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Non-use of bipolar medication typically follows careful ‘risk–benefit’ evaluation



Well-known member
Mar 23, 2009
Non-use of bipolar medication typically follows careful ‘risk–benefit’ evaluation

An investigation into why and how patients with bipolar disorder manage their moods without medication has found that most individuals are initially motivated by concerns about side effects.

In-depth interviews with 10 patients revealed that, having decided to live without medication, they used a wide range of strategies to manage their moods, including nutrition, self-discipline and channelling their energy into something positive.

“Professionals should place more emphasis on non-medication approaches in order to increase engagement with people who do not use medication,” say the study authors, who were led by Reed Cappleman (Fieldhead Hospital, Wakefield, West Yorkshire, UK), writing in the Journal of Affective Disorders.

The researchers undertook qualitative interviews with five women and five men, all of whom had chosen not to use medication for at least 3 months. Half of the cohort had a history of hospitalisation for bipolar disorder and one participant was currently hypomanic while the remainder were euthymic.

When asked about their reasons for stopping medication, all participants cited side effects as a major concern, describing distress resulting from problems including weight gain, tremors, loss of libido and lithium toxicity. Participants also frequently described side effects changing their view of themselves in ways they found undesirable.

Having decided to stop medication, participants searched for experiences and practical strategies that would help them, often developing their ideas at support groups or in therapy. Of note, they tended to seek out experiences and ideas that were congruent with existing ideas about themselves and their moods.

Strategies included trying to keep moods at a desired level and staving off undesired mood changes, such as by using essential oils, medication or cognitive techniques, and channelling their energy into something positive when they felt their mood was high, such as exercise or creative pursuits.

Participants were generally very aware of their moods or relied on close friends and partners to highlight changes in their moods; they also reported regularly evaluating their decision not to use medication against their previous experiences while taking medication, in order to be sure that the balance was favourable.

Cappleman and colleagues say their study is the first systematic evaluation of the processes by which people manage bipolar moods without medication and note that the findings challenge the widely held view that nonadherence to medication in patients with bipolar disorder is driven by a lack of insight.

“[P]eople who have chosen not to use medication may have already very carefully weighed up the costs and benefits, and a professional stance that emphasises the importance of adherence to medication may act as a barrier to such individuals engaging in services”, they write.

“Instead of focussing on medication adherence, services emphasising a broader range of approaches might engage people who have decided not to use medication.”

medwireNews - Psychiatry - Non-use of bipolar medication typically follows careful ‘risk–benefit’ evaluation

How relevant is something based on only 10 interviews ?


Jul 30, 2012
Ten people surviving without drugs is a good enough demonstration of the ability for people to survive without drugs


By the descriptions of coping techniques

Such as essential oils

I think those ten people were hate crimed with bipolar mk2

Now is it possible for someone with lets say more intense experiences to survive without drugs


What about thrive without drugs


The choice is simple. Take the hand of satan or take the hand of god

And cocoa

Are exempted substances


“Professionals should place more emphasis on non-medication approaches in order to increase engagement with people who do not use medication,” say the study authors
Yes yes yes.
Rather than belittle, ignore, discharge.


Jul 30, 2012
Okay put the kibosh on the holy black and white thinking mr redux

I'm not sure what it is exactly that people need

I don't subscribe to the drug paradigm

But this world is replete with drugs

I think aftempting to remove as many of these drugs from your diet and fluid in take is necessary... Even just once... For one year to know for sure or with more certainty where you stand

Obviously some people aren't going to be able to do that completely for all manner of reasons

But as much as possible its worth trying

I did it a few years ago

It didnt make much difference other than I felt phtsically haealthier

Which is no bad thing

There is a woman much courted on twitter who blog about bipolar and insists that ultimately all bipolar must be medicated

Her view fits the status quo and is thus lauded

I think you've got to take a very honest look at yourself and your life and arrive at your own conclusions

Im seemingly in a chaotic state but thats pretty much all in my head

Out and about im lucid and changing and pinged with wit

Not a bad state to be in

And of course theopenness of people this time of the year adds to the buzz

Its a busmans holiday really

No one can advise anyone in the final analysis

But you can point the way or introduce a bit of dissonance

Energy is energy which ever way you frame it

And its in finite supply

I'm learning how to hold mine back

And alcohol is probably the worst drug that someone with any kind of mood problem could possibly use

Yet remains the most used