Q:  Mood Stabilizers & Prednisone Treatment

My father reacts terribly to prednozone but depends on it to survive severe asthma. He takes it on occasion. I was diagnosed with bipolar and I'm worried my father may have it. His doctor knows about his reaction to the steroid but, apparently nothing can be done. It's been said that he would die without it so we all just have to deal with him losing his normal personality for a time and become well to put it mildly, very fn frightening. Would my father recieving a diagnoses of bipolar help him in managing his reaction to this drug? Like if he were on mood stabilizers while taking prednozone, is it possible his reaction would not be as severe?

I hate meds and I hate this diagnoses and do not think it would be beneficial to my father to suggest he get help now, just for when he takes the prednozone.


Dear Shawna -- 
There's a lot of energy in that note. Sorry to hear you're having to deal with bipolarity on two fronts, yours and his. Bad enough on one. It does bring to mind a concept that might be of some use, before turning to your question.  Goes like this: "Suffering = pain + struggle." 

The idea there is that pain is one thing, but struggling with and against it is another, which leads to suffering.  Or viewed the other way around, one can work at suffering less by working at struggling less. One will still have pain, that's a separate matter. But one may be able to suffer less with it, and that can often be very helpful. Some people can tolerate a lot of pain, if they figure out how to stop struggling with it. As you can gather, that idea has to do with your comment about hating the diagnosis. Bad enough to have it. Worse to hate it, perhaps? 

Now, as for prednisone: yes, sometimes the respiratory doc's feel like they just have to use it, and I wouldn't argue with them (beyond simply making my concerns know about how it affects the mood condition I'm trying to treat). Would mood stabilizers help keep his reaction to them more under control? I think that is very likely. Does he need to have a diagnosis of bipolar disorder to take mood stabilizers? No, I don't think that's necessary, and might not even be appropriate. We could call this "Mood Disorder due to a General Medical Condition", DSM code 293.83. The focus could instead remain on treatment. The respiratory doc' could ask for a psychiatric consultation, a limited role simply to focus on mood stabilizer treatment during prednisone treatment. 

Good luck with all that. 

Dr. Phelps

Published October, 2005