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Depression – Breaking Bipolar

Last week was my birthday. I didn't do anything or mark it in any way. That is mostly because, on my birthday, I look back and see bipolar behind me and I look forward and see bipolar in front of me.
I think I’m pretty great as a general rule. I’m kind, caring, intelligent, creative, talented, sexy, witty and a bunch of other stuff. Not particularly greater than anyone else, just the normal amount of great. Except for when I’m not, of course. Except for when I'm darkness sliced from evil. Except for when my slithering existence requires extinguishing. Then, I’m not so great.
Sometimes people don’t believe I’m particularly sick. They meet me, I look fine, I interact, I charm, I wit and all seems, if not normal, at least something reasonably normal adjacent. And that’s fine. It’s by design. Being a high-functioning mentally ill person, I can’t really afford to run around with my hair on fire. But faking normalcy, happiness and pleasure is a tricky and very expensive bit of business.
As I mentioned last time, many doctors feel that antidepressants actually make bipolar disorder worse. Some specialists, in fact, will routinely take people with bipolar disorder off of antidepressants when the bipolar is doing well. Like I said, it’s a matter of perspective. And I get asked all the time about getting off of antidepressants and other medication. So, exactly how should you get off an antidepressant and what should you worry about when doing so?
While many people with bipolar disorder have and continue to be treated with antidepressants along with many other medications, there is a controversy in the medical community as to whether this is an appropriate approach. In bipolar disorder there is some risk of antidepressants inducing mania or perhaps worsening rapid-cycling. But is this true? What evidence is there that antidepressants work in bipolar disorder? What evidence is there that they will make bipolar disorder worse? What do you do if you can’t take an antidepressant?
I recently received a comment regarding bipolar medication, its development and the mental health care system in general. The commenter accuses the mental health community of being corrupt and asks, “Why are we forced to take such bad bipolar medicines?”
Congratulations; if you’re reading this you’ve survived the holidays, or most of them anyway. You’re past the late-night wrapping sessions, the overindulgence in eggnog and the stuffing that you never like but every year are forced into eating anyway. Huzah. But if you’re a bipolar like me, you’ve found that all that forced merriment has left you feeling hollow, tired and depressed, so it’s time to take action to get back to your pre-holiday self.
OK, so I admit it, I haven’t spent a whole lot of time thinking about gender’s relationship to depression. I know the basic pieces of information: more women are diagnosed with depression than men, and more women attempt suicide while more men actually commit suicide. But there is a lot to understand beyond that. Did you know that men are up to 15 times more likely to commit suicide than women?
I have been through very long, dark nights of the psyche. I have been in pain I didn’t think I could survive. I’ve been in pain I almost didn’t survive. I have done things I never wanted to do. I have done things I never thought I would do. I have been to places most people wouldn’t even come up with in their nightmares. And when I’m not there, I’m grateful. No matter how much I might think things suck, I’m not sitting in that particular pile of blood and muck. No matter how I feel today I can honestly say it can get worse. Every time I think I’ve hit bottom I’ve found there is actually more bottom beyond that. It is unfortunate but true, there is no maximum to pain. And any time I even think about changing meds I’m worried I will go there again.
What I know about the brain is a fragment of what is known about the brain. What we know about the brain is a fragment of what there is to know about the brain. That being said, what we do know is worth taking a look at. In the 1960’s scientists discovered that increasing levels of dopamine, norepinephrine, and serotonin in the brain reduced depressive symptoms. This suggested that a depressed brain didn’t have enough of these chemicals and this is where the chemical imbalance theory came from. It was quite reasonable and made perfect sense, but we’ve learned a lot since the 1960s.