“But You Seem So Normal!” -A Compliment

When I disclose I’m bipolar, I’m fortunate enough to typically receive understanding and support. However, many, many times I’ve been greeted with some super inappropriate comments, the most common being “but you seem so normal!” or “but you’re so happy!”.

Here’s the thing: I am GREAT at masking my symptoms. I would go as far as to say I am a professional at faking it. I can pretend to be happy when I’m drowning inside my head. I can fake calmness when I’m so anxious I’m going to throw up and I can’t stop grinding my teeth (which ALWAYS hurt, by the way). I’m a fantastic actress and an even better liar. I can usually fake being okay when my depression is making it feel like I’m drowning in fog. The days I can’t fake it, I stay in bed all day. No one except my partner sees me at my worst, and that’s by design. So when you tell me I’m “too happy” to be bipolar, keep in mind that you don’t see the major depressive episodes, and that is on purpose.

I am not as great at faking stability when I’m hypomanic, mostly because being hypomanic is typically either super fun and I don’t want to hide it, or I’m so anxious and jittery I physically can’t stop shaking my hands, clicking my pen, or bouncing my leg. However, people usually don’t notice the hypomania unless they know what to look for. I’m seen as high energy, passionate, bubbly, or teased for drinking too much coffee that day.

Hearing that I’m “too normal” or “too happy” to be fighting this battle in my head is super minimizing and harmful. It implies that people don’t believe me because I present as stable most of the time. It implies that I’m faking my illness or making it up. The battles I fight in my head to do basic things like get out of bed, shower, (when I’m depressive) or not blow months worth of savings on a fish tank (when I’m hypomanic) are real, they’re intense, and they severely impact my everyday life. It takes a lot of discipline and work to stay stable, and sometimes nothing I do can prevent an episode. Don’t minimize how much work it takes me to function in society like everyone else. Don’t minimize how much work it takes to get out of bed, work full time, and smile at people who ask me “how are you?” when they don’t want to hear the real answer.

Side note, and kind of a funny story: I actually did spend months worth of savings on a fish tank set up when I was hypomanic once. Every dime we had saved was blown in a single shopping trip. Because I was hypomanic, I didn’t follow directions to wait 24 hours before putting the fish in the water (because patience is NOT a characteristic of someone who is hypomanic) and I literally killed every fish I bought within two days. It’s funny now, but at the time it was detrimental to our financial situation and we struggled for a while after that to get back to a place of financial security.

I know that not everyone who responds in these ways mean harm. Sometimes they even mean it as a compliment. Like, “good job, you can pretend you’re fine and no one even notices you’re sick!”. But that’s also a problem. The fact that I’m praised for and seen as “strong” because I can mask my symptoms shows how detrimental the stigmas surrounding mental illnesses are. I’m a strong person whether I am symptomatic or not. My strength is not determined by whether I can fake “being normal”. I should be able praised for my intellect, my passion for the planet and people’s rights, or the fact that I can knit without looking. I should not be praised for my ability to pretend I don’t have a mental illness. Now, I always want to hide my symptoms. I never want anyone to see me when I’m not at my best. Part of that is because of this response. Part of me believes that my strength lies in my ability to blend in and present as stable. That is part of why I decided to start writing about my experiences. I can’t claim to be a mental health advocate, determined to end stigma against those with mental illnesses if I hide in my room to avoid showing anyone I’m not well. My goal with transparency is to prove to myself and others that strength doesn’t lie in faking it, strength lies in trying to do what it takes to stay well.

If someone you love (or a stranger) discloses they have a mental illness, take time to respond appropriately. Ask them questions about their illness and their symptoms. Ask what you can do to help when they’re struggling. Do some research so you can better understand what they’re going through, but keep in mind everyone is different and illnesses manifest in different ways.

Perspectives of psychology

    Within the field of psychology, there are many different methods for approaching abnormalities in behavior. These methods are commonly referred to as “perspectives”. Perspectives of psychology provide multiple methods for treating mental illnesses. One perspective within the field of psychology is the cognitive-behavioral therapy perspective, or CBT. CBT operates with the view that psychological problems including abnormal behavior and mental illness are the result of maladaptive, harmful ways of thinking and/or maladaptive learned behaviors (Hupp, Reitman, Jewell, 2008). Because of this view, CBT suggests that maladaptive and harmful behaviors can be changed through a combination of mindfulness techniques designed to edit one’s way of thinking (Hupp, Reitman, Jewell, 2008). CBT focuses on adapting and improving ways of thinking by teaching patients to identify maladaptive thought patterns that contribute to the abnormal behaviors and change the thoughts to something more productive (Coyne, Burke, Freeman, 2008). Techniques that CBT can use to assist in rerouting these thoughts include improvised problem-solving skills (Hupp, Reitman, Jewell, 2008), improved confidence, practicing mindfulness in regards to calming the body (Hupp, Reitman, Jewell, 2008), and learning about behavior and mental illnesses for a better understanding of the principles and science behind the treatment options (Coyne, Burke, Freeman, 2008).
CBT involves editing one’s way of thinking to improve behavior and mental health, specifically by focusing on problem-solving skills (Hupp, Reitman, Jewell, 2008, pp. 271-272). Problem solving skills like reducing avoidance and impulsivity when solving a problem, increasing ability to find and implement a solution (Washburn, et. al, 2012). According to Hupp et. al (2008, pp. 271-272), there are two basic responses to a stressful situation: problem-focused coping in which the person has some control over the stressful situation and can change something about it, like their communication; and emotion-focused coping in which the person has little-to-no control over the stressful situation and must change the way they are responding to it emotionally by use of relaxation or mindfulness  (Hupp, Reitman, Jewell, 2008 p. 272). According to this theory, maladaptive cognition like depression and anxiety disorders stem from cognitive distortion, which includes selective focusing, making arbitrary assumptions, overgeneralizing, and exaggerating when presented with a stressful situation (Hupp, Reitman, Jewell, 2008 p. 268).
Non-suicidal self-injurious behavior is defined as a behavior that intentionally causes external damage to the body, which can include scratches, cuts, bruises, burns, and banging (Gratz, et. al, 2015). The definition excludes self-harming behaviors that are “socially accepted behaviors like tattooing, piercing, or religious rituals” (Brown, Plener, 2017, p. 2). A crucial component for NSSI is a lack of suicidal intent. In other words, the injurious behavior is done with motives that are not wanting to end one’s life (Brown, Plener, 2017). NSSI is a rising issue amongst the adolescent community (Washburn, et. al, 2012).
The cognitive-behavioral model suggests that NSSI is used as a coping strategy for handling aversive situations and stress (Dawkins et. al, 2018). People who have a heightened emotional response, defined as “heightened emotional reactivity, including heightened sensitivity to emotions, experiencing more intense emotions, and taking longer to recover from an emotional response” (Dawkins et. al, 2018) are more likely to use NSSI as a coping strategy to handle overwhelming emotions (Dawkins et. al, 2018). Errors in cognition including repetitive, unwanted, and overwhelming thoughts which seem uncontrollable contribute to the behavior of NSSI as the person will use NSSI in attempts to cope with his/her/their intrusive thoughts (Dawkins, et. al, 2018) or in attempts to elevate mood (Gratz, et. al, 2015). The cognitive model suggests that NSSI can be used to elevate mood after a stressful situation as it can provide a distraction from the emotional turmoil (Dawkins, et. al, 2018).
Perceived self-efficacy plays an important role in the use of NSSI because self-efficacy relates to one’s belief that one will be successful in their situation. In other words, if one believes NSSI will help them feel better, they are more likely to engage in that behavior (Dawkins, et. al, 2018). Refusal self-efficacy, the belief that one has no control or cannot resist NSSI, also contributes to the behavior of NSSI as a coping mechanism (Dawkins, et. al, 2018).  Cognitive-behavioral therapy suggests improving coping skills to provide more options for handling stressful or emotionally tumultuous situations (Dawkins, et. al, 2018). Challenging cognitive thoughts and adapting them to more productive and positive methods of handling situations is another method that cognitive-behavioral therapy uses to decrease NSSI (Dawkins, et. al, 2018).
The cognitive model states that the function of the behavior of NSSI is a combination of automatic and attention, or social desire (Brown and Plener, 2017). Automatically reinforcing behaviors are behaviors that are internally reinforcing while socially reinforcing behaviors are behaviors performed to gain attention or social interactions. Automatic negative reinforcement, that is, using NSSI to reduce an aversive emotional state, thereby reinforcing the behavior of NSSI, seems to be a strong indicator that the youth will continue using NSSI as a coping mechanism (Brown and Plener, 2017).
The sociocultural perspective in psychology focuses on the role that one’s social interactions and culture play in shaping behavior (Scott and Palincsar, 2012). This theory, which Lev S. Vygotksy contributed much to, places much importance on social interactions between children and adults, and children with other children (Scott and Palincsar, 2013). Vygotksy also emphasized that it is not just about what the other person presents to the child, but the child can bring and contribute a lot to the interaction as well (Scott and Palincsar, 2013). Sociocultural theory suggests that one’s beliefs and behaviors might be understood by looking through the lens of their culture (Scott and Palincsar, 2013).
Through this lens, NSSI would be viewed as a product of one’s social and cultural interactions. A psychologist operating under a sociocultural umbrella would emphasize that NSSI behaviors are influenced by social relationships (Heath, et. al, 2009). Youth might engage in NSSI to communicate their pain or feelings of loneliness to their social circle when other forms of communication are not effective, or to strengthen social bonds (Heath, et. al, 2009). Social bonds can be strengthened by connecting with peers who also self-harm, relating to songs or media about self-harm, or for attention and connection from someone in their life who cares about them like a parent or a friend (Heath, et. al, 2009). According to a study performed by Heath, et. al (2009), youth who self-harm are more likely to report having a friend who also engages in NSSI. Youth who have poor emotional regulation skills are at a higher risk for engaging in NSSI if a friend also engages in NSSI, indicating a social component (Heath, et. al, 2009).
Combining the cognitive-behavioral perspective with the sociocultural perspective would be beneficial for determining the motives behind NSSI. The cognitive-behavioral approach states that the function of NSSI could have a social component, and the sociocultural lens describes that component more clearly, painting a complete picture for the reasons for engaging in NSSI. By assessing a situation from several different lenses, one is able to expand their views and better discover the function of the behavior, which makes it easier to treat. In treating NSSI, it is important to use both methods: cognitive-behavioral therapy will assist the person engaging in NSSI to change their maladaptive ways of thinking and improve their coping skills and problem-solving skills to help them better handle stressful and aversive situations, while the sociocultural model will assist the person in realizing the social components of their behavior so they can work to improve their communication skills and find more appropriate ways to build and solidify social bonds.
Non-suicidal self-injurious (NSSI) behaviors are becoming more prevalent amongst adolescents (Washburn, et. al, 2012). NSSI has two primary functions: automatic negative reinforcement in the form of using self-harm to remove an aversive or overwhelming emotion (Brown and Plener, 2017); and social in the form of communicating when other forms of communication are not working, and strengthening social bonds (Heath, et. al, 2009). Youth who struggle to regulate emotions are more likely to engage in NSSI if they know a friend who does it, or they see a reference to it in the media (Heath, et. al, 2009) because they lack the necessary coping and problem-solving skills to handle aversive, overwhelming emotions and situations in a healthy manner. CBT suggests teaching new coping skills and problem solving skills (Hupp, Reitman, Jewell, 2008) to reduce the likelihood of engaging in NSSI in the future (Dawkins, et. al, 2018). The sociocultural lens suggests teaching better communication skills and finding appropriate, healthy ways to strengthen social bonds and find a sense of belonging (Heath, et. al, 2009). These perspectives can be combined to best understand and treat NSSI in adolescents.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition. Arlington, VA: American Psychiatric Association, 2013.
Brown, R. C., & Plener, P. L. (2017). Non-suicidal self-injury in adolescence. Current psychiatry reports, 19(3), 20.
Coyne, L. W., Burke, A. M., Freeman, J. B. (2008). Cognitive behavioral treatment. Handbook of clinical psychology, 23, 694-727
Dawkins, J. C.. Hasking, P. A., Boyes, M. A., Greene, D., Passchier, C. (2018). Applying a cognitive-emotional model to nonsuicidal self-injury. Stress & Health, 35(1), pp 39-48.
Gratz, K. L., Dixon-Gordon, K. L., Chapman, A. L., & Tull, M. T. (2015). Diagnosis and Characterization of DSM-5 Nonsuicidal Self-Injury Disorder Using the Clinician-Administered Nonsuicidal Self-Injury Disorder Index. Assessment, 22(5), 527–539. https://doi.org/10.1177/1073191114565878
Heath, N. L., Ross, S., Toste, J. R., Charlebois, A., & Nedecheva, T. (2009). Retrospective analysis of social factors and nonsuicidal self-injury among young adults. Canadian Journal of Behavioural Science, 41(3), 180-186. https://doi.org/10.1037/a0015732
Hupp, S. D., Reitman, D., & Jewell, J. D. (2008). Cognitive behavioral theory. Handbook of clinical psychology, 2, 263-287.
Scott, S., & Palincsar, A. (2013). Sociocultural theory.
Washburn J. J., Richardt, S. L., Styer, D. M., Gebhardt, M., Juzwin, K. R., Yourek, A., Aldridge, D., (2012). Psychotherapeutic approaches to non-suicidal self-injury in adolescence. Child and Adolescent Psychiatry and Mental Health, 6(14).

Hemingway and Mental Illness

Ernest Hemingway, a prominent author during the early 1900s, struggled with mental illness and substance abuse for most of his adult life which culminated in his suicide in 1961. Thanks to Hemingway constantly writing both literary works and personal letters to friends and family members, it is possible to trace his mental health and substance use throughout his lifetime. The purpose of this paper is to explain how Hemingway fits the diagnostic criteria for bipolar disorder with psychotic features and borderline tendencies, which was intensified by substance abuse and trauma, and evaluate the treatment he received using current information regarding effective treatment options for bipolar disorder. 

The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-V; American Psychiatric Association, 2013) states that bipolar disorder is classified as experiencing a state of mania which may be followed by a hypomanic or a depressive episode. The DSM-V defines mania as a period of intense euphoria or irritability for longer than one week. Symptoms of mania might include heightened self-esteem, grandiose statements, reduced sleep, racing thoughts or speech, distractibility, increased focus on a task, and engaging in risky behaviors including risky sexual interactions, overspending, or engaging in behaviors that could cause physical harm (DSM-V). Depressive episodes contain symptoms such as a feeling of hopelessness, loss of interest in activities, decreased energy levels, feelings of worthlessness, feelings of guilt, feelings of solitude, lack of focus or cognitive abilities, and thoughts of suicide (DSM-V). Throughout Hemingway’s life behaviors indicating bipolar disorder can be seen through his personal letters, his writings, and information from his friends and family members (Martin, 2006). 

    Hemingway expressed through his personal writings a tendency to experience periods of euphoria in which he was able to complete several pieces of writing rapidly (Martin, 2006). It was reported by his publisher that Hemingway engaged in grandiose behaviors like referring to some of his manic writings as the best writings he has completed (Martin, 2006). Others in Hemingway’s life have reported that he was grandiose with his comments about himself and his abilities (Martin, 2006), which supports the bipolar diagnosis as grandiose behaviors are a part of mania (DSM-V). Hemingway engaged in risky hobbies including bull-fighting, bar fighting, and driving while under the influence of alcohol (Martin, 2006). Hemingway was a hunting enthusiast and often engaged in risky behaviors while hunting that could have resulted in serious injury (Martin, 2006). He was reporting on several wars, but placed himself in the middle of combat which resulted in a serious hospital stay (Martin, 2006). Hemingway was also a known womanizer (Wagner-Martin, 2000). Risk taking behaviors (including risky sexual behaviors) are listed in the DSM-V as a characteristic of mania.

Through different periods of his life, Hemingway faced periods of intense depression in which he was unable to write, did not socialize, and had dramatic weight fluctuations (Wagner-Martin, 2000). He also dealt with bouts of insomnia during his depressive episodes (Wagner-Martin, 2000) which is a symptom of bipolar depression (DSM-V). Hemingway had other health issues for which he was taking medication, but the medications he was taking both have side effects of increasing depression (Martin, 2006). Common to those struggling with bipolar disorder (DSM-V), alcohol was a constant in Hemingway’s life, often causing problems with his health (Wagner-Martin, 2000), safety, and relationships (Martin, 2006). Alcohol is a depressant, thus exacerbating the depression that likely led Hemingway to drink excessively in the first place (Martin, 2006). Hemingway was injured in several accidents involving alcohol including pulling a skylight onto his head and several vehicle accidents which resulted in several potential traumatic brain injuries (TBI) (Martin, 2006). TBIs have significant effects on memory and mood stabilization (Vakil, Greenstein, Weiss, & Shtein, 2019), and later in life, probably due to cognitive impairment from the repeated brain injuries, the alcohol abuse, and his intense depression (Wagner-Martin, 2000),  he lost his ability to write, which was his only healthy coping skill to handle the mood swings (Martin, 2006).  

Later in life, Hemingway’s cycles between mania and depression became more rapid (Kottler, 2005). His mood swings scared his current wife, Mary, and his friends (Wagner-Martin, 2000). He was plagued with paranoid thoughts (Kottler, 2005) including thinking his phones were tapped and the FBI was following him (Martin, 2006). He stated that he believed someone was plotting to assassinate him (Kottler, 2005). He wrote letters to Mary where he expressed fear that he was “cracking up” (Wagner-Martin, 2000 p. 47). The paranoia and delusions that accompanied his manic and depressive episodes would add the qualifier of “with psychotic features” to his bipolar diagnosis (DSM-V). 

Frequent thoughts of death and/or suicidal thoughts are a criteria of a major depressive episode (DSM-V). Starting from a young age, Hemingway wrote often of death and suicide (Martin, 2006). Hemingway wrote and published seven novels, and five of those ended with intense deaths (Kottler, 2005). He fantasized many times of killing his parents and often played out these fantasies in his writings (Marin, 2006). When his father committed suicide, Hemingway stated that he was distraught and felt like he had died that day, too (Martin, 2006). His friends also reported that he frequently mentioned that his life would die by his own hand (Martin, 2006).  

Hemingway also exhibited some borderline personality traits including unstable relationships, self-image issues, impulsivity, narcissistic traits, and trouble controlling rage (DSM-V). He frequently and seemingly impulsively destroyed relationships, both platonic friendships and intimate relationships (Kottler, 2005). He was often overly competitive and controlling and was quick to cut people off if they outdid him (Martin, 2006). After his father died, he assumed the role of head Hemingway and was controlling of his siblings, even going so far as to cut out his sister for marrying someone after he forbade her from doing so (Kottler, 2005). It was often said that Hemingway was overly masculine (Wagner-Martin, 2000). He struggled with his identity as a hypermasculine male because his mother dressed him as and referred to him as a girl when he was a child, and he resented her for it (Martin, 2006). Any action that challenged his masculinity upset him greatly, to the extent that when his child came out as transgender (MTF), Hemingway was distraught (Kottler, 2006). Many hypothesize that Hemingway struggled with his homosexual urges throughout his life (Kottler, 2006). Those around Hemingway were aware of and sometimes fearful of his impulsive rage (Martin, 2006). His publisher despised him and avoided confronting Hemingway regarding his writings (Kottler, 2005). His grandiose behaviors included overt confidence and narcissistic tendencies (Martin, 2006) including obsessing over his appearance like clothes and hair (Kottler, 2005).  

Along with Hemingway’s identity issues, he was vain and refused treatment for a long time (Martin, 2006). He finally, under pressure of his wife and his doctor, entered inpatient care for the first time in 1960 (Martin, 2006). He was treated with electroshock therapy and then discharged, and upon returning home he lived a healthier lifestyle with reduced alcohol consumption and a strict writing regiment (Martin, 2006). Unfortunately his period of stability did not last long, and in 1961 he had an interrupted suicide attempt where Mary found him as he was loading his gun (Martin, 2006). He would go on to have two more interrupted suicide attempts immediately after that (Martin, 2006). He was readmitted to the hospital where he underwent more electroshock therapy, but still fixated on ending his life (Martin, 2006). When he was discharged from the hospital, he took Mary to dinner and then ended his life by shooting himself in their home the next morning while Mary was still sleeping (Martin, 2006). 

Hemingway battled mental instability his entire life (Wagner-Martin, 2000) and it had large, negative impacts on his quality of life. From a young age, he was witness to how mental illness affected, and eventually resulted in the death of, his father (Martin, 2006). Throughout his adolescent and adult years, Hemingway struggled with a sense of identity and stability (Wagner-Martin, 2000). He often turned to what few coping mechanisms he had, like writing, romancing women, and drinking excessively (Martin, 2006). His mental instability resulted in him chasing away his friends (Kottler, 2005), broken marriages (Wagner-Martin, 2000), and extreme risky behavior that resulted in several serious injuries (Martin, 2006). Eventually, his illness resulted in his suicide (Martin, 2006).

During the time Hemingway was receiving services, treatment options were limited (López-Muñoz, Shen, Pilar, Romero, & Álamo, 2018). Lithium had just been proven to have helpful effects on mania (López-Muñoz, Shen, Pilar, Romero, & Álamo, 2018). Today, therapeutic options are much different. Medications are the first line of defence against bipolar disorders, but many people with bipolar disorder tend to be at least a little medication resistant and will require additional interventions (Gaudiano, Weinstock, Miller, 2008). Therapies including cognitive-behavioral therapy, psychoeducational therapy, and family-based treatments can also be implemented (Gaudiano, Weinstock, Miller, 2008). Electroshock therapy can be used if the patient is extremely resistant to other types of treatments (Qinyu, et. al, 2020). 

Hemingway’s battle with mental illness began in his childhood and plagued him until he took his life via gunshot to the head (Wagner-Martin, 2000). According to the diagnostic criteria listed in the DSM-V for bipolar disorder, Hemingway qualifies for a diagnosis of bipolar disorder with psychotic features and borderline tendencies. Hemingway attempted to self-medicate with alcohol abuse which likely contributed to the rapid cycling between mania and depression and cognitive impairment later in life (Martin, 2006). The cognitive impairment he suffered due to his illness, alcohol abuse, and TBIs throughout his life took his ability to write away, thus leaving him vulnerable to the psychosis and delusions that required hospitalization (Martin, 2006). Electroshock therapy seemed to provide some short-term relief, but relapse happened quickly (Wagner-Martin, 2000). Were Hemingway to be treated by a provider today, the psychologist would likely plan with Hemingway, aiming to treat the alcohol dependence alongside the bipolar disorder with an integrated treatment plan containing components of medication and cognitive-behavioral therapy (Gaudiano, Weinstock, Miller, 2008) and electroshock therapy could also be a helpful additive to treatment (Qinyu, et. al, 2020). 

A professional treating Hemingway would most likely use an integrated therapeutic approach to handle the comorbidity of bipolar and alcohol abuse (Grunze, et. al, 2021). Depending on how Hemingway wants to engage in treatment, cognitive-behavioral therapy or mindfulness could help get the drinking under control (Grunze, et. al, 2021), and medication could be used to help mitigate the mood swings (Gaudiano, Weinstock, Miller, 2008). If Hemingway was unable to quit drinking, an inpatient stay to assist with sobriety could be helpful. If the medication did not control the mood swings, more intensive medication might be needed and could be paired with psychoeducation or therapy (Gaudiano, Weinstock, Miller, 2008). If he is still struggling to maintain stability, electroshock therapy could be used (Qinyu, et. al, 2020). Hemingway had some success with electroshock therapy in his lifetime as it was reported that he was relatively stable with good eating habits, a strict writing regimen, and limited alcohol consumption for a short time after leaving inpatient care (Martin, 2006). Combining the electroshock therapy with medication management and continued therapy could offer more lasting results. 


American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association, 2013.

Gaudiano, B. A., Weinstock, L. M., & Miller, I. W. (2008). Improving Treatment Adherence in Bipolar Disorder: A Review of Current Psychosocial Treatment Efficacy and Recommendations for Future Treatment Development. Behavior Modification, 32(3), 267–301. https://doi.org/10.1177/0145445507309023

Grunze, H., Schaefer, M., Scherk, H., Born, C., & Preuss, U. W. (2021). Comorbid bipolar and alcohol use disorder-A therapeutic challenge. Frontiers in Psychiatry, 12, 660432-660432. https://doi.org/10.3389/fpsyt.2021.660432

Kottler, J. A. (2006). Divine madness: Ten stories of creative struggle. Pages 77-101.

López-Muñoz, F., Shen, W. W., Pilar D’Ocon, Romero, A., & Álamo, C. (2018). A history of the pharmacological treatment of bipolar disorder. International Journal of Molecular Sciences, 19(7), 2143. http://dx.doi.org.library.capella.edu/10.3390/ijms19072143 

Martin, Christopher D., (2006) Ernest Hemingway: A Psychological Autopsy of a Suicide, Psychiatry, 69:4, 351-361, DOI: 10.1521/psyc.2006.69.4.351

Qinyu Lv, Qiongyue Hu, Wenzhong Zhang, Xinxin Huang, Minghuan Zhu, Ruijie Geng, Xiaoyan Cheng, Chenxi Bao, Yingyi Wang, Chen Zhang, Yongguang He, Zezhi Li, Zhenghui Yi, Disturbance of Oxidative Stress Parameters in Treatment-Resistant Bipolar Disorder and Their Association With Electroconvulsive Therapy Response, International Journal of Neuropsychopharmacology, Volume 23, Issue 4, April 2020, Pages 207–216, https://doi.org/10.1093/ijnp/pyaa003

Vakil, E., Greenstein, Y., Weiss, I., & Shtein, S. (2019). The effects of moderate-to-severe traumatic brain injury on episodic memory: A meta-analysis. Neuropsychology Review, 29(3), 270-287. https://doi.org/10.1007/s11065-019-09413-8

Wagner-Martin, L. (Ed.). (2000). A historical guide to Ernest Hemingway. ProQuest Ebook Central https://ebookcentral-proquest-com.library.capella.edu

First Day Reflections

Today was a busy day! Firstly, I received my first dose of my COVID vaccine. I am so excited for the possibility of being able to reduce the numbers enough to find out what the new normal is going to be. I don’t know that we will return to how things used to be, but I think that the option for more social events and gatherings are possible in the near future and that is exciting! I miss concerts and the ability to travel, and it would be nice for my family to be able to safely visit this summer. The process for getting vaccinated was super streamlined. I entered the hospital at my appointment time, followed the red lines to various stations where I filled out necessary allergy and consent forms, got my vaccine, waited in an observation room for a duration of 15 minutes with a nurse while I played on my phone, and then left with an appointment for my second dose already scheduled!

Then, I grabbed some coffee (of course!) and headed to my first day at my new job! Some of you read the blog I wrote about why I left my last job (there were MANY reasons– see my previous post for details). I am happy to announce that I am working as a Family Support Specialist for Catholic Community Services. I am basically working alongside a team as a counselor for suicidal youth. I am thrilled to be working in a position where I am doing more counseling, as well as a position where I am working with kids and families again.

I found out about this job through a friend of mine who works there. She was constantly telling me how wonderful her job is and how much she loves the company she works for. She recommended that I apply and assured me that I would love working there. I was concerned at first because I am not catholic at all (I identify as pagan– I’ll probably write about that later), and I identify as part of the LGBTQIA+ community, not to mention the piercings, tattoos, and mermaid hair. However, this company is amazing. They are so accepting and encouraging of our individuality. The first thing my boss said to me today was “oh my gosh, I LOVE your hair!”. I even met another person who works there who is also pagan and wished her a happy Imbalc (the Gaelic holiday celebrating a goddess who is basically mother nature. Fun fact: her name is Bridgid and she was loved by the catholics and made a saint).

As soon as I walked in, I knew I was going to love it here. My desk was decorated with a monster picture and a basket of goodies waiting for me including a thermometer, a bag of PPE, a first aid kit, some candy, a coffee mug, and some markers. (I have my own desk!). I was issued my work computer and phone and after the few technical issues which always happen with me and a new job, I was all set. Then came the new hire paperwork. I counted: I signed and wrote my name about 100 times today.

My desk with my monster welcome poster and my basket of goodies including a thermometer, PPE, first aid kit, some candy, a coffee mug, and some markers!
So. Much. Paperwork.

The company itself is founded on amazing principles involving complete acceptance of all people, which includes in-depth antiracism training. I am thrilled that they understand the importance of the fact that we must actively fight racism within ourselves and within society as it will not go away if we are passive or pretend to “not see color”. There is an entire company program called the JEDI program in which we collectively learn more about and brainstorm ways to continue fighting racism, help others fight racism, and make sure we are best supporting our clients of color and making sure the staff of color feel respected and included.

Other perks: I get to make my own schedule; I have the option to do admin/paperwork stuff and virtual meetings at home or at the office; the pay is pretty great; I get reimbursed for mileage; AND I get to bring Aurora to the office! She is a registered Emotional Support Animal, and a Therapy Dog in training, so going to the office will be great practice and a wonderful way for her to get her training hours in! Also, the staff are so excited to meet her. There is also a program called WOW in which we plan fun team building events like trivia, retreats, and other (COVID safe) events. This Friday, Aurora and I will be getting together with some coworkers to make Valentine’s day cards (socially distanced, of course).

Over all, my first day could not have gone better. I have said it before, but I am thrilled to be working for such a wonderful company, and I am sure that I am going to love working with the families once I get my caseload. I will be in the office or doing virtual trainings for about 2 weeks, then shadowing for a while before I get my own team and clients.

It is looking like this is going to be a wonderful journey!

Sexual Harassment In My Previous Workplace

But first a cute dog picture

Lately, life has been tumultuous and uncontrolled. In October, I left my job as a behavior tech in ABA (working with kids who have autism) and became a behavior therapist at a mental health crisis center. At first, it was great. I was working nights which was an interesting experience, and the chaos that came with working at a mental health crisis center was exciting and kept me on my toes. Over the two months that I worked there, however, I started realizing that the company didn’t care about employee safety and often put us in dangerous situations, both with COVID-19 and with violent patients. It also became clear that the company only cared about income and did not care if we were actually helping people, even going as far as allowing patients who have assaulted staff to return time and time again.

During my time there, I was also sexually harassed by two male staff members. I received inappropriate comments and gestures every day that I worked. I brought it up to a coworker who informed me that complaints have been filed with management before and nothing was done, so it was suggested that I should not complain because all that will happen is I will create drama and might suffer repercussions from these staff members while at work. However, one night it escalated and one of them grabbed my wrists and pinned me against a door in a utility area with no cameras and a lock on the door. I was able to easily get away, thankfully. (Thanks, Dad). But after that I decided that it was not an option to not report these two men in hopes of protecting other women that they encounter. I submitted my notice to leave the job, and filed a complaint with management and HR.

When I discussed this with friends and family, I heard some people say things like “wow, I didn’t realize that still happened”. Let me be super clear: workplace harassment happens CONSTANTLY. Many of the women I know personally have experienced similar harassment. It is super common. Women are called irrational, told they’re making it up, told to take a joke, or blamed for wanting it or inviting it in some way. Like I was.

Unfortunately, the coworker was right. The men were put on administrative leave pending an investigation, however the director defended them and they were permitted to return to their jobs. I left the company without fulfilling my remaining two-weeks. When I informed HR that I was not returning, they said “that’s unfortunate because they’re short staffed now”.

I cannot express how much I don’t care about their staffing issues.

I am thrilled to be started a new job on Monday. I will be a counselor for suicidal youth. I am excited to be working with kids again, and I think it will be wonderful to be able to build rapport with clients and see progress again. Working at the crisis center did terrible things for my mental health, so I am excited to have a job where I find positive meaning, with a company who cares about people and has strong values. The company I am going to is very active in social issues, which is amazing to me and I cannot wait to be a part of that. One of the most exhausting things about working at the crisis center is that almost no one cared about LGBTQIA+ people and I found myself correcting pronouns and names every time someone trans or non-binary came in, which is RIDICULOUS for mental health professionals. Also, many of our Black mental health professionals experienced racism in the work place constantly and it was exhausting to have to fight that daily. At first I was passionate about advocating and educating, but some of those people were intentionally and deliberately saying these hurtful things and I was obviously fighting a losing battle.

In conclusion, I cannot wait for this new adventure, and I am excited to be back on a regular, Monday-Friday daytime schedule. I have had the whole week off to rest and do some intense self-care to make sure I’m mentally healthy. I spent time with my partner, cuddled lots of animals, enjoyed some time with friends, and took the dogs outside to enjoy the sunshine and get some physical activity in my day. AND I had my hair done!

How the Navy Handles Suicide

My partner, Jake, has been suicidal for as long as he can remember. Usually, he is able to push the intrusive thoughts away and get on with his day with little repercussions. While serving in the Navy, those thoughts became constant and loud, impossible to ignore. He began making plans, and in a couple of instances, acting on those plans.

Disclaimer: all of this is written with his approval. He proof read the entire post before it was published, and is comfortable sharing everything I’ve written.

Jake struggled with his mental health at several different points during his career in the Navy. At his training command he saw a Navy therapist a few times to deal with the stress of schooling. Once in Washington, he was feeling good and ready to be on an actual submarine instead of in school. That quickly changed. We arrived in Washington in January of 2019. By September, it was very obvious that he was struggling mentally. He was a shell of a person, honestly. He would go to work, come home, stare at the ceiling for a while, then go to bed and repeat. He had no interest in doing anything. He rarely had days off, and when he did he just wanted to sit around the house because he didn’t have the energy for anything else. There was a lot of pressure at work to qualify (a certification process that all reactor operators must accomplish to be able to man the reactor independently) quickly, and he struggled to handle it. Stress management has never been his strong suit; he’s working on it.

One day in November of 2019, I received a phone call while I was at work. It was his chief asking me if I knew where Jake was because he didn’t show up to the boat that day. By this point, I knew he was struggling, and I knew he had been thinking about suicide, but I didn’t realize how serious it was yet. I think we were both under the impression that the thoughts were intrusive and he dwelled on them, but he wasn’t making plans or acting on them. His chief let me know that they were going to my house to get him and take him to work. I requested they call me once they arrived to let me know he was okay. They called me when they arrived at my house to tell me that the car was there, but he wasn’t answering the door and they were calling the police to do a wellness check. At this point I rushed out of work and started the 30 minute drive home. A few moments later, I received a call from the Kitsap County Sheriff who had arrived at my house. They advised me to come home right away.

Upon arriving at my house, his chief greeted me and told me that the Sheriff did not want to break my door down. I unlocked the door, but the Sheriff said that they would not enter my house and I had to be the one to go inside. I stood in the doorway for what felt like a long time, but was probably only a few seconds, preparing myself to find my partner dead in my home. He was alive, but in a crisis situation. We talked and I convinced him to get dressed and go outside. I went outside to inform everyone that he would be out momentarily, and the Sheriff responded by yelling at me for having firearms and medications in my house. He told me I was irresponsible and this situation never should have happened. He said I wasted his time (reminder that I wasn’t even the one who called him…). When Jacob came out, his chief lectured him for missing work, for making his division’s job harder, and for making them spend two hours at his house when they all should have been working. Then they left and made him drive himself to work. They also opened a malingering case against him, which is a very serious charge for faking a mental illness to avoid work responsibilities. Everyone told him he was faking it. 

After that, it seems like he told me everyday about how he had a plan to end his life. He had preferred ways he wanted to do it. That was scary because his preferred methods were so easy for him to access and I didn’t have the power to prevent him from carrying his plans out.

Another day, I was at my favorite yarn store with a dear friend when I received a call from him. He said “I’m going to do it. Please say goodbye. Please let me go.” I’m sure I turned white as a ghost. I dropped everything I was holding. I asked him where he was and he wouldn’t tell me, so I told him to not move and I hung up on him to call his chief. I explained to his chief that he was somewhere close to the boat or parking garage and he was attempting suicide. His chief sent one of his friends to find him and my friend drove me to base. I received a call from his friend while we were on our way. He told me that he was with Jake and they were safe. Then I received a call from his chief. His chief informed me that I overreacted, Jake was sent back to work, and the chief said he did not understand what the issue was because underway Jake performed so well. “It must be something about being at your home that is the problem”. My friend stayed on base with me for several hours until Jake’s shift was over so I could drive him home. Also, my bunny died that day, just to make a terrible day worse.

Jake went underway in January of 2020. When we said goodbye as I was dropping him off, I was thinking to myself “this might be the last time you ever hug him”. Neither of us expected him to survive that underway. He wrote me so many goodbye letters in his journal.

A little while before the underway, his therapist had his credentials taken away. He lost his security clearance because he was deemed unstable by medical. He wasn’t supposed to go on that underway. His therapist had hoped that with the boat gone, Jake could focus on getting himself in a better place mentally, and he would be healthy and ready to work when they returned. Instead, the boat said that he had to come. They reinstated his security clearance and told him he was going on the underway the night before they left. Jacob had one night to get ready to be gone for months. While he was packing, I was frantically writing letters that he could open on bad days, basically begging him to come home. To hold on a little longer.

I spent every day of that underway waiting for a chaplain to show up at my door to tell me Jake was gone. 

When he came home from that underway, he was supposed to get a week off. They took that away. They took away his weekends, he was working 12 hour days and they were preparing to leave again immediately for an even longer period of time. One morning, Jake slept through his alarm. I woke up to a call from his friend telling me that Jake was going to be late if he didn’t hurry. I woke Jake up but he was not himself. I don’t even know how to describe that morning. He refused to move, he wouldn’t answer me, when he did speak it didn’t make sense. The only thing he said that made sense was a plan to kill himself on his way to the boat. A Navy person showed up at the door to collect him. I turned them away and called 911. I still had bad memories from the last time the police were involved in a mental health crisis situation, so I specifically asked the dispatcher to send paramedics. They didn’t listen to me. Police rang my doorbell a few minutes later and I almost didn’t let them in.

One officer talked to Jake in the bedroom while the other sat in the living room with me as I busied myself doing anything I could find. I made coffee for everyone, even though no one wanted coffee, I cleaned the table and the counters and swept the floor. The officer finally asked me to sit down so he could ask me some questions about Jake. We were lucky: those officers were amazing. They built rapport with him and treated him with respect. They convinced him to willingly go to the emergency room. I drove him in, but because of COVID I couldn’t go in with him. I sat in the parking lot for twelve hours until they told me they were keeping him overnight. I called one more time before bed to check in, and they told me that he wasn’t there anymore. Long story short, I thought the hospital had let my suicidal husband just check himself out, but they were actually transferring him to a military hospital (despite neither of us wanting that, and without telling me… that’s another story). He spent a week there.

When he went back to work after being discharged from the hospital, he was informed that he was being masted the next day. For those who aren’t military, a Captain’s mast is when a sailor is in trouble and he has to go before the captain and other superior officers and basically stand trial. He was stripped of his rank for missing work the day that he was in the ER. Jacob requested that the Captain let him be discharged from the military, and thankfully the captain agreed and signed off on the discharge paperwork. He was transferred and we began the process of getting out. He was discharged under “general, under honorable conditions”, thankfully, but they still didn’t exactly support us on our way out. We are currently fighting because they never paid us for his leave days that he had earned, and they took away our medical coverage on day one, when we were supposed to have it for 90 days after being released.

Getting discharged was the best option for us, and I’m glad it went as well as it did, because for so many it was so much worse. I was inspired to write our story because it needs to be publicized that the military is terrible to people who have a mental illness. The rate of suicides in the Navy, specifically in the Nuclear program are astronomical and nothing is being done to help these people. We are grateful that his captain cared about him enough to let him out without making it dishonorable. He could have refused to let him out at all.

Jake is doing much better now. He still has those thoughts, but the plans are gone and he is able to engage in outlets that help with stress. He’s able to take care of himself and that makes a lot of difference. Being home with all the animals helps, too! If you have questions or need to reach out, we are both pretty open about our experiences.

Bipolar and the Common Cold

My mental state takes a huge toll on my physical state. Bipolar causes things like racing heart beat, upset stomach, shaking hands, grinding teeth, and can cause flu like symptoms during a depressive episode. The reverse is also true: my physical state plays a large role in how I feel mentally.

This week, I caught a cold (thanks, Jake. He started it). My miserable physical state caused my mental state to deteriorate. I battled with a bout of depression that I am just coming out of today. While my nose was running and I was coughing, I was also feeling insecure and hopeless. Being physically sick effects the mental state so much because so much of my routine that I rely on to stay balanced mentally gets disrupted. I had to fight both the physical illness and the mental illness simultaneously. My physical illness is still present, but my mental state began to elevate today, thanks to a lot of self-care and a talk with my therapist. I found self-care activities that didn’t require leaving my home or expending too much energy, like knitting, listening to podcasts, listening to Benedict Cumberbatch read Sherlock Holmes (ahhh!), and enjoying time with my dogs. I read some educational articles revolving around my job to keep my mind busy and engaged.

I have a planner/journal that I keep, and on the very first page is a huge list of self-care activities that I refer to when I’m struggling. During depressive episodes, I will make a to-do list for the day with one task for work or the house, and one self-care task. This gives me something to accomplish which makes me feel good, without putting too much pressure on myself.

What are your self-care activities? How do you take care of yourself on not-great days?

Warning Signs: Ways to Tell I’m Symptomatic

This is the hardest post I have written so far. When I am struggling with my mental illness, I hide. When I’m too low to smile and fake being okay, I stay in my house in isolation so no one sees me like that. I typically don’t notice when I am hypomanic until someone points it out, but I don’t like having it pointed out to me and I often become defensive and deny it. I want everyone to think I’m fine all the time, but the reality is, I’m not. My goal with writing this blog is to be open with my mental illnesses, and that means being open about my struggles. Hopefully, these posts are educating and encourage others to be open with their stories as well so we can end the stigma against mental illness. But, for that to happen, I need to be completely open, and that means sharing my struggles. So, here are the ways I (and you) can tell if I’m toeing the line between being okay and having an episode.

We will start with depression because it’s the easier one to identify the warning behaviors.

  1. I let my house get messy. The first thing to go is always the dishes. I don’t mind doing dishes at all, but for some reason I always let them pile up when I’m slipping into depression, and then there are so many of them it becomes too overwhelming to do them at all.
  2. I don’t eat much. Food doesn’t taste good and I don’t have the energy to prepare anything or go to the store, so I just don’t eat much. I’m also super picky (more so than usual), and will usually fixate on one food and that’s all I will be willing to eat.
  3. I talk less. I try to avoid having conversations about myself when I’m feeling down, and I try to avoid topics that will require me to do a significant amount of the talking. Instead, I prefer conversations where the other person does most of the talking and I can listen quietly.
  4. I stop engaging in hobbies. Depression steals a lot of joy and motivation. When I start slipping, I don’t want to do any of my hobbies, specifically knitting and reading. Instead, I waste my evenings either playing on my phone or staring at the ceiling. While my partner was deployed, I was really struggling with depressive episodes, so my therapist, my best friend and myself made an accountability plan where I would engage in 20 minutes of any hobby I wanted every night. That really helped get my creative mojo back which helped pull me out of that episode.
  5. I sleep. A lot. Typically I have a pretty good routine going, but when I’m depressive I go to bed earlier and wake up later than usual. I also have very restless nights.

Hypomania is a little harder to identify because I act like myself, just amplified.

  1. I struggle to have a full conversation. I will often switch topics quickly or at inappropriate times, or make comments that aren’t obviously related to the conversation at hand.
  2. I make eye contact less during conversations. When I’m hypomanic, having conversations is hard. I struggle to stay focused on one thing long enough to talk about it, and part of that struggle to focus is a struggle to keep eye contact. I often look around the room or fix my eyes on something else while talking.
  3. I am easily irritated or snappy. This is one of the tells that I can notice about myself. I don’t typically notice the difficulty focusing or difficulty having conversations, but I usually notice when I’m irritated and being short with people or the dogs. I am not angry with anyone, but my head is spinning so fast, and it feels like everyone else is moving in slow motion. I get frustrated that no one can keep up with me.
  4. I go on a cleaning spree. When I was cycling between hypomania and depression every few days, this worked out great. I would let the house fall apart for a few days, then go hypomanic and deep clean everything.
  5. I sleep less. Again, my routine is pretty spot on and when I’m balanced I go to sleep easily and wake up easily at the same time every day. Hypomania makes me stay up later and wake up earlier than usual.
  6. I’m jittery. Imagine me on 21 cups of coffee. I bounce my legs or click my pen, which is typically obnoxious. My bad.
  7. I make bad financial decisions. If I’m impulsively spending more than usual, that’s a sign that I’m not stable.

So what if you notice one of these symptoms? That’s a great question because I don’t know the answer yet. I don’t have a preferred way to be approached, other than quietly. I will probably tell you I’m just tired if you notice I’m acting depressive, and I will probably get defensive if you suggest I’m hypomanic. Definitely tell me, but just know I might not be super appreciative at the time. I’ll thank you when I’m stable again.

Fluff, Slobber, and Love: How Animals Make Everything Better

Shiloh, Aurora, and Vader waiting for mom to get done taking her pictures so they can get pupaccinos.

My family consists mostly of pets. My partner and I have 6 animals. We have three dogs: Shiloh, a pit mix who loves sleeping on the people bed, snuggling everything, and hiking; Vader, a lab/great dane mix who loves anything involving water, fetch (specifically fetch in the water), and snacks; and Aurora, a Saint Bernard who loves being around her people and belly rubs. We also have two kittens: Ashes who loves her space but demands two hands of pets when she feels like it, and Embers who meows constantly and loves to sleep on my partner’s computer while he games. Last but not least, we have a bunny named Azel who loves all things food related.

Aurora is our newest family member, but she has already made a huge impact in our lives (which is to be expected since she is like 110lbs). Aurora has a natural ability to know and understand the emotions of the people she is around. She frequently follows me around and insists her head goes on my lap on days when I am particularly anxious. She has laid on the floor with me for hours while I stared at the ceiling or played on my phone to chill out after a bad or emotional day. Saint Bernards require a lot of grooming and attention, and sitting outside in the evenings to brush her long fur is a wonderfully mindless and calming task that helps ground me.

All the dogs are helpful on bad days. My favorite thing to do on days where I’m having a depressive episode (which I affectionately call Eeyore days) is to get all three dogs on the bed or couch with me so I’m surrounded by fluff and slobber and love. On Eeyore days, it can be so hard to get out of bed, but often getting up, taking a shower, and getting some light exercise can be crucial to feeling better. The dogs encourage me to get up and stay active. Taking the dogs for a walk around the neighborhood can improve my mood exponentially.

Kitten and bunny snuggles on Eeyore days are also effective medicines 🙂

For these reasons, my therapist and I decided that Aurora would do really well being my Emotional Support Animal. Emotional Support Animals, or ESAs, do not have the right to enter buildings that animals are not allowed in, however she is allowed to fly with me on a plane and live with me in any establishment, whether pets are permitted or not (of course we would never live somewhere pets aren’t allowed!).

Aurora is intuitive to everyone, not just me. She recently met a neighborhood kid who has autism. He was instantly enthralled with her, and she gently laid on the ground with him while he gave her belly rubs and put his head on her for snuggles. She has such a gently, relaxed personality, which is a stark contrast from my other two high-energy pups. For this reason, we are training her to be a therapy dog. Therapy dogs have the ability to go to places like rehab centers, hospitals, nursing homes, behavior health clinics, etc. to visit patients there and help brighten their day. Aurora is still in training, but we are expecting her to be ready to be certified this fall. COVID permitting, we will be visiting people this winter!

Playing the Med Game

Hi. My name is Kaitlyn. Almost 2 years ago, I was diagnosed with Bipolar 2 disorder. This diagnoses came after many months of episodes and hardships. I put my partner through a lot before I was diagnosed and on proper medication. The diagnoses didn’t magically stop the symptoms, though. After the diagnosis came the painstaking medicine game. My psychiatrist and I worked tirelessly to find the right medicine cocktail that would both keep me stable and let me feel like myself. Now, two years later, I think we finally have the right combination of meds.

What is bipolar disorder?

You’ll have to do your own research, but I’ll give you a basic rundown. There are several different categories of bipolar, but I’m going to focus on Bipolar 1 and Bipolar 2. Bipolar 1 is when a person has periods of extreme depression and periods of mania. The durations differ for everyone, but typically each episode can last from a few days to a few months. Mania is basically a super-high state where consequences mean nothing. People who are experiencing mania tend to feel great and nothing can bring them down. Sometimes they can have delusions such as believing they can fly or that they are a god. People experiencing mania tend to have delusions of grandeur which can lead to them impulsively quitting their job to open a business or spontaneously taking a trip across the country. Consequences mean almost nothing during a manic episode, so people in that state might engage in risky behaviors that they would not typically engage in. Mania causes intense energy and a lack of sleep.

People with bipolar 2 also have episodes of extreme depression, but instead of mania, they have hypomanic episodes. Hypomanic episodes are basically less-extreme versions of manic episodes. Someone in a hypomanic state might spend all their savings, and engage in risky behaviors. Personally, when I was hypomanic, I would spend ALL our money, despite having worked for months to save it up. I would do spontaneous things like drive to Ohio by myself in the middle of the night, or buy a truck. I often felt like the world was moving in slow motion. I had so much energy and no one could keep up with me. I got drunk a lot and would be frustrated when the people I was drinking with were done and wanted to go to bed. I struggled to hold conversations as so many thoughts were racing in my head. By the time the person responded to what I had said, I was ready to move on to a different topic. This made it difficult for my friends and family members to hold meaningful conversations with me. I also become super irritable because I feel like everyone is moving so slowly and that is frustrating.

I’m mostly stable now, but it was a long road to get here, and the work is not done. Finding the right medicines is hard. It’s exhausting. The antipsychotics or antidepressants can mess with so many aspects of your body and mind. Weight gain and loss of sex drive are super common side effects with many medications. Some medicines make the menstrual cycle worse. Some can make people moody or sad or angry. My most common side effects were brain fog, where I felt like the whole world was grey and in slow motion, and an upset stomach. I recently had to switch to a new medication because one pill made me throw up every day, 10 minutes after I took it. Because I kept throwing up, the medicines weren’t being absorbed into my system all the way and I ended up having a hypomanic episode as a result.

Medicines take weeks to reach therapeutic levels. It’s frustrating to start a medicine, wait several weeks for it to “kick in”, wait a few more weeks to see if it is working, wait for an appointment, only to decide it’s not the right medicine and start over with something else. Finding the right medicine combination took me TWO YEARS. Two long years of trying dozens of medications and different doses until we found a combination that prevents me from going manic, curbs the depression, calms the anxiety, and still lets me feel like myself. 

My work is not done, even though the meds are working. I still have to go to therapy, be intentional about my self care, and check in with my body daily.

I wanted to share this because I advocate passionately to end the stigma on mental health. I figure the best way to help end the stigma is to share my story unapologetically. I plan to use this blog space to blog about my entire life: knitting, hiking, the animals, and my mental health. Awareness and understanding are crucial to ending the stigmas that surround mental illnesses. By educating those around us, we can each help end the stigma and move toward a future where people who are mentally ill are not portrayed as crazy, deranged, or dangerous.

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