This blog entry is for psychiatrists.
Dear Dr.
If your patients are alive but without quality of life, is your treatment really working?
I studied clinical psychology. It was a calling for me to learn about the mind, what goes wrong, and what goes right. Whatever I learned at university in the UK was not enough to prepare me for real patients. During my postgraduate studies in Egypt, I visited and trained in hospitals and soon realized that whatever was written in books had little to do with reality.
First of all, diagnosing someone is not that simple. Guided by mostly what the patient tells you, you tiptoe your way to a diagnosis listed in one of the manuals you studied. Sometimes the clinical picture fits exactly, but more often personal differences make things far less clear-cut.
Secondly, prognosis. In these public hospitals, as a psychologist, I rarely saw someone who looked like they were ever going to recover. People were very sick, discarded, with nothing to look forward to; no job, no family. They were outcasts. Their suffering was surreal. Most had comorbid diseases – no wonder, given the heavy psychotropics, sometimes even ECT, and nonexistent lifestyle hygiene.
I soon realized that as a psychologist, there was little I could do that made a difference. My role felt useless. I was supposed to help, yet could only offer empathy and understanding. Senior staff were not helping much either. This was far from what I imagined.
Were we still in the Middle Ages?
As a patient myself – in Egypt and France – my initial prognosis was not so much different. I went in and out of top-notch private psychiatric units to find the same cycle: get “stable”, get out, repeat. Many of us returned after failed suicide attempts. Most of us were told that this disease was something we had to live with. All of us feared how it would end.
Things were not different in the addiction ward. Most admitted they daydreamed about discharge only to buy drugs again.
Psychiatry focuses mainly on the presence or absence of symptoms. Rarely did one ask me about my quality of life, as if it were impossible to have any and be bipolar at the same time. I felt medicated simply not to bother the system – “just take these pills and stay quiet.”
The way bipolar disorder is classically treated feels like a waste of time and resources. I believe one day it may even be considered malpractice.
Dear doctor, I am here to tell you there is another way – and I am living proof of it.
In 2019, I learned that my genetics predisposed me to subthreshold bipolar disorder – a subtype rarely diagnosed, though common because it does not follow the guidelines.
When life became too stressful, the genes expressed themselves. I have variants that impair the conversion of T4 to T3, and they manifest as bipolar symptoms. To solve the problem, I take high-dose Levothyroxine (HDL) to flood my system with T4, which I then convert to enough T3 to stabilize my mood.
That’s it, no more bipolar disorder. It has been six years. Truth be told, some patients on this treatment also require a mood stabilizer. But in my case I only now take 600 mcg daily.
So you see, bipolar disorder is not psychiatric but endocrine.
When I talk about this, medical professionals are astonished. They either do not grasp the science behind it or deem it dangerous. A few remain interested and make the effort to read about it, but the rest refuse to believe.
How come the health system – where millions are spent on care for bipolar patients – is not actively seeking a solution? Why must people remain disabled just because psychiatrists do not update themselves with recent discoveries? Why the resistance?
Back to quality of life.
Since becoming stable on HDL, I live life to the fullest. I am happy, resourceful, creative, emotionally stable, and resilient. I would rate my quality of life 10/10 compared to a 0/10 when I was treated with psychotropics, and 7/10 before realizing I had this genetic endocrine variation.
Please, dear doctor, I invite you to read about the role of thyroid hormone in mood disorders beyond the basic panel done when you admit a patient to a hospital.
The treatment I am on was first introduced about 8 years ago and is now published in the Maudsley Guidelines and is known as The Zamar Protocol (including HDL up to 1000 mcg + rTMS). The guidelines clearly state that the protocol can be used as the first line of treatment.
Every single day I wake up grateful to have met a doctor who has finally treated me correctly. My family and friends are witnesses to how life-changing this treatment is.
This is a treatment for bipolar disorder without needless side effects. It has proven effective for many patients, not just me.
Interestingly, some of the patients with these genetic variations can sometimes switch off their genes after long periods on HDL. This means – and yes, you read that right – that over time they may reduce their dose or stop taking the medication altogether and still show no sign of mood disorder. I am happy to say that I reduced my dose from 700 mcg to 600 mcg, and I have never been better.
Dear doctor, you vowed to help us – patients – when you chose your profession. To do so you must agree that many bipolar patients commit suicide because the treatment they receive is not effective.
I know I am asking you for a shift in perspective, but do not fear progress. Do not fear losing legitimacy. Do not fear disapproval from colleagues who refuse to move forward.
I need you to fight this battle, and any other battle for the voiceless. Believe me, this fight is worth it.
I will leave you here with resources to explore this treatment. You can always email me with questions, and I will be more than happy to answer.
Happily Depressed... 
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