When you’re changing medications, it becomes very clear how much bipolar medication changes suck. Being on the first one(s) sucks and changing to the next one(s) sucks, too. And people not on medication may not get this. They may not get what it’s like to have to take medication for bipolar and they certainly may not get why bipolar medication changes suck.
Why Change Bipolar Medications?
There are several reasons for changing medications in bipolar disorder. (Whether you’re changing a single medication or a medication in a cocktail, it’s pretty much the same.)
The medications aren’t working.
The medications are causing unacceptable side effects.
The medications aren’t working well enough.
The current medications are clashing in some way.
But no matter for what reason you are changing medications, it’s never an easy decision to make and it’s never good news, per se, when that decision is reached.
Bipolar Medication Changes: Getting Off of a Medication
While many doctors don’t recognize it professionally, there absolutely are withdrawal effects when getting off of a medication. This is not true of all medications, but it is for some. What’s more, some people may experience this withdrawal while some others don’t so you can’t anticipate what your withdrawal experience might be. In my experience, the more difficult it was to get on the medication, the more difficult it is to get off it, too. Of course, there are exceptions to every rule.
There are ways to reduce withdrawal effects such as:
Only changing one medication at a time (always a good rule).
Withdrawing very, very slowly – much slower than you think.
Doing a cross-taper where one medication is added slowly as you slowly reduce the other.
Ceasing or slowing withdrawal even further if major bipolar symptoms re-occur.
Of course, no one should try to do any of the above without a doctor’s sign-off.
Bipolar Medication Changes: Getting On a Medication
Similar to getting off a bipolar medication, getting on one can really suck as well. Getting on a bipolar medication often involves withstanding many side effects – often many nasty side effects. The good news is that side effects often go away over time, but the bad news is that they may go away only after many weeks to months.
To reduce side effects when getting on a bipolar medication, slowly, slowly getting on the medication helps a lot. Again, this is much more slowly than you think. Also, starting with a tiny dose is helpful. (Of course, this isn’t always possible as some people are in such distress that they simply can’t wait this amount of time.)
Changes in Bipolar Medication Sucks
In short, between the side effects of getting on a medication and the withdrawal effects from getting off a medication, it’s no wonder that people are scared of changing their medications. I have made changes more times than I can count but I can tell you at this point, that changes scare me more than ever because my balance is just so delicate now.
Nevertheless, it’s important to change bipolar medications sometimes. It’s obvious when you’re in a terrible state that you need to change them but often even when you’re in a so-so state it’s worth changing them because “just good enough” isn’t. Because just surviving with bipolar isn’t enough. Because every person with a mental illness deserves to live his or her best life. Because there often is better, if we can handle releasing a tepid reality.
Of course, it’s also okay to make the decision not to change medications if you just feel like it’s too dangerous for your own mental health. This is a perfectly acceptable decision. Because while side effects and withdrawal effects suck, they do tend to fade. A massive amount of instability, psychosis, etc., is much more difficult to deal with and sometimes it’s just not worth the risk. And no one should judge a person for making that decision.
Check out Natasha Tracy’s book: Lost Marbles: Insights into My Life with Depression & Bipolar and connect with her on Facebook, Google+ or Twitter or at Bipolar Burble, her blog.
Image by Katy Warner from Orlando, FL, USA – rapid release (02-18-08), CC BY-SA 2.0, Link.