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).

Bipolar is a disease that takes over your brain – well, parts of your brain anyway – and these affected parts of your brain change your psychology right along with them. So once when you felt “normal” or let’s say, average, you now feel utterly destroyed. Your emotions are altered thanks to the attack on your brain. And what’s worse about this is that bipolar or depression fundamentally changes who you think you are at that moment. If you used to be a fun-loving, happy-go-lucky sort, in a depression, nothing could be farther from the truth. When manic, all your thoughtful, careful ways become things of the past. You can barely identify with the person you were pre-mood. And perhaps even worse than all that is that some part of you sees this dissonance. You know that who you are at that moment isn’t who you really are. It’s like someone else, a crazy person, moved right into your head and body and coopted your life. Bipolar snatched your body and brain.

Guilt – noun – a feeling of responsibility or remorse for some offense, crime, wrong, etc., whether real or imagined. And people with a mental illness feel guilt over a lot of things. I hear from people every day who feel guilty about their illness, what they’ve done, what they haven’t done and how their mental illness and their behaviors due to it affect others (Feeling Guilty Because You Have a Mental Illness). But mostly I consider guilt a waste of time in mental illness recovery.

I’m sitting on my red, plush couch in my living room and I have started crying. Tears well in my eyes at first while I try to convince them not to roll down my face and splash the back of my glasses. As usual, the tears don’t listen and soon my cheeks and lips and chin are wet with saline. I take off my glasses and put them on the wenge coffee table and my head falls into my hands. Loud crying now, choking sobs wrack my body as I feel the pain of illness that I had been pushing away for so long beat me once again. And I wonder – will it get better?

People self-harm for many different reasons and self-harm in and of itself is not a symptom of bipolar disorder. But like many people with extreme pain in their lives, many people with bipolar disorder do self-harm. I have been one of them. And as sure as I’m sitting here I can tell you, stress precipitated most of the self-harm.

This was a question recently asked of me, “can people with a mental illness, like bipolar disorder, live alone?” The answer to me was obvious – yes! Absolutely. Of course a person, even with a serious mental illness, can live alone. But then I thought about it for a moment and maybe it’s not that simple. Maybe there are some tools that facilitate living on your own.

Self-talk is something we all do. In psychology they call it intrapersonal communication – or communication with oneself. It could be the voice of your mother in your head tell you to “take a jacket” or the voice of an old lover telling you that “you’re fat” or simply a recitation of the lyrics to YMCA for an hour at a time. However you do it, we all have an inner voice no matter how unconscious it may be.

As I work, I battle the stigma around mental illness. It feels like often, all day, every day, it's the only thing I do. But I do it because I feel it's important. I feel it matters. I feel it changes people's lives. And one of the misconceptions I've heard multiple times recently is about bipolar and mental illness diagnosis. That by accepting a diagnosis of a mental illness this somehow removes the responsibility from the individual for their own wellness. That, somehow, a mental illness diagnosis makes the patient weak because now they are looking for someone to "save" them or "cure" them. Well nothing could be farther from the truth. Getting a mental illness diagnosis is only the first step in what a patient must do in order to recover.