In the first of this series I discussed antidepressants and addiction. Some people contend antidepressants are addictive; however, not only is the term “addiction” not defined medically, the use of antidepressants does not generally match the symptoms of any defined substance use disorder either. (More information on substance abuse and substance dependence.)
This time antipsychotics are up to bat. Are antipsychotics addictive? Are people dependent on antipsychotics? Do antipsychotics cause withdrawal?
As I mentioned, people with bipolar type II spend 35X more time depressed than hypomanic, and yet there are very few treatments available.
As we discussed last time, the neurotransmitter glutamate and the inflammatory complex are two new, badly-needed areas of bipolar depression treatment research. Here are three additional bipolar depression treatment areas you probably don’t know about: diet, antioxidants and modafinil.
People with bipolar disorder 2 spend 35 times more time depressed than hypomanic. As a person with bipolar type 2, I can tell you how true this is. Bipolar type 2 is more like a depressive disorder than a bipolar one. However, this doesn’t mean bipolar disorder 2 can just be treated like unipolar depression. If only life were that simple.
Bipolar disorder type 2 depression treatments must not induce hypomania or mania, and antidepressants used alone often do that. For this reason bipolar 2 depression treatment is generally like happy hour (full of cocktails). And many of us are very frustrated with the fact no new medications are being developed for our mental illness.
So here’s some hope. Here are five bipolar depression treatment areas you probably don’t know about.
I recently received a couple of comments on the antidepressants and dependence / addiction post from Tabby. My response to her second comment ended up being so long I decided to put it in it’s own post.
Here is an excerpt from Tabby’s comments (edited for length). If you would like to read them in their entirety, please see here and here. (Symbol […] indicates removed text. Other ellipses are from the original text.)
Comment on Are Antidepressants Addictive?
I know of people who cannot go not 1 day without their medication and the medication not be a life saving med like a blood thinner but be a Anti-depressant. They become all anxiety ridden and panic filled because they just know that if they miss that 1 dose or those 2 doses for that 1 day […]
They can’t sleep and they get agitated and they get quite vile until they get that dose or doses. They resort to sobbing, they resort to melodrama of threatening suicide…
[…] I’m talking a cymbalta, or a lexapro. I work in a MH agency and we have patients call cause they’ve gone 1 day without their prescription. […]
I am also one with Bipolar and when your entire day, or entire life, is solely dependent on whether you took your pill or pills that 1 day… I dare to say, you have a dependence.
Now… you have blood clots and you miss 1 day of your blood thinner.. then we may have a major issue. You miss 1 day of your Seroquel, or your Cymbalta, or your Depakote… seriously, it will be okay… if not, use your psychotherapy techniques. Oh, that’s right… not too many actually do psychotherapy… it’s all the meds baby.
[…] I am well aware of the benefits of medication compared to no medication for those with Mental Illness. My point was – too many people seek out the comfort of the medication to handle their daily life’s issues […] than to try and work on figuring why they are having the problem in the first place.
Folks do not wake up, naturally, anxious. Something has to have occurred to trigger that emotion and anxiety is an emotion that triggers a physical response. Yet, too many run to the cabinet and down pills to “calm” the anxiety rather than try to do something else non-medicated that […] The first reaction is to kill the emotion/feeling… not to try and figure why it’s happening.
No therapy doesn’t work in all settings or all situations but if you never try, then it will certainly never work. In that your blogs are predominately med supporting… I could say that you mock those who try to use more psychotherapy than meds.
Seroquel and Depakote are not equivalent to Warfarin or some of the other medications needed for literal body functioning. Yet, if you have been on a med for a long period of time, for example Seroquel to put you to sleep every night.. and then suddenly you miss a dose or 2… YOU WILL HAVE SYMPTOMS. That’s med dependence and you’ll have a psychological dependence because you’ll become frantic wanting your med.
[…] Many folks suffer with their Bipolar symptoms, or any MI symptom, long before they ever take the 1st pill. So, the life-saving aspect is only a “feeling”.
I know the meds help but have they literally saved me? No. They take away the uncomfortable and the frightening… but they don’t keep me from dying. If they were the sole and only reason, then I’m a walking med cabinet.
Even folks that take a plethora of meds, every single day and swear on a stack of their most revered book… still kill themselves […]
Thanks Tabby for your response. I think your thoughts on the issue represent a perspective of many.
I didn’t want to be an addict of any sort as I’m quite familiar with the horrors of addiction, having addicts in the family.[push]Will I get addicted to antidepressants?[/push]
Busy. Crazy. Crazy busy. New antipsychotic. You know how it is.
Mental Illness Articles You Should Read
As per the usual, however, I plow through my own research materials like a crazy person possessed. So I do know of many excellent articles you should be reading.
Check out these articles from Breaking Bipolar and other great sources:
Schizophrenia Awareness Fights Fear and Stigma – This is a video embedded in a post at Breaking Bipolar and has been quite well-received. Please take a look at this short piece and learn something about a mental illness that most people irrationally fear.
Do Mental Illness Diagnoses Matter? – Sometimes people argue that diagnoses are too broad and overlap too much. I’ve even heard of doctors not wanting to tell their patients their diagnosis because they don’t want them “hung up on it.” But I argue that even if ill-fitting mental illness diagnoses do matter. (Also read a good piece about addiction terminology. Did you know “addiction” isn’t in the DSM?)
Doctors Asking Questions About Suicide – Sometimes it seems like the questions doctors ask about suicidal thought are useless, but I don’t think they are.
Making You Want Something You Didn’t Know You Needed
I despise drug ads. No one should be interrupted from watching the season-finale of House only to have a picture of a highly unkempt woman on a couch quickly to be turned into vital young dream girl thanks to the latest wonder-pill. That is absolute poppycock.
Colman et al. showed those who took antidepressants had better depression treatment outcomes than those who didn’t, eight years later, once confounding variables were taken into consideration.
I’ll now point out the strengths and weaknesses of this study as well as some other interesting tidbits shown or cited in the study. Oh, and I’ll give my opinion on what it all means.
Recently the controversy over long-term outcomes of those who use psychotropic medication has flared up again. Some people argue depression/bipolar/mental illness patients do the same, or better, when they don’t take psychiatric medications long-term. However, the statistics they use to assert this claim are often faulty.
A study from Calgary, Alberta, Canada (yes, we do research up here too) has attempted to fix some of the bias seen in other long-term depression treatment outcome statistics. I’ll cut to the chase for you:
Over the course of eight years people with depression who took antidepressants had better outcomes.
One of the crazy things that will happen to you when you seek treatment for being crazy, is doctors will ask you what treatment you want. Usually your psychiatrist/doctor will give you two options: Would you like to try psych med A or psych med B? This provides the mirage of control over your mental illness and your mental illness treatment.
Frustration, thy name is bipolar.
Patients Choosing Psych Meds has an Air of Hilarity to It
This choice, of course, is ridiculous.* How should you know which medication to pick? They’re the doctor, the fancy psychiatrist, aren’t they supposed to know?
What criterion could you possibly use to pick a psychotropic medication that would conceivably compare to an actual doctor?
One of the problems with the antipsychiatry movement is they assert all of psychiatry, all doctors, all science is lying, pretty much all of the time. Any biological evidence for mental illness must be wrong, because if it isn’t, then psychiatry might make sense. Any evidence that antidepressants help a brain must be wrong, because otherwise antipsychiatry views might come into question.
But seriously, does any rational, thinking person really believe all of science, all over the world, is lying?
Hot on the heels of my post about the neurobiological evidence for major depressive disorder comes this: the first blood-based diagnostic aid for schizophrenia.
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