Q:  Soft Bipolar & Medication Risks

Dr. Phelps
I think you should explain that somewhere in your site if you can't email me. I 've studied all mood stabilizers and I  realized that their side effects are significant and sometimes (even rare) could be fatal. Do you really think it worths the risk for someone with a soft bipolar subtype to use them?
Thank you.

Dear Spark -- 
Good question.  If someone has a soft bipolar subtype, they could have minimal symptoms, or severe symptoms.  In other words, it's not the diagnosis that determines severity -- there are mild and severe versions of bipolar II, as well as mild/severe versions of BP I.  

So, if a person has quite mild symptoms, you're right:  it may indeed not be worth the risk of medications.  A regular personal schedule, especially sleep (regular bedtime and rise time); and a good exercise program; and a social environment that insulates from too much stress, and provides good support for those stresses that do occur -- that could be enough.

For people whose symptoms are more severe, or don't respond to that kind of approach, at some point -- as the severity of the symptoms increases -- are basically forced into considering medications which do indeed carry risks.  Each person will approach this risks vs. symptoms trade-off in her/his own way, and some will wait until their symptoms are really severe before being willing to try a medication approach.  Others will judge the medication risks not so scary versus continued symptoms and start earlier.  

Thank you for your question. 

Dr. Phelps

Published May, 2003