This article is a continuation from Multi-Polar - The Many Moods of Bipolar Disorder part one.

Recently a reader asked me to describe the moods of bipolar disorder in my own words. OK, I thought, but a lot has been written (by me and others) about depression, mania and hypomania before. But then I thought about it and realized that there were actually many moods in bipolar disorder and just saying there are “up” and “down” moods sort of does a disservice to everyone struggling with bipolar disorder.

As I wrote, some people believe that if you don't have a mental illness, you can't understand someone with a mental illness. I'm not sure this is true.

I use the word “doctor” quite liberally and often use it interchangeably with “psychiatrist.” The reason is quite simple – psychiatrists are, in fact doctors, they are just specialists. Yes, that’s right, your psychiatrist has all the rights and privileges that any other doctor has and could probably remove your spleen, if the occasion called for it. Nevertheless, there are some crucial differences between “doctors” in general and “psychiatrists” in particular. And sometimes you need a psychiatrist and sometime any old doctor will do. So how do you know if you need a psychiatrist?

One of the challenging things about being a person with a mental illness who talks about psychiatry (and doesn’t hate it) is that all those people who do hate psychiatry perk up and get mad. These people often identify as “antipsychiatrists” and I’m not their biggest fan. While I consider it quite reasonable to question your doctor, psychiatrist, treatment, therapist and other treatment aspects, I consider going after an entire branch of medicine ridiculous. There is no “antioncology” faction in spite of the fact that a large percentage of people with cancer die (depending on the type, of course). And this manifests in many of our lives. It’s not that antipsychiatrists just attack me; it’s that people of that mindset attack your average person who is just trying to deal with a mental illness. It’s the people who say, “mental illness doesn’t really exist” or “psychiatric medicine doesn’t work” or many other things that many of us hear online and in our real lives all the time. So how do you talk to these people who have decided that your disease doesn’t exist and you shouldn’t be in treatment?

Earlier this week I wrote a piece about being scared of trying antidepressants and as one commenter pointed out, there are increased risks associated with treating a person with bipolar with antidepressants. In fact, some would say that treating a bipolar person with antidepressants can worsen the course of the illness (always contraindicated as monotherapy and possibly undesirable altogether). Now, when I wrote the article I was only thinking of unipolar depressives, but, as one commenter pointed out, being diagnosed, correctly, with bipolar disorder, in itself, can be a challenge. And this is absolutely true. Studies have found that it takes 5-10 years (from the time of the first episode) for a person with bipolar disorder to get an accurate diagnosis. There are many reasons for this, predominantly that people don’t get help when they have their first episode, but a major contributing factor is also misdiagnosis. People with bipolar disorder are often diagnosed with depression or schizophrenia first and this can have devastating outcomes.

For some reason people like to come on here and tell me (and sometimes others) that I’m not bipolar. They feel, for whatever reason, that my writing is not that of a person with bipolar and somehow it indicates that I’m not bipolar. I’m not expressing the right emotions. I’m not writing whatever it is that a “real” bipolar person would be writing. And this happens in real life too. People somehow feel qualified to determine a person’s mental status simply by the way a person with bipolar acts in front of them. Well, for the record, I would like to say from me, and all the other mentally ill people in the world: bite me (or, you know, us).

If you’ve been poking around for mental health information for a while you’ve probably seen them: The people who decry psychiatry and all associated therapies. These people come in various shapes and forms but they often call themselves “psychiatric survivors” or “antipsychiatrists.” These are people who claim that psychiatry is evil and psychiatrists are nothing but abusers. These are people that claim that psychiatric medication will cook your brain and that those who use psychiatric services have simply been duped into believing the lies of “big pharma.” It should surprise no one that I’m not a fan of these people. In my opinion, these people prevent sick people from getting the help they so badly need and they can cost someone their life. And writing off psychiatry as a field of medicine reminds of refusing to eat Chinese food.

Mental health is something that matters whether you’re seven, seventeen and seventy, and any of those ages can fall victim to a mental illness. Depression, for example, is quite prevalent and undertreated in the elderly. But if you’re underage, it may be more difficult than just going to your doctor to start the process of getting help for your mental health. It likely means explaining your mental health concerns to your parents; which, quite reasonably, is scary to a young person. (It’s scary to an old person too, but I digress.) So how do you tell your parents you think you need mental health help?

When I told my mother I had a mental illness, I’m pretty sure she didn’t believe me. She didn’t come right out and say it, but it was pretty clear she was suspicious. Once she did feel something was wrong, she was sure it could be fixed with vitamins and herbs. It couldn’t. And this is a pretty common reaction from family members. You have one of the hardest conversations of your life and the family member responds with, “you’re not sick.” Or, “you look fine to me.” Or, “you’re just being dramatic.” Or many other things that will tell you that they don’t believe anything is wrong. So how do you approach a family member and explain to them that everything is not OK.