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
I understand your frustration at your doctors just not getting it. I don't condone it, but I lied to my pdoc to get off off Geodone and onto Abilify. And it made a whole world of difference. We have to be our own advocates. Too often pdocs feel that as long as you aren't in the hospital or suicidal it doesn't matter the quality of the life you lead.
I don't think splitting up a dose of seroquel into three will make much difference because most of the people I know will take their whole dose of seroquel at night because it makes them too drowsy otherwise. Changing doses like you do - may not be the best idea. It gives you ups and downs which make hypomania and depression more likely. The ideal would be to find a dose of seroquel and stick with it. It the fatigue is getting to you, you may want to try it all at night.
What I worry about is the kindling theory. Each time you allow yourself to reach a mixed state, depression, or mania/hypomania the pathways in the brain are forming a stronger connection. Its like if one person walks on the grass there is no path formed, but if that same person travels that path 3-4 times a day eventually the grass will give way and a permanent path is formed. They think it is similar in the brain. That each time we experience an episode it makes the next episode stronger and more frequent. If we can stop episodes from happening, the pathways in the brain will weaken, and we'll get less episodes. Again this is a theory, not a proven fact, but from the neuroplasticity stuff I have been reading more of lately it makes a great deal of sense.
Here we can't get meds without a doctor's prescription so I have to play by his rules. I am lucky that I am smart enough that I can advocate for myself, and sometimes tell him what he needs to hear to change his mind versus the 100% truth. Don't get me wrong my pdoc is a lovely caring man. I think the world of him, he helped me out of a very dark time. He is a human though, and he wasn't listening, so I did what I had to to get the treatment I needed.
Good luck