I am a very difficult case of bipolar to treat. Believe me. I have been on more bipolar medications than anyone I know and finding an effective cocktail is akin to walking on water. It’s possible, but it’s pretty darn rare. And recently I made a medication change from one antipsychotic to another. It went very badly in a whole host of ways. In fact, I terminated the medication trial early and went back to my previous medication. I see my doctor this afternoon and now I have to tell him the bad news about how it went. And I feel guilty about failing another bipolar medication. I know he will be disappointed and I feel bad about it.

The first thing I thought of this morning was killing myself. Literally, as consciousness slowly overtook my brain thoughts of suicide were all that were there. It’s a bad day.

OK, maybe it seems like I’m being a bit hard on commenters. I swear I’m not. I like people who comment and express their opinion, but sometimes their opinion spurs one of my own. This is one such comment: I’m bipolar, and I think we ALL should have to take a Dialectal Behavior Therapy course. The DBT course helps with coping skills, year class, and helps  . . . these skills work if you want them too. Here’s someone singing the praises of dialectical behavior therapy (DBT). She would certainly not be alone as many people find DBT to be helpful. The problem I have with this comment is the last bit, “these skills work if you want them too [sic].” So, this means that if the skills learned in DBT don’t work for someone it’s because they didn’t want them to? I don’t think so.

I have been on every bipolar medication you can name and likely a few you could not. I have been on more medication combinations than I can remember. I have spent years dealing with medication side effects. There is very little medication pain that I cannot tolerate. I have taken medications that have made me feel amazingly well and bipolar medications that have made me feel intolerably ill. I’ve seen treatment miracles and treatment devastations. And still, I feel nothing but terror when I think of taking new bipolar medication.

In one year I write over 100 blog articles for Breaking Bipolar. I’m honoured to say that many people have responded to this writing and it has spawned many great conversations. Popular topics this year ranged from self-harm to passing down of bipolar to your kids to the understanding of mental illness. Check out these popular articles you might have missed.

I believe the holidays hit everyone. Sometimes that hit is very positive, sometimes it’s really negative, but I think that hit is real and pretty universal. If it’s not parents, it’s siblings, if isn’t not kids it’s money, if it’s not partners it’s the planning of perfection. In short, there’s something for everyone to be stressed about at this time of year. For me, personally, I can’t count the number of times I would leave my family and cry and sob for hours as I drove home. Holidays have never really hit me positively. And as I’ve said before, even if you’re lucky enough to get a positive kick from the holidays, even good times can lead to bad health. But knowing the hit is coming, is there anything we can do to soften it?

Some time ago, I wrote about generic medications. I explained that generic medications are bioequivalent to brand name medications within a given margin. Generic medications may use binding and other inactive agents that are different from the brand name medication. All of this can lead to a generic being less effective than the brand name drug in a small percentage of cases. Usually though, the generic works just fine for people and the switch is unnoticeable. And all that information was correct. But new information has arisen. And it’s alarming information to me. It’s information on exactly how bioequivalence is determined for medication and in the case of one generic medication, the generic of Wellbutrin XL 300 mg, it caused an ineffective drug to be allowed on the market for many years.

You’d let them take an ice pick to your brain if you thought it would help. Bipolar disorder impacts different people differently. For some people, bipolar disorder is immanently treatable. These people find doctors, therapy and medication and walk off into the sunset with few bipolar symptoms left with which to contend. These people lead the same lives as everyone else and besides (likely) controlling certain lifestyle factor that contribute to stability, they don’t have to think about bipolar disorder on a daily basis. Then there are the people who are more affected by the illness. These are people for whom treatment partially works. They likely find doctors, therapy and medication too, but in spite of best efforts, they live with bipolar symptoms every day. These people might live your ordinary life or might live a life that is more affected by the illness, such as one where they can only work part-time. And then there are the people that are severely affected by bipolar. Even with treatment these people tend to have intractable moods and likely can’t work because of them. These people do not live average lives. They live lives dictated by the illness and the treatment. These people are in pain every day. And it’s only chance that places you in one of those three groups.

One of the problems with psychotherapy (and, keep in mind, I like psychotherapy) is that psychotherapists try to look for a cause for every emotion. And this seems reasonable. Or at least it does, to a person without a mental illness.

One of the things that is so debilitating about a chronic, long-term mental illness is that it is so relentless. Day in and day out you face the challenges it brings. On your birthday, it’s there. On Christmas, it’s there. On Arbor Day, it’s there. And no matter how you’re feeling and what’s happening in your life, you have to deal with it. Mental illness isn’t the kind of thing that you can push “pause” on. Mental illness doesn’t wait for later. Mental illness is like a 2-year-old. It wants you now, now, now, now and if it can’t have you, then heck hath no fury like a two-year-old ignored. But I swear, I could be a better crazy person if I could just get a break once in a while. If I could just get all the nuttiness in my head to shut up for a while I swear I could get on with things like work, and taxes and cleaning and the gym. But the nuttiness in my head will not be quelled and this, I think, is one of the hardest things about mental illness.