Right, so I firmly believe that Bipolar Disorder (BP) cannot be cured. Since this assertion is so wildly disputed I’d like to get that straight right out the blocks – if you disagree and aren’t willing to engage in meaningful debate you can leave now.
The primary reason I don’t believe BP can be cured is that studies have shown a genetic predisposition to this hell, with a sprinkling of contributing environmental variables.
Also, in some respects the term “I am Bipolar” also grinds my gears. I am who am and Bipolar is part of what makes me, me. Warts and all. So “I have Bipolar”, rather than I am Bipolar. I have rapid cycling Bipolar Type I.
It’s just one of the things that contributes to an identity.
So, with context covered lets get back to adherence to BP medication. I’ll say straight up it’s something I struggle with immensely, often. What makes this a super interesting discussion is that compared with adherence to my HIV medication it’s like chalk and cheese.
Perhaps I have the remnants of self-stigmatizing and haven’t really “bought” into the BP diagnosis. I’ll write about my journey to a BP diagnosis some other time, but what’s important to remember is that there’s no medical “test” for BP: there’s no blood indicators, no high resolution MRI’s and brain scans or fancy medical tests that can tell anyone, definitively, that they have BP.
A BP diagnosis is often, and certainly in my case, a long journey of behavior and history of (hypo)mania and depression. And it’s really up to a competent psychiatrist to join the dots and come make the diagnosis, which is difficult enough since episodes at the extremes may be rare and dispersed over time so that connections aren’t immediately apparent.
This is juxtaposed with an HIV diagnosis: it’s cut and dry. You prick your finger, put a drop on the test strip the second dot lights up and bam you’ve tested positive (later you’ll have a blood test to confirm). So with HIV it’s clear that without taking your meds at all it’s likely that the disease will progress into AIDS and eat years off a healthy existence. Same with sporadic adherence to antiretrovirals: often the body builds up tolerances to medication which can have dire consequences.
The thing with BP is that a slow creeping doubt enters your psyche when you’re feeling “fine”. Maybe that quack got it all wrong and in fact everyone around you are being overly sensitive, are just lazy, or generally boring. There’s in fact nothing wrong with me and my head is firmly screwed on just fine.
So there it is: acceptance of a Bipolar diagnosis is difficult. A failure to accept a diagnosis is a primary reason for quitting BP medication.
The result? You stop taking your BP medication forthwith because you’re just fine without it. Without tapering off probably which could (and usually does) have catastrophic consequences both physiologically and mentally.
There’s a whole host of other reasons why BP folk stop treatment that I intend to explore a whole lot more some other time, but lets reflect on the “I’m fine” justification. Inevitably, and without exception in my case, the destructive consequences of the disease return.
The mania (and also depression) creeps up on you like a clear day might turn to a foggy soup and before you know it you’re up to your old tricks, singing at the top of your lungs in your underpants with the curtains open because you’re that good and the neighbors would be privileged to attend this performance.
Not pretty.
