When I was diagnosed with bipolar disorder in 2003, I knew nothing about pharmaceutical treatments or how they worked.
I believed that prescribing medication for psychiatric disorders was an exact science, so I assumed the first medications prescribed to me would be the perfect regimen. My unrealistic view of how psychiatry and medication worked set me up to be very disappointed.
My First Experience Taking Bipolar Medications
When I was discharged from the hospital where I was diagnosed, I walked out holding two prescriptions that I assumed would fix everything. I truly thought all I needed to do was take my medication as prescribed and I’d get better immediately.
I filled the prescriptions the same day I was released and took them exactly as prescribed. I was determined to get well. The time I spent in the psychiatric ward -- equal parts scary and eye opening -- had convinced me that I wanted no part of being sick.
The first week or so on the meds was uneventful, but then the side effects started. My mouth was dry all the time, and I craved liquids. After I took my “night pills,” I would babble incoherently before falling asleep. I was groggy during the day and didn’t feel quite like myself -- and not a better version, either. None of this made me feel better.
The bipolar symptoms changed, but they didn’t go away. I felt different, not better. The depression started to settle, and I could sense the familiar suicidal thoughts start to creep back into my subconscious. All I could think was, “What’s wrong with me?”
It never occurred to me that the medications could be wrong, that my doctor needed to re-evaluate me. Moreover, it certainly never occurred to me that bipolar disorder was a lifelong illness that needed to be continuously managed. Because of my lack of understanding, all I felt was failure, disappointment, and fear.
How Prescribing Bipolar Disorder Medications Works
Almost a year after my diagnosis, after going back and forth to the doctor several times and being prescribed different combinations of medications, I finally broke down crying in my doctor’s office and asked what was wrong with me. He looked at me a bit puzzled and asked what I meant.
I explained that I was taking my medications as prescribed and I wasn’t getting better. “Every time I leave your office, I fill the prescription and take the medications perfectly, and yet I always end up back here. I don’t know what I’m doing wrong.”
My doctor finally explained to me that the treatment for bipolar disorder is time-consuming and involves a lot of effort on the part of both the patient and the doctor. He explained that my responsibility was to show up for the appointments, take the medicine as prescribed, and inform him of my symptoms and any medication side effects.
But I was doing all the things perfectly, so why wasn’t I cured?
“Because,” he continued, “there is no cure for bipolar disorder. Only management. When it comes to managing your illness with medication, we have to try different combinations of drugs, including different dosages. We then monitor the outcomes and make changes until we reach a level that works for the patient.”
I asked him why it was taking so long, and he explained that most people managing bipolar disorder, like myself, need a cocktail of medications. A doctor can’t prescribe them all at once because then they won’t know what medication is having what effect on me.
Each medication takes 6 to 8 weeks to reach maximum efficacy, so this clearly isn’t something that can be resolved quickly. Once this was explained to me, I began to feel considerably better.
Originally, I thought that needing to see my doctor was proof I was an inferior person, destined to remain sick. But I was looking at it all wrong. Seeing my psychiatrist wasn’t proof I was failing -- it was proof I was moving forward.
And as long as I was moving forward, I could reach recovery.