As happens from time to time, I recently received feedback from someone who was not a fan. Anonymous's remarks included: …The way you go about it, you’d suggest that anyone with bipolar or any kind of mental illness shouldn’t lead a full life. Let me be clear. You can lead a full life. Anyone can. What I recommend is calibrating your definition of “full” to allow for a mental illness.

A commenter recently asked about how to handle New Year’s Eve celebrations with bipolar disorder. Basically, she was concerned because her husband wanted to celebrate New Year’s but she would rather sleep through it to keep her bipolar in check. So the question is, what do you do if you’re feeling pressured into celebrations?

In my last article I wrote about creating reasonable expectations for the holidays and how that can help your mental health. Today, I want to talk about the stress of holidays with family. Now, don’t get me wrong, family can be great, but more often than not, holidays cause a gathering of family members you both gel with and those you don’t and I hear from a lot of people that they hate such family gatherings. But why? Are family gatherings worse for people with a mental illness?

I believe the holidays hit everyone. Sometimes that hit is very positive, sometimes it’s really negative, but I think that hit is real and pretty universal. If it’s not parents, it’s siblings, if isn’t not kids it’s money, if it’s not partners it’s the planning of perfection. In short, there’s something for everyone to be stressed about at this time of year. For me, personally, I can’t count the number of times I would leave my family and cry and sob for hours as I drove home. Holidays have never really hit me positively. And as I’ve said before, even if you’re lucky enough to get a positive kick from the holidays, even good times can lead to bad health. But knowing the hit is coming, is there anything we can do to soften it?

It’s the holidays. Some people love them, some people hate them, but as a general rule, it’s tougher for people with undertreated mental illness than for others. For people battling with the symptoms of bipolar disorder, holidays and hope may be the last thing on their mind. But, believe it or not, while the rest of the world glistens and twinkles, you too can find things to be hopeful about and things to feel grateful for, even if you happen to be in a black pit bipolar-wise.

You’d let them take an ice pick to your brain if you thought it would help. Bipolar disorder impacts different people differently. For some people, bipolar disorder is immanently treatable. These people find doctors, therapy and medication and walk off into the sunset with few bipolar symptoms left with which to contend. These people lead the same lives as everyone else and besides (likely) controlling certain lifestyle factor that contribute to stability, they don’t have to think about bipolar disorder on a daily basis. Then there are the people who are more affected by the illness. These are people for whom treatment partially works. They likely find doctors, therapy and medication too, but in spite of best efforts, they live with bipolar symptoms every day. These people might live your ordinary life or might live a life that is more affected by the illness, such as one where they can only work part-time. And then there are the people that are severely affected by bipolar. Even with treatment these people tend to have intractable moods and likely can’t work because of them. These people do not live average lives. They live lives dictated by the illness and the treatment. These people are in pain every day. And it’s only chance that places you in one of those three groups.

As I’ve mentioned, recently I’ve started volunteering for a local bipolar organization and what I do is give presentations to others. One part of the presentation is my “bipolar story.” It’s the story of my life before diagnosis, the process of treatment and whatnot. It’s long and, well, not that happy. But one of the things that stands out is that treatments have turned me around, but then they stopped working and new treatments had to be found. And these new treatments were extremely hard to find. In fact, successful treatments have been found through guessing as often as through any type of clinical judgement. And there’s a reason for this: bipolar disorder and bipolar disorder treatment are moving targets and our responses have to move with them.

Ah, the human brain. It’s a wondrous thing. It calculates, it categorizes, it makes connections and it remembers the square root of 144. I’m constantly awed by its power. But one of the annoying things that can happen to a brain is that somehow, a song gets stuck in it. Somehow, even though its great power and ability, the catchy hook of the latest pop song gets stuck inside some errant neurons and plays over and over. And this causes a lot more trouble in my bipolar brain than it does for others.

I wish someone had asked me before naming a class of drugs “antipsychotics.” I mean, I understand that to psychiatrists it might not be a big deal, but to the medication-taking public out here, let me just say that the stigma around medication is about 10-fold when you say you’re on something called an “antipsychotic.” Tell someone that you’re on “antipsychotics” sometime and watch them back away slowly. I’m not kidding. It’s like they think an axe is about to magically materialize and you’re about to use it to chop off their head.*

One of the problems with psychotherapy (and, keep in mind, I like psychotherapy) is that psychotherapists try to look for a cause for every emotion. And this seems reasonable. Or at least it does, to a person without a mental illness.