Although I was initially diagnosed at atypical bipolar II, within a few years of taking medication (which, as my regular readers know by now, didn't work for the most part), I was labeled medication-resistant.
Lately, I've been thinking a lot about how I felt about that designation, which, of course, was the most disturbing of all. Why? Because, all the information I read confirmed my worst nightmare: there was no hope for me whatsoever.
Imagine how you would feel if you were medication-resistant and read the following: "Fifteen percent of the bipolar population is medication-resistant, and this is the most difficult group to treat. It often takes years to find the right combination of medication (if we can find it at all), and this group has the highest suicide rate." It's not exactly uplifting.
What truly bothered me was the dispassionate nature of the analysis. Somehow, I always thought that when you take away a patient's hope--which is so critical to their ability to survive--you should do it with great fanfare. I would have preferred dramatic drum rolls and clashing cymbals, rather than mere words on a page. It was disappointing to be utterly devastated in such a non-dramatic way.
Of course, optimist that I am, the only way to continue to persevere was to stop reading bipolar books, and stop visiting bipolar sites. The best attitude for me was to think outside the box. And recently, I asked myself: What if psychiatrists looked at the medication-resistant cohort from a different perspective?
In fact, let's use the diabetic population for comparison. When people with diabetes I (and sometimes diabetes II) are given insulin, it controls their blood sugar. But if you give insulin to people who aren't diabetic, it makes them sick.
When you constantly give psychiatric medication to people whose body won't accept it (like mine), perhaps it's like overdosing someone on insulin. The side effects for insulin overdose are headaches, irregular heartbeat, increased heart rate or pulse, sweating, tremor, nausea, increased hunger, and anxiety.
In fact, these are all side effects I've experienced and so many more. But unlike "regular" doctors who might have done a series of tests to see why I kept on having these side effects, my psychiatrists just piled on more medication. And unlike insulin, psychiatric medication affects your brain, not just your pancreas.
Years ago, I found statistics about how many people who originally suffered from clinical depression became bipolar after they were given antidepressant medication. I'm unable to find the info in my research folders (which I finally threw away because they depressed me), but I seem to remember that the number was around 37 percent.
What if...giving bipolar medication to people who truly may not have been bipolar when you prescribed the medication...caused them to become sicker and sicker? Perhaps those of us who suffered from untreated depressive episodes for many years needed a different type of treatment altogether.
Maybe our problem has to do with cortisol. On a site called All About Depression, I read, "Of those individuals who are clinically depressed, about one-half will have an excess of a hormone in their blood called cortisol. Cortisol is secreted by the adrenal glands...Cortisol may continue to be secreted even though a person already has high levels in his or her blood."
The fact is that high cortisol can cause depression. And some adults with depression or chronic stress have high cortisol. A few years ago, when I asked my psychiatrist about this, he said something like, "There's no way to measure cortisol or you can't use cortisol as a marker."
But that's not true. In fact you can measure it. And it's quite possible that people who have had untreated depression for years might have high cortisol.
My point is this: Since bipolar depression was largely ignored until 2003, and psychiatrists were prescribing medication without any idea how it affected us, the truth is that they may have been entirely wrong about what they were/are prescribing.
And since psychiatrists and endocrinologists don't work in tandem, it's quite possible that those of us with untreated depression should have had our cortisol levels checked, and it might be that if these levels were checked during a depressive episode, doctors would find that it's the increased cortisol that's causing the depression--and if it's suppressed--the depression will go away.
What bothers me is that there has been so little thought given to the so-called biochemical causes of depression. If a person is depressed, but not psychotic and has no other psychiatric symptoms, perhaps the underlying cause is not psychiatric in nature. And perhaps, all along, people like me should have been seeing specialists who are endocrinologists rather than psychiatrists. It's just a thought.
What do you think about that?