Delusions are false beliefs that are held in spite of a lack of evidence or even evidence to the contrary. For example, a delusion might be believing that the FBI is surveilling you every day or that you can predict the future. Delusions are a part of psychosis which can be present in bipolar depression or bipolar mania. Delusions are easiest to spot when they’re exaggerated, like in the above examples, but I would suggest that delusions are much more common when we give them credit for. I would suggest that delusions are present in most cases of severe bipolar depression.

One of the most controversial things the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) did was remove the bereavement exclusion from the depression diagnosis. Previously, people grieving the loss of a loved one couldn’t be diagnosed with depression for two months after the loss. Now, however, this is no longer the case. Now, even a person grieving the loss of a loved one can be diagnosed with depression. And some people say this is a further medicalizing of normal emotion. I, however, would argue that there was a good reason for this change and that skilled clinicians can tell the difference between grief and depression. Here are some ways grief and depression differ.

A normal life is something I’m not very familiar with. I’ve never really had one. From the time I was a kid with an alcoholic father, to the teenage years I spent depressed, to my adult years dealing with psychiatrists, symptoms and medication side effects, I’ve never really enjoyed anything termed normalcy. But the question is, does anyone with bipolar enjoy a normal life?

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.

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.

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.

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.

A get questions from all sorts of family members and friends of people with mental illnesses and, luckily, many of these people want to help. The trouble is people feel intimidated by a diagnosis of mental illness. They don’t even know where to start to help. This is completely normal. A probable lifetime diagnosis is enough to make anyone feel powerless. But you are not powerless. If you love someone with a mental illness, there are many things you can do to help.

O Romeo, Romeo! wherefore art thou Romeo? Deny thy father and refuse thy name; Or, if thou wilt not, be but sworn my love, And I'll no longer be a Capulet. There’s a piece of knowledge stuck in a cranny of my mind. Shakespeare. An important guy who wrote some important works, to be sure, and we all study him, for good reason. But how many of us use Shakespeare in our lives? Not too many, I’d wager. And yet I don’t recall a single class being taught on mental illness. Not one reference to the signs of suicide despite it being the end to Romeo and Juliet, the same play stuck in my mind's crannies. Not one reference to mental illness in my education. And one-in-four people could use that later in their lives.