3. I Miss My Mania
Greg feels bereft now that he is no longer manic. He longs to go back to that wonderful state of mind. He's tempted to go off meds so he can be that high-flying person again.Sure, mania can be fun (if psychotic symptoms don't make it terrifying). You know you can do anything. There's nothing frightening in the whole world. You can outsmart anyone. You have a limitless supply of money. Your creativity soars past the sky to the sunbursts of newly-forming stars.
As Andy Behrman wrote in Living Mania-Free, "There's a tremendous amount of loss associated with 'saying goodbye' to mania, as it was my friend for so many years." Unlike Andy, your mania probably didn't land you in prison, and if you're lucky, you didn't ruin yourself financially. But you can't stand the loss of creativity or the feeling that you always knew what to do in every situation.
You were manic for so long that the "new you" who isn't manic is a stranger. Redefining yourself as someone who is not manic isn't a one-step process. Andy sought ways to "fill the gap" left by his departed mania, and it took quite a while. Life can still be rewarding, but you have to give it time.
After you've listed all the things that were bad about being manic-depressive, you'll have a basis for getting to know the stranger you've become. Then when you hunger for the highs, review the list. Is it really worth going off your meds to bankrupt yourself, to tell your boss (in fast-talking, exquisite detail) why you are right and she is wrong to the point that you lose your job for insubordination, to write a book (in a week) that seems to be perfection but that no one else can understand? And is it worth crashing into the torments of depression?
4. I'm Better Now, I Don't Need Medication Anymore
Rhonda has had a great response to medication after being diagnosed with clinical depression. She can't remember ever feeling as good as she does now. She has energy. She can make decisions easily that last year were tormenting. Instead of sitting in a chair staring mindlessly at the television for hours, paralyzed over what she should be doing, she is getting things done effortlessly. She's cured! So why should she continue to take medication?Because she's not cured. Stop the medication, and the depression will probably return.
In Rhonda's case, the antidepressant she is taking may be triggering hypomania as well. Rhonda's doctor should be monitoring her behavior and mood state closely. Hidden bipolar disorder may have been uncovered.
Sometimes depression that's related to a traumatic event like the death of a family member may respond to temporary use of an antidepressant. When enough time has passed for the person to have adjusted to what happened, the antidepressant may not be necessary any more. That call can only be made by the patient and prescribing doctor together. They may find that when the antidepressant is discontinued, depression does return, at which point grief counseling, therapy and/or restarting medication treatment are all options.
But long-term clinical depression doesn't go away forever on its own. Rhonda could be headed for a serious mood crisis if she stops taking her medication. Her doctor should evaluate whether to try prescribing a mood stabilizer along with the antidepressant.
Next: The problem of side effects
