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Tuning Knobs To Medicate or Not To Medicate? The answer to this question is obvious when one can not function outside an institution, or the answer is more obvious. But now lets fine tune this problem some more. Lets say you got some meds that work well enough you can function outside an institution ... And yet you cycle high and low, or even have an occassional severe episode. At what point do you go asking for more or different meds? We know the meds can turn us into zombies at certain levels (or I do). Where is the trade off between those cycles and that zombie condition? Or take that severe episode and the emergency meds - where is the trade off there? To ride it out or be knocked out? I am looking for as high a quality life as is attainable - which is some sort of delicate balance between Bipolar wrecking havoc on my mind and life versus medication wrecking havoc on my mind and life. Linda Linda, Anyone who accepts their "condition" and wants to manage it, instead of having it manage them, thinks much the same thoughts as you. It comes down to an individual decision based on a few key areas: 1. How self managed you are - by this I mean how good you are at doing the things that are required to be a "good" Bipolar (track key indicators, keep informed...). 2. How bad your condition is - If we agree that everyone's condition varies in severity (like blood pressure - some is higher than others), then I believe that an individuals medication options directly relate to the level of their condition. 3. What your life expectations are - If you want to be the next corporate rising star, it might be hard to not be on some kind of medication program. If your goal is to do the best you can with what you have been given, then you may have some options. Perhaps some examples Managed - high, Condition - low, Expectations - low = Minimal Medication Managed - low, Condition - high, Expectations - high = Must Medicate Suzie Suzie, This is excellent stuff here as I can envision 3 tuning knobs. 1) self managed 2) condition or severity of symptoms 3) expectations For me, I went undiagnosed for decades - I believe because my symptoms were not severe enough for me to complain. Looking back, I can see them, but I got by. This is no longer true. Bipolar would kill me given half the chance. So my middle tuning knob went from low to high over time. I would love for it to go back, but for now, that hasn't happened. So my point is these 3 indicators are not set in concrete. The tuning knob can turn or be turned. Likewise with self managed or expectations. I am just beginning this pathway of living with this beast. I am better then I was, but not as good as I can be, at self managed. The tuning knob turns. Expectations were high and are now low - I am looking for the baseline that allows me to live free of an institution. Again the tuning knob turns. So in thinking of your tuning knobs and the 2 medication scenarios I proposed (more meds, or status quo) when the condition or severity of symtoms knob turns higher, I turn up the self managed and turn down the expectations. It is not until I can no longer turn up the self managed and turn down the expectations, that I need to go for more medication. A truly great descriptor because that is precisely what I am coming to realize I can do to avoid more medication. Turn up the self managed, turn down the expectations - ride it out and then maybe those dials can be twisted the other way. These are not static knobs, they constantly change. Linda, Simple tuning knob box made with dimmer switches and light bulbs. Linda, The theory on this is that the better you get at the self managed knob, the more potential you have for the "condition or severity of symptoms" knob getting turned down. As a result, you can turn up the "expectations" knob. For many, after their first break #1 is very low, #2 is very high, so #3 has to be set very low. This is very difficult for anyone to accept. When folks do, and take the approach you mentioned, they start back on the right path. Believe it or not, this can open up new doors in anyone's life, and although they may not be the same person they were before being diagnosed, they end up learning to like the person they have become. Susie Susie, Practical experience had me start out with #2-condition/severity mid way, #3-expectations very low, and #1-self managed just off mid way, lower then #2-condition/severity. When #2-condition/severity went up, all I could do was turn down #3-expectations. I needed to increase my #1-self managed skills. I see now that #1-self managed is always maxed to the most that I know, while #2-condition/severity is mid way, and #3-expectations is very low. When #2-condition/severity has to increase, #3-expectations is reduced. This is similar to calling in sick to work (reduce #3-expectations) when you are sick (#2-condition/severity increases). The key in any case is how #1-self managed you are. Linda

Recommended Reading - Must Reads For Bipolar's and Their Families

Cognitive-Behavioral Therapy for Bipolar Disorder, Second Edition Absolutely the best description of Bipolar Disorder I have read anywhere. An excellent read for giving your mind a chance to over come mood.	The Bipolar Workbook: Tools for Controlling Your Mood Swings By the same author as Cognitive-Behavioral Therapy. This is the CBT workbook I have needed from the beginning. Truly non-pharmaceutical Mind over Mood stuff - that works.
An Unquiet Mind: A Memoir of Moods and Madness An easy, quick read that both the person with Bipolar will recognize themself in, and their loved ones will recognize what Bipolar Disorder is. Kay Jamison both has Bipolar Disorder, and is a Psychiatrist. If you read no other book - read this one.	Wellness Recovery Action Plan Wellness Recovery Action Plan WRAP - the most self empowering recovery method I have run across anywhere.

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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