Can You Stop Your Bipolar Medication? – Maybe Here’s How

Bipolar disorder is a serious mental illness that involves recurring episodes of depression and either hypomania or mania. It normally requires medication to treat the acute episodes as well as keep them from coming back once they resolve. But there are people who go periods of time without medication.

However, if you go too long without meds while you are having an episode, the period of time you spend in those episodes without treatment makes future episodes harder to treat. It’s called the kindling effect.

A therapy that can help bipolar disorder is interpersonal and social rhythm therapy. This therapy has been shown to reduce the time of episodes and delaying the onset of future episodes. This can be useful if you are trying to stay off medication in your interepisode period. Interpersonal therapy focuses on problems in your relationships and social rhythm therapy helps you establish regular daily routines.

Five item Social Rhythm Metric (SRM-5)
You would track times for the following activities
(1) Get out of bed, (2) First contact with another person, (3) Start work, housework or volunteer activities, (4) Have dinner, and (5) Go to bed

Videos mentioned
Comparison of Bipolar 1 to Bipolar 2: https://youtu.be/ydLWlAqCpLA
References
Geddes JR, Miklowitz DJ. Treatment of bipolar disorder. Lancet. 2013;381
Naik SK. Management of bipolar disorders in women by nonpharmacological methods. Indian Journal of Psychiatry. 2015;57(Suppl 2):S264-S274
Haynes PL, Gengler D, Kelly M. Social Rhythm Therapies for Mood Disorders: an Update. Current Psychiatry Reports. 2016;18:75.
Step-BD study showing the course of the illness, 58% of people reach full recovery
Miklowitz DJ, Otto MW, Frank E, et al. Psychosocial Treatments for Bipolar Depression: A 1-Year Randomized Trial From the Systematic Treatment Enhancement Program. Archives of general psychiatry. 2007;64(4):419-426.

The article about people doing better when they keep a routine
Frank E, Soreca I, Swartz HA, et al. The Role of Interpersonal and Social Rhythm Therapy in Improving Occupational Functioning in Patients With Bipolar I Disorder. The American Journal of Psychiatry. 2008;165(12):1559-1565.

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