Alone and cycling
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Alone and cycling

Q: I can't talk to anyone here right now so hopefully you will be able to give me some advice. I am a 19 year old female attending college and I have been diagnosed with bipolar disorder since before high school. I go into these cycles where i will take medicine for awhile(a few months) and the for some reason i will just stop and not refill the medicine or just quit taking it. I have taken prozac, depakote, neurontin and currently i am supposed to be taking zoloft. I have mood swings on average more than 2 or 3 times a day (utradian, i believe). I know i have a problem and i know i need to do something about it, i have not spoken with my psychiatrist since may i believe. I am starting to get bad again where sometimes i hate myself so much for no reason at all to where i believe that i am the most wonderful talented person in the world. I want to know what i can do to make myself take medication regularly because i know that if i start on medication again, that at some point in time i will want to stop again. I do not like going through withdrawal on these medications, it is not fun. I have also started back again with thoughts of death, which really scares me when i look back on those episodes. I don't want to tell my parents or anyone around me because i don't want them to worry and i don't want to burden them with my problems, so i need to know a way that i can do this on my own. I know that you say we can't handle this on our own, but i can't burden anyone else with this. I am sorry that this is such a long letter, but i know that there must be other people out there that feel this way and your response will hopefully help them as well as myself. Thank you for you time.

Dear Darcy --
More briefly than I would wish, here goes: First, how to approach staying on med's depends on why you stop them.  If it's for side effects, you have to try a different approach without such side effects (the only true "mood stabilizer" you've been on so far, Depakote, causes weight gain commonly -- maybe that was the problem?).  If it's because you get better and think then that you don't need the medications, then you need to work with someone to develop a plan to combat that in advance.  One of the best such plans is to have a relationship with a therapist at least, if not the doc' prescribing the med's in the first place (which is better yet).

You've had several antidepressants and only one real mood stabilizer, so you haven't seen much yet in terms of what the med's can really do.  So, not having much confidence in that route is pretty understandable.  I worry more about your belief that you shouldn't worry your parents with this.  Such a belief leaves you very alone with these symptoms, for one thing, and that in itself can actually end up being very dangerous.  People do indeed commit suicide from symptoms, and are more likely to do so when feeling alone like you.  So whether it's your parents, or some therapist from the college's student health center, or somebody: you need to get more connected.  It's like wearing a seat belt (you do do that, don't you?).

Finally, I can tell you as a parent that I would be mortified to discover that my child wasn't telling me about their experience of the world as important as this, because they didn't want me to worry.  I'd worry like crazy to think that I wasn't hearing about stuff like this. I absolutely would want to know, although I hope I'd have the sense to then ask how you wanted me to handle it -- watch from a distance?  listen?  help you find a therapist or a psychiatrist?  understand why you feel like you can't really do college right now?  support your effort to try to do college anyway, and see how you do?

Put on your seat belt, and explore your treatment options, and think about telling your parents (e.g. whose needs are being served by telling or not telling? whose needs do you wish to address?).  Good luck to you.

Dr. Phelps

Published November, 2000

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