It’s devastating to get a diagnosis of bipolar disorder or another mental illness. It means many things to many people, but I know for me, it meant a lifetime condition and a lifetime of treatment. It honestly felt like a death sentence. But a bipolar diagnosis doesn’t just affect the person with bipolar disorder. A bipolar diagnosis can affect their family and friends, especially if the person with bipolar disorder is younger. It’s completely understandable for a parent to wonder if bipolar disorder is a death sentence. It’s completely understandable for a parent to wonder if his or her child is going to be okay.

Recently I went through a nasty bipolar medication change. I stopped one antipsychotic in favour of another. Of course, this was to improve my overall treatment. And as I’ve said before, if you change nothing then nothing changes, and in this case, I had to change medications in the hopes of changing my mental wellness. It did not go well. What ended up happening was a gradual slide into horrific suicidality. The new med was not effective for me. But I learned something from this experience. Before changing bipolar medications, it’s a good idea to put into place a medication change safety plan.

I am a very difficult case of bipolar to treat. Believe me. I have been on more bipolar medications than anyone I know and finding an effective cocktail is akin to walking on water. It’s possible, but it’s pretty darn rare. And recently I made a medication change from one antipsychotic to another. It went very badly in a whole host of ways. In fact, I terminated the medication trial early and went back to my previous medication. I see my doctor this afternoon and now I have to tell him the bad news about how it went. And I feel guilty about failing another bipolar medication. I know he will be disappointed and I feel bad about it.

Recently, our blogger Natalie Jeanne Champagne wrote a post: Mental Illness: Understanding Rational and Irrational Fears and this got me thinking about the fears I, and others, have had about bipolar medication. Some of the bipolar medication fears are completely justified and rational while some really are not. Some are fears that stem from real possibilities while others are often propagated by fear-mongering groups online or our own internal catastrophizing.

The first thing I thought of this morning was killing myself. Literally, as consciousness slowly overtook my brain thoughts of suicide were all that were there. It’s a bad day.

OK, maybe it seems like I’m being a bit hard on commenters. I swear I’m not. I like people who comment and express their opinion, but sometimes their opinion spurs one of my own. This is one such comment: I’m bipolar, and I think we ALL should have to take a Dialectal Behavior Therapy course. The DBT course helps with coping skills, year class, and helps  . . . these skills work if you want them too. Here’s someone singing the praises of dialectical behavior therapy (DBT). She would certainly not be alone as many people find DBT to be helpful. The problem I have with this comment is the last bit, “these skills work if you want them too [sic].” So, this means that if the skills learned in DBT don’t work for someone it’s because they didn’t want them to? I don’t think so.

I am not an angry or an aggressive person. This is not to suggest I don’t have my moments, as we all do, but overall, I have far fewer issues with anger than most people I know. There are lots of reasons for this, I’m sure many have to do with my psychology the way I view anger (I view it as pointless and particularly undesirable). Nevertheless, it seems that people with bipolar disorder do, on the whole, have anger issues. I’m a bit surprised to hear this as anger is not a diagnostic feature of bipolar disorder, but people write in again and again and talk about either having bipolar and being very angry or being with someone who has bipolar and this partner being very angry. But are these just anecdotal accounts or do people with bipolar disorder have aggressive and angry tendencies?

Last time, I wrote about the terrors of getting on new bipolar medication. Many people identified with this, including one commenter who said: Sounds all too familiar. I’ve been drug free for several years and seriously doubt that I will ever put myself through that trial and error program again . . . at least for me, that relief is not to be found at the bottom of an orange vial with a childproof cap. I hope you find something to relieve the pain. I also hope you consider the notion that you’re likely stronger and more resourceful than you think you are. Now, I’m not calling out this commenter for doing anything wrong. I have no problem with his comment, nor with him. However, I find this comment insulting. Not because the commenter meant it to be, but because it suggests that people who don’t take medication for bipolar disorder are “stronger and more resourceful” than those who do.

I have been on every bipolar medication you can name and likely a few you could not. I have been on more medication combinations than I can remember. I have spent years dealing with medication side effects. There is very little medication pain that I cannot tolerate. I have taken medications that have made me feel amazingly well and bipolar medications that have made me feel intolerably ill. I’ve seen treatment miracles and treatment devastations. And still, I feel nothing but terror when I think of taking new bipolar medication.

I have talked many times about how important a routine is in bipolar disorder (Limitations and Rules that Keep Us Safe). There are many reasons for this, but one of the main ones is because bipolar disorder is considered a circadian rhythm disorder by many medical professionals. Your circadian rhythm is critical to your functioning as a human as it tells your body when to sleep and when to be awake (among other things) and trying to go against it is like swimming upstream. Assuming bipolar disorder is, indeed, a circadian rhythm disorder, we should do everything we can to work to regulate our circadian rhythms in a healthy manner. Keeping a strict bipolar routine is one major way of doing that.