In my WIP urban fantasy series, the #1 MC has bipolar disorder in connection to an even larger supernatural plot point. So, I've been doing a little research on bipolar disorder for the sake of writing the character correctly, as even though there are supernatural complicating factors to her condition, it's still a real condition and I want to potray it authentically and not avoid it either. I've made a thread previous on this general topic under character development, but I wanted to follow up with more specific questions focusing on an accurate potrayal. One of the specific topics I have a particular interest in here is treatment options. The relevant character is in fact a student of psychology, and very motivated to overcome her condition, so I want her to be using a realistically effective regime of clinical and self help methods. On the flip side, the character strong drive to overcome, and strong awareness of, her issues is conflicted with her insecurity about it. As a result, something I am considering is having her stop taking medications before the story starts, partly because of her desire to not feel as if she needs an outside fix. Looking into it, my first impression is that managing bipolar disorder without medications is a reasonable option. It doesn't seem like the medications for it are all that effective, and have significant side effects. And there does seem to a strong base of support for various other methods of managing bipolar. What I would like to know is what do people here with relevant experience think about managing without medication, and what alternative methods of managing bipolar do they think are effective? If I elect to specify bipolar I or II does that make a significant difference?
I have no expertise at all, but that’s very much the opposite of my impression. If the plot calls for a struggle to manage a normally-medicated condition without medication, I think that there are other conditions that might serve that better. Returning to add: I got curious. I looked up bipolar disorder, ADHD, anxiety, and depression in WebMD—assuming that that would likely present the view of pretty mainstream medicine. For the other three, medication was mentioned as one of the possible treatments. But for bipolar disorder, the article said, “While medications are usually the cornerstone of treatment for bipolar disorder...” This is confirming, for me, that bipolar disorder is not one of the more likely candidates for medication-free treatment. So my curiosity is largely satisfied.
It is standard practice to medicate it, but I saw a number of articles seriously questioning the effectiveness of medication, as well as pointing out how many people stop using medication. The plot doesn't call for it. I just thought it might be interesting to explore.
Well, there are many people who will also tell you to treat cancer with herbal tea and meditation. I’m just saying.
This. I've had coworkers and relatives who tried to manage their bipolar disorders without meds. They may think they're managing well without meds, but...no. In fact they often self-medicate with a cocktail of various substances, such as alcohol, tranquilizers, or heroin (to calm down the manic highs) and cocaine, speed, and mega energy drinks (to lift them up from the major lows), plus everything else between. ETA: It's also very common for patients to go off their meds because they feel "good" and mistakenly think they no longer need the meds. I had a relative who did this. Part of the disease is the delusion that they don't need the meds...I think it's called the "superhero" phase or something to that effect.
Nah, they dish out meds because it's profitable. By medicalizing normal human emotions, the industry created a huge market for its products. The drugs are actually quite dangerous.
Coming on a big strong there. Veering towards conspiracy theory. Bipolar is not exactly 'normal human emotions'.
Not theory. Fact. But believe what you want. Go around pretending you know things about reality. I don't care.
No, not gaslighting. Off meds my relative was batshit crazy, and when his doctor was asked why he would go off meds when they were clearly needed (because the relative did extremely well on meds and was functional while on meds, so going off them seemed illogical to us), the doctor explained the psychology and chemical processes in his brain that caused the delusional belief that the medications were not needed. I'm done with this thread.
That is my view, yes. There are conditions where I agree that medication is not necessarily the best idea. This is not one of them. If I were to sort conditions in order by the ones most reasonably managed without medication, and ones where you really want the medication, I'd tend to put bipolar disorder toward the "really want" end. Not all the way over with insulin for Type 1 diabetes, but leaning in that direction. Am I wrong? Possible. But I don't think so.
I'm not super well-educated about BD, but I do know that abrupt cessation of medication is usually a bad time. I used to have a friend who had a hard time consistently paying for her meds and it wreaked havoc on her mood/mindset. If you're going to have your character go from medicated to non-medicated, it should probably be a whole other rabbit hole of research on how that could be affecting her at the beginning of the story. I'd be leery of non-traditional treatment, as well. That said, another friend of mine had cyclothymia, which she affectionately referred to as 'bipolar's little cousin' -- you might have more luck treating that sans drugs as it's generally considered less severe than BD. I'm just personally very leery of any narrative that pushes the "yoga and herbal teas will fix your brain chemistry!" agenda. I'd hope for the character in question to realize that there's no harm or shame in taking medication for a disease.
The idea was she is already not taking medication at the start of the story, no transition. I wasn't thinking herbal teas and yoga type things. More like therapy, group and individual exercises, that kind of thing. It is looking like the articles I found may not be particularly trustworthy based on what people are saying, which is disappointing because I found them very easily and they seemed superficially reasonable, and that doesn't bode well for the state of the issue.
There are certain anti-medical treatment religious groups / organizations that are very good at pushing their no meds agenda, and the articles and "research" they push look frighteningly legit. So you may have accidentally stumbled onto some of those. Not just for bipolar, by the way. They often don't believe in medical treatment for anything else. That's all I'll say. Thank you for considering what we've said.
Considering a less extreme alternative plot point where the character takes medication less often, or perhaps weaker medication. Do you know how that might work out?
It seems highly unwise on the character’s part, though of course characters can be unwise. Sort of like a diabetic character deciding that deliberately failing to take the proper amount of insulin would show strength of character.
Surely there is some variation in the strength of people's treatment regimes, based on the nature of their condition and how they respond to treatment?
But dosage would usually be determined by a doctor. I may have misunderstood—I thought you were talking about the character varying their dose without medical guidance.
I don't think I want to push into territory that's too controversial here, so given there seems to be doubt about claims of alternative options, I am strongly gravitating towards sticking with meds. That's not what I am looking to do.
You could certainly realistically depict the person going off meds and that experiment going very badly. It's going well that feels unrealistic.
Not taking the meds was supposed to be a more positive thing, to the effect of 'you must have a good handle on things if you don't need meds'. So if not taking meds is very unlikely to work, the not needing meds part can't really be justified.
Yep. Sheer moral strength, will power, etc. won't process sugar in a Type 1 diabetic's blood, thin the blood of someone at risk of stroke, kill germs in someone with pneumonia, or correct the brain chemistry of someone with bipolar disorder. Medicine is needed.
As a final note, I am bipolar. I have severe ADHD. The world I lived in while unmedicated was an infinite nightmare! I can say without a shred of doubt, that if my BPD went without meds, I would be dead, or in prison. There is no cure, it is not aquired. People are born bipolar. It may never trigger in their life, or much later in life. If it is triggered, it will not go away. No prayer, no diet, no voodoo alligator skulls, or special TV offers will put the monster back in the closet. Get genuinely educated and licensed before you make ANY suggestions, statements, or opinions. Medically untreated BPD is as deadly risky as untreated seizures. In fact, seizures, BPD, ADHD, ADD, anxiety disorders, depression, alchohol and substance abuse, and obsessive disorders, are all in the same group and are genetic. DO NOT speculate or even debate casually, as the result of that influence may prove DEADLY. There is no ambiguity. OP: I wish you every success with your story, and most humbly plead for it to advocate treatment of these disorders. If you wish to truly know the euphoric and nightmarish experience of untreated BPD, and the drastic results of successful teatment, I am now emotionally comfortable to share that with you. I am one of few survivors. There is extreme drama to be expressed. for the love of God, amen.
