I have been through very long, dark nights of the psyche. I have been in pain I didn’t think I could survive. I’ve been in pain I almost didn’t survive. I have done things I never wanted to do. I have done things I never thought I would do. I have been to places most people wouldn’t even come up with in their nightmares. And when I’m not there, I’m grateful. No matter how much I might think things suck, I’m not sitting in that particular pile of blood and muck. No matter how I feel today I can honestly say it can get worse. Every time I think I’ve hit bottom I’ve found there is actually more bottom beyond that. It is unfortunate but true, there is no maximum to pain. And any time I even think about changing meds I’m worried I will go there again.

What I know about the brain is a fragment of what is known about the brain. What we know about the brain is a fragment of what there is to know about the brain. That being said, what we do know is worth taking a look at. In the 1960’s scientists discovered that increasing levels of dopamine, norepinephrine, and serotonin in the brain reduced depressive symptoms. This suggested that a depressed brain didn’t have enough of these chemicals and this is where the chemical imbalance theory came from. It was quite reasonable and made perfect sense, but we’ve learned a lot since the 1960s.

I am a word-fetishist. I adore words. They are my playthings. They are my blankies. I generally mold them, shape them and occasionally break them at my leisure. But I also respect words. I respect their meaning and their use outside the bounds of current politically correct, self-help thinking, but somehow the rest of the world wants to complain because I call a spade a shovel.

I have been through more bipolar treatments than I care to recall; probably everything you’ve heard of plus a bunch of bipolar treatments you haven’t. And yes, obviously, I have failed the vast majority of these bipolar treatments. And while not getting better is certainly nasty enough, it always feels like it’s my fault that the treatment didn’t work.

Over the years I’ve been treated for bipolar, I’ve come to the conclusion that when you sleep and when you wake (your circadian rhythm) is key in stability and wellness. If you do not wake up at the same time every morning and go to bed at the same time every night you are in for a world of hurt. This is mostly my opinion though. There is some research on the matter, but nothing as conclusive as I feel about it. Or at least nothing that I knew about until I heard of the Chicago Psychiatry Associates’ Program in Psychiatric Chronotherapy. (Sounds complicated, but it isn’t. Stay with me.)

Many of us with a mental illness have tried to “power through” it. We have tried to muscle through the pain without getting help of any kind. Most of us don’t want to admit we need help. Most of us don’t even want to admit we’re sick. We think that we’ll be fine without doctors and therapists and pills. We think that they are the enemy. We think we’re better off without them. We are so ridiculously wrong.

I get all manner of comments here and many of them scrape against my bones. Because I know these people. Because I know their brains. Because I am these people. Sometimes people think because I write or advocate or win awards I am not them, but it is precisely because I am them that I can do these things. It is precisely because I feel their desperation that I can truly write about it. One does write what they know, after all.

Let me just come right out and say it: psychiatric medications suck. They just do. Waking up every morning with your first thought to choking down brightly-colored circles, ovals and squares is a bad way to start the day. Similarly, having your last act at night be downing medication to induce what used to be the natural process of sleep is equally unfortunate. But psychiatric medications are a reality for people with a mental illness. They are important. In fact, for many of us, without them we would have no chance at a life at all. So if we admit we hate them, but admit we have to take them, how does one manage to stay on psychiatric medications?

I know that as a semi-public person with bipolar disorder I am supposed to beam hope. I am supposed to remind people of it, write about it, speak about it, and give it to everyone wrapped in a shiny happy wrapper. I don’t do this. There is, without doubt, hope to be had, out there in the bipolar treatment world, but that doesn’t mean I particularly feel too strongly about it personally.

There are exactly two settings on my dial: blow your mind and blow your brains out. I’m bipolar. We’re like that. Not surprisingly, the sex mostly happens on the blow your mind setting.