Raise the Bar on Bipolar Treatment – Hold Your Doctor to Task
Let me be honest. Even when my treatment is at its best, I never get to the place of zero bipolar symptoms. I’m well, I can handle the remaining symptoms with coping skills, I can be happy but there are always lingering symptoms of bipolar disorder.
And this may be an indicator of being difficult to treat because what we know is that the more you can successfully treat all the symptoms of bipolar disorder, the more likely you are to have fewer relapses. In other words, if you continue to experience bipolar symptoms during treatment, you’re more likely to experience future episodes and we really want to avoid that as each future episode tends to make your bipolar harder to treat.
For this reason, it’s critical to aim for zero bipolar symptoms during treatment, whenever possible.
Can You Achieve Zero Bipolar Symptoms?
It depends on who you ask, but yes, I believe it is possible for many people to achieve zero bipolar symptoms during treatment. Like I said, I’ve never been one of these people, but I believe that many people can.
The Problem with Achieving Zero Bipolar Symptoms During Treatment
The thing is, no one will ever get to the place where they are free of bipolar symptoms during treatment if they don’t try to get there. In other words, if we (or our doctors) simply accept partial sickness all the time, then we’ll never get to the place of zero symptoms during bipolar treatment.
The President of the Depression and Bipolar Support Alliance (DBSA) says it well,
If a person doesn’t achieve zero symptoms, they haven’t failed, but if they are never given the opportunity to achieve that goal, the system has failed them.
So it’s critical to hold you psychiatrist to task. You can’t accept partial sickness and you shouldn’t allow him/her to either. In the military they say, “accepting the suck.” You can’t afford to accept the suck because being sick just leads to being more being sick.
Target Zero to Thrive This April
The DBSA has initiated the Target Zero to Thrive This April campaign. This campaign raises the expectations of bipolar treatment and what we require from our healthcare professionals. This campaign encourages everyone to accept only the best treatment possible. Don’t settle of “okay,” or “good enough,” or “functional.” In other words, treatment is only a true success when you achieve zero bipolar symptoms. Treatment is only a true success when you get the self you had pre-bipolar back.
Now I will grant you that I am unlikely to ever meet this goalpost but that doesn’t mean that I don’t think it’s a worthy goal to have. So what I encourage you to do is to hold your doctor accountable for your best possible health and support the Target Zero to Thrive This April campaign by sharing it on your social media channels. Everyone needs to know that we can do more than just survive – we can live fully. We can thrive.
Well they do say to reach for the stars, because even if you come up short you still would have gone further without trying… With that said, I will say having had Bipolar ii for 8 years, you know the type that doesn’t respond to medication real well, doesn’t really ever let up for more than a moment, and is constantly shifting and on the move, I don’t think I’ll be reaching “zero symptoms” anytime soon… However it is a good pursuit and people without as many “issues” may be able to reach it.
I just want to be happy and be able to focus and work all day without giving out. I’m Ok during the morning and then all of a sudden I just lose all need or want to move forward at all. Nothing gets done I go nowhere my kids, I have 3 they are 17,18, and 22 want to know why I come home from work and go straight to bed I’m just exhausted and want to be left alone. I feel so bad because I love them so much I want to be with them and do things with them but I just don’t have it in me it’s like my bed is my best friend. I had to hire a cleaning lady because I just can’t do it alone. And it seems that no one understands. I get a little better but not all the way or even close.
Zero symptoms? It’s important to understand that everyone’s life, bipolar disorder or not, will include down times. That isn’t a symptom of bipolar disorder that’s a simple fact. I think the zero symptoms is completely unrealistic!!!! Yes, you should work on bettering yourself but not have the expectation you can “beat” this illness. You can’t. It’s for life. It’s important to understand hard times come with life. Don’t run to amp up your medication every time you experience a down emotion. I do agree our system could do a lot better. We can live more fully. Living fully and being “symptom free” are not the same thing at all!!
I am closer than I was for a long time. However, I am a childhood onset case of bipolar I disorder with psychotic features and I also have hyperactive ADHD. The only way I can make the distinction between the two is one is careless and just odd and the other is pressured and takes on a life of it’s own. I have to take meds for both too. Dexedrine will make me quiet so people can’t tell I am manic if it is by itself and just the mood stabilizer (Lamictal with PRN Klonopin) will still have hyperactivity which often creates so much havoc that it sends me into a manic state.
I am on an odd combination for someone with my issues but I only take the Haldol/Ativan for mania and adjust the other meds if it flares up then stop. I don’t do well on long term antipsychotics and Lamictal prevents moods the best in my case oddly. It is useless if I am manic but it stops the switching.
Dexedrine, Lamictal, Haldol, Klonopin and Ativan. Interesting? Speed, Seizure meds, anti-psychotic and two types of Benzodiazapines. All from one doctor? The brain like any chemistry experiment is VERY complicated. One chemical like the mechanical components on the front end on my Jeep effects all the others. Same as trying to extract one substance from an other. Sometimes what your extracting has a chemical structure of greater complexity then the original.
BP one, ADHD and psychotic features. Well in my opinion all these diagnoses are very close to nothing if only guidelines. You brain like mine is very complicated. Much more then your liver, kidneys and so on. If there is a problem there is a problem. Small Pox used to be the Devil now it isn’t. Same will be true of BP and so on. WN
Is bipolar a gift or a curse? For me it was a curse for awhile. I could never get all the symptoms to go away, and traditional treatments only keep people in recovery for periods of time – crisis is inevitable. So I tried something different. On my resource page, I talk about Tom Wootten, who has a program that takes the positive symptoms and behaviors and helps you to take advantage of these; and reduce or eliminate the negative behaviors. Now I can go with sustained mania or depression until I decide on my own to intervene with coping skills and medication to change my mood. I can deal with psychosis now for 3 days before intervening, or regular mania or depression for some time. I’m really at my best now most of the time, no matter what state I’m in. I recommend taking a look at my resource page for more information. This program was world-changing for me. Zero-tolerance is a horrible idea and it just won’t work. Bipolar is no longer a curse for me that I want to eliminate symptoms from my life – it is a gift and a blessing most of the time.
Hi Natasha. First many thanks for your blog. I read it religously.
Secondly i saw in your posts that you give a lot of presentations. I have to give a presentation at a postgraduate seminar next week and i am terrified. I think i will burst into tears mid presentation. I have put on some weight recently because of my meds and have no self esteem altogether. Could you give me some quick tips about how to survive public speaking?
Sorry for my bad English i live in Malaysia, and i am doing my phd in Urban Planning. Thanks again for your blog
Being symptom free sounds like a good goal- but it is really a fine line. I think it is sometimes hard to tease out what are ups and downs that are in response to life and need to be dealt with in one’s life or in therapy, and what is truly a symptom that needs to be hit on the head with medication. Of course sometimes it is obvious if you are off the wall manic, etc. I think that we can develop more comfort with experiences that some would label symptoms. The best thing that a therapist ever told me was that I had been suicidal for so long, I would probably always have suicidal thoughts. I had been waiting for them to go away. This helped me to go on with my life. She was wrong- they eventually got much better, but it took many years, and I am glad I didn’t spend those years waiting.
i’m new to your site and i’m just so happy to have stumbled upon it. i love the literacy and eloquence we bipolar peeps have! but what does “zero symptoms” mean, please? i feel like my meds are a nice cocktail, but i have no basis of comparison – it’s either comparatively asymptomatic or maniacal or depressed. What is this “normal” people speak of? Maybe this is it?
Danger of this approach however is… you start medicating emotions as opposed to actual symptoms. Because if you obsess over your mental health and desire to be “normal” everything becomes a symptom.
Imho medication has side effects serious enough to consider that at least some symptoms you handle with coping skills and alternative strategies. One can actually learn to expand their comfort zone and distress tolerance. As opposed running to your doctor with every little emotional owie. If one learns to body surf the emotion… to a certain degree, they became much lesser deal. (so maybe it’s their version of “zero symptoms”? Instead of freaking out, it’s “oh, well”).
I think that focusing on living well and enjoying life is better than obsessing over every tiny symptom. Especially if you admit it’s unrealistic goal to many.
Right ON, Venus. You make many insightful points. Thank you.
Agree with much of what you say Venus, but I just tried to get off my SSNRI and it didn’t go well. I think I may die soon if I do. Went about three weeks to give it a good try. I’m beginning to believe I have a very bad disease and maybe better drugs may even solve the problem someday, if I live long enough.
I rarely if ever run to my Dr. Little they can due as we are all different and all this chemistry is experimental anyway. WN
May want to be careful with insisting your prescriber assist you in getting to ZERO symptoms, because often times – that would lead a prescriber to “over-medicate” someone. Over medicating does no one any good, not really, not in the larger scheme of things.
It does not assist one’s daily living functions to be drugged nearly out of your mind, in order to just not “feel” today or tomorrow or G forbid, next month.
Also.. if you managed to get ZERO symptoms while in treatment.. then that would mean that you were no longer “actively” ill with the disease and/or disorder. If you are not “actively” ill with it; then you should no longer be considered DISABLED by it… because you’ve achieved ZERO symptoms and therefore are not affected by them in your daily living function.
Zero symptoms is what I call my middling place.
No mood extremes,peace,focus.
Things that would bother be in other moods just don’t during this time.
My mind is quiet.
Ah bliss…
My goal..to have it occur more often.
Yes,every day is indeed a struggle,but @ least here we all share common denominators.
It’s a struggle,but acceptance that you cannot do it alone is crucial.
Here we have a safe haven,to share,and exchange ideas and experiences……
My problem is that I don’t know if I’m achieving zero symptoms during treatment because I’m not sure I’d recognize what zero is. I often find myself thinking about how well I’m doing, but also find myself having certain obsessive thoughts or internal overreactions to things that I know are bipolar responses. But those are “good days” for me – I am content, more calm and peaceful, and I’m able to keep those feelings under wraps. Those feelings are so normal to me that I wonder if they are truly symptoms or just part of who I am.
This is very hard for me to explain and I’m not sure I’m doing a good job with it. It’s an interesting goal – zero symptoms. It’s a hopeful goal.
Me too. What is good sight to someone who has blind their whole life? Or good hearing to the deaf? WN
WN-
I cannot express how important your posts have become to me. You always keep it real. Like Natasha has said although she has never achieved zero symptoms for her, she still puts out the effort. You, too, put out the effort by continuing to be part of the conversation. Even though a blind person or a deaf person is disabled from birth they can learn to read with braille or communicate with sign language. The kicker is there are blind or deaf persons also diagnosed bipolar! The goal is zero symptoms with treatment. Zero symptoms for me will be zero symptoms for you. Never give up, never surrender, and never say never.
Thanks that you appreciate me trying to be honest. Mostly I suspect it just annoys people. I could only imagine what it would be like for someone who is deaf and/or blind to also have BP. As if one isn’t bad enough. I guess what I meant about being blind/deaf was meant about those who have never seen or never heard. I suppose it may be difficult to imagine what having those abilities is to someone who has never experienced them. Same as it is hard for me to imagine not being depressed. Though slightly if not very different as I do remember a little what it was like to be happy when a young child. Those are distant memories and may even make things worse. I’m not sure. A lot like the “is it better to have loved and lost or to have never loved at all” saying. I try to put myself in those situations and have my take on it but as we are all individuals. Who knows?
I get a thought for the day and since you used a saying I thought you might enjoy this one:
Leave No Man Behind…
“Out of every one hundred men, ten shouldn’t even be there, eighty are just targets, nine are the real fighters, and we are lucky to have them, for they make the battle. Ah, but the one, one is a warrior, and he will bring the others back.”
― Heraclitus
I agree that this is a great goal but I believe that the key phrase is “during treatment”. One size does not fit all. A regimen of medications might work for me one day, for example, and I can achieve zero symptoms for me. I go to my group and I feel okay and nothing I hear triggers me that day. However, the stigma from my past behaviors seems to never go away. Life continues and on another day I notice that the meds are no longer doing it for me and when I go to my health care appointment another medication regimen gets prescribed. I know that I will never stop treatment again. I must put out the effort. I must accept my diagnoses. I must never give up and never surrender.