Adjustment of Meds

My daughter (20 yrs old) was just diagnosed with Bipolar II.  She has been on the meds (Wellbutrin & Seroquel).  She was doing great when she got out of the hosp. for about 2 days.  Her Dr. upped the seroquel & she seemed somewhat better.  I was wondering how often the meds are adjusted in the beginning?  Right now she does not have a doctor to adj meds for about another week.

Any insight you could give me would be greatly appreciated.

I can definitely help you here.  Med’s are usually adjusted frequently in the beginning even changed possibly, until that “just right” (I won’t say perfect because we all know nothing is ever perfect) combination is found that makes us feel most stable.  And do any of us ever reach 100%? I’m not sure.  I really don’t think so.  100% would mean a cure, and we all know there is no cure. But the goal is to get as close to that 100% as possible.  So the doctors are constantly tweaking the meds in the beginning until we can say we are feeling more and more stable.  Once we level off and we have reached a plateau then they will quit messing with the meds and you will just maintain what you are doing at the time.

However, this does not always last.  We, as people with bipolar, will have mood shifts periodically thru out the years that might require a med increase or decrease or med change entirely.    Or our body may build up a tolerance to a med over time and it will have to be periodically increased.  Nothing is ever simple.  So just because the Doctor may get your daughters meds situated now (whenever you get her in to see a new doctor) don’t get comfortable in the fact that it will always be this combination at this level.  Our bodies are constantly changing and how we tolerate, break down and process medication changes with them so we must always be aware and ready for the fact that our medication will have to change with them.  Medicine is a constantly changing field as well.  There is always something new on the horizon.  Sometimes what you are taking now may not be as good as what they have to offer in a year when your medication quits working and your doctor may want to try something new.  The important thing is to have open communication lines between you and the doctor.  Give your opinion and listen to his.  This is not a one man show on either side.  He can’t make all the decisions because it is your body, and you can’t make all the decisions because you don’t have the medical knowledge to know what medications are out there.  So I suggest, do your own research and make informed decisions together.

On a personal note it took about 6 months of them changing dosages and trying different meds before they found the right combination that worked for me, in the beginning.  That lasted for about a year.  Then I went into a deep depression that lasted for about two years.  We tweaked my meds for a while and after all that since jan.2011 I have been the most stable I have ever been in my life.  I was diagnosed bipolar 5yrs ago.  So it took 4yrs to find the -just short of perfect- med cocktail for me.  Was it a long and hard road, yes.  Would I change it, no.  I learned a lot about myself in those four years.  I learned that I have true strength, that I AM a survivor, that I’m not a quitter, and that I can make it in this world on my own two feet.  I also learned that I do have family that truly loves me.  Those are lessons I wouldn’t trade for a million years returned.

I hope this helped.  Stay strong for your daughter.  If she is just starting out she is going to need a lot of love and support.  We aren’t the easiest people to live with or get along with, but if you let us love you, you’ll never be loved by anyone else more.

2 thoughts on “Adjustment of Meds

  1. What I love about this blog is the “real life” aspect of the questions and comments, which are often not discussed in the books I’ve read about BPD. No one seems to discuss the effects of the meds in enough depth to help those with BPD understand the “cause and effect” issues of the meds. From 35 years of observing close family members taking medications for BPD I have learned the following:

    1. People leaving a hospital environment have had their meds “balanced” in an atmosphere away from the daily grind of life. It doesn’t take long for the actual stresses of dealing with everyday life to begin to “work against the meds”, so to speak. In our family, this usually meant the loved one with BPD having difficulty sleeping at night and increased “hyper” behavior. At this point, the meds needed to be adjusted again (increased dosage).

    2. Adjusting the meds is is very tricky because too small a dosage can trigger a spiral up or down in mood. Too much anti-psychotic medication and the effects can be “zombie-like.” My daughter used to be a person who was up three hours before leaving for work, zipping around the house getting ready. With medication, it sometimes takes until 11:00 am for her to be able to move. At that point, she needs to work with the doctor on the meds again. Sometimes it’s a “catch-22” situation. If she reduces the meds so she can function effectively, and then a stressful life situation occurs, then the reduced medication is not sufficient so she’s back to the insomnia again.

    3. This “tricky” aspect of balancing meds can seem endless at times, but it becomes easier once a person begins to understand how stress, excitement, stimulation, etc, interact with the BPD medications. For some people it can take YEARS to connect the dots! The quicker the person understands and adjusts to the meds cycle, the easier it is to cope with life….kind of like walking a tightrope.

    What I’ve mentioned is specific to my family, but I’m sure that many other people experience similar situations. As a matter of fact, my daughter once met someone in a support group who explained the meds cycle to her and recommended helpful strategies, but it took years before my daughter really paid attention and accepted how she handled stress and learned how to work around/avoid stressful situations.

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