Q: BP Symptoms Mediated by Therapy?|
Dear Dr. Phelps,
I'm disturbed about recent developments relative to what had been described as
bipolar disorder, a problem with which I dealt for al,ost 20 years. I am now 50
years old. There is no question that even a well-educated layman would arrived
at the same conclusion to the diagnosis given the facts.
In point of fact I would have to say that my particular case of bipolar disorder
would have been described among the more serious. And yet there has been a
peculiar change of condition in the last four years.
I'm well aware of fact that bipolars tend to have a poor track record in
compliance with medication. And of course I would have to be listed among
them. I underwent an extensive sessions of therapies, both group and private
for a number of years with an organization in my state known as Circles of
Care. It was during these therapy sessions that I began to discover how to
change my behavioral patterns. In short, I have not been on any medication
whatsoever for the treatment of the disorder in almost four years. During this
time, I have had no symptoms to
suggest either a manic or depressive phase.
I'm confused as to whether I've actually made a sufficient change my behavioral
patterns to allow me to live a "normal" life, one that allows me to pursue my
professional career as a music director (which I have). Is it possible for
someone to receive therapy to the degree that symptoms could be mediated to such
a remarkable degree?
I monitor my condition very carefully. There have been a number of situations
in which have taken Xanax for a very short period of time when stress levels
have been exceptionally high. After several days of this treatment, everything
seems to quiet down without further complication.
Of course I would prefer not to take a lot of medications given my current
state, which seems remarkably well adjusted.
Any insight you might be able to offer with regard to the situation would be
Dear Mr. R' --
Your experience may be exceptional, but in any case, congratulations. Sounds
like you've had a great outcome. Often when this kind of thing happens for my
patients, we celebrate without knowing precisely what was the basis of the
improvement. In your case, it sounds like you think the Circles of Care therapy
played a role.
As you may have learned, there is no clear evidence
that a therapy, including this one, can treat the symptoms of bipolar disorder
to the extent that they do not return. Your story is thus exceptional. I
believe it is possible that a few select people could get this kind of
response from a therapy (as opposed to a medication). There is a story, for
example, of a fellow who was able to control his rapid cycling by limiting
If those around you are able to confirm that you do
indeed seem to have arrived at "mood stability" over time -- since this can be
hard to judge on one's own sometimes -- then you may continue to see just this
(because 4 years is a long time to go without symptoms). If your doctor sees
the same stability over time -- we are not good judges because we see only a few
"snapshots", instead of the whole video -- she/he might be willing to sit back
and wait for any further symptoms before turning to a medication approach. Good
luck with that.
Published February, 2002