Why People Stop Taking Medication in Bipolar Disorder
Can bipolar disorder be treated without medication? Yes, most definitely. Bipolar disorder involves extreme mood swings, going back and forth from low or depressed mood to one of elation or mania. The low mood can make you unable to function at work and in other areas of your life. Mania makes you extremely energetic when you can accomplish a lot of work, but it also puts you at risk of making injudicious, reckless and risky decisions. Also, if the mood is too low or too high, it can lead to psychosis in the form of delusions and hallucinations.
The Royal College of Psychiatrists finds that nearly 1% of the adult population experience symptoms of bipolar disorder at some point in their life. As per the National Alliance on Mental Illness (NAMI), around 2.6% of people in the US suffer from bipolar disorder. Out of these, around 83% of cases are severe. Typical age of onset is 25 years.
As of now, there is no cure for bipolar disorder. However, it can be managed quite effectively with proper treatment. In addition to medications, there are a few other therapies that can also be very helpful.
However, more than 60% of people diagnosed with bipolar disorder stop taking their medications at some point. This is often due to the unpleasant side effects those drugs cause, drugs such as the mood stabilizer lithium and antipsychotic olanzapine. These side effects include dizziness, diarrhea, slowed down movements and considerable weight gain. Added to this, the success rate of medication regimes deployed in bipolar disorder is just 33%. For instance, lithium is helpful only in one out of seven patients. And, lithium is a very toxic drug that damages the kidney, often leading to kidney failure.
Luckily, there are a lot of other alternatives available to manage bipolar disorder, such as:
- Lifestyle modifications
- Alternative therapies
Psychotherapy is one of the more effective ways of treating bipolar disorder without medication. Hence, you can say yes to the question “Can bipolar disorder be treated without medication?”
Cognitive behavioral therapy (CBT) is helpful in tackling the symptoms of bipolar disorder.
A 2017 meta-analysis showed that “CBT is effective in decreasing the relapse rate and improving depressive symptoms, mania severity, and psychosocial functioning.”
These effects of CBT were “mild to moderate,” and the improvements were most significant if a person attended sessions of 90 minutes or longer.
CBT helps you to identify negative and harmful thinking patterns and behaviors, and to substitute them with more positive ones.
Family therapy can help family members to learn how to communicate effectively and calmly, and also reduce overall stresses in relationships. Psychotherapy can also provide valuable psychoeducation for problem-solving, building resilience, and developing self-care habits.
Lifestyle modifications’ success in treating bipolar disorder is another reason to say yes to the question “Can bipolar disorder be treated without medication?”
There are some simple lifestyle modifications that you can make, which will go a long way in bringing your bipolar symptom sunder control and improve the overall quality of your life.
Bipolar disorder could upset your sleep quality and rhythm. For instance, when you are undergoing the manic phase, you tend to hardly sleep at all, feeling refreshed even after a few hours of sleep, while during low moods you may end up sleeping long hours. But, without good sleep your mood can worsen. Hence, to get proper sleep, you need to practice good sleep hygiene in the form of:
- Go to bed and get up at regular hours
- Make sure the room is comfortable
- Avoid screen time and any stressful activities before bedtime
- Do not eat a large meal close to bedtime
- Avoid or limit caffeine and alcohol intake, particularly at night, close to bedtime
If the above measures do not lead to good sleeping patterns, then consult your physician.
Have a Healthy Diet
A healthy diet is an important component of lifestyle modifications that are helpful in bipolar disorder.
A 2011 study showed that nearly 68% of people with bipolar disorder were overweight or obese. In addition, they were found to be at higher risk for diabetes, cardiovascular disease, and diminished bone density. A healthy diet and regular eating habits can set right these problems.
A healthy diet means:
- Eat at regular intervals of time
- Ensure your diet is well-balanced, with variety, and includes plenty of fresh vegetables and fruits, whole grains, lean meats, cold-water fish, eggs, low-fat dairy, soy products, and nuts and seeds.
- Avoid the “Western” style diet, which is rich in red meats, saturated fats and trans fats, and simple carbohydrates.
- Avoid high-carbohydrate diets, which can crash your moods.
- Limit your fat and sugar intake.
- Avoid mood-damaging foods, such as chocolate, caffeine, and processed foods.
- Space your meals out through the day, so that your blood sugar never dips too low.
- Prepare and stick to a meal plan for the week
- Incorporate new recipes in your diet to ensure you stick to your diet regime more easily.
Moderate and regular exercise helps in balancing mood and also prevents obesity. Research shows that exercise can help you improve your low moods.
Reviews published in 2015 and 2016 showed that exercise is “a viable and effective strategy to deal with the depressive phase of bipolar disorder” and “was associated with improved health measures, including depressive symptoms, functioning, and quality of life.”
Aerobic exercise such as running, dancing, swimming, or climbing, all activities that keep both arms and legs active, are very effective at improving depression symptoms. Exercise at least 30 minutes a day. Ten minutes here and there can also be just as effective. Walking is a very good choice for people at all fitness levels.
People having bipolar disorder are at higher risk for getting involved in addictive behaviors. A study shows that 56% of people with bipolar disorder were addicted to alcohol or drugs at some point.
Certain brain circuits propel you to pursue rewarding experiences by giving you a high each time you do so. One study suggests that these circuits are more activated in people with bipolar disorder. This could be the driving factor behind their indulging in risky behavior, where you focus on the short-term rewards, overlooking the inherent long-term risks.
Drugs such as ecstasy, amphetamines, and cocaine can trigger mania, while tranquilizers and alcohol can trigger depression. Even moderate social drinking can derail your emotional balance. Substance use also disturbs your sleep and may cause dangerous interactions with your medications.
To avoid getting addicted:
- Become more aware of tendencies to engage in risky behaviors
- Seek help if you already have a problem in this regard
- Seek the support of friends and loved ones for making healthy decisions. For instance, friends who are clued into your risky behaviors, might persuade you to go see a movie instead of going to a bar or casino on your night out.
Stress can trigger episodes of mania and depression in people with bipolar disorder. Hence, keeping it under control is vital.
Avoid stress by knowing your limits, both at home and at school or work. Do not take on more than you can handle and take time off if you feel overwhelmed. Relaxation techniques like deep breathing, yoga, meditation, and guided imagery can be very effective in reducing stress.
Don’t Isolate Yourself!
Isolation and loneliness can cause depression. Hence, maintain regular contact with supportive friends and family members. Reaching out to others is not a sign of weakness. It is important that you have people you can count on to help you through rough times.
Join a Bipolar Disorder Support Group
Spending time with people who are experiencing similar symptoms and problems as you can be very therapeutic. This is because they know what you are going through and can honestly say they have “been there”. You can also benefit from their shared experiences and use the advice coming from the group members.
Managing a Manic Episode
While it may not be possible to prevent a manic episode, you can handle it better by paying attention to any impending signs of a change in mood.
Following are the tips to help you with this:
- Consult a doctor, if the manic episode occurs for the first time, or if you have discontinued treatment, or if treatment is not working.
- Keep up regular appointments with your doctor for proper adjustment in doses of medications from time to time.
- Stick to a healthy sleeping pattern and avoid unnecessary stress as far as possible.
- Eat a healthy diet and get regular exercise.
- Avoid alcohol and drugs.
- Track your feelings and moods.
- Share with people around your symptoms and seek their support.
Alternative therapies are another reason why you can say yes to the question “Can bipolar disorder be treated without medication?”
Some people suffering from bipolar disorder resort to herbs and supplements to find relief from their symptoms. Always consult your doctor before starting any alternative therapy. This is because some alternative therapies can adversely interact with other drugs, and they themselves can have serious side effects. The FDA does not regulate herbal products and supplements. So, exercise caution and buy only from standard and reputed outlets. Otherwise, you may not know exactly what you are buying.
Omega-3 Fatty Acids
The omega-3 fatty acids extracted from fish oil can help in bipolar disorder. There is evidence that bipolar disorder occurs less in countries where people consume a lot of fish. People with depression also tend to have lower blood levels of omega-3. It is best to consume omega-3 fatty acids in their natural form. You can increase your intake of omega-3 fatty acids by eating cold-water fish such as salmon, halibut, and sardines, soybeans, flaxseeds, canola oil, pumpkin seeds, and nuts such as walnuts.
Magnesium has been postulated to play a role in regulating mood and makes some medications work more effectively. Hence, some doctors recommend magnesium supplements. You could get your daily dose of magnesium by taking a multivitamin-multimineral supplement daily.
Vitamins like folic acid and vitamin C might help in mood regulation in bipolar disorder. However, the evidence for this is weak. More studies are needed to confirm their benefits in bipolar disorder. Note that green leafy vegetables have high content of folic acid, and citrus fruits are high in vitamin C.
Thus, we have seen many reasons above as to why the answer to the question “Can bipolar disorder be treated without medication?” is a definite yes.