So, interesting thing. Mental illness has a tendency to run roughshod through a person's life. Everything in life goes by the wayside to make room for the unbearable being of crazy. You know you're alive because you're in pain. And then, against all odds, or at the very least against some odds, you start to feel better. It's a miracle. Breath and life and oxygen and delight fill the lungs. Suddenly life is easy. Cupboards get organized, relationships get mended and Work Gets Done. Life is Good. Why, then, is it so freakin' scary?

I write at HealthyPlace about the problems associated with living with bipolar disorder, and let’s face it, there are many. I also talk about the problems with the treatment of bipolar disorder, and yes, there are many of those too. But just because I recognize issues, discuss genuine, painful emotion and make loud an inner voice that among most people is strangled, doesn’t mean my treatment has been a failure. Just because I’m not “all better,” that doesn’t mean treatment doesn’t work.

In the times when I've had prolonged periods of wellness, I don't particularly think about bipolar disorder and I don't feel its implications. I just get up, get out of bed, say 'hi' to my cats, and go about my day. True, the med-taking is a reminder, but bipolar isn't necessarily top-of-mind. This does not mean, however, that I can forget about the bipolar disorder. Forgetting about bipolar disorder is one of the most dangerous things you can do.

Every medical treatment comes with risk. If you have a headache, you could take ibuprofen or you could have a craniotomy looking for brain cancer. One has considerably more risk than the other. (Of course, if you have brain cancer, then the reward could be quite great.) This means every time you undertake a bipolar treatment knowingly, or not, you weigh the risks vs. rewards in your head. And one of your doctor’s main jobs is to manage that risk vs. reward scenario. Doctors, for example, almost never prescribe barbiturates anymore due to the fairly large risk of addiction. Instead, they prescribe benzodiazepines (or nonbenzodiazepines; very similar) which do not carry such an increased risk. In both cases, they carry the reward of managing anxiety. But some people don’t want to take benzodiazepines either, because some people tolerate more risk than others.

Due to my frequent flirtations with treatment-resistance over the years, I have discussed ECT with a variety of doctors. To the first doctor, and the one after, I said simply, “I would rather die than do that”. Well, as it turns out when faced with death, you’ll do a lot of things you didn’t think you would.

I’m not a fan of New Year’s resolutions. I generally find them phony, unreasonable and dead by the second week of January. I feel if you’re ready for change in your life you make change at that moment, not when a ball drop tells you to. That being said, people insist on making New Year’s resolutions anyway. It’s a psychological and societal time of renewal and a life reset that people choose to mark with promises. So if you’re bipolar, what kind of New Year’s resolutions might be helpful?

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.

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.

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.