I have been suffering from Depression bipolar2 for last 4 yrs.Tried all the med.What shud I do ?

Question

i am fed up with the depression.All the medicines have been tried by my doctor except ECT.I don't want to go for ECT.Is there any other way to end this deadly disease?

Answer 1

First, before treatment actually starts, you and your doctor must be sure that you don’t have thyroid changes causing your mood problem. This can be done with a simple test called "TSH", which measures the level of "thyroid stimulating hormone". Usually your doctor will also order other tests at this time, if you have not had a recent check of cell counts and blood chemicals, to make sure you don’t have other potential medical causes for your mood problems. Because it is not very common to find a problem using these tests, treatment can start even before the results are back. The doctor is just making sure she/he doesn’t miss something unusual. (Thyroid hormone has also been shown to act as a treatment for bipolar disorder in some cases, so it is important to know just where your "TSH" is).

Now, the three most important principles, in my view of bipolar treatment:

Rely on medications called mood stabilizers.
Strongly consider using one of the specialized psychotherapies for bipolar disorder, if you can find it in your area.
Beware of antidepressants (but do not stop yours now!; you must work with your doctor -- more below -- or things could be even worse).
We'll look at these principles in reverse order now, because I think that "C" is crucial. This is just a quick overview of the basic principles. For more on each of these concepts, take some of the links in each section. But I'd like you to see the "big picture" first.

Principle C: Beware of Antidepressants

This principle is not agreed upon by all mood experts. More details about the role of antidepressants in bipolar disorder treatment, including links to relevant articles that form the basis of the views expressed below, and a summary of an alternative point of view, can be found on the Antidepressant Controversies page.

First, here are the generally agreed upon risks of antidepressants. Even these, however, are somewhat controversial because some doctors think they are not so common; and some think that if they occur, then one simply treats them and continues the antidepressant.

Antidepressants can cause "rapid cycling". Technically this means more than 4 mood episodes per year, of any type (depressed or manic or mixed), but cycles can be as often as every day or few days and a few people can go even faster, so-called "ultradian (more than one per day) cycling".
Antidepressants can cause hypomanic or manic symptoms (sometimes called "switching", meaning from depressed to manic). Overall, this is thought to occur between 20 and 40% of the time when a depressed patient with bipolar disorder is given an antidepressant. Though one review found much smaller percentages, the first study dedicated to looking for this rate came out with a switch rate of 20-30% in the first 10 weeks.Leverich
Antidepressants can cause "mixed states". Remember, bipolar disorder is not like the north and south pole; hypo/manic symptoms can occur while depressed symptoms are also present. In a way, this is the same problem as #2 above, except that instead of switching from one state to another, you have both at the same time. Usually this looks like agitation or anxiety, or irritability; and difficulty sleeping; and depression, all at the same time.
Secondly, here are the more controversial risks.

Antidepressants appear to cause "mood destabilizing" -- increasing cycle frequency over a longer period of time; in other words, having more mood episodes than before, or more rapid switches from one mood state to another. This is regarded as worsening the mood condition overall, making it less stable. This is one of the main concerns expressed by one of the lead experts on this issue, Dr. Ghaemi, whose work is cited extensively in the Antidepressant Controversies essay.

Finally, could antidepressants cause "kindling", in which the illness worsens more quickly with time than it might have if antidepressants weren't there? I don't hear other experts fretting about this as I do, so I won't worry you with it here. If you'd like to hear some more of my concerns, there is a section on "kindling" on the AD controversy page.
Whatever you do with antidepressants, you really need to work closely with your doctor on this. DO NOT STOP your antidepressant; it must be tapered at minimum, if you're going off, or you could -- for sure, I'm not making this up -- actually end up quickly worse. You have to plan this out with your doctor. If you have trouble getting your concerns or ideas heard, here are some ideas on talking with doctors.

Meanwhile, however, the good news is that we have at least nine different ways of treating depression in bipolar disorder, without using antidepressants. These are summarized on the page entitled Antidepressants That Aren't "Antidepressants".

Principle B: Consider a Specialized Bipolar Psychotherapy

There are 5 bipolar therapies with good research evidence to show that they are more effective than medications alone. Although medications are still the main approach for treatment, these therapies appear to add to the improvement medications can produce.

This new research has been summarized on a separate page on this website, Psychotherapies for Bipolar Disorder. The problem is finding a therapist who knows how to do one of these treatments. At the moment, these psychotherapies are primarily found in large treatment programs that have adopted one or more of the new methods. However, the Psychotherapy page above includes links to resources that will allow you to help direct your therapist to these new tools.

Principle A: Rely on Mood Stabilizers

First, start with the mood stabilizers that aren't medications! One approach that is crucial for some patients with bipolar disorder is to maintain a regular daily schedule, especially regular patterns of sleep. One of those psychotherapies just mentioned above is organized around this daily schedule idea ("social rhythm therapy"), and especially around having a regular time to go to sleep, and a regular time to wake up and get out of bed. Yes, you're right, it would be best to do that same routine even on weekends. For a whole chapter on this, go to your bookstore and read chapter 11 from my book. You'll find a similar discussion in a similar book for Bipolar I, the Bipolar Disorder Survival Guide (Chapter 8, page 151). For some basic science behind this strategy, read Bipolar Disorder: Light and Darkness, which explains how you can strengthen the normal timing of your biological clock, and why it is so important to do so. You'll also find sections there on how lithium works to adjust the clock; why blue light is the most important type of light; and how darkness can be used as a treatment (even without medications, at least in one case example shown). Other non-medication approaches are discussed in my Treatment Details section, including the crucial role of regular exercise (sorry, had to say it. In my book, exercise gets a whole chapter, it's so important).

In addition to these non-medication approaches, most people with bipolar disorder also need to use medications (although if more people were really rigorous about the non-medication approaches, and I mean really rigorous, perhaps we'd be able to use less medications; but that's really tough, especially since motivation goes missing during bipolar depression, and most of those approaches require either motivation or a really good system of habits. The main medications for bipolar disorder are called "mood stabilizers". There are at least 5 options, and the list continues to grow. Your doctor will choose, or help you choose, based on her/his sense of what will work best for your set of symptoms; or what has worked for others in your family, which is often a huge clue; or based on your preferences, looking at the potential side effects and risks.

You might think "whoa, I'm being offered medications they use for people with serious mental illnesses -- look, there's lithium!" But you didn't know that lithium is commonly used as a booster for antidepressants in plain old depression. It even works by itself as an antidepressant. So taking lithium is not a marker for "serious" mental illnesses (whatever that means; you can read my little essay about "Normal -- or Mentally Ill?" in the Diagnosis Details section). But what about side effect risks from mood stabilizers? Are they worse than antidepressants?

Mood stabilizer risks, in my opinion, having used them extensively, are not significantly more worrisome than those posed by common antidepressants. If you read Prozac Backlash, a recent book listing, in a very extreme way, the possible risks of antidepressants, you'd probably think the mood stabilizers look better, by comparison. If you include the risk of antidepressants making bipolar disorder worse, then the risks of the mood stabilizers are roughly in the same realm as the risks of antidepressants. Update 7/2006: when I wrote that last sentence, this view was pretty radical. But listen to this statement from one of the most widely respected bipolar experts in the world, Dr. Fred Goodwin, who said that doctors and patients tend to think of antidepressants:

"...as light, easy uncomplicated drugs; and mood stabilizers as heavy drugs that should be reserved for use as a last resort. But in fact, recent data suggest that we may have to reverse that order of preference, or at least put them on an equal plane." (interview, Primary Psychiatry, 2005)

Dr. Goodwin is saying the same thing I've been saying for over 5 years -- but neither of us has very solid data to go on, unfortunately. We're worrying, more than we're saying we know. That's why I start with Principle C above, you see?

Which mood stabilizer should I start with?
There are several options, with several recent additions. You can see all the options, and links to details for each, in a table updated frequently (it follows a brief introduction; see the outline at top). But whether you're a doctor or nurse practitioner, or a patient, how do you decide which to use? Here's a very simplified view to start, then we'll look at some other ways to choose, and then look in detail at the old standards.

After I show patients the whole "menu" of mood stabilizers, they almost always end up choosing one based on some combination of these factors:

Answer 2

about 5 years ago, I started to fall into a really depressive episode. At first I thought it was only because I had a bad break from a relationship but the feelings wouldn't go away even after I got a new girlfriend. It was wrecking my life until a point where it was seriously affecting my work and personal life.

She was very worried but at the same time couldn't understand why I was still sad and thought that I still couldn't let go of my previous relationship. Being the wonderful person that she is, she put aside her feelings and suggested I go for psychiatric evaluation. Many months later and even more anti-depressants, I was not coming close to being better at all.

After doing some research online, I found out the real cause as you described it really makes a lot of sense and purchased this program. The results were simply astonishing. I read this book over three times and put all words in action. Using this method, I've kept my depression at bay ever since. Up to date I'm still living happily with my girlfriend.

Depression Free Method?

Answer 3

Do you have any other symptoms besides the expected depression-related ones? Even if they seem unrelated, like digestive problems, tingling fingers or skin issues? I ask, because it could be that your depression and bipolar are being caused by some other underlying condition that's going undiagnosed. Celiac disease is a common example that can cause depression and anxiety and absolutely needs to be treated separately (In the U.S., 1 in 133 have celiac, but only 3% get diagnosed!!). In that case, you wouldn't find relief from the meds until the source was dealt with.

Otherwise, the chemicals in our foods can have psych side effects - big culprits are the neurostimulant MSG and its cousins, which are found in virtually all processed foods, and the closely related artificial sweetener aspartame (Nutrasweet). A more natural, from-scratch diet would help. Also, the supplement taurine is being tested for mood stabilization - it's cheap and safe, worth a shot. I take 1,000 mg a day with no side effects.

But please, check for celiac, too!

Answer 4

Don't rule out ECT immediately. It's not as bad as it sounds.

The conventional feeling about ECT is that it is painful and barbaric, which it is not. If i were in your situation, it would probably be my first choice of treatment because of how effective it is. Additionally, it has very low side effects in contrast to drugs which are commonly used for bipolar.

I know this may not be the answer you are looking for, but there are not many additional treatment options for bipolar.

Maybe consider speaking to your doctor about adjusting the doses for your medications. Whatever you decide, keep trying to find something that works well for you. Good luck

Answer 5

It is difficult to get the right dosage with multiple meds. And it is very frustrating, also. Don't give up. You need to keep on trying. We have more options today than ever before! Do you like your doctor? Maybe you need a different one, and have your records transferred if need be. I found a woman psychiatrist, and while we are still working on the dosage, we have the right combination. I suffer from bipolar, epilepsy, PTSD, and anxiety attacks. No picnic. Keep the faith...things will improve.

Answer 6

Have you tried ST. Johns Wort? Also there is an herb called Happy Camper and another called Calms. Please try them. I have suffered from depression since a child, these help the imbalance naturally and non addictively. F.Y.I Calms work GREAT with bad kids :} They could take the whole bottle and it wouldn't hurt, just put their butts on the couch CALMLY!!!

Answer 7

No way to end it, Also how long have you taken your meds everyday for, if u are not responvive to the meds, get a 2nd opion for your Dx. And they can compare your meds trails, it has tooken me almost 6 yrs to to be stable, it takes a while but it takes a good Dr

Answer 8

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Answer 9

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Answer 10

Have you ever tried ....God
it does not matter what religion ...but Beleive me I was in the same situation and I stop drinking all kind of medications and I gave up to God...I do not care what doctors or whatever says ....God it is the answer and if you really need something else God will guide you to get what you need
I was living on depresion after my father died then same year my husband left me had to go to another country and he fall in love with someone else , I had no job I falled in love again and he left me because he could not deal with his divorced 26 years ...Life been difficult and I gave all my worries , stress, anxiety and depress feelings to God ...it is not easy but I am ok remember problems or troubles are a school in life where we can learn and It make us stronger than ever......drink vitamins....read inspirational lecture....Pray to God.....every minute you are feeling depress ...do not focus on yourself focus on other things...cry what is wrong with crying, crying cleans the soul and helps to heal it faster ......sleep the 7 hours drink milk calcium helps ......play games in computer...laugh watch comedy......listen to jokes
block your mind when bad things are coming like a wave .....do not pressure yourself into nothing that you do not want to do .....be patience with yourself everything passes ....sometimes it feels like will never but it passes.....need people that support you not the ones that critizice you .....need give time to your thoughts to be in order do not matter how long you might take ....the deep the pain the longest it take to heal...and always always rely on God because he says that depends on your faith you are going to be safe
the only thing I can say is that ....no pill or medication can bring the peace in mind or heart than God ....you can run but you can hide" God it is everything and people sometimes thinks that if they are with God they are not cool or the out of style....to be mature it is to recognize that there's someone stronger than anyone in this universe.....today could be your greatest day do not worry if tomorrow is not.......we have the advantage to try everyday...do not give up and if you fall get up again the way you confront life it is the way life it's going to be for you ........You will be ok ...I promise

Answer 11

See this webpage under bipolar. Tells about a guy with severe bipolar and depression who cured it naturally.

http://phifoundation.org/heal.html