I once again answer the critics on why this blog about bipolar disorder believes in medications for bipolar disorder!

med questionI continually receive comments, posts on social media and direct emails trying to ‘open my eyes’ to the dangers of psychiatric medications. If you look below to the post under this one, you will see a post on Lamictal (lamotrigine) from a few years ago.

I re-posted the entry so that you could see the comments I receive from those who for some reason feel that a balanced blog that stresses management skills with medications when needed would be open to the idea that NO ONE with bipolar disorder should take medications.

 I guess they think I just love putting these toxic things in my body! I don’t like what medications do to us physically, who would. But as someone with very severe rapid cycling where I can go in and out of strong mood swings five or more times a day, sometimes a great management plan isn’t enough.  When I can’t sleep AT ALL because the mania is acting up,  using my management skills often isn’t enough.  The latest comment  I received gave what I consider dangerous advice to a reader- the advice- Get off psych meds as they are toxic and don’t really work.

Let’s be really clear here.

Medications are TOXIC! But to say they don’t work is ignorance in its most basic form.

 Please know  that I love a good debate- I love opinions and I often post opinions I don’t agree with. But when the opinion is dangerous to the health of those with bipolar disorder, I will post it, but I will not let the misinformation move forward without adding my opinion.  For those out there who are against medication use in mental illness, please know I respect your opinion! If you have a serious mental health disorder and it works for you not to take medications, I am happy for you.   If you want to get your message to the world, you are in the right country to do so.  But please know that this blog is not the right platform for your views.

 The comment that got me going this morning basically said that anyone who takes Lamictal is a fool and should stop it immediately as it doesn’t work and any success a person has on Lamictal is a placebo effect. Here is my reply: 

Hello Ellen, I’m posting your comment as I believe that a conversation about medications is important. I also like your balanced approach in writing. I will say that I do disagree with you about the Lamictal for a reason you might not expect. Robert Whitaker got it right in so many ways- but the biggest issue I have with the argument you present is that there are some of us who will die if we don’t have medications such as Lamictal. This doesn’t make the medications any less toxic. Do you think I like the stiff neck, breathing problems and itchiness I get with Lamictal? Heck no! But… when I don’t take it I often go down to 50% functioning because my rapid cycling is so all encompassing, I don’t have the energy to do what I have to do to move forward in life. Just this week my hypomania was so intense I had to take EXTRA medications to get back to baseline. I don’t want to do this! I have to do this.

I have a question- Do you take any medications? Tylenol? Aspirin? A sleep aid? Maybe something for a persistent physical illness?  Have you read their side effect profiles? I especially love the bleeding stomach ulcers that come with aspirin. I rarely find people who are against psych meds who are just as against meds for physical ailments. I ask this question with respect- do you go onto blogs that address those who have heart conditions and tell them to get off their medications?

Do you tell cancer patients to tough it out and NEVER use chemo? Would you put people’s lives in danger on sites that are not about mental illness?

If the answer is no, then how on earth can you in good faith go onto a blog such as this one and tell people to stop the medications that might be saving their lives? Think about it.

My coauthor Dr. John Preston and I revised my book Loving Someone with Bipolar Disorder to address the medication question more fully. We added a new chapter in 2012 that addresses the dilemma all of us with bipolar disorder face when we need medication.

When people tell others not to take psych meds, they are risking the lives of the other person. If you are ok dispensing information such as telling someone the medication that helped was simply a placebo affect, are you just as willing to talk to the loved ones if that person takes your advice, goes off meds and ends up killing herself?

If you are willing to take this risk- then I say continue your work to make others feel bad about taking medications that are often needed, but be aware of the moral liability. I do respect your right to an opinion- which is why I posted your comment. I do respect that what you described worked for you, but.. and I mean this with the greatest respect- bipolar disorder is a very dangerous illness and anyone who has the nerve to get online and suggest to ill and often fragile people that medications don’t help is a danger to people with mental illnesses.  People who are ill often can’t see that they need medications and feed off of information such as yours- ask any parent who has gone through this and they will tell you that it’s the misinformation on the web that causes the most problems when a manic and psychotic child desperately needs help but instead sends the parents links to comments such as yours. I used to be quiet about this, but after five years of coaching parents and partners who are in this exact situation, I’m using my voice to do something about it.

Many of us would not make it without medications. I can’t stand what they do to our bodies- the weight gain, the skin problems, the twitching, the apathy and the memory loss- but, if I have to go through that in order to get myself out of a serious episode I will. You may notice that I have ZERO drug sponsorship on my sites. I could make a lot of money going that route, but I don’t do it. I believe in a full spectrum management plan where drugs are a PART of the system. This is why I am often off drugs for long periods of time.

Please know this simply isn’t the place for scaring and confusing others who are starting the journey to management. Bipolar disorder is not anxiety -it’s not depression and it doesn’t fit into the more moderate type of psychiatric illness that can be treated without medications. Instead, it’s a complicated and dangerous illness that often presents all of the symptoms at once- as you see in dysphoric manic episodes.

In the future, I hope you can find a blog that fits your needs. Bipolarhappens.com is not that blog. This blog has always been and will continue to be a place where those who want and need medication can come for information.

The Bipolarhappens.com blog also offers free information on how to manage this illness outside of medications. This is not a site where we put down the use of medications: ever. This is a site where the balanced use of medications if needed is discussed. No one is blind to the problem, least of all me- ask me again about my three cracked teeth, weight gain, rashes and fibromyalgia- I do get it that having to take these medications sucks. I use a management plan for 75% of my symptoms- it’s called The Heath Cards- when the 25% shows up- such as my continual hypomania- I TAKE MEDICATIONS.

Thank you,


Reader Question on Lamictal (lamotrigine) Side Effects

LamictalLamictal is a mood stabilizer used to treat bipolar disorder depression.

The generic name is lamotrigine.  The basic dose is 200 mg, though the dose can vary greatly depending on the person. It usually has very low side effects, but there can certainly be some that interfere with life! Here is a question from a reader (Jon) about Lamictal side effects.

Hi Julie,

I’m taking 800mg of lamictal a day for epilepsy, and Ive had a problem with my throat for the past 2 years (almost since Ive been on the medicine. Primarily continual clearing of my throat and a sensation of something stuck in the back of my throat. Ive seen tons of drs, checked me for all nasal and stomach issues, all to no avail. My last dr said it could be some type of tic, but I wasn’t sure. Has anyone else heard of something like this? Any help or advice would be greatly appreciated!!! And thank you all for sharing your stories.  Jon


Hi Jon, this is a normal side effect of Lamictal. I’ve noticed a lot of side effects that affect the head area. Neck pain and twitches, itchy face, yawning, trouble breathing, trouble catching your breath. It’s a great drug (in terms of having to take meds)- and it usually has few side effects. 800 is a LOT of Lamictal. I take 700 and that is also high. These doses are not studied in terms of bipolar disorder. So these side effects are not well documented. I’ve been on it since 2005 and if I go off it, my depression is quick. I wish I could have stayed on a lower dose, but it stopped working. The 700 has helped for a few years. I don’t think I will go up with it. I would rather add something than risk going higher.

Another thing to get checked. An ear, nose and throat doctor can check for cysts on the thyroid. This doesn’t mean there is anything wrong with the thyroid- they are very common- but I often feel there is something stuck in my throat.

Spreading out your doses can help.

And finally, is it there all of the time? Or does it come and go? Or…. does it start when you take the meds.

Regular medicine rarely understands the side effects we go through- they are so odd! Who would think a medication could cause constant yawning!

Hope this helps!


My Bp Magazine Blog Post: Does My Teenager Have Bipolar Disorder?

Teenagers gloomy


It’s hard to know if your teenager has bipolar disorder simply because teenagers are emotional creatures!   How are parents supposed to figure out what is typical and what is a possible bipolar disorder symptom when so many teenage behaviors seems to mimic the ups and downs of bipolar disorder? I address this question in my latest blog for Bp Magazine.




After years of working with parents who ask me this exact question, I came up with a quick tool all parents can use to at least determine if a teenager needs an evaluation from a health care professional.  It doesn’t take a lot of time, but wow, it can save a lot of future grief!

Click here to read the blog post from Bp Magazine and visit BP Magazine on Facebook and let me know what you think!



Do You Care About Someone with Bipolar Disorder Who Refuses Help for Bipolar Disorder?

communicate blueYou are not alone! Many people with bipolar disorder can’t see they are ill and many know they have the illness, but stubbornly refuse help!

Here are three tips to ease your loved one into future treatment: 

1. If the person refuses to say the words bipolar disorder, don’t try to force the issue…yet. Instead, talk about feeling good, feeling down, feeling upset or feeling angry.

2. Focus on sleep. Many people with untreated mood disorders are open to getting help for sleep. Talk about sleep studies, small doses of melatonin four hours before midnight and talking to a professional to get help for sleeping issues.

3. If it feels right, talk about anxiety. I’ve learned through working with parents and partners that people who refuse to use the words bipolar disorder will often have an open discussion about anxiety, especially men.

There is always hope. People change and those who can’t see they are ill or who simply refuse help today can get better. I see it in my work all of the time!


Do You Have A Helping of Chronic Pain and Inflammation Along with Your Bipolar Disorder?

Paleo Coach coverI do! I’m currently eating a Paleo diet with the autoimmune protocol (no nightshades, dairy, etc) to deal with an intense back and hip injury from a  biking accident.   When I say I’m eating a Paleo diet, I means I’m working it, but I haven’t reached a point of following it completely.

The Paleo concept isn’t complicated. Many of the foods we eat today are so new our bodies are not always able to digest the foods in a natural way.  This way of eating isn’t about losing  weight, it’s about ending physical problems. The basics:  You eat nutrient dense foods with an emphasis on meat, vegetables and fruit.  Grains and legumes are not consumed due to their propensity to cause digestion problems. This is why beans, beans the edible fruit, the more you eat the more you toot happens! Some people eat dairy, but for myself the resulting digestive problems have made it obvious I’m not able to digest the lactose at this time, etc etc. It’s a very personal diet that represents a life style and not a quick fix.

I have so many emotional issues around eating and my bipolar disorder that changing my diet completely wasn’t a realistic beginning goal. I’m taking it slowly! 

 I’ve lost 35 pounds so far- I have miles to go before I sleep and many promises to keep and… I’ll stop the poetry here, but you get the idea! I was overweight when the accident happened, but quite healthy.  I have 60 pounds to go and will keep you posted!

My advice?

If you have bipolar disorder and any inflammation problems from joint pain and fibromyalgia to tiredness, bad skin and bloating to being overweight,  the Paleo approach offers an alternative to living a life in pain. My goal is to one day follow it fully over a long period of time. It’s what I have to do in order to stay out and about. I got my life back- I feared my injury ( crumbling back, dislocated hip, slipped pubic bone and the resulting ligament and muscle damage from the biking accident) was permanent and that the chronic pain would continue. Paleo gave me a free ticket to a happy life in a strong body. Following it is a BIG, TOUGH and DIFFICULT challenge, but I will not stop until I have a strong and trim body that can hold up my crumbling spine!!!

I taught myself to manage my severe bipolar disorder two. I can do the same to create a strong and healthy body!

I recommend the book The Paleo Coach as a primer. I’ve met the author Jason Seib and he is the real deal.


Bipolar Disorder II and Psychosis

ensor psychosisI call psychosis the forgotten bipolar disorder symptom!

My bipolar psychosis started at age 19.  I consistently had hallucinations of seeing myself killed  and thought it was normal! I eventually learned to manage my psychosis, but it sure would have helped if the health care professionals in my life had explained the symptoms of psychosis and that it was a normal part of the bipolar disorder diagnosis!

I just received the following question from Mario on the topic:

Julie, I thought that people w/ Bipolar II don’t get psychotic? Or did you have a psychotic depression?

Hi Mario,

Believe it or not, I’m writing an article on psychosis right now. People with bipolar II can definitely get psychotic. I’ve had psychotic symptoms since age 19. Mine are always with depression – as it’s rare for someone with bipolar II to have psychosis with hypomania. One reason I can identify with so many forms of bipolar disorder is the psychosis. I have hallucinations and as I got older, delusions!

The difference for those with bipolar two who have psychosis is in intensity- people with bipolar I have full blown psychosis – usually with mania. In fact, 70% of people with full blown mania have full blown psychosis at the same time. This is when most people with bipolar I  have to go to the hospital and often have to be committed by a family member.

If you have bipolar disorder or care about someone with the illness, it’s essential that you learn about the signs of psychosis. I have a psychosis  Health Card (my treatment plan) and am especially careful to look for paranoia (a psychotic delusion) when I’m speaking in public!

Thanks for writing!


PS: Here is an explanation of the difference between bipolar i and bipolar II. If you are new to bipolar disorder terms, I think you will find this helpful.

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