I'm Bipolar and I Want to Stop Smoking. Any Ideas?
September 16, 2006 2:07 PM   Subscribe

WhineFilter: I'm bipolar and I am having a very hard time quitting smoking. Does anyone have any ideas that I haven't tried yet?

I have been smoking cigarettes since 1987. My first serious attempt to quit was in 1995, when I tried the patch. The patch failed miserably. After I watched my mother-in-law die a horrible death from cancer in 1997, I quit again using Wellbutrin/Zyban. I stayed on the medication and off cigarettes until 1999, when I was diagnosed with bipolar disorder and ADD.

My doctor calls my bipolar condition "Bipolar d/o Mixed, Rapid Cycling", which seems pretty accurate to me. I was taken off the Wellbutrin in 2000 because it wasn't the right drug for my cycling. As soon as I was off the Wellbutrin, I started sneaking cigarettes. Within a few months, I was back up to a pack a day.

Since 2000, I have been in a seemingly never-ending cycle of quitting and stopping that roughly mimics my mood swings (even though they are much milder than they used to be.) When I am at midline, I quit. When I get depressed or (especially) manic, I smoke.

I've tried nicotine replacement therapy (NRT) and cold turkey after the Wellbutrin. Neither of them has worked very well for me.

I understand that the burden is upon me to control my willpower and quit. I'm not trying to use my bipolar disorder as a crutch. I just think that my condition is making something that is very difficult extremely difficult.

I know that I can quit. I just need someone to tell me how.
posted by SteveTheRed to Health & Fitness (14 answers total)
Here's a book that might help.
posted by LeisureGuy at 2:24 PM on September 16, 2006

I've read good reviews on this. You might not feel as bad about it if its not totally screwing your health, and break some of your mental addiction.

I know I've read that people with problems like yours can typically self-medicate by smoking.

I found I quit smoking when I just read a bunch of stuff on how bad it was, and just decided I wasn't going to do it anymore. Let yourself quit, and don't beat up on yourself if you slip, just try again.

And the one thing that I did to help me quit smoking was quit drinking, I think it was the single reason that I actually quit. For a couple months after quitting, I refused to drink alcohol, because I found that having a few Guinness really dampened the "I don't want to smoke cause now it will hurt" reflex.
posted by gregschoen at 2:32 PM on September 16, 2006

Dextromethorphan (cough syrup, make sure it's 100% DXM). It helped my wife quit. DXM acts on the cholinergic system, same as cigarettes. Just one other option and it doesn't cost more than $4.
posted by rolypolyman at 2:44 PM on September 16, 2006

Try reading Allen Carr's "Easyway to quit smoking", it worked for me (have smoked for 10 years) and some other people I know.

The book itself is pretty annoying and repetitive but I forced myself to read it and it worked like a charm. The guy brainwashes you (it's pretty obvious while you're reading it but nonetheless it works) into thinking that you actually don't need cigarettes, which now after having quit, I really don't need.
posted by barrakuda at 2:48 PM on September 16, 2006

rolypolyman, can you elaborate on the DXM treatment? How much did your wife take, and for how long, etc? I've never heard of using DXM to quit smoking before, but it kinda makes sense given its antidepressant properties. How did your wife hear about this use of the drug?
posted by nixxon at 3:04 PM on September 16, 2006

i would try again with the patch and welbutrin together.
Use the patch and step down slower than the guidelines. Step down very slowly.
posted by alkupe at 6:11 PM on September 16, 2006

Thanks for your answers.

The DXM idea is interesting, but I take some heavy-hitting medications already. The pharmacist is very happy to see me each month. I'm not supposed to drink alcohol or take any Rx or OTC medication w/o checking with my shrink first. I've tried violating this rule a few times. The punishment, in terms of mental or physical illness, is usually swift and severe.
posted by SteveTheRed at 6:22 PM on September 16, 2006

I am bipolar also and was fiercely addicted to tobacco for 25+ years. I read a book (can't remember the title, sorry) that helped. Here's what I remember from it:
1. It's almost impossible for the true addict to quit cold turkey. So taper off before trying to quit. To that end,
--Stop smoking the second half of the cigarette--it is much richer in all the good addictive stuff.
--Switch to a lower tar/nicotine cigarette.
--Every 2 or 3 months, switch again to a lighter cigarette.
2. Attack the behavioral side of the addiction:
--Stop smoking indoors.
--Stop smoking in the car.
--Stop smoking brands you like.
--In short, arrange to enjoy smoking less.
--Substitute some other behavior for a smoke break. I learned to juggle. I played more guitar. I did crosswords (these days I do Sudoku). To start with, skip one smoke a day and pursue a new behavior. Find things you enjoy, because you need make up for the enjoyment you're losing from your addiction.
--Over time, skip more smokes in favor of your new pleasures. Do this systematically.

After 18 months using these strategies, I found myself smoking 3 Carltons a day. A Carlton is sort of like breathing hard. I found I could quit without physical discomfort from that level. Of course, the mental battle remains. I've been a non-smoker for 10 years now & every once in a while I still get the urge. Usually when I see someone light up in a movie.

That worked for me. YMMV. Good luck.
posted by RussHy at 6:48 PM on September 16, 2006

I second Allen Carr's "Easyway to Quit Smoking." I'd been a smoker for fourteen years, and after reading the book, I haven't had one cigarette, nor any cravings, and I know it's over for good.

Carr just lays everything out for you in a way that no one else really does, and by the end of reading the book (which is all information you may already know, but maybe never thought of in quite the same way - no shock tactics), the desire to smoke is removed. I know many people who have all had the same success. It's like a freaky magic book. Completely brainwashing, as barrakuda said, but extraordinarily effective.
posted by scallion at 6:52 PM on September 16, 2006

For myself while nicotine replacement helped some, the real battle is psychological. I created a program of cognitive reinforcement: I made lists of specific, positive benefits I expected to receive from quitting, and I made lists of specific, simple actions I could take when the cravings bore down particularly hard. I studied these things multiple times daily leading up to my quit date and thought really hard about the fact that I wouldn't get any of these things if I didn't stop smoking. I worked on how I thought about it - somehow it helped me to consider that while I couldn't honestly not want to smoke, I could honestly want to be a smoker. I focused on the idea that quitting was inevitable - it was obviously crazy and stupid to keep smoking. I wasn't crazy or stupid. I would have to quit at some point. If I didn't carry through my quit date, I would just be postponing the inevitable.

When the date came, I actually carried graphical flash cards based on those lists (what I called reasons and methods) ofr a while. For about a month I let myself off the hook of other personal improvement. If I didn't feel like it and I could get away with it, I didn't do it. Strangely, I found it (and still find it when the need arises) useful to remind myself that I could smoke if I wanted to - that in the end it was a decision I had to make. I had to decide what I wanted. In a way just getting right down to it and facing that decision - my want, the consequences, the simple reality of my choice - makes it easier to just set it aside after I make the choice and not dwell on it. The worst thing for me is fixating on it and becoming self-pitying for being "deprived" of this thing I want. I try not to give that bullshit the time of day, I'm not being deprived of anything, I'm just making a choice. The end, next thing.

I quit once that way for a couple years, started chipping at parties and such and ended up more or less where I started (not quite but bad enough) within a few years, waffled and avoided for several years (basically what you've been doing, so at the least I can say you don't have to be bipolar to be catastrophically on the fence) and finally went through an abbreviated but still fairly involved repeat of the whole thing (thinking that I could just step adroitly back up on the wagon was I think a big part of my problem quitting the second time around). I am not so confident in myself this time which seems a sensible position, all things considered, and I am very hopeful I will carry it through the long term this time around. certainly feel what I've got to lose by screwing around a lot more acutely now.

I'll say this: after going a couple years, as smoothly as I was drawn back into it and as hard a time as I had getting off it again, I never for a minute could bring myself to accept being a smoker as my "natural" state, as I did for a decade before I quit the first time. Having quit, once the nastiest bit is over, is SO much better than being a smoker it isn't even funny. Good luck.
posted by nanojath at 6:58 PM on September 16, 2006

Oh, and I presume you're reading the billions of pages of more advice?
posted by nanojath at 7:00 PM on September 16, 2006

(oh and in paragraph one of my first answer, "could honestly want to be a non-smoker...)
posted by nanojath at 7:07 PM on September 16, 2006

Check out alt.support.stop-smoking. It's an online support group which has been around for years. Real people, hundreds of them, going through the same thing. Some post how long they've quit. Some bewail that they had 'just one' and are now back to two packs a day. Some use the patch, Some went cold turkey. Some give encouragement. Others seek it. And it's all no bullshit.

Stopping smoking is hard. But many people have done it. It helps to go through it with others.
posted by mono blanco at 5:44 AM on September 17, 2006

What worked for me was taking up Tai Chi. Not only exercised my body (to help flush out the residual gook) but got me focusing on Breathing, which is the first thing you lose when smoking - your breath. I suppose any exercise routine that engages your breathing would do the same (swimming, jogging, basketball, etc.). The trick was to help my lungs remember that a deep fresh breath was tastier than smoldering tar.
posted by iurodivii at 9:49 AM on September 18, 2006

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