Every medical treatment comes with risk. If you have a headache, you could take ibuprofen or you could have a craniotomy looking for brain cancer. One has considerably more risk than the other. (Of course, if you have brain cancer, then the reward could be quite great.) This means every time you undertake a bipolar treatment knowingly, or not, you weigh the risks vs. rewards in your head. And one of your doctor’s main jobs is to manage that risk vs. reward scenario. Doctors, for example, almost never prescribe barbiturates anymore due to the fairly large risk of addiction. Instead, they prescribe benzodiazepines (or nonbenzodiazepines; very similar) which do not carry such an increased risk. In both cases, they carry the reward of managing anxiety. But some people don’t want to take benzodiazepines either, because some people tolerate more risk than others.

I’m a science gal. I practically drown in the stuff. True, I have a natural curiosity for pretty much everything, but also, I try to keep abreast of what’s happening in the research areas of mood disorders and psychopharmacology. Yes, it’s a lot of work. I certainly don’t catch everything, but one thing I did catch a while back was this, “Study Finds No Difference In Nonsuicide Mortality Between Two Anti-Psychotic Drugs.” Basically, neither Zyprexa nor Geodon will kill you more. But is that actually what the study showed?

As I mentioned last time, many doctors feel that antidepressants actually make bipolar disorder worse. Some specialists, in fact, will routinely take people with bipolar disorder off of antidepressants when the bipolar is doing well. Like I said, it’s a matter of perspective. And I get asked all the time about getting off of antidepressants and other medication. So, exactly how should you get off an antidepressant and what should you worry about when doing so?

I recently received a comment regarding bipolar medication, its development and the mental health care system in general. The commenter accuses the mental health community of being corrupt and asks, “Why are we forced to take such bad bipolar medicines?”

If you’ve been diagnosed with a major mental illness, you’re probably not leaving the doctor’s office without a prescription in-hand. There’s a good reason for this: people only get help when they’re in bad shape. When people are in bad shape, medications work the most quickly and the most reliably (except electroconvulsive therapy, but that isn’t generally a first-line treatment for a host of reasons). So, if you’ve just been handed you first prescription with incomprehensible handwriting and a drug name with too many syllables, what’s a person to do? Well, you can start by following these Psych Med Commandments.

On Monday, I talked about what to do if you’ve just been diagnosed with bipolar disorder, and if you’ve read that piece then you know, I recommended a lot of breathing and thinking. I notably did not suggest decision-making. Well, you can’t live in a yoga studio forever.