My mood episode is under control, when can I stop taking these pills??

The following question was posed by one of our blog readers: 

“If I start taking medications for bipolar, will I have to be on them my whole life?”

The answer, unfortunately, is often yes. There are some great treatments for bipolar disorder that can keep the illness under control, and maintaining that control is the best thing you can do for your health, your relationships, and hopefully your life overall.  

We can learn about the natural course of untreated bipolar disorder by looking at how the illness progressed back in the days when there were no medications to treat it at all.  Observations showed that some people would end up spending ten or more years in a depressive episode.  As the illness progressed over time there would be more and more episodes, with shorter and shorter periods of healthy stable mood in between. Luckily, this no longer has to be the case.

 

But it can be a scary and daunting thought to imagine taking a medication for your whole life, especially when there are side effects that you are having difficulty with. 

On the positive side, many studies have shown that the earlier and more comprehensive the treatment for a mental illness, the better the response.  This isn’t too different from what we would expect from any other chronic illness, like diabetes or heart disease.  Studies have also shown that mood stabilizers are actually good for the brain and can protect it. For example, lithium increases the amount of gray matter in the brain (i.e., brain cells) of bipolar patients.

Here is an article that talks about this in a bit more detail.

However, if the side effects are just too intolerable for you to imagine a life on your particular medication, that probably means it’s not the right medication for you. I always hope that my patients will be honest with me about how they really feel about the medication—I won’t take it personally if you hate what I prescribed you!  Your doctor should make you feel comfortable to express your opinions about the medications, and you should always discuss with him or her before making any changes or stopping any medications-- to be on the safe side.

Dr. Mednick