Bipolar Expeditions Read Free

circumstances so that medications could be adjusted, to gather information about the comparative side effects and benefits of various drugs, and to assiduously develop structured life habits (diet, exercise, sleep, mood charting, or recreation) that help optimize moods.
    Doctors often shared this desire for patients to monitor themselves. Publications well known among support group members, such as psychiatrist Peter Whybrow’s A Mood Apart, describe the importance of self-monitoring in manic depression. Whybrow enacted the thoughts of a hypothetical patient for me in an interview.
    If I look back over the last week, I’ve had increasing shortened sleep, my energy is beginning to pick up, I’m thinking faster, and I’m interrupting people. There’s no reason why a thoughtful person can’t say, “That’s the beginning of the mania—I’m going to increase my lithium, and I’m going to insist that I stay in bed even though I’m not asleep, for seven hours. I’m not going to go out tonight and stay out until two a.m.,” and so on. So individuals then become their own gatekeepers.
    Whybrow is imagining the patient detecting the early symptoms of a manic episode and taking measures, medicinal and behavioral, to prevent it from entering the “gate,” that is, becoming full-blown.
    In contrast to their reticence in support groups, people use Internet newsgroups devoted to manic depression to delve into the effects of drugs and drug interactions, comparing their experience and knowledge. In this context, many people clearly see the manic-depressive person as the “manager” of the shifting cocktails of drugs that have become the preferred mode of treatment for their condition. For example, one writer responds to a message in a newsgroup on manic depression from a person who is considering not taking her medication anymore in the following way:
    First of all I understand how in times of distress and frustration your drug therapies are seemingly useless and pointless. However if you were only diagnosed in May of this year you couldn’t possibly have tried even a majority of AD’s [antidepressants] because many if not most require a 4–6 week optimization period. Others require increases in titration in 2 week intervals after assessment. I’ve been through about 14 different AD’s over the past 3 years and I’ve still got tons I haven’t checked out. The point is that don’t give up on thinking you’ll find the right cocktail blend for you no matter how concerned and impatient you are for results. Bipolar isn’t like a normal situational anxiety that is often medicated by tranquillizers. We’re talking about finding the right control and balance of Serotonin, Norepinephrine, Dopamine. That all takes time and can be masked and distorted by the use of other over the counter meds, alcohol, [and] caffeine, not to mention other social drugs. 6
    This message, another example from an Internet newsgroup, responds to a person who had an unfortunate experience with her psychiatrist.
    A person can have a biochemical imbalance, but that doesn’t mean that the rest of the world is sane. For me, getting my biochemistry stabilized makes it easier to cope with an insane world. That doesn’t mean it numbs me to the reality of how messed up my environment is. On the contrary, it gives me the stability to cope with it, and the energy and focus to do what I can. I have my own biases too. For years, I subscribed to the “willpower, not pillpower” theory. Somehow, I thought it made me less of a person to be a “mental patient on mood stabilizers.” I blamed all my problems on a bad environment and a messed-up personality. I hated myself for not being able to control my moods no matter how hard I tried, and it seemed like just as I had things under control, for no reason at all I’d lose control again. One therapist