How Treatable or not Treatable is Bipolar Disorder?
This essay was written by myself. My name is Linda. Greetings. I was motivated to go find the actual statistics on how treatable or not treatable Bipolar Disorder is; by a series of questions I began asking. I have been studying the statistics hoping there was some magic answer in them. If there is, I haven't seen it. Oh, there's an answer - it's just not magic. It turns out we (Bipolars) are all different. These are the statistics. Bipolar Disorder is a lifelong chronic illness. Bipolar Disorder has no cure. Okay, let's move on. Bipolar kills. Someone is going to treat us. We'll see to it and we won't stop till we find someone that can help, right?Per the Texas Implementation of Medication Algorithms Bipolar Disorder Guidelines Manual In April 2002, the American Psychiatric Association published its new Practice Guideline for the Treatment of Patients with Bipolar Disorder. Significantly, the Guideline though at the same time acknowledges both the severity and the long-term course of this illness by emphasizing the need for the psychiatrist to establish and maintain a therapeutic alliance with his or her patients.
A patient is considered mood stable on their current medication regimen when they have a full response as determined by a greater than 75% reduction in symptoms, are tolerating the current medication regimen and have returned to their previous level of functioning."What? Treatable and mood stable is not the same thing! Huh? Per the article Building Foundations Toward Recovery in Bipolar Disorder prepared by Martin L. Korn, MD as a Medscape Continuing Medical Education activity: Although bipolar disorder was originally seen as a disorder of episodic affective relapses alternating with periods of remission, it has become increasingly clear that this is not the rule. Most individuals with the disorder suffer from chronic symptoms that result in ongoing psychological and psychosocial impairments. Furthermore, the current pharmaceutical armamentarium has increased our ability to effectively treat the disorder, yet polypharmacy and partial remission is often the rule. ... These issues were the subjects of a symposium held at the 2002 World Psychiatric Association meeting in Yokohama, Japan."So, most individuals with the disorder suffer from chronic symptoms ... and partial remission is often the rule. Huh? And treatable is any reduction in frequency or severity of episodes, while mood stable is a 75% reduction.
Futhermore per the same
Practice Guideline For The Treatment Of Patients With Bipolar Disorder from the
American Psychiatric Association - Clinical Resources has this to say: Even during periods of euthymia, patients may experience impairments in psychosocial functioning or residual symptoms of depression or mania/hypomania. It is estimated that as many as 60% of people diagnosed with bipolar I disorder experience chronic interpersonal or occupational difficulties and subclinical symptoms between acute episodes."Does this statistic clear up the matter? Not really, but opens a whole other can of worms. There are 4 presently recognized (by the DSMV IV) Bipolar diagnosis. That of Bipolar I, which was just referred too. That of Bipolar II, that of Cyclothymic, and that of Bipolar NOS (not otherwise specified). The earlier statistics did not differentiate between the 4 diagnosis. Bipolar I is the most severe. We could look at this a few ways. We could lump this Bipolar I statistic in with the statistics referring to all 4 diagnosis grouped together, but that could skew things negatively as far as treatable is concerned. We could wonder about that 80% treatable statistic and how that actually broke out for the 4 diagnosis (like maybe Cyclothymic (less severe) is 100% treatable and Bipolar I is 60% treatable assuming equal populations). But I think what I am going to do is use it as further evidence that treatable and symptom free are not the same thing.
I have not found exact numbers (nor maybe is there any), so if we take a simple equal spread of 20% not treatable at all, 20% get a 25% reduction, 20% get a 50% reduction, 20% get a 75% reduction and are considered mood stable, and 20% get a full remission. Using this spread it is easy to see where chronic symptoms and partial remission is the often the rule, rather then the exception.
Or an equally reasonable spread would be 20% not treatable at all, 10% get a 25% reduction, 40% get a 50% reduction, 10% get a 75% reduction and are considered mood stable, and 20% get a full remission. Also with this spread it is easy to see where chronic symptoms and partial remission is the often the rule, rather then the exception.
So while the treatment is very likely to work (80% chance), once they have found a treatment for you (one that works at all - it's often trial and error till you get this far) - that treatment has equal potential to simply make you feel better (less than 75% reduction in symptoms), as to make you well - mood stable (greater then 75% reduction in symptoms).
I wasn't told this as a person with Bipolar Disorder, and what public awareness there is doesn't seem to understand we may be still symptomatic despite the best of treatments, and even the symptom free Bipolars don't seem to understand this. This knowledge has been liberating for me, because now I know that medication might not fix it, and I know why I can't work. I am too symptomatic. The doctors give us a diagnosis of our untreated Bipolar Disorder. Then we come under treatment. Most of us have residual symptoms to some extent. It is those residual symptoms that govern our quality of life - not how mighty the original diagnosis is. Now granted, you might not be on the right meds, but you also may be on the only meds that worked at all, for you. p.s. I hope the links work for you. They work today, but you know how links go. |
Cognitive-Behavioral Therapy for Bipolar Disorder, Second Edition
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The Bipolar Workbook: Tools for Controlling Your Mood Swings
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An Unquiet Mind: A Memoir of Moods and Madness
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Wellness Recovery Action Plan
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My name is Linda. I welcome your feedback.
However, please be gentle and speak softly.
Ordinary real life rocks my mood, and I really
don't need Internet email, to set off a mood episode in motion - you know what I mean?
I look forward to hearing from you, and if I can be of help in any way, I sure will try.
Disclaimer
The intention of this site is to provide understanding, information, and commentary. The diagnosis and treatment of Bipolar Disorder requires trained medical professionals. The author of this site is NOT a trained medical professional and cannot give professional advice, diagnose, prescribe, or in any way treat Bipolar Disorder. The information here should NOT be used as a substitute for seeking professional care for the diagnosis and treatment of any medical/psychiatric disorder. If you feel you are ill or know someone who may be, seek medical attention as soon as possible.
© Copyright 2003 Linda Fisher™
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