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> Worse still, some people I know are aware and accepting of the fact that they have issues, but they > refuse to treat them because they fear antidepressant

> Worse still, some people I know are aware and accepting of the fact that they have issues, but they > refuse to treat them because they fear antidepressants or mood stabilizers will impact productivity. > One person I know explicitly refrains from treating his bipolar disorder because he thinks > manic episodes make him productive. :-/ The issue is a little more complicated than that, first amongst the many problems is the tendency to medicate unnecessarily - there're many different and interwoven reasons for this, amongst which are the financial incentives to prescribe, deficits in empirical understanding of the issues, and the extremely severe and detrimental effects of some of the medications. It's easy to blame a patient for unwillingness to participate, which can be the case, but doing so without an objective look at the reasons doesn't fundamentally address the problem. There are many other conditions both physical and mental, that are personally and societally difficult to discuss openly, yet they aren't plagued by similar levels of reluctance in patients. Why is that? I would add more so much more, as I hope you can understand, and as the article alludes to, these aren't issues easily discussed, especially not with relative strangers on the Internet and I'm not interested in hiding my opinions behind a throwaway. Suffice it to say that my own experiences have led to similar choices to the person you described, and whilst I've never experienced mania, I too believe myself to be better off for those choices. I can categorically say that the opinions shared by those closest to me, the effect on my creativity, productivity and my sense of "self", corroborate that. In my case, the choice wasn't to refuse all treatment or therapy, but only to refuse specific types of treatments which were drastically over-powered and negatively impacted me beyond any perceptible benefit. Subsequent consultations corroborated that decision, and criticised the treatment I was initially suggested as being so heavy handed, that it's analogous to treating a cut finger with amputation of the entire arm. One size does not fit all, and until approaches to treatment reflect that, we will keep repeating the same mistakes to the detriment of the afflicted. If you're lucky enough to have a supportive network of family and friends around you, I can only reiterate the article's salient point: "talk about it" and add the suggestion that you educate yourself to the best of your ability, to help making the best possible decision.

electronvolt 12y ago
Just on the subject of not medicating, specifically for bipolar disorder: in the case of bipolar disorder, medication is considered the only completely responsible primary treatment, with anything else acting as a supplemental treatment. (Therapy simply won't prevent later episodes, lifestyle changes can only lower the chance, and are less reliable than medication.) Medication adherence is also a problem in bipolar patients because mania and hypomania are characterized by euphoria, delusions of grandeur, overconfidence, and a lot of other symptoms people find enjoyable in the moment. I'd echo the suggestion of educating yourself to the best of your ability. Most people from HN are pretty intelligent: learning about one disease and the treatments for it is not difficult to do at a basic level. Generally those who've spent years studying it (say, doctors) are going to know more and be able to better contextualize that information, but it helps to know what the evidence is for a particular treatment, if it's considered responsible, what side effects to expect, etc., as it helps you better evaluate the doctor and makes you aware of your options.

electronvolt 12y ago

Just on the subject of not medicating, specifically for bipolar disorder: in the case of bipolar disorder, medication is considered the only completely responsible primary treatment, with anything else acting as a supplemental treatment. (Therapy simply won't prevent later episodes, lifestyle changes can only lower the chance, and are less reliable than medication.) Medication adherence is also a problem in bipolar patients because mania and hypomania are characterized by euphoria, delusions of grandeur, overconfidence, and a lot of other symptoms people find enjoyable in the moment. I'd echo the suggestion of educating yourself to the best of your ability. Most people from HN are pretty intelligent: learning about one disease and the treatments for it is not difficult to do at a basic level. Generally those who've spent years studying it (say, doctors) are going to know more and be able to better contextualize that information, but it helps to know what the evidence is for a particular treatment, if it's considered responsible, what side effects to expect, etc., as it helps you better evaluate the doctor and makes you aware of your options.