What does treatment-resistant mean?

I had my pdoc appointment yesterday and we talked about how I still have episodes despite being on all the types of medication and different combinations she can think of. We talked about how the cycle hasn't really changed at all since my first episode and how I've never been stable and said I'm treatment resistant. I've heard that before but I have no idea what it really means. Does it mean there's not really any hope for stability? My cycle is every one or two months, manic for one or two weeks then depressed for a few days to a week. She said her next step would be to put me in the hospital for an extended period but she doesn't think it would do anything because I've been admitted so many times and its never had any effect.

So, what now? It seems I've finally run out of options. The medication combination I'm on now seems to help with the depression and that's it, and its the first one that's worked at all. What to do? I would actually give the hospital another try if I thought it would help at all.

I am sorry to hear you are in this position. Did your psych say what would be the treatment and goal of a hospital admission. If not that is the first thing I would ask. Have you had therapy too as sometimes a combo of both can work wonders.

Cracked

I think the goal of the hospital would have been to find a way to get me stabilized, so they would probably do a complete overhaul with my medication regimen, maybe try a therapy I haven't done before. I know the hospital does ECT but I dont think it'd be helpful in this situation (although I know nothing about it).

I've already done CBT for anxiety and DBT when they were saying I had borderline, I've never been offered anything else but talk therapy but the therapist I've been assigned kind of makes me uncomfortable and I don't feel right asking for a new one simply based on his gender. It makes me feel rude for basing my decision on something as trivial as that but I don't feel comfortable talking to guys.

Hi Ricky,

I was labelled treatment resistant at one point too. The psychiatrist at the time decided the best thing to do was drug me so completely that I'd turn into a zombie and therefore unable to be manic. I hope you don't have to go through that. I lived in Alberta for 4 years and it seemed like every single bipolar I met there had gone through ECT in Alberta Hospital. Every single one of them regretted it because of the memory impairment.

It's possible there are more factors in your bipolar than simple neurotransmitter imbalance. Nutrition, routines, & sleep hygiene were the BIG ones for me. Once those were addressed, along with opening up about past trauma, things finally started to fall into place. I also came to realize my hormones were horribly imbalanced and it was having a negative effect on my moods. It was a problem solved by altering diet & taking some herbs.

This is your journey, though, and I suggest you listen to your own instincts about what your solutions can be. Remember the only expert in your life is yourself.

RickyBee wrote:I think the goal of the hospital would have been to find a way to get me stabilized, so they would probably do a complete overhaul with my medication regimen, maybe try a therapy I haven't done before. I know the hospital does ECT but I dont think it'd be helpful in this situation (although I know nothing about it).

I've already done CBT for anxiety and DBT when they were saying I had borderline, I've never been offered anything else but talk therapy but the therapist I've been assigned kind of makes me uncomfortable and I don't feel right asking for a new one simply based on his gender. It makes me feel rude for basing my decision on something as trivial as that but I don't feel comfortable talking to guys.

I think that you are allowed to question about having a female therapist. I had issues about that. I was told that it might help me to have a male one and I might be challenged about it by the therapist to explore why I needed to have a woman but that I could ask for one. It might be worth a try.

Cracked

ladyswan wrote:It's possible there are more factors in your bipolar than simple neurotransmitter imbalance. Nutrition, routines, & sleep hygiene were the BIG ones for me. Once those were addressed, along with opening up about past trauma, things finally started to fall into place. I also came to realize my hormones were horribly imbalanced and it was having a negative effect on my moods. It was a problem solved by altering diet & taking some herbs.

This is your journey, though, and I suggest you listen to your own instincts about what your solutions can be. Remember the only expert in your life is yourself.

How would I find out which ones of those would help me if any? My wife had me taking vitamin D for a bit but I just couldn't stand taking another pill if I didn't absolutely have to. It just seemed like too many.

CrackedGirl wrote:I think that you are allowed to question about having a female therapist. I had issues about that. I was told that it might help me to have a male one and I might be challenged about it by the therapist to explore why I needed to have a woman but that I could ask for one. It might be worth a try.

Cracked

I know why I would need a female its just kind of a stupid reason that I need to put behind me, and if they asked me about it I highly highly doubt I would say anything. I think the thought of being asked about it is what might be keeping me from asking about changing therapists.

Right I see. Do you think you could tell them you have a reason for it but you dont want to discuss it?

Cracked

I'm sure I could at least try that. Realistically I know they would be accepting but I just can't bring myself to say it to them for some reason.

The best way to find out would be to have your blood & urine levels checked, but most GPs don't order these kind of tests anymore. I had to go to a naturopath and paid almost $300 to have it done, along with a battery of allergy tests. She found several deficiencies, some overabundance of nutrients (which can be just as bad as a deficiency), and a couple of food allergies. If you have good insurance it'll usually cover a certain amount for these type of appointments each year.

The other option is to educate yourself as much as possible and to keep a food journal. Write down everything you eat and what time you ate it ate. Record your moods throughout the day as well. Eventually you'll see a pattern emerge and can learn to avoid the food that have a negative impact on your moods. Try to remember that if your eating schedule is irregular your blood sugar may become imbalanced and contribute to mood swings.

RickyBee wrote:I'm sure I could at least try that. Realistically I know they would be accepting but I just can't bring myself to say it to them for some reason.

Sounds like this is a real issue for you. Do you think you can psych yourself u and say today I am going to ask, and take a dee breath and say it. I know it is difficult.

Cracked