Rational vs. Irrational Fears About Bipolar Medication

March 6, 2013 Natasha Tracy

Recently, our blogger Natalie Jeanne Champagne wrote a post: Mental Illness: Understanding Rational and Irrational Fears and this got me thinking about the fears I, and others, have had about bipolar medication. Some of the bipolar medication fears are completely justified and rational while some really are not. Some are fears that stem from real possibilities while others are often propagated by fear-mongering groups online or our own internal catastrophizing.

Bipolar Medication Fears

I’ve written before about the fear of taking antidepressants and I suggested that you shouldn’t let fear stop you from trying a treatment that is appropriate and may help you regain your mental health. I’ve also written about how scary it is to take new bipolar medications and how that fear can feel overwhelming. So I acknowledge that fear is real and it has real effects on how we choose treatment.

Rational Bipolar Medication Fears

And many of these fears are completely rational and reasonable. For example:

  • I’m scared of gaining weight
  • I’m scared of getting worse
  • I’m scared of long-term use effects
  • I’m scared of the effect these medications may have on my emotions (feeling numb)

These are quite reasonable fears. And these fears have rational responses:

  • You can track weight and cease medication if your weight starts to change
  • You can track your mood and alter treatments as needed if your mood changes
  • Routine physical s and blood tests can keep track of your health long-term and alert you to any issues
  • If you find (after a suitable period) that you are not feeling “yourself” you can re-evaluate treatment choices

And because the fears were rational in the first place, rational responses can normally alleviate them.

Irrational Bipolar Medication Fears

But then there are the irrational bipolar medication fears. Because these fears are irrational, they can be much harder to alleviate with reason and logic. For example:

  • I’m scared of being addicted to the drugs
  • I’m scared the drugs will kill me
  • I’m scared that I can’t trust my psychiatrist
  • I’m scared that the medications don’t work and are only placebos

Now, to be fair, some of these fears are partially rational but they are also partially irrational because:

  • Addiction requires both the dependence on and the abuse of the drug. This means that you would harm your life or the life of others in order to obtain more and more of the drug. This just doesn’t happen with drugs like antidepressants and mood stabilizers.
  • There is no evidence that this is the case. I know that some groups will try to scare people into believing this is true, but it just plain isn’t. (And for the record, many other types of drugs do, routinely kill people. Psychotropics (when used as directed) are incredibly safe, comparatively.)
  • It really depends on why you don’t trust your doctor. Do you simply not mesh with him/her? Then it’s time to find a new doctor. However, if you don’t trust your psychiatrist simply because he/she is a psychiatrist, then you are being irrational.
  • Study after study proves this is not the case. The FDA requires this proof to approve a drug. Yes, the placebo response is real, but so are the therapeutic effects of these drugs.

However, if you really do strongly have those irrational fears, my rational answers might not have helped you feel better.

Standing Up to Irrational Fears about Bipolar Medication

Instead, we need to acknowledge that a fear is irrational in order to conquer it. Irrational fears are only bested when we, personally, stand up to them and say we won’t listen to dark, illogical, fear-mongering voices.

And once we do that, the logical answers become much clearer and much more comforting.

Because it is completely reasonable to have fears around bipolar medication; but it’s important to evaluate these fears with reason because irrational fears can hold you hostage if you’re not paying attention – and that’s no way to live or to get better.

You can find Natasha Tracy on Facebook or GooglePlus or @Natasha_Tracy on Twitter.

APA Reference
Tracy, N. (2013, March 6). Rational vs. Irrational Fears About Bipolar Medication, HealthyPlace. Retrieved on 2024, July 17 from

Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate, and author of Lost Marbles: Insights into My Life with Depression & Bipolar. She's also the host of the podcast Snap Out of It! The Mental Illness in the Workplace Podcast.

Find Natasha Tracy on her blog, Bipolar BurbleTwitter, InstagramFacebook, and YouTube.

March, 6 2013 at 8:43 am

I am afraid that the psychiatrists are too readily led by the drug companies, and that if the medication doesn't work and you don't respond that the patient is blamed (i.e. the p doc takes it personally that you're not following directions or not trying hard enough.) Any feedback?

March, 6 2013 at 8:50 am

Thanks for this I just picked up Depakote to add to my Prozac. I'm terrified of gaining weight and going bald. And that I will have no up times when I need them. Do you know of blogs or sites where people share fears and stuff -- or would they just be a big blog of negativity? Ugggh. Blessings

Melody Brown
March, 6 2013 at 7:41 pm

Yet again, your timing is immaculate, Ms Tracy. Have been on quetiapine for two weeks. Yesterday, I fainted. Was sent to A&E for ECG and bloods. I'm perfectly healthy, apparently. Makes me wonder if the reading of side effects makes you get them...Not that you shouldn't read the side effects, but does knowing what it can do make it happen? Anyone else find this?

March, 7 2013 at 3:05 am

I went to my first meeting with psychiatrist today who told me I have bipolar 2, not surprisingly. Now I have to add lamotrigine and decrease the antidepressant I already take. And as Linda says I am afraid there will be no up times and that I will be really flat with no emotions and not feeling myself, because I like myself when I am hypo!!! :(
I guess I will just have to wait and see...

Charles Mistretta
March, 7 2013 at 3:28 am

One analyst defined me as thrill seeking. Ok, so fear is not one of my primary concerns, but I still have to live with the consequences of my acts, and that can be scary.
The results of drug-use was made acceptable by managing medications myself - with the aid of my doctor. If something works, I continue to use it, if not, I stop using it. Keep in mind that most chemicals have a half life - they will linger on (details omitted) after they are discontinued. For this reason and a whole lot of others consult your doctor before changing dosage. Thourghly research any recommendations for changes to medication before presenting them to your doctor. Don't be disappointed if he/she disagrees with you. And, doctors can be like clothes when they don't make you look or feel good. You change them. Unlike clothes most doctors are usually qualified to advise. Bi Polar is a mental disease, not a lifestyle.

March, 7 2013 at 8:14 pm

Everyone who's trying to get handle on their mental &emotional illness _Bless you all!!!Know it may sound pat or trife But it does get better!Well remember 43yrs earlier when first suffered reality break &didnt receive proper diagnoses until six yrs later!Only then was I put on proper meds for B.P.What joy that was to get diagnoses!Took over half life time !For all to improve !Thankfull it all has!Systems have improved as well!Thank Gods!!!

Dr Musli Ferati
March, 8 2013 at 8:48 am

Medication of bipolar disorder as primary psychiatric treatment option exhibits many types of fears, which ones compromise seriously current psychiatric treatment of this mental disorder. Your classification of these fears into two groups has got important clinical importance on the one hand and indicates great meaning on definitive outcoming of this provocative psychiatric entity, on the other side. In the meantime, medication should to be unavoidable therapeutic approaching og bipolar mood disorder for long time period under close supervision of clinical psichiatrist, in order to control and prevent eventual relapse of mood disorder. To avoid side nus effects of bipolar medication it ought to respect the recommendations of psychopharmacologic treatment of this illnesses. To achieve these therapeutics aims, it should to educate patient and its close relatives on cardinal principles of medication and its crucial role on satisfying treatment of bipolar disorders. Anyway, medication of bipolar disorder outruns all these rational and irational fears that exist on psychiatric drugs and their side effects, as well.

March, 30 2013 at 12:20 pm

I don't agree with your categorization of irrational fears.
The entire placebo issue regarding antidepressants was fluffed over in this article, and that's a mistake. Learn more about selective publication, for just ONE reason all those studies showing these drugs work great are not to be relied upon. This FDA thing is just wrong - drug companies ran a dozen drug trials for Paxil (pretty sure it was Paxil) in order to get just 2 studies showing it was effective. They cherry-picked those 2 studies and submitted them to the FDA, and were approved.
And antipsychotics do routinely shave years off of peoples' lives, with long term use. Psychiatrists admit this, but not generally to patients. Antipsychotics are NOT incredibly safe compared to most prescription drugs.
Lithium DOES ruin your kidneys with long term use.
Why not be concerned about long term use when the docs say you have to take these drugs forever? Isn't that long term use? Why is that an irrational concern, that you will need a kidney transplant someday, or you are going to get diabetes from your antipsychotic and die 10 years younger than you probably should have?
I think there is some confirmation bias going on here. Nobody makes excuses for chemo drugs - they are poison, and people decide the poison is worth it to save their life (many decide not to do chemo). Bipolar drugs are poison too, especially in the long term, and they don't work nearly as well as people think they do. Don't fluff over that. It's not informed consent when people are told these concerns are irrational by their doctors, or by friendly bipolar bloggers who are trying to help.

March, 30 2013 at 12:21 pm

I should have suggested that people here read the article by John Ionnidis about antidepressants and how there can be so many wrong studies about them. His article is the most downloaded article ever on PubMed.

walter smithfield
November, 19 2013 at 10:11 am

So as to avoid "irrational concerns" readers should inquire pursuant to their legal right to informed consent:
* what is the efficacy of these drugs I am prescribed?
* In studies, what percent of patients responded positively?
* In those studies, what was the definition of a successful response?
* What are the risks and why should I take risks that appear to jeopardize my general health goals?
Patients have the legal right to know the answers to their questions that some demean as, "irrational."
Each patient has the legal right to self-determination unless he is judged to be a threat to himself or others.
In each State, the federal government establishes offices to protect and ensure the rights of the mentally ill free of charge. Contact the Protection and Advocacy agency in your State for advice about your legal rights and privileges.

Michele simko
September, 16 2014 at 1:48 pm

Need to stop lithium due to hyperparathyroidism. After 30 yrs of taking lithium need to switch to depakote. Fearful I will have stow thoughts slow movement etc. live alone . No close friends or family. I've needed help before and no one was there. I hate to go thru that again. It is so hard. Where is the compassion in man. I know I will do my best,however often when not feeling well I fall short.

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