Medication for Bipolar
I wrote this reflection for my problem identification class at the University of Rochester. The professor asked us to reflect on a particular reading, the reading for this reflection was Chapter Six, Treatment of Bipolar Disorder of Basic Psychopharmacology for Counselors and Psychotherapists by Sinacola and Peters-Strickland (2011). I have included my reflection below.
Medication for Bipolar
This week, I chose to reflect on Chapter Six, Treatment of Bipolar Disorder Basic Psychopharmacology for Counselors and Psychotherapists by Sinacola & Peters-Strickland. The authors gave a brief overview of what bipolar illness is as well as information on its prevalence, types, and some of the hypothesized neurological or medical causes of the disorder. A very brief section of two paragraphs describes psychotherapy as an option. However, the text quickly moves on to other treatments, of which the text touts pharmacology as the cornerstone. Over the following ten pages of content, medications are advertised and divided into three main categories: Lithium, Anticonvulsants, and Typical Antipsychotics. The text offers alternative medications and treatment approaches, such as ECT. The chapter then moves on to prescribe the best way to "drug-up" your candidate bipolar patient, starting slowly and then increasing. The chapter describes the importance of education for the patient and their family, especially to convince them to stay on their meds. We finish with two case studies showcasing how drugs fictionally can save patients.
My initial reactions to this piece, unfortunately, were quite triggered. I have had personal experiences that I felt related to this chapter. For me, once I left a traumatic family system at age 18, I began feeling depressed, so I began binge drinking two to three times a week during college. I saw a general practitioner who put me on antidepressants, which I took on and off for about ten years. At age 25, my father passed away in very traumatic circumstances, and I began to experiment with stimulant binging every couple of months, along with my alcohol use, to try and numb the pain and cope. All of this was a secret that I kept from my work and friends, I was still holding down a good job and keeping up appearances. Finally, at age 31, I met a clinical psychologist who helped me to try and deal with the trauma and stop alcohol and drugs. As part of this process, I elected to also see a psychiatrist. When I described my situation to the psychiatrist, he diagnosed me with Bipolar II.
The psychiatrist gave me a diagnosis of Bipolar II after just a 30-minute conversation. The psychiatrist then told me to take medication, and I spent about 6 years on and off differing cocktails of medication. This first was Lithium for about 12 months, which I hated. It made me feel blunted, and I put on weight. The psychiatrist then transitioned me to others such as Zyprexa, Risperdal, Topamax, Seroquel, Geodon, and Lamictal, mixing in with all of these different antidepressants as well as different benzodiazepines. I would be prescribed a drug and take it for a couple of weeks, but then I could not stand how it felt. I think the longest drug I stayed on may have been Lamictal for 18 months before deciding I had to stop all of these completely.
In parallel to my check-ins with my psychiatrist each month or so, I was still working with my therapist weekly. By age 35, I was so fortunate to cease all drug and alcohol consumption successfully. After this point, my mood steadily became much more stable. I attribute this success to my therapist. Working with the therapist, I finally got off all prescription medication, too. Today, as a 44-year-old man, I can say that I have been 9 years clear of drugs and alcohol and 6 years clear of any medication at all. My life is fantastic and has been for years since I was clean. I believe I never actually had Bipolar II; I was just a guinea pig for a sadistic psychiatrist who was taking his personal anger out on patients by incapacitating them with medication. I wish so dearly that instead of starting to take any medication, I worked with a therapist from a young age, 18 or even younger, if we could have gotten one for our family. The medications I took I do not think helped, I think they only made things worse.
I must admit that reading this chapter made me feel sick and angry that the pharma industry touts this information as correct. I feel reinvigorated in my new career to strive to help people rather than allowing the industry to medicate them unnecessarily. There is no such thing as a magic pill to make problems go away, it requires work. I feel angry that the pharmaceutical industry preys on people who are facing challenges and pushes pills down people's throats for profit. I believe that in the coming decades, we will look back at this era of pharmaceuticals for mental illness as being deviously sinister and harmful, the same way we look back at bloodletting or lobotomies today. I wonder who funded the publication of this textbook, and I cynically believe it must be big pharma or people in cahoots with that industry.
As a counselor, I am very aware that my bias is against medication. I need to have continued self-awareness of this and not judge people who are working with medication or seeing benefits from medication. I can potentially do this by realizing maybe that I was one of the few lucky ones who was able to recover my own mind and no longer need to rely on medication and that so many other people are not that lucky and need medication to have a shot at life. For these people, I hope to champion new technologies, such as AI-assisted therapy, nanotechnology, or neuroscience, that don't use drugs. Furthermore, I can advocate for more innovation in public or private services and increase the awareness of mental illness to rally more people to join the search for innovative solutions. I also wonder if we can affect policy change to stop big pharma's ability to advertise directly to consumers.
For me, simply stopping alcohol and drug use was number one and was a game changer. My moods, within months of stopping, really leveled out. Furthermore, talking through the trauma I faced with a therapist helped me reconcile it. I was also able to adopt a spiritual mindset. I augment this mindset with a regular reading practice, a community of fellow spiritualists, and a daily meditation practice I have followed for 6 years. I eat healthy, get more sleep, and have built secure and healthy friendships and relationships. Thinking clearly and rationally instead of jumping to conclusions. Being authentic and patient. All these things cured the Bipolar II that I never really had anyway. It makes sense that someone's mood fluctuates if they are being abused and taking drugs a lot. Resolve those issues, and the problem will go away.
