Bipolar places limitations on our lives. It might be the fact that we can’t go out and enjoy a cocktail after work or it might be the fact that we can’t stay out all night. Or it might be the fact that we can’t work full time or that we have to live with medication side effects that make us sick. Limitations are there, no matter how you look at it. But what happens when you don’t respect those limits? What happens when you choose to ignore them? I can tell you. You feel like a dog’s breakfast. Just ask me. I did it on Monday.

In psychiatric studies, generally response and remission are recorded for the effectiveness of medications. So, a certain percentage of people positively respond to medications (get somewhat better) and a smaller percentage of people go into remission (get mostly better) from medications. The definitions of “respond” and “remit” vary, but typically it’s a reduction in symptoms, as measured on a scale, to a specified degree. In practice, this means that a medication can still be deemed “effective” even if it only moves you from a 10 to a 5 on a scale of depression. Well, this isn’t good enough.

While it seems hard to believe, some people want others to stay mentally ill and, indeed, sometimes even individuals themselves, choosing to maintain mental unwellness. You have the obvious example of people refusing medication and thus becoming very sick but there are other forces as well that can encourage a person to stay acutely, mentally ill.

There is something I have noticed about my busy bipolar brain. I’ve noticed that it seems obsessed with multitasking. It almost seems to not allow me to do one thing at once. If I sit down to watch TV, for example, I can’t stop myself from also picking up my computer or playing a game on my cell phone. When I sit down to write an article, I have to constantly also be checking in on my social media at the same time. People always wonder how I can be everywhere at once. That’s easy. I’m everywhere at once because my brain is everywhere at once.

Bipolar moods vary in duration by person but typically, an untreated bipolar mood can last months or even years. All a bipolar disorder diagnosis requires is the presence of one manic/hypomanic mood episode and one depressed mood episode. This means that a person could be in a year-long depression and have only experienced one week of mania, a year ago, and still qualify for a bipolar diagnosis. This is much to the surprise of many as there is a pervasive belief that bipolar disorder is about frequent “mood swings.” However, simply “being moody” is not indicative of bipolar disorder.

Bipolar disorder is a scary illness, but sometimes even scarier is the idea of treatment. Logically, going to the doctor, getting a diagnosis and getting help doesn’t sound scary, but if you’re the one faced with psychiatrists, personal, probing questions, destroying what you know and treatments that might make you feel worse before you feel better, you might find the concept daunting. But what do you do if you’re a loved one of a person with bipolar (or another mental illness) who is refusing treatment?

When I speak to kids about my experience with bipolar disorder, really, I have a series of failures to explain. I tell them how treatment after treatment failed. I talk about drug failures, the failure of the vagus nerve stimulator and the failure of electroconvulsive therapy. I lot of my sentences have the word, “unfortunately,” in them. And after one of my presentations last week, one person asked what I would say to someone who was going through a similar experience. I thought that was a very important question. So here’s what I would say to someone who’s experiencing treatment failure.

I recently finished an 8-week mindfulness meditation course. I went into it not knowing why I was there, other than the fact that my doctor had recommended it. I went in not knowing what the outcome was supposed to be. When we were asked to write goals for the course, mine were blank. I had none. I really just wanted to see if there was any benefit to all this mindfulness meditation stuff. Turns out, I believe that there is benefit in mindfulness meditation. And here’s some of what you might find in a course.

A reader recently contacted me and asked me about psychomotor agitation. Psychomotor agitation is actually a symptom of bipolar hypomania and bipolar mania (and depression) and yet few people know what this means. In fact, according to this study, it is poorly defined and measured even within the medical community. Psychomotor agitation is often translated into “restlessness,” which doesn’t seem overly descriptive to me. So here’s my take on psychomotor agitation: how it feels and what we know about it.

I first started receiving psychiatric treatment when I was 20 years old. At that time, I was pretty separated and not very attached to my parents. Nevertheless, they and their opinions did have an impact on me. And when I told my mother I had bipolar disorder her reaction was akin to not believing me. She was entirely ignorant about mental illness (and to be fair, I had been too) and mental illness treatment. She, naturally, wanted me to treat this problem with herbs and other nonsense. And in spite of the fact that I was detached from this woman, her lack of support affected me. At the time, all my energy was being used to fight bipolar disorder, and now I had to fight her too. It was kicking me while I was down. Way, way down. And while she didn’t see it that way, I can attest to the fact that it sure as heck felt that way. But luckily for me, I was not under her care. Luckily, even though she eventually pressured me into trying out alternative nonsense, I still got the real, medical help I needed. Had I have been younger, this might not have been the case. And unfortunately, some youth are in this position right now. Some youths feel they have a mental illness and are in the charge of their parents’. And some youths have even told their parents that only to be met with a wall of disbelief or told they’re “overly dramatic.” I feel for these youths. They’re in a really tough spot. But there are things youths can do even if a parent doesn’t believe their son or daughter has a mental illness and refuses to support their desire to get help.