Is It Okay To Discontinue My Medication So I Can Tell If I Still Need It?

“I have bipolar disorder. Every few months I stop taking my medication. It seems as if I would be more stable if the medication was working. But, then I have a terrible time. Once I even wound up in the hospital. My doctor tells me this is dangerous, but how else will I know that I am better if I don’t do this?” 

This is a somewhat common question. Many people with bipolar disorder assume that their dependency on medication to maintain stability is not a permanent situation. Research has occasionally, but not usually, indicated that this occurs, but seldom. The etiology of a bipolar disorder is partially physiological and partly psychological. The physiological component refers to an abnormality in the brain, the psychological component relates to environmental factors.

While environmental factors can be addressed in therapy, physiological factors must be addressed with appropriate medication. The process of reaching the most effective medication usually takes from several months to several years. Hence your statement: “every few months I stop taking my medication,” is a real issue for me. First of all, you are not giving the medication enough time to take full effect. In addition, it is a small minority who are able to “get off” medication. These are invariably people who have less of a physiological etiology for their illness, and a stronger influence from environmental factors. In addition, they have addressed their psychological issues and have changed their lifestyles to include regular exercise, healthy eating habits, regular sleep patterns, regular medical checkups and other health enhancing activities. In other words, these people anticipate the inevitability of triggers and do everything within their power to “ward them off.”

So, you will know you are better when you feel stable for at least three or four months, if not even longer. When you have maintained your stability, including the ongoing practice of a healthy lifestyle, you may wish to discuss the level of your medications with your prescribing psychiatrist, with the possibility of lessening or eliminating medication over a period of time to see what happens. The extended length of this process and the strong need for medical supervision is most important.

With these efforts, you may be one of those rather rare people who are only on medication for several years, rather than a lifetime. The most important factor in this process is your own commitment to change and support from others. You will not be able to eliminate the need for medication on your own. You will also need to develop a network of support systems in order to have a better chance to meet your goal. With a good support system, even if you have to continue medication, I guarantee that you will be healthier, happier, and lead a richer, more fulfilling life.