The Poison Isn’t the Medicine: Antipsychotics, Mania and Sleep


What is the appropriate level of antipsychotics necessary to come down from a bipolar mania? This question should be garden-variety to doctors that invest over seven years of their lives into education plus countless hours in practice. What follows is an embarrassment. My insurance was billed over $100,000, six months of my life evaporated and I had to endure the worst abuses of the ruthless psychiatric system all in an effort to find an answer to a very simple question.

After watching the horrific treatment of the United passenger a couple weeks back, I’ve decided to tell my story with full candor in the hopes that others don’t suffer from the same mental lapses that plagued me as a patient. The time has also come for the anti-psychiatry movement to rally around a few key points rather than paint psychiatry dark with broad brush strokes. If we’re honest with ourselves, we haven’t made a dent in stopping the psychiatric bubble that now plagues nearly half of Americans, which is too bad considering that there are a few common sense reforms we should all agree upon.

My doctors have been prescribing mood stabilizers for as long as I’ve been diagnosed bipolar, but the drugs have no obvious effect because at the end of the day I control my moods, not a pill. Lithium was thought to remedy mania since as far back as the Greeks, but it was actually the hot baths where the lithium originated that made the patient’s body tired and finally willing to succumb to sleep, which is the obvious way out of a mania. The other class of mood stabilizers like oxcarbazepine have no active ingredient and no sedative effects; the rumor is that combined with antipsychotics they produce some kind of magical potion to pull a patient out of mania. This theory is complete rubbish. We know antidepressants work just barely better than placebo, meaning they don’t work at all. Something like lithium that is a poison at level 10 cannot be a salvation drug at level 7, otherwise we should all be consuming more lithium. But sadly, doctors are a bit too squeamish to apply such remedies to themselves or their family members.

To test the theory that a lack of sleep would trigger mania and resumption of sleep would restore health, I conducted what I thought would be a straightforward experiment: while still on lithium and a low dose of antipsychotics, I suppressed sleep for a few days. Immediately I could feel the roar of mania within my brain. My mind figuratively stretched and the supposed safety net of the cocktail I was on did nothing to prevent my third mania from occurring. As expected, I felt creative and enjoyed the natural high for a few weeks, but anyone that’s been manic knows that lack of sleep for days on end is analogous to torture. The time finally came to be treated, but sadly, as you’ll soon learn, hospitals have little training for reducing mania if the patient doesn’t exhibit obvious signs like rapid speech and full out psychotic symptoms.

The first hospital I checked into gave me antipsychotics and released me after 48 hours even though I was begging to stay and be treated more thoroughly. The economics of a hospital bed are simple: at $10,000/night, mania/lack of sleep cannot be billed for more than a night or two, and they don’t give two damns what happens to you in the outside world when another sick patient is waiting with insurance willing to pay for longer use of the same hospital bed. After a handful more days, the time came for a second hospitalization. Same initial process, but this time they recognized that I needed more than a 72-hour hold and kept me in the psych ward for a week. However, I had no voice in my treatment and despite obviously needing sleep, the doctor thought it a good idea to wake me up at 5:00 every morning to receive an injection that supposedly dripped antipsychotics into my system, but in reality had no sedative effect and simply robbed me of a couple hours of sleep I badly needed.

Again before I was in total remission (and how could I be in remission having to wake up so early every morning?), they released me only to treat me again a week later. The problem is that the dose they gave me in the hospital worked and made me fall asleep fairly quickly, but in the outside world the recommended dose was lower and didn’t have enough sedation to make me fall asleep consistently. I eventually flew to a different city in the hope that a different staff would finally recommend the magic potion that would CONSISTENTLY work. My outside doctor intervened and gave me a prescription for Risperdal, but again at a dose that was too low to be effective. So I took matters into my own hands in a way that could have ended tragically. Manic, sleep-deprived and very scared of a world where no one cared whether I was healthy or not, I took pill after pill until, almost before I knew it, 4,500 milligrams of Seroquel were in my system and I was walking aimlessly through the airport unsure of what my next steps were.

A cop happened to pull up to the curb and noticed me in obvious distress. “Spit out what’s in your mouth, NOW!” A half dozen pills came tumbling out. Soon, a few more cop cars descended and they took a statement from me while I was handcuffed and sitting on a curb, beads of sweat coming out of every pore in my body. Had I fatally overdosed? Would I survive? Why was the ambulance taking so damn long to get there? The cops were, to their credit, professional, and quickly turned me over to the EMT workers who were mortified that I had taken such a large dose. Sadly, only a fellow mental patient or an accused terrorist in Guantanamo could relate to the delirious and painful effects a prolonged period of little to no sleep has on the psyche. To my chagrin, after a brief stay at a good hospital, they transferred me to a place with metal rods for a mattress and the same ineffective dose, releasing me after a couple days when I was no longer a threat to myself.

At this point, my money was running low and I had to fly back to my native San Francisco. My parents were flabbergasted that I had spent so much money and was going in and out of hospitals; they didn’t know what to do and refused to allow me entry into the house until I got help. But every time I got help, they put me on the same low dose and lithium combinations that didn’t do the necessary job. By this point I was homeless in San Francisco and found myself going to the police station to feign self-harm so I could be admitted to a hospital and hopefully connect with a doctor that understood. But incredibly none of them did. I was placed in a halfway house for a couple weeks, only to be kicked out because they didn’t feel I was improving fast enough. But I couldn’t improve when the Seroquel dose wasn’t sufficient to sedate. I would check myself back into the hospital only to find them offering Benadryl — fucking Benadryl — in the hope that I would simply go away.

But my anger started spilling over at this point. I demanded to see a psychiatrist, and after a three hour wait, a doofus from the psych ward finally emerged. I spoke slowly and explained I needed something between Benadryl and Fentanyl in strength. I did NOT want to be forced back into emergency psych’s locked unit where I had been three times over the last month, all to no avail. But because I was homeless, the expansive definition of GRAVELY DISABLED meant I had no rights and they wheeled me up to psych anyway.

SF General’s Emergency Psych Ward is one of the dirtiest, dingiest dungeons in all of America. Three SF police officers are stationed to make sure no angry patient makes contact with staff, and staff believes it is perfectly reasonable to spend only 10-15 minutes per day interacting with each patient. I began spitting in the vicinity of the police officers, but not at them because that’s assault and they were only doing their jobs, sitting in chairs bored as can be. But this lack of viewing me as a human being was bothering me. To compound my anger, the place was so grizzly that the average American would be shocked — twenty beds fit into such a small, unclean space that supposedly was designed to help people.

The staff ordered me into a seclusion room which I went into, thinking the worst was over. But no. Before I knew it, a half dozen SF sheriffs were pounding on my door. I immediately leaped onto the bed stomach first with my arms to my side. Anyone that’s watched Lockup on MSNBC knows what happened next. They assaulted me, the officer stationed to my head pushing so hard on my neck that I would later need to be treated for neck pain. An officer on each arm, the two sheriffs responsible for my legs bent my knees and pushed up as hard as they could, sending pain searing through my entire body.

They knew I had disrespected their fellow cops and thought it their right to inflict as much pain as possible without leaving bruises, several of them hurling obscenities at me as if I was an actual criminal as opposed to someone paying for the service of trying to get better within a hospital rather than a maximum security unit. After five excruciating minutes, my arms and legs were strapped and a spit mask placed on me as I lay claustrophobic on the bed, shaking at the extreme example of violence that so quickly escalated over something so stupid as spit. And to make matters worse, the doctors knew who I was from my previous visits, so they fake injected me in order to write in their reports that I was so manic and out of control that this display of violence was justified.

A couple hours passed and a friendly nurse untied me and gave me something to eat. The next day they wheeled me up into the psych ward, and this time the doctors treated me seriously. They introduced me to Thorazine, one of the oldest and most sedative of drugs, and combined Seroquel with the moderate dose of Thorazine. Finally, after nearly four months of hospitalizations, a way to permanently come out of the mania. The female doctor patiently explained that the combination of drugs is what worked; any one drug in a moderate dose wasn’t enough to give me the sedation I needed to sleep. Eventually they moved me off Thorazine to 6 mg of Risperdal and 200 mg of Seroquel, which put me out within two hours every single night.

Obviously, this was a horrifying ordeal to go through. But I never again have to question what works and what doesn’t, nor am I scared of big, bad Thorazine. The pharmaceutical drug market knows that Thorazine was and remains a miracle drug in terms of sedation, which is why every attempt from Risperdal to Seroquel to Zyprexa and now Abilify is simply a knock-off of Thorazine. The infamous side effects are as much a response to physical violence as they are to the drugs themselves. I was shivering not from what was happening inside my brain but from what my body had been exposed to as a result of the assault I went through. I witnessed other cases of similar violence, but a doctor’s order is the law and that’s that.

What can we as reformers advocate around for immediate change? Unlike Tom Wootton and his beliefs that drugs are always bad (which simply feeds into his business model being the healthy alternative), we have to recognize that short-term acute can become long-term chronic in the flash of an eye. They threw all sorts of labels at me on top of bipolar, including anti-social personality disorder and schizoaffective disorder — nonsensical terms I quickly brushed off because I knew mania was my one and only problem. To keep things simple, I propose three rallying cries that we can all unite and work towards to improve the system and alleviate short-term suffering:

1)  Newspapers and governments have ombudsmen — why not a hospital? 

Yes, there are patient advocates that appear on court days and spend a whopping twenty minutes speaking with patients and preparing them for a visit with the judge. But what about the cries for help that are ignored daily on each and every emergency psych ward, from people that doctors dismiss as out of control patients? A poor woman had a hernia and the doctor was too busy surfing the Internet to heed her pleas and simply threw her into an isolation room. It wasn’t until other patients and staff intervened that the doctor applied what limited knowledge he had in attempting to treat this woman.

Nurses are subservient to doctors and too many lack empathy to properly function as a liaison between patient and doctor. And if we’re being honest, virtually every doctor working in an emergency psych ward suffers from antisocial personality disorder themselves. Why is it okay to spend ten minutes a day per patient and bullshit and waste time with colleagues the rest of the time? An ombudsman should have seniority over a doctor and be able to write objective reports linking the connection between a patient’s pain and the doctor’s treatment for the army of hospital administrators that never step foot on the ground floor of this travesty known as involuntary holding rooms.

2) Rally newspapers and magazines to our cause against forced stays and shoddy conditions

Sadly, in America, hear-no-evil see-no-evil is the status quo. Only when One Flew Over the Cuckoo’s Nest was released did the barbaric practice of lobotomies ebb. Since the average American cannot picture a modern dungeon without shows like Lockup to take people into the world of an emergency psych ward, the blame for being there in the first place is placed squarely on the sick patient. If Americans had exposure to SF General’s Emergency Ward, if pictures could be taken and interviews with patients done, every single person responsible for working in that dungeon would be fired within a week. How can we turn cameras and attention to these conditions the same way African Americans used images of police brutality in the 1960s to win civil rights concessions? This question should be on all our minds because that’s how this fight could end overnight. But what the mainstream doesn’t know, they don’t know, and we’re too busy chasing our own tails to educate them on the obvious abuses of power that occur every single day.

3) Draw a deep line of demarcation between short-term acute and long-term chronic

We come across as radicals when we lament things like increases in the number of dopamine receptors when these obviously go away from atrophy after the acute crisis is over. Brain damage was the last thing on my mind as I was looking for a cure, but modern medical research claims there’s no such thing as sleeping drugs. Yes there is: combinations of antipsychotics. I’ll remain on my cocktail for another month or two to make sure I fully come out of any lingering mania, and will always have a bottle nearby in case I have sleep problems again. Simple breathing exercises and counting down from 1,000 help, but nothing works better than 6 mg of Risperdal and 200 mg of Seroquel. Schizophrenics also have acute mania crises and this combination of drugs helps restore order, but as Robert Whitaker has advocated, the evidence is highly suspect that these people need permanent doses far in excess of what’s necessary to return to normal. If we work with psychiatry to acknowledge that modern medicine has its place, we can fight for limitations to these authorities and their incredible range of power over human lives.

I had to go through a deep personal tragedy to find a cure that can be applied to anyone suffering from mania. The lesson is to not fight with doctors but to ask for the highest dose they’re willing to prescribe of a combination of antipsychotics. When order is restored, the choice is entirely ours whether to continue taking medication or not. And levels of sleep, not fear of the unknown, should be our guiding light as to what is an acceptable level of treatment. Having the peace of mind to know that I can slip in and out of mania in the future and have a cure handy makes me highly comfortable moving forward. But sadly, the fight for true reform still remains in the earliest of innings because we foolishly cannot narrow our scope and decide what exactly we’re rallying against.

[Editor’s note: due to personal circumstances, the author has chosen to publish under an abbreviated version of his name.]


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


  1. “The lesson is to not fight with doctors but to ask for the highest dose they’re willing to prescribe of a combination of antipsychotics. When order is restored, the choice is entirely ours whether to continue taking medication or not.”

    Not really at least not with me, I got the mania as part of alcohol withdrawals. I went to an ER for detox instead of buying more alcohol and got transported to a UHS psychiatric hellhole, UHS is infamous for kidnapping people till insurance runs out >

    Long story short they tried zombifying me with a massive 3 drug cocktail including Haldol and I refused and then they threatened me with an injection. I got to keep this short but I threatened them back stick a needle in me I may see you outside this hellhole someday and stick a needle in you so they threatened to call police and I said go ahead all did was make the exact same threat of stabbing people with needles that you just did at me. Police were not called but I was just going to make the exact same complaint of people making threats that they were. How is it OK for them to make threats and not me ? Eye for an eye bitch.

    What would have happened if I took the massive dose for a month ? When I got out I would have had the same problem but instead of not being able to sleep without alcohol I would not be able to sleep without lots of pills after being saturated for a month. Of course I put up a fight, I lived Zyprexa withdrawal years before after just taking what they gave, something worse than kicking benzos and 100 times worse then kicking alcohol. Not doing nueroleptic withdrawal again.

    I have a stash of Seroquel in case of run away insomnia to knock it down but screw that take massive amounts of drugs for “prevention” they tried pushing on me again.

    That hospital nightmare will never happen to me again, if some tragedy gets me so upset and ‘manic’ that I start drinking again and get to that point, that horrible point of dysfunction hell, I won’t go within 100 miles of a hospital instead its a high end rehab for Ativan Seroquel to come down. A place with a gym, yoga classes nice food and of course by the beach. Been many years since I had problems but if it happens that’s the plan.

    I was so upset by what happened in that ‘hospital’ , kidnapping and threats at me, the first thing I did was get alcohol when it was over, the nearest store, then when I was thoroughly sick from drinking for about another week I made it to a nice rehab.

    Even for someone that does not have addiction issues like I had the ticket might be to claim them, get drunk and claim alcoholism, and MI if you think it would be helpful, cause it is very difficult to find anything besides a locked hellhole for straight up mental illness but drug and alcohol rehabs are all over the place and they compete for customers by offering nice amenities.

    • OK I’ve taken a deep breath. Perhaps the author is facing involuntary circumstances at the moment and has to speak in code, and this is just sort of a cry for help. But it’s tragic to see someone so thoroughly ensconced in the same fraudulent system that has been responsible for so much torture in his life, and only seeing relief in the form of “reforms” while accepting his “diagnosis” as a fact of life.

      • Hard to say. If the editor’s blurb at the top of the comments is correct, this throng of shrinks he’s seen induced his misery from the get-go with some bungled antidepressant treatment where the prescriber spent no time searching for dysperceptions in the “prescribee”, and consequently launched the first of this series of episodes of flailing and failing psychiatric endeavors.

      • Medication Spellbinding… Why do so many individuals persist in taking psychoactive substances, including psychiatric drugs, after adverse mental and behavioral effects have become severe and even disabling?

        But give the guy a break, I have been there, I can’t sleep and those bastards won’t give me the good stuff to get me to sleep ! There is more to my story the that one hospital, the last, that lead me to writing here like every day. That very last psychiatric kidnapping was all different cause medication spellbinding was gone I knew the truth of psychiatry and I had no interest in going back to hell.

        Before that One time inpatient they started taking my mattress after blood pressure wake up bullshit I guess the thought being if early wake up would lead to early sleep if I could not go lie down, sleep deprivation the thing that really got me to the hospital was now going to cure me. I really should not even be thinking about this 15 year old memory but I already hate them. Back then I still thought the answer was good downers. Medication spellbinding, I could not even imagine my problem was the treatment itself. I never said to myself I was 100x better of before I ever went near those quacks and if I just walked away and got off all that crap I would return pretty much to the way I was before.

        Load me up with all the brain dead zombie shit that made me tired but not sleep, tell me to take it I guess forever. Well WTF give me the damn Xanax, what possible difference does it make if it is addictive if I need to pop pills every day anyway ?? Give me a logical answer. At least it made me sleep !

        They gave me Haldol , I was still up all night. The next hospital how much later I can’t remember but the same crap, That time Abilify and the can’t sleep nightmare. WTF I can’t sleep everyone else is sleeping.

        I was at the point of hating psychiatry over the locked abusive part of inpatient, they could go to hell but the medication spellbinding still had me. Maybe the author is still at that point.

        I am not an anti drug warrior and anti psychiatry what does that even mean? Take what ever damn pills you want but force is a human rights violation and I always call forced drugging rape cause they violate your insides as opposed to assault that violates just your outsides.

        Thinking about the mania, heavy drugging is just like ice on a burn, take the ice away pain comes back or like on the drugs your still in the mania but zombie at the same time that makes it more frustrating. I hate to even use the word mania, its insomnia anxiety and anger all mixed up.

        I know what I have to do to stay out of it or not do, the party drink and get high lifestyle can’t do it, I would like too but I end up a mess. The fun to hell ratio sucks. I also know to plan my life to not include the necessity to wake up early, that’s worse then an occasional drinking party. I have said no to good jobs, I know what happens with that early wakeup requirement with me. I can’t sleep till real late then get just a few hours day after day till I get so tired out eventually I bug out.

        “Just get up early so at night you are tired” Oh please STFU my whole life that never worked.

          • I was initially irritated and also thought the author might be gong through something drastically different then I did till later when I though back to what I went though before I came out of it. Maybe that was the point of publishing it. It was a psych survivor talking to me that initiated my coming out of it.

            Also I see alcohol and drugs in this picture, psych hospitals and homelessness just go with drinking or doing drugs.

          • The_cat has it correct: you have to go through a case of extreme sleep deprivation to understand that the drugs are not the problem; they are the solution.

            OK that’s as far as I go with this. Oppression is the problem. Liberation is the solution. I know what not being able to sleep is like. Neither Cat nor I concur with your conclusions however. But you seem too ensnared by the system right now for logic to have much relevance. Good luck.

      • Oldhead, I don’t think the writer has read any of Whitaker’s books or anything else critical of psychiatry. I used to believe psychiatry was a legitimate branch of medicine.

        We all have to start somewhere.

        I guess MIA has abandoned its stance of anti-psychiatry/psychiatric criticism. If it ever had one.

  2. I went straight up when I stopped lithium – but it wasn’t genuine mania it was more a change in personality from flatness to enthusiasm. I my view I have never in my life been clinically depressed or clinically elated.

    Anxiety was my main problem when I stopped medication. But this has changed now as I have worked my way through it.

  3. Anyone who has “can’t sleep mania” should read this The myth of the eight-hour sleep

    Sleeping at the “right time” what a steaming pile of horse crap. If you read it now you know. Also below,

    Delayed sleep phase disorder- Attempting to force oneself onto daytime society’s schedule with DSPD has been compared to constantly living with jet lag; DSPD has, in fact, been referred to as “social jet lag”. It is responsible for many patient complaints of chronic insomnia. However, since many doctors are unfamiliar with the condition, it often goes untreated or is treated inappropriately; DSPD is often misdiagnosed as primary insomnia or as a psychiatric condition. A chief difficulty of treating DSPD is in maintaining an earlier schedule after it has been established, as the patient’s body has a strong tendency to reset the sleeping schedule to its intrinsic late times. People with DSPD WILL improve their quality of life by choosing careers that allow late sleeping times, rather than forcing themselves to follow a conventional 9-to-5 work schedule.

    “Just get up early so at night you are tired” Oh please STFU my whole life that never worked.

    We get lots of views someone who never heard of Delayed sleep phase disorder is going to read this and be like finally that explains it !

  4. Good God! These clowns conned Vlado out of his time and his money. And, at the end of this fraudulent malpractice, they did no more than he could have done, had he been permitted to LEGALLY “self-medicate”. Folks in the Mad community are often forced to drug themselves to the limit, in order to secure consistent sleep and protect themselves from being court-ordered to “treatment” (i.e. caged, brainwashed, poisoned, and raped with needles and/or electrodes). For instance, Linda Gray Sexton wrote about her experience with “calculated narcoticizing” in her memoir, Half in Love. Compared to a healing bath, this self-care option is pathogenic and barbarous. And over the long-term, what we need to do is criminalize EVERY Mad health care protocol that isn’t 100% safe. But, until then, Vlado has set an excellent example of how to psychiatrize, while assuming the least possible risk of harm. Way to go, Vlado!

  5. Okay, so you needed a major tranquilizer to sleep. I believe you. I don’t see how it follows from that that there is anything worthwhile about psychiatry. In fact, you made the case that you would have done better without it if you would have had the short-term access to major tranquilizers that psychiatric gate-keeping initially prevented.

    The time has also come for the anti-psychiatry movement to rally around a few key points rather than paint psychiatry dark with broad brush strokes.

    By definition, that would not be anti-psychiatry. Psychiatry deserves only to be abolished, because it is an illegitimate medical specialty and as such will always harm people. Your own story attests to that fact.

  6. I don’t believe that antipsych medication is the only effective way to sedate yourself.

    During my experiments with raw diets in the early 2000s, I experienced hypomanic or perhaps manic episodes (without disability) and would go without sleep for 3 days (that is my record). I was still attending grad school and functioning during the day. Hypersexuality was a problem though. I was never diagnosed and never reached a point where I needed help.

    It later occurred to me how to best deal with such episodes and I came up with a set of sedative methods. They work against insomnia, and they work against hypomania and severe agitation. I occasionally experiment with hypomania to this day, just for fun, but I now know how to control it.

    Without further ado:

    1) The simplest calming diet consists of whole-grain bread and water, but I recommend the following “depressant diet” instead because it is more balanced and effective: whole-grain bread, boiled meat (normal-fat or fatty), and nuts (preferably pulverized in a blender; note that peanuts are not nuts). The depressant diet (not the bread-and-water diet) is likely to cause constipation; therefore, you can add raw fruits and vegetables. That’s it. Dairy is not allowed, and neither are junk food and various seasonings and food additives. If you have problems with anger, then my advice is to exclude any pungent vegetables such as horseradish, garlic, onions, hot peppers, and spices. This diet can make you apathetic and depressed within a few days or weeks. Nowadays, in my normal state, this diet makes me feel like a zombie in a few days. Nuts are an especially heavy food that makes you feel awful in large doses.

    2) A hot environment, several days or longer. Increase the temperature in your room or home using a heater and a fan or central heating, if you can, and put on extra clothes: thermals, a warm sweater, etc. Oppressive heat causes fatigue and will bring you back down to earth. It is a scientific fact that patients with schizophrenia have better outcomes in third-world countries (most of which are in the tropical zone).

    3) A hot bath or a hot shower (excluding the head). These have a relaxing effect but only a temporary one. Can be combined with a hot environment.

    4) Excessive amounts of physical exercise: they will keep you fatigued and sedated. (Small or moderate amounts of exercise will have the opposite effect.) A stationary bicycle in your home is the easiest form of exercise. You can do a 30- to 60-minute workout 6 days a week as follows: Turn on a TV or a radio or put on some music. Do 10 minutes of normal-intensity cycling followed by 30 seconds of maximal-speed cycling. Next, do 20–30 situps. Then do 10 minutes of normal-intensity cycling and another 20–30 situps. Add another one or two repetitions if necessary. Take a shower. All done.

    5) Breath-holding exercise. Three to four breath-holds (30–60 seconds) with an interval of about 5 minutes. These sessions can be repeated once a day when sedation is needed. This is an exercise for the brain and is known to have strong effects on the brain, for example, this method can cause a panic attack in some patients with a diagnosis of anxiety. But usually, this treatment has a sedative effect and if I do it everyday, then I start feeling depressed.

  7. I finally realized the MI System would never help me. They were determined not to let me recover and the brain drugs they fed me completed my helplessness. Finally, I chose to relocate. Going off my drugs, through with therapy, wellness groups, and all that other nonsense. I hope when my withdrawals are over I can write again. Maybe even go off the SSI my emotionally abusive shrink told me I would always need, like her pills! Wrong about one–probably wrong about both. 😛

  8. “Vlado C.” is younger than 35, I’ll bet…..
    I’ve just read through all the comments above, and I found it quite painful.
    Before I insult anybody, I’ll let it go, for now….
    “mainia” = “mental illness”?
    The *result* of lack of sleep is NOT “mental ilness”….
    Wanting OTC Ativan is called “drug seeking” behavior….
    It’s a form of so-called “substance use disorder”….
    I call Bullshit, Vlado….

  9. I was diagnosed with bipolar II disorder by a family physician with little experience in psychiatry. I told her that no antidepressant helped me and she said if the antidepressants weren’t working, I must be bipolar. She put me on lithium which made me absolutely sick. Then I went to see an actual psychiatrist, but I couldn’t shed the bipolar label and they kept giving me horrible mood stabilizers and antipsychotics that made me ill. I’m on a small dose of abilify now, 10 mg. That’s a low enough dose that I don’t feel sick.
    I never had hypomanic episodes until I went off lithium and then after I went off of each successive mood stabilizer and antipsychotic. After a few rounds of that, I started having hypomanic episodes for no apparent reason.
    But I have discovered a cure for my hypomania. Nine milligrams of melatonin at bedtime gets rid of it every time. It seems to me that because lack of sleep brings on mania, the melatonin system must be involved in bipolar disorder some how. It could simply be that the melatonin puts me to sleep, and the sleep itself cures the hypomania.
    Anyway, I hope someone else can benefit from my discovery that melatonin will eliminate a hypomanic episode. It should be noted that my hypomania has never been severe and this may not help someone who has full-blown mania or more severe hypomania than I have.

    • Going without sleep can certainly make you whacky!

      If you go a whole night (24 hours) with no sleep or three days (72 hours) with only 3 or 4 hours of sleep, take a mild tranquilizer for a few nights. Melatonin is better, if it works. No shrink necessary!

      There are plenty of over-the-counter drugs to knock yourself out. Be careful though. Be sure to stop taking them as soon as the crisis is over and you are sleeping again.

      When I was going to an MI Center I had slept badly for a night or two. A friend told me to get my psychiatrist to prescribe me Lunesta. Not for a week or two. Like all psych drugs–forever and a day!

      I decided against such a stupid course of action. My friend continues to get worse and worse. She “deteriorates” as she takes more and more drugs and gets hospitalized 3 or 4 times a year for “maintenance.” And they call that a “full and productive life!”

      • There are also folks like me, whose melatonin system is outta whack somehow. I do not say this because of anything a Dr put together. I recognized a seasonal pattern to my life- winters were way hard emotionally, I had low energy, craved sleep and carbs. I was a journal-er, so it was easy to go back and read and confirm. And I happened to read an article about this very phenomenon happening in northern latitude regions. The theory was that sunlight taken in through the eyes triggers a waking response in the brain, signaling us to slack off the melatonin production because dawn is breaking and it’s time to get up. If there’s not enough sun to trigger this response, the melatonin production doesn’t slack off enough. The solution is very bright full-spectrum light, which you can switch on and read your morning paper by, or a dawn simulator that wakes you up with light, soft at first and gradually full intensity. Light therapy worked for me! This is the one and only brain chemical imbalance that I claim, but I do claim it because it rings true in my center, that place of wisdom that knows what’s what. And it makes total sense because my eyes have always been very photo-sensitive; ever since I was a kid I squinted.

        • I’m pretty weird in that I tend to have prolonged bouts of sadness–sometimes for no big reason–in the spring when there’s more daylight. Like the reverse of SADDS. My dad has this problem. Our ancestors came from the extreme north of the world, which may account for this odd problem. This sadness lasts 2 or 3 weeks. Never more. Generally it’s accompanied by insomnia. In the autumn I feel perky!

      • It is insidious. I think I began to believe in the label. I believed I was bipolar, so I became bipolar. But I haven’t had a hypomanic episode in a few years, so maybe I’m over it. And I’m afraid to stop taking the Abilify because it helps with my depression like no antidepressant ever did.

  10. What the hell did I just read?
    Short term medications for acute mental breaks is where the hell begins!! Your brain chemist, your spirit, and your physical body cannot handle the saturation of medications that fast, that hard, and that much! Never!
    Vlado C, YOU NEED TO heal….you are not going to heal from using synthetic meds, which are nothing more than products of an oppressive patriarchy, used to make us docile, compliant robots.
    OMG! What did I read on MIA? I am so disturbed by this.

  11. Hi Vlado, I thought I’d highlight some of your comments on MIA so far and as you really have me confused and your comments also have started alarm bells ringing for me. So here are some of your comments:

    Critical of medical/psychiatric model (mainly from your first post):
    ‘What’s scary is that a fallible doctor, relying on a manual that pathologizes any and every behavior or emotion, determines whether we’re acute or chronic. It’s unclear to me how they sleep at night.’

    ‘Not knowing anything about psychiatry and trusting these people were real doctors’

    ‘I’ve come a long way in the years since and have rejected the bipolar/mentally ill label.’

    ‘What I am is someone capable of experiencing mania. And for that reason alone, psychiatry wishes to hold onto me forever.’

    Vlado, was this a way of gaining a platform on MadInAmerica, then gradually you begin to throw in the comments below:

    Support for Ativan:

    ‘At long last they gave me the sedative, Ativan, which if available in stores would have saved me all this trouble.’

    ‘If I could get Ativan over the counter, there would be no doctor.’

    ‘I wish Ativan was available over the counter. I know a couple of those tablets make me fall asleep every single time. But releasing Ativan to the masses subverts psychiatrists and they’re not in favor of anything that takes away the power of their pen and pad.’

    I have just read about how there is $7 billion on average to be made when a drug goes from prescription to over-the-counter. Funny how Ativan’s patent has expired and is not as profitable anymore? Is this your agenda or are you so blind to the lack of effectiveness Ativan has outside of your own experiences and the incredible amount of damage it causes. Maybe you should check out: or You are either incredibly self-centred to wish these were available over the counter or are pushing Ativan as part of your agenda?

    Support for meds:

    ‘Either an anti-psych or benzo enables me to sleep, lessening the effects of mania’

    ‘The lesson is not to fight with doctors but to ask for the highest dose they’re willing to prescribe of a combination of antipsychotics.’
    Vlado, following this advice can and does kill people!!!!

    ‘nothing works better than 6 mg of Risperdal and 200 mg of Seroquel’
    For you, maybe. For others, it’s been a disaster

    ‘you have to go through a case of extreme sleep deprivation to understand that the drugs are not the problem; they are the solution’
    No, you don’t. You can just read and study the likes of the works of Peter Gotzsche, Robert Whitaker, etc. You don’t have to have been a ‘peer’ or have had a ‘lived experience’ to realise the drugs ARE the problem

    ‘Half the people in a psych ward legitimately cannot sleep and need drugs’
    Seriously?!? In my current role I regularly visit a psych ward. I wouldn’t sleep either if I knew at any second I could be forcibly held down and drugged, could have my human rights taken away or could be given ECT involuntarily but no, your solution is not to address why people aren’t sleeping just drug them or yourself up so you can sleep…

    ‘in my opinion they don’t sufficiently address the short-term, acute need for medication which is psychiatry’s single main-stay as an institution.. This is the bread-and-butter use case for why psychiatry should exist.’
    A lot of people’s journey on the destructive psychiatric merry go round starts when they have acute needs for help/support and given drugs for this and you are saying that this starting point is legitimate…really???!!!!

    ‘By this definition, the system is absolutely nuts. That’s why, to me, a reforms-based approach to dealing with the ills makes more sense than talking down the medicine, which is legitimately helpful to those who have a need.’
    Have you read anything on MIA about the science for the ‘medicine’, i.e. dangerous and destructive drugs?

    Confusion or lack of consistency over how you label or diagnose yourself and your experiences after saying that ‘you have rejected the bipolar/mentally ill label:
    ‘I’m a patient struggling to figure out what works and what doesn’t.’
    A ‘patient’: so you haven’t left the ‘bipolar/mentally ill’ label behind? or you forgot that this was part of your narrative/script?

    ‘What is the appropriate level of antipsychotics necessary to come down from a bipolar mania?’
    Again – ‘bipolar/mentally ill’ label left behind?

    Support for more insurance/more access to services/more money for psychiatry/Big Pharma:
    ‘If you have insurance, they want to keep you as long as possible. If you don’t or have bad insurance as I had, you’re not a priority and decisions are made based on dollars and cents as opposed to common sense. I was furious that even though I didn’t exhibit common symptoms of mania, had a place to stay, they still treated me like a zombie and held me against my will. It’s how they make money, bodies to beds. Until we have a single-payer system of insurance, this system won’t change.’
    Big Pharma and psychiatry would love this $$$$$$$$$

    ‘Money is at the root of this system. My old doctor charged $175/30 min..’
    More insurance, more $$$$$ for psychiatry/Big Pharma

    Support for psychiatry:
    ‘The point of MadInAmerica, and where you and I have common ground, is how far psychiatry has strayed from its mission statement.’

    ‘As for psych being a “junk science”, most consider mania, depression, psychosis, to be real medical conditions when diagnosed correctly.’
    Consensus doesn’t equal fact/’science’

    ‘I have yet to see an article on M.I.A. about how to come back to “baseline” without meds. I’m sure it’s possible as our ancestors didn’t have these drugs available; I just don’t know how at this point. And in relieving these short-term conditions, I don’t believe psych is a junk science.’
    Vlado, this is an insult to many contributors to MIA who have produced many articles highlighting alternatives to meds to help with distress. And how about just time? Or finding some good, trustworthy, authentic and supportive people in your life to be with you during times of distress to help bring you back down? Or how about getting out into the bush/forest/green spaces? Or finding a safe, warm comfortable places where you can breathe/switch off? Or how about talking about the meaning and depth of your distress? All ways of coming back to ‘baseline’ and who decides this ‘baseline’ anyway? Again, have you read anything on MIA? Have you searched for anything in relation to distress?

    ‘There IS a place for anti-psychotic drugs even if we agree that anti-depressants and benzos are sham. If psychiatry was all-bad, why would it still be around in 2017? I needed professional advice on how best to sleep/reduce the mania and that dialogue was missing until the very end.’

    ‘It’s a major problem in how far they’ve strayed from the basics of their profession.’ – subtle support here where you are saying it’s a good profession really, it’s just lost its way a bit, poor psychiatry like the paedophile priest that was sent to the next diocese and not punished because ya know, he’ll be ok in the next one, he just needs time to reform…

    Psychiatry’s tactics of ‘we will find the underlying biological cause soon, just give us more time’:
    ‘Until neuroscience identifies what causes psychosis or depression, little of psychiatry has any scientific merit. Instead it’s an art form where all too many of the practitioners are poor in practice, in large part because they haven’t seen enough genuine patients that can function drug-free at a high level.’
    Who the hell are ‘genuine patients’ and who gets to decide this? The experienced psychiatrists/doctors? You?

    Attempt to de-legitimise anti-psychiatry movement:
    The anti-psych movement will NOT gain ground until those numbers grow or until someone goes deeper into explaining why these drugs are harmful.’
    Vlado: seriously?!?? have you read anything by the likes of Robert Whitaker, Peter Gotzsche, David Healy, Peter Breggin, Joanna Moncrieff – are their analyses not deep enough for you?

    Vlado, from what I have read I don’t trust what you are trying to sell. You are either very confused or using extremely solipsistic or self-centred ways of seeing and responding to distress or you have another agenda that involves defending psychiatry, pushing more medical insurance coverage and supporting some really harmful and destructive drugs. Big Pharma is very skilled at trying to infiltrate organisations and plant seeds of doubt here and there. It uses social media to its advantages and identifies and responds to threats. MIA is definitely a threat – I wonder if this is what is happening here? Just a thought…

  12. “What is the appropriate level of antipsychotics necessary to come down from a bipolar mania?”<—FIRST line in article, above….
    I'm a proponent of the "K.I.S.S." philosophy. KISS = Keep It Simple, Silly! (Yes, sometimes "keep it simple, stupid!" really does work better!)
    So I'm gonna answer Vlado's question. *NO* "antipsychotics" are *necessary* to come down from *ANY* mania. Some drug-induced manias can be counteracted with other drugs. All manias resolve with sleep, time, and appropriate self-care, and appropriate medical care. Saying "bipolar mania" is basically bullshit, because so-called "bipolar" is an imaginary disease that was invented as an excuse to sell drugs. Many, if not most, persons who have been fraudulently "diagnosed" as having, or being "bipolar", are better served without such a flagrantly fraudulent diagnostic label, and the inevitable stigma which such a label carries. So far, I'd say the commenters here at Mad In America have fairly well deconstructed Vlado's *PROPAGANDA*. We're still waiting for a coherent and comprehensive response from Vlado….

      • I don’t think so. I think Vlado is trying honestly to provide his perspective, and I think it’s important that we respect his experience, even though I think most of us would not adopt his suggestions as a good general policy on how to engage with someone in distress. He’s found a way that works for him – good for him! And I think his argument holds elements of empowerment – that psychiatrists should enable their customers to utilize the offered drugs in ways that work best from the customers’ point of view. This would, of course, involve psychiatrists admitting that their entire approach is not scientific, but is basically the offering of substances to make people temporarily feel better subjectively while making no effort whatsoever to figure out what is really wrong, which they would never allow, but still, there is a legitimate point in there that deserves recognition.

        — Steve