Am I getting worse?

I was diagnosed with bipolar about 10 years ago, while I was in rehab for drug addiction.  That’s where I learned about self-medicating.  Coming out of rehab I was free of my disease, but now had another friend by my side and that was this mental illness thing.  I have been out of work for 3 years.  At one time I owned a creative studio in the heart of Chicago which flourished and was successful.  But the success, after 12 years waned as I could not concentrate like before, I was scared all the time and I was constantly telling myself, I just don’t know who I am anymore.

These past three years has been a struggle to find a job, but even if I found something that was of interest, I was scared that my bipolar would jeopardize my position.  Hence, I look but not really.  I feel at times I’m really losing it.  I am on all the “right” meds and at fairly high dosages (klonopin, Effexor, Lithium, Seroquel.  I think sometimes if I get off all my meds, I would be able to see straight and not be afraid.  But I have been warned about that by my Doctor and my psychiatrist.

Am I getting worse? Does bipolar increase itself in intensity? 

I am sorry to hear that you have been struggling for the past three years.  There could be a number of reasons as to why you feel like things are not right or are getting worse.  Before I address your question I would like to say that as much as we would like to believe that we are “free of our disease” this is not a realistic assumption.  I have bipolar disorder as well but I am never really “free of it”.  My symptoms may lessen or subside at times but they are never completely gone for good.  My symptoms tend to come and go and it is really hard to predict how things are going to be for me on any given day.  Because bipolar consists of an imbalance of chemicals within our brain it will always be with us.  However we can take measures to help manage the disorder as best as we can.  Medication for example can help manage bipolar symptoms but that is only part of the picture.  There are so many other factors that can make our symptoms worse.  Things like not getting enough sleep or exercise, not eating well balanced meals, and too much chaos or stress in our lives can all impact how we will feel and do on a daily basis.

From what you have described it seems like something is definitely not right.  You mention that you are on “all the right meds” but I can’t help but wonder if the type of meds that you are on and/or the combination of meds are no longer working.  Sometimes the meds that we are on stop working or do not work as effectively as they once did.  It could be that your symptoms are worsening because you need a med adjustment.  My suggestion would be to discuss this with your doctor.  And as much as it can be desirable to get off “all of your meds”, your doctors are correct in that you should not stop any of your meds.  If you were to suddenly stop taking them you can do some serious harm to yourself and actually make things even worse.  My doctor believed that I was on the incorrect kind of medication and he “slowly weaned” me off of what I was on.  Again never stop them on your own as it is not safe, always consult with your doctor and get directions from them.  Once my system was stripped of all medication my doctor started me on a low dosage of Seroquel and went from there.  Eventually we were able to get to a level of stability with gradual increases.

It is also possible that you may have another disorder/s on top of having bipolar.  For instance I not only have Bipolar Disorder but ADHD and Generalized Anxiety Disorder as well.  And because I have 3 different disorders it complicates things even further and each disorder needs to be medically treated separately.

It is my hope that you do not have any other type of disorder but it is a possibility.  I would ask your doctor if he thinks that you could be suffering from other things as well and ask if you could be “re-assessed”.  If your doctor does not accommodate you and you believe that you need another opinion seek out another doctor for a second opinion.  For me it took years and years to be correctly diagnosed with all 3 disorders and get the appropriate medical treatment.  Other things that can also come into play which can worsen symptoms could be present as well.  Like I mentioned early things like too much stress can even worsen one’s symptoms.  So it is really important for you and your doctor to look at all aspects of your life and what is “currently” going on.  For example there may be something else going on that is preventing you from being able to work.  It is really hard to say at this point.  I have been on long term disability for 7 years because I am not able to maintain or sustain full time work for a long period of time.  Unfortunately I am just unable to work a full time job, it took time for me to accept this as I was functioning at a very “high level” when I was working.  However this did not last as over the years I deteriorated and basically “burned out”.

You also mention that you have been scared and that you do not know who you are anymore.  It is good that you have some awareness and insight into that.  This also tells me that something is certainly not right and I would let your doctor know about how you have been feeling.  The more you can monitor things like your mood, feelings and energy level the better.  Relay this type of information to your doctor as well because giving your doctor as much information as possible can speed up the process of figuring things out.  And because you say that “you really feel like you are losing it” that is another red flag that something is just not right.  You have asked if “you are getting worse” but it is really hard for me to say because I am not a doctor or psychiatrist.  All I know is that you are struggling and things just do not seem to be getting any better for you.  As far as bipolar increasing in intensity, it certainly can.  This can be due to a number of factors.  However I am unable to “pinpoint” any one particular thing and that is why it would be important for you to have a doctor “re-assess your mental status” as soon as possible.

You may also want to have your doctor give you a referral to a counselor or a psychologist if you are not already seeing one.  Many people find that it is helpful to have some other support until they are more stable.  I would suggest getting as much support as you can.  Depending on your area some places also have bipolar support groups which may also be beneficial to you.  Or if you are more comfortable seeking support online through sites like “askabipolar” that would likely be helpful too.  I am glad that you have sought out help and support from us, thank you for your question.  If you have future comments or questions please submit them to us at www.askabipolar.com

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