remission recovery etc..

[adel_ezz]

Remission is the state of absence of disease activity in patients known to have a chronic illness that cannot be cured

A recovery is a restoration of health or functioning.

in BP pts cannot be cured so i understand there is no remission (except perhaps temporarily like in euthemia etc..) although i read once that it can be outgrown at the age of thirty but i don't believe it, i.e. a lifetime disease.

In my case, for the 1st time, in this past 2 years i am almost stable and functioning thanks to seroquel. I go to work and am only absent from it one day every few weeks. So it's ok i suppose. I also didn't consult any pdoc like I used to do it regularly every week or so especially during my 2 manias. So 2 years with no mania, no depression and no pdocs

HOWEVER, I have a friend doing a master degree in biology and interested in neurotransmitters, he told me what i do w.r.t my meds is wrong and very bad for my brain and will destroy my recovery because my meds are: 1mg risperidone, 1mg stelazin (typical AP) constant dose, but he criticized my dose of seroquel. I take 150mg, then after a few days i feel very lethargic and depressed a little and sleep a lot so i reduce it by 12.5mg (half a pill of 25mg) if i find that i am still sleepy i reduce it by another 12.5. Directly my mood is up and feel ok, but after a few days i have a beginning of mixed states, so I up my dose again by half a pill, etc..etc.. So in fact i am alternating between 125 and 150 for months now. Moreover the pamphlet says seroquel is taken twice a day, but i take in general 37.5 in the morning before going to work (sometimes 25 only) then 50 at noon and 50 before sleep. This friend says i shouldn't do that except with the consent of my pdoc. However i never felt stable except when i quit visiting him, for pdocs in my country are bloody ignorant donkeys, some are better like shoemakers. In fact my mother is my best pdoc. My father read tons of articles about bipolarity. He concluded that none knows anything and all is trial and error. So really they are my pdocs and i am stable for the 1st time in 2 years, i don't use any AD anymore, perhaps I changed from BP2 to BP1.

Do you think I am committing a mistake, OR it's OK
many thanks

[Anneinside]

The kindling effect works with both mania and depression. In fact if you have one episode of depression you have a 50% chance of having another. with 2, you have a 75% chance of another, and so it continues.

[lindahand]

My understanding is that kindling works in both directions. If you only get mania/hypomania and not depression than the kindling would only happen towards the manic end of the spectrum but if you get both than both the mania and depression would be 'kindled'

[adel_ezz]

i posted a view about kindling in the post kindling effect. I am rewriting it here to see your opinion about it

I agree about the kindling effect. But the episodes will be to the manic side. i.e. the fear that you will get another mania and the maintenance dose is higher up. Do you agree

My 1st episode was a depressive one. Under an AD i became manic, then depressive again with a lesser AD then manic again. Now i don't take any AD but only an AP, yet i am high with a tendency to hypomania or mania. So i assume kindling is sensitivity towards mania and NOT depression.

[Anneinside]

You would have only changed from BP 2 to BP 1 if you had a full blown manic episode. Depression, or the current lack of it doesn't mean your diagnosis has changed. How are you getting your medication if you aren't seeing your pdoc? Your family physician? You should be telling your prescribing doctor what you are doing with your medications. If you are doing well, and you seem to be, he/she will probably just formalize what you are doing and write the prescription to fit that. We can't trust everything we read on line such as the idea that you outgrow bipolar at the age of 30.... no one outgrows bipolar. If you are lucky, you stay stable and don't have episodes for a long time, but you don't become cured.