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SacredDepravity -> RE: Huge question... (3/21/2013 5:18:41 PM)
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Two things immediately:
1. Many drugs that are routinely used in managing bipolar are anti-seizure/convulsant meds. The way it was explained during one of my psychopharmacology (can't spell today so hope it's right) is that the mood swing that occurs with bipolar comes from basically the areas of the brain controlling emotions begin rapid firing left, right, or both based on the type of episode similarly to how the somatic nerves rapid fire in a person with a more typical body muscle seizure disorder. The meds work by restoring normal firing patterns basically and keeping them normal. It works for some kinds of pain disorders because they are also a rapid firing area of the brain where pain is processed. This is not a traditional anti-depressant medication therapy. It is very specific to the type of firing patterns that are often responsible for bipolar mood shift. That's a waaaaay simplified version, but hopeful it paints the basic picture.
2. ANY drug that changes the way a brain is currently functions tends to have a risk of increasing symptoms depression, etc. Brain chemistry is tricky and dosage and types of drugs as well as when they are taken and how faithfully can have a huge impact on these types of side effects. Also, there is this window that I call the "danger zone" when talking to people who have recently started on a new med where the medication is not a full effect, but is having just enough effect to feel a little more energy. I call it the danger zone because that slight increase in energy combine with still feeling hopeless and all around crappy is prime breeding grounds for a suicide attempt. It means the medication is actually working, but they haven't reached the light at the end of the tunnel. A few more days to a couple weeks later, the person is usually feeling much better and this issue goes away. It can resurface with weaning off of a medication, dosage changes, or missing a dose or several doses.
While I am glad your friend is getting help, I am concerned that the Dr. did not respect her wishes to deal with her condition without drugs. She has every right to not have treatments forced upon her unless she becomes a danger to herself or others. She needs to enforce her rights as a patient and her boundaries in care sooner rather than later or a pattern will be established that she can be bullied into accepting treatments she does not want and may have any number of valid objections to receiving. This is a relationship too and it is time for some communication. I wish her the best in her recovery.
SD
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