July 14, 2014

Mental Illness Q&A: Medication Doesn’t Work for Bipolar Disorder. ~ Gabe Howard



*Disclaimer: Elephant Journal articles represent the personal opinion, view or experience of the authors, and can not reflect Elephant Journal as a whole. Disagree with an Op-Ed or opinion? We’re happy to share your experience here. 


Dear Elephants,

Welcome to this week’s Ask Me Anything: Mental Illness Q&A! My name is Gabe Howard and I am a man living with severe bipolar and anxiety disorders. To submit questions of your own, please email me at [email protected]. I answer all my e-mail, although not all questions will be published. Questions that are selected for publication will always remain anonymous. I enjoy reading your thoughts in the comments section. Be respectful, but don’t be shy!

Dear Gabe, 

My son is 33 and a college graduate diagnosed with bipolar disorder with psychotic tendencies. He has been on many meds, but none seem to work for him.

What was your turning point and do you take any medication? Thank you in advance.

Bipolar Meds Don’t Work

Dear BMDW,

I do take medication and the “turning point” took years.

It was at least two years before I started to approach wellness and every bit of four or five before I reached where I am today. There was no “A-ha” moment for me; I just kept moving forward, every day, a little bit at a time. And honestly, sometimes I would go backward. It was analogous to a yo-yo on an escalator.

I was moving up and down, but the escalator continued upward. That was what my progress looked like.

I know firsthand that medication can be challenging. However, when folks tell me medication doesn’t work, I point out there are over 300 approved psychiatric medications and people with severe mental illness (such as bipolar disorder) often need to take more than one.

I, for example, am on five different medications. Using 300 as the estimated number and assuming your son also needs five meds, then he has 19,582,837,560 potential combinations before he can be certain that medications won’t work at all for him.

It is important to note that medication isn’t prescribed randomly.

A doctor gathers data and makes educated choices about dosages, medications, and therapies. The way an individual patient responds to each medication provides a wealth of data for the doctor to use to determine how to move forward. It is highly unlikely that you will need to try more than 10 to 15 different combinations.

However, this is a time-consuming process. Given the limits of medical science as they exist today, it should be. People aren’t lab rats and we shouldn’t tolerate a system of care that just loads people up with the first medications that come to mind. We want the right medications, not just any medication.

All of this can be overwhelming and that is understandable. This is a complicated and potentially deadly illness. The way medication is prescribed is a long process. It needs to be a long process.

Each medication takes approximately six weeks to reach therapeutic levels in a person. Each medicine needs to be prescribed, typically, one at a time. So, assuming my doctor was able to prescribe each medication perfectly, it would have taken 30 weeks, over six months, to reach the perfect medication combination.

We also have to factor in the time it takes to learn the limitations of the disorder. It also takes time to acclimate to the medication and any limitations or side effects they caused. I also gained valuable insight from experience and therapy.

I believe that many people don’t realize this illness has to be fought daily. I sure didn’t. The first year of my diagnosis, I was devastated every time a medicine didn’t work. I felt personally responsible. I felt like a failure. I was sick, hurting, and desperate and I didn’t know what to do. I judged myself. Harshly.

Society is already judging the illness; let’s not judge the treatment as well.

There are no easy answers. It takes hard work, determination, and patience. Most people with bipolar disorder and other serious mental illnesses will need medication to reach recovery.

I am aware that the internet has many stories of people managing bipolar disorder without medication and I wish them all the best; but it is the exception, not the rule. We need to consider the internet has stories of people surviving sky diving falls without parachutes, as well. I don’t recommend it.

We need to consider that discouraging people who are sick from seeking appropriate medical treatments is helping no one.

Mental illness is a medical illness, and it needs medical intervention. What that medical intervention looks like is between the patient and their doctor. It shouldn’t be between the patient, their doctor, and society.

I firmly believe it is the judgmental, discriminatory, and stigmatizing actions of our society that is making people wary of treatment. Taking medication is a daily reminder of all that criticism. It is a difficult thing to accept and adds yet another layer of “symptoms” to an already complicated and painful illness.

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Editor: Catherine Monkman

Photo: Bark/Flickr

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