Hi Bipolar 2,
Meds are a very big issue for people who have psychotic mental illnesses like Bipolar Disorder or Schizophrenia.
In my opinion anyone who tells you to just do what your doctor tells you is giving you very poor advice.
Throughout the western world there are a number of different “models” of mental health. The advice you will get from your psychiatrist, psychologist or some other mental health worker will depend very much on which model they follow. It can also depend on where you live and which mental health service you connect with.
This is a major world wide issue that people with mental health problems are often completely unaware of.
The most common model, world wide, is the Biomedical model. This models views mental illness as an organic brain disease that is either caused by or is the result of chemical imbalances. Diagnosis is typically based on a manual produced by the American Psychiatric Association. The current version, known as DSM-5, stands for Diagnostic and Statistical Manual of Mental Disorders.
These brain diseases are typically diagnosed using DSM-5 as a reference and then treated using one of four different types of drugs from a multitude of different brands that each claim to be capable of performing miracles. Occasionally, Electro Convulsive Treatment (ECT) otherwise known as shock treatment is also used.
While the biomedical model is simple and easy to understand and apply, its main drawback is that it is nowhere near as effective as its advocates claim. There is also considerable controversy amongst experts these days over the claim that mental illness is an organic disease of the brain. Furthermore the prescribed drugs often don’t work and frequently have troubling side affects. To the extent that they do work they normally only alleviate symptoms rather than cure any underlying problem.
Two other models of mental health are also in common use. They are the Psychological and Social models.
The psychological model had its roots in the work of Sigmund Freud and a few others from that era. It is often referred to as talk therapy. Talk therapy in the beginning was a very slow and inefficient process. When the biomedical model emerged in the early 80’s with the promise of a pill to instantly fix any problem, talk therapy and the classic psychiatrists couch drifted out of fashion.
But while it went out of fashion it didn’t die. Significant gains have been made over the ensuing years in a number of areas. Possibly one of the best known and most effective is a collection of techniques known as Cognitive Behavioural Therapy (CBT). CBT has proven itself to be effective for a whole range of mental health problems. It however has strong and vocal opponents, particularly from those who are ardent advocates of drug therapy and the biomedical model.
A third important model is the Sociological model. If a person is struggling to pay the rent, put food on the table and otherwise make ends meet it is obviously going to have an impact on their life satisfaction and sense of well-being. It is therefore not surprising that people in this situation, will be more prone to depression and other forms of mental illness than average. Another social cause of mental illness that is increasingly being recognised is trauma particularly, but by no means exclusively, related to childhood. The sociological model can lead to complex political debate around issues like poverty and inequality. It can also lead to populist agendas with groups of people playing the blame game and resorting to fierce emotional arguments to promote their causes.
If we look at the mental health model used by the Australian Federal government as opposed to the states we could probably describe it as a Sociological-Psychological-Biomedical Model. In other words a broad based approach that takes in bit of everything. It seems to me that nearly all the innovation and development in mental health treatment in recent years that has taken place in Australia has been done at the Federal government level.
Even your diagnosis of Bipolar Disorder, which will most likely be based on the DSM-5 manual, will be questioned by some advocates of the Sociological and Psychological models and there are quite sound reasons for challenging these ideas.
Your feeling that something is not right may well be because something isn’t right for you. It is easy enough to do your own research online. You will quickly discover that there are many different opinions and a lot of disagreement amongst professionals.
In my opinion, advice from Federal government organisations are much more likely to have a more balanced view than that from state governments but my experience is based on Victoria which may not be representative of all states. Finding a mental health practitioner who will guide you through finding the treatment that works best for you can also be a big challenge.
I would say don’t just except the first solution that is offered to you which is likely to be something based entirely on long term medication. Shop around and explore other options. They certainly exist.
Just for the record I personally use medication but very sparingly because I am very prone to side affects. It took me many years to find a knowledgeable and cooperative psychiatrist who was prepared to help me work out my current medication regime. I am also a big advocate of structured psychological interventions like CBT which can actually treat the underlying cause rather than just suppressing symptoms.
Here is a link to what appears to be a fairly balanced article from the Australian Black Dog Institute who are affiliated with the university of NSW.
Bipolar Disorder treatment
Regards
Willy
