Medication and Grandiosity

Posted on January 13, 2006 in Mania Psychotropics

After the Aguilar shooting last month, I waded through a few bipolar blogs which parroted the media line “If he’d only taken his meds, he would have been all right. I do and I never go into mania.” I could not help but be impressed with the cocksuredness of these. What superhuman powers they give themselves and all bipolars who take medications! The disease is cured, stayed, kept from chewing at the bone-shaped neurotransmitter heads! You have Accountability in a pill. Or in a cocktail, rather.

Raine averred that one of the symptoms of our disease is our belief that we don’t need the medications once we are stable. A local psychiatrist, Hirimasu DaSilva, calls this the “aspirin syndrome”. Let’s say you have a headache. You take an aspirin. The headache goes away. This is over-the-counter-medical culture. You take pills on an as-needed basis. It holds true, too, for antibiotics. You’re not on erythromiacin forever, after all. So, we reason, we can take the lithium until we feel better and drop it.

I wouldn’t call this an symptom as much as I would call it a behavioral conditioning which we must learn to override. Family, friends, and zealous busybodies can become determined adversaries to our regular taking of the medications. It’s not just us, but the people around us who might promote the idea that the time has come to get off our meds. With all that purple noise streaming from the tonsils of our loved ones and our endured ones, it takes a strong strong bipolar indeed not to resist if resistance must be a stand s/he takes alone.

Unquestioning faith in the meds, I think, may actually be more symptomatic than the aspirin syndrome. Mark this: I believe in the meds. Mark this also: I realize that the meds will not work forever for me. Those who do not know this face disappointment. Those who believe that the meds will always be efficacious strike me as victims of delusions.

When we ask the impossible, we lend ourselves to being preyed upon by mania.

I fear for the true believers in allopathic miracles because when they find themselves in mania, they will keep taking the meds without checking the practicalities with their doctors. They will assure themselves that all is well, that they are the Model Bipolar. The Meds, the Cocktail is the Final Answer. They need no other, no adjustment by their psychiatrist. (Well do I know how cunningly a bipolar can hide his disease from his doctor). Ascendant on the cloud of their hyper-ecstasy, these others will not recognize that their meds need to be changed. In their grandiosity, they damage themselves and all bipolars, medicated or not.

We need to encourage compliance and realistic expectations; and we need to change “shoot-to-kill” protocols that bring down not terrorists, but bipolars. For every plan, there needs to be a backup plan. Bipolar sufferers can go into mania even if they are taking their medications. What the meds do is reduce the likelihood of manic and depressive episodes. They do not end them. To act as if otherwise were true is foolhardy. And possibly manic.

For my bipolar friends:

I have found it helpful to keep a mood chart. This is a daily record of how I felt, how I slept, and what medications I took. It let’s me keep an eye on where I have been over the course of a month. My psychiatrist, my therapist, and even my other doctors find it helpful to check my compliance with the medications and their effects on my general health.

Here are two moodcharts you may find helpful:

• Healthyplace.com Bipolar Mood Chart (in full color!)
• DBSA’s “Just Diagnosed” pamphlet

A mood chart is not the perfect guard against losing track of one’s moods, but it can help you learn to discern where you are. Watch your energy and watch your sleep. Knowledge of those matters even more than taking your meds as you should. (But don’t stop doing that. Let your psychiatrist decide.)