[raulsaul]

I’m not at all claiming to be an expert, but my understanding is that currently, the best treatment we have today is adherence to lithium and other medications used to treat BD (I used BPD earlier but realized that’s an acronym more regularly used for borderline personality disorder).

By the way I assume you were using chemotherapy figuratively, but in case not, I’ve never heard of chemotherapy being used to treat BD. All medications have side effects and it really does come down to a cost-benefit analysis, which I think is especially hard for mood disorders as the medicine can feel like it’s taking away someone’s sense of self.

I agree understanding and avoiding triggers are part of treatment. Some well known things like jet lag are known to make the condition worse, and I’m unsure if things like that are unavoidable for my brother.

A lot of what I was alluding to when asking about sticking to treatment and medication was anosognia, which is when someone is unaware that they have a condition. In the case of pure manic BD, I suspect a lot of people struggle to identify their condition as an issue because they rarely hit that depressive low, which results in refusal to treat their condition (even holistically, disregarding any medication), and ultimately, repeated hospitalization.

[aatd86]

Chemotherapy is actually a general term which means treatment by medicamentation as opposed to other kind of treatments.

I agree that nowadays it helps, and it can stabilize patients.

I was just explaining that it's not a cure nor a panacea and sometimes, the adherence has worst outcomes if it's forced despite the negative effects it can create on patients. The issue is that some effects of the medications are attributed wrongly to the illness by clinicians.

But yes, on the patient side, there can be a lack of awareness of the dangerosity of their altered behavior. Although I'd tend to believe there is (at least partial) awareness of the altered cognition.

The truth of the matter is that because the chemotherapy is too crude an attempt to control/tame the neuro-transmission, it can also affect mood and cognition in ways that make the treatment difficult to sustain for the patients or can lead to worse outcomes.

My point is that before medicamenting people suffering of such ailments to oblivion, there needs to be more research being done. Then again, in acute manic or psychotic phases, taming the CNS and PNS is of course the priority.

It's really a delicate balance.

There are a lot of psychoactive substances other than drugs that clinicians neglect mentioning (tea, coffee etc) that can in some cases be triggers. Also, it might sound a little too edgy (although it is part of some therapies) but properly conducted meditation (neutral observation at a distance of one's own thoughts, emotional state and sensations) can help. The rationale being that people tend to identify with their thoughts but the brain can be naturally chatty. It can help to take some distance from it as if it was someone else (not depersonalization which is something else).