I was diagnosed as case of bipolar disorder about 20 years ago since then I was under treatment. Though I had psychiatric treatment earlier also. At present I am being treated by a veteran retired visiting psychiatrist and on librium tapering off. It is reduced from 10 mg TDS to 5 mg BD in last three weeks and we are likely to finish it in next three weeks. I am taking bupropionSR 150 OD and topiramate 25 BD. I am also taking amlopres. I feel anxiety and hyperdynamic specially in morning to noon rest of the day is normal. I take librium 5, topiramate 25 and amlopres at 7.00 from 8-12 or so I feel above mentioned symptoms rest of the day is normal. As I read more about the disorder medicines prescribed, their interaction and side effects watched related videos I feel more scared and confused. My question is tapering off schedule and treatment wise are we on right track?

Dr. Saul PereiraPsychologist47yrs exp

93% (43633 ratings)

Ask Free Question

If you have read so much about the condition I am sure that you have read that you must work with a therapist in tandem with the medication. That you have chosen not to involve yourself in therapy is causing all the confusion, delay and the lack of recovery. It can be a crippling disease if not treated and if treated early the prognosis is good. When you work in tandem with a counselor for a long time you will learn coping skills and techniques to handle the daily challenges you will face. There are certain adaptations that will suit you during the elation phase and there are certain behaviors that are required during the depressed phases. In the meantime you can do certain things that will give you benefits anyway. Emotional therapy will alleviate a lot of the problems faced in this condition because it is a mood disorder. You need to particularly look at your levels of anger both for its reasonableness and to express it in appropriate manner. I suspect that much of this anger may have origins in early childhood that you may never be aware of now. Talk to your parents and explore that angle. This information will help the counselor too. Also you will need to check whether there is any genetic factor involved. You must exercise regularly, eat healthily and sleep normally too. If your motivation and cooperation is good much can be achieved. You must have a time-structured schedule filled with interesting and reasonable activities and it must be monitored for compliance and delivery. The reason I say this is that many times you will be inclined to have grandiose notions and confidently believe that you can do without the medication. This will set you back many months in the treatment and delay and sabotage the recovery: forewarned you are forearmed. If this combination of medication with therapy is maintained for at least three years without any episodes or breakdowns, it is possible to taper the medication in consonance with the doctor. Bipolar is characterized by two extreme poles i.e. feeling very high (mania) and suddenly feeling very low (depression). 

1 person found this helpful