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Will marijuana affect me? I am bipolar. I take Lithium, Risperdal, Depakote and Klonopin.

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A lot of people, probably yourself included, like the mellow high of smoking a joint. To justify their habits, they will say to themselves and to other who will listen things like, "hey – it’s cool – it’s organic – its not a heavy drug – it won’t hurt you, you can’t get addicted to it, etc.". All of this is basically a load of crap that is intended to justify self-destructive behavior. Marijuana is a real drug that you can become addicted to. It does bad things to your brain and body. It contributes to cancer. It can make you paranoid. It destabilizes your brain. It is not a healthy thing. Yes the high feels good – but it is not worth the problems it will cause you.

Persons such as yourself who have (judging from your medicines) problems with anxiety, mood swings and psychotic symptoms should NEVER NEVER EVER go near marijuana. Your brain is already having some problems staying stable. All those medicines you are taking are there to try to hold your brain together in a reasonable semblance of normalcy. If you take these medicines as prescribed, you can have a good chance of remaining reasonably healthy. If you smoke or eat marijuana you will be sabotaging your treatment – hurting the chances of your medicines to help you remain stable, and forcing your brain to get even more whacked out than it already is. If you even hang around with other people who smoke, you’re going to want to smoke yourself. Only thing is – you can’t afford to smoke because your brain will blow a gasket. If you care about yourself – if you care about other people around you (your family, your friends, your loved ones, a therapist you respect, anyone at all who you might care about and who might care for you) then please ditch those pot smoking friends, and stay away from marijuana.

Just for your information, there are treatment facilities and 12 step groups out there (they are rare now – but they still exist in some locations) that treat people with dual diagnosis problems – people with a psychiatric disorder who are also having problems avoiding alcohol or pot or cocaine, or whatever. Dual diagnosis programs are sensitive to your mental and drug conditions in a way that a pure psychiatric or pure drug program cannot be. You might want to just keep that knowledge in your back pocket in case you ever need it.

Postscript: (November 2008)  This particular question/answer has generated a lot of negative comments in its eight year life, mostly aimed at me (Dr. Dombeck). Those of you who were unsatisfied with my answer my younger self gave here may wish to read the comment I have made to Dr. Allan Schwartz’s more recent essay Marijuana Makes It Worse: Severe Mental Illness where I have offered a softer restatement as well as an apology for speaking overly harshly. 

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