Monday, April 16, 2007

Good News???

Have you ever had mixed feelings about good news? I remember one college course that I took, and I was pretty nervous about our first exam. It was to be an essay exam, which I think are the most difficult due to their subjective nature. The next time that our class met our professor made an announcement. There had been one person who had a perfect score (100). Yep, it was me and I was a little bit embarrassed because every one turned to look at me, some raised their eyebrows, and some were perplexed. I was forty-three years old.

Well, things got worse when our instructor began to read the class my essays. I was ready to crawl under my seat. I'm just introverted enough to not want to be in the limelight. Then, it dawned on me that with a score of 100, there is only one direction to go. It was extremely improbable that I would repeat my success on every exam. So, I received that "good news" with mixed feelings.

I now want to share what might be good news for those of us who have Bipolar Disorder. You might read about this on a number of sites, but I ran across it at the Medscape Medical News website. I will now quote some excerpts from that rather lengthy article.

March 30, 2007-"According to the Systematic Treatment Enhancement Program for Bipolar Disorder, a large placebo-controlled trial of community-dwelling patients with bipolar depression who were receiving mood stabilizers, adjunctive antidepressant therapy did not reduce symptoms of depression, neither did it increase the risk for mania."

"One group of experts was saying, 'When you get depressed, you should add an antidepressant,' and another group of experts was saying, 'When you get depressed, if you do a really good job with a mood stabilizer, you don't need an antidepressant.' This study proved that the latter group was correct, and that it is perfectly reasonable to treat patients without the addition of an antidepressant, as long as you are doing a good job with mood stabilizers."

According to this article, though, this study is being deeply scrutinized by the medical community. Some medical professionals believe that more studies need to be done before a change is made in standard treatment for patients having Bipolar Disorder.

Personally, I'm having a mixed reaction to this "good news." I don't want to take more medication than I need, and I certainly want to avoid medications that might negatively affect my treatment. On the other hand, I am concerned that I might fall into a deeper depression than is typical, if I don't continue to take antidepressants (Wellbutrin) in addition to my mood stabilizer (Lamictal).

In previous blogs, I have warned you that taking an antidepressant, without the addition of a mood stabilizer, can increase the number of depressive episodes. That is ONLY true if you have Bipolar Disorder. Those of us who have unipolar depression should continue to take our medication, unless advised otherwise by our doctor.

I'm also concerned that some patients might think they would be better off if they didn't take any medication. I believe that would be a dangerous conclusion. Discontinuance of any medication without consulting with your doctor would be ill-advised.

One of the ongoing problems that we depressives have is non-compliance with our doctor's advice and prescribed treatment. This is one of the reasons why people who have chronic clinical depression have difficulty stabilizing. In the future, I plan to discuss the critical issue of non-compliance.

So remember, "good news" might be "bad news" in disguise.

I want to thank everyone who so kindly prayed for me during my most recent episode of deep depression. I am doing better now. I have come to the conclusion that I rapid-cycle, so I will always be riding the roller-coaster.

["I'm so low, I could do a ten minute free-fall off the edge of a dime."]


Neva said...

Thankful that you are better--I will keep praying anyway, because you are my brother.


Radin said...

i am a bipolar and have been through similar situations. there is a kind of individuality side to all bipolars which has to be into consideration by both the doctor and the patient. Visit me if you care. Your comments will be so useful.