side effects of meds.
    Many docs know it but it is easier for docs to prescribe meds. 
    However I went on meds few years ago when it was severe depression with psychosis and I run way from home.

  28. Thanks again for your helpful video 🙂. Best advice, stay with your medications, especially if they're working. I know that we wish for a cure, but living with our BP and living well is a good thing. People are not meant to go through life alone, so staying on your meds can help keep you "steady" being less moody may help keep your spouse or partner. Be well, take care and GOD BLESS

Leave comment

Your email address will not be published. Required fields are marked with *.