How much do you know about bipolar disorder? You might mention the mood swings. The depression. The mania that follows.

If you don’t live with it, or know a loved one who lives with it, that’s likely where your knowledge stops.

But what else is important about bipolar disorder that we don’t talk about? To honor Mental Health Awareness Month, we teamed up with the International Bipolar Foundation to explore the unspoken corners of bipolar disorder, and asked what parts of bipolar disorder really need awareness not just this month, but every month.

Here’s what they had to say:

1. “The effects of various types of medications — from weight gain (or loss) to ‘brain fog,’ forgetfulness, word-finding difficulties… It’s frustrating and can lower your self-esteem.”

2. “It seems like no one, including doctors, wants to discuss the ‘hyper-sexuality
that can come along with bipolar mania. This can be a very shameful part of the illness. It can cause serious damage to the person suffering.”

3. “Manic states aren’t fun, like many think. You can become self-destructive, and often impulsive decisions are made that have potentially devastating consequences. It can be overwhelming to deal with racing thoughts, and I get incredibly irritable. I think mania reduces my inhibitions and I get aggravated much more easily. I also don’t sleep much at all when I’m manic. It’s not a euphoria for me, and it’s often followed by severe depression.”

4. “The media portrayal of the illness is very narrow. It focuses on the acute stage of mania and depression and rarely acknowledges that patients have stable moods and their symptoms can be in remission for a good deal of time.”

5. “Having bipolar can lead to darkness in your life. Mental illness is just as deadly as many other life-threatening diseases.”

6. “People don’t talk about how it actually feels to have bipolar. People talk about signs and symptoms, but not what it actually feels like going through them. How frightening it is to have it, how totally out of control it makes you feel. People without it don’t see it as debilitating — they know it as a ‘mood swing’ when it’s so much more.”

7. “People need to understand it is not an excuse, it is a disorder. Read about it before you judge.”

8. “I think nobody talks about the difference between our mood swings and our actual emotions we feel as human beings. I have encountered my legitimate feelings being mistaken for my mental illness. I feel like my mental illness gets blamed for anything negative I’m going through, taking away my right as a human being to feel those emotions.”

9. “The mixed episodes are rarely mentioned. People without bipolar often assume there’s only two phases, mania and depression, and they present in specific ways with specific symptoms. However, each episode can present itself uniquely and aren’t always pure mania or pure depression.”

10. “I’m very open about my bipolar disorder, but I never talk about hallucinations. People can handle when you explain highs and lows, but trying to explain hallucinations when manic is just a recipe for disaster.”

11. “It can take many years to get an accurate diagnosis and then find and receive a treatment plan that helps. Many patients suffer from co-disorders such as addictions. People, in general, don’t want to talk about bipolar disorder and tend to shun those who suffer from the illness.”

12. “The suicidal depression or the life-wrecking mania… they both affect everyone who loves you.”

13. “It is amazing how quick you can feel OK on meds and your mind says, maybe you don’t need this stuff. And then you’re manic or hyper-manic, which at some point will result in the dreadful depression — back at square one again.”

14. “You shed so many tears from pure frustration because no matter how hard you try, sometimes the anxiety and depression won’t let up. You try to be strong in public, but in private you roll up into a ball in anxiety and fear.”

15. “I hate the frightening paranoid symptoms — feeling unable to trust people, not feeling safe and in fear for my life.”

16. “There’s a stereotype of the manic-pixie girl who’s so mysterious and cool because of her illness. Stop romanticizing bipolar disorder. It is nowhere near glamorous.”

17. “Trying to decide which is more damaging to your marriage: medication side effects or unmedicated illness. Ever since I started medication years ago, I have had zero sexual desire.”

18.Children can have bipolar disorder, and even though the symptoms are different in children, it’s still a devastating illness for both the child and the family.”

19. “The awkward shift when you’re not up or down, but moving either up or down. The in between valley and plateau period. The time where you’re unsure how low you may go or how manic you may get.”

20. “Bipolar disorder is different for each person who has it.”

21. “People refer to bipolar disorder as another word for mood swings. It’s so much more than that. Also, no one talks about the impact it has on families, not just the individual.”

22. “People with bipolar disorder can have children and be good parents. It’s not easy by any means, but it’s possible with a support system you trust, made up of mental health professionals and loved ones. Having my girls was the hardest but most rewarding decision of my life. They are my light through the darkest of days.”

23. “The importance of a establishing a crisis action plan. Knowing who to call, where to go and giving prior consent to those in your support system to intervene during times of crisis.”

If you or someone you know needs help, please visit the National Suicide Prevention Lifeline. You can also reach the Crisis Text Line by texting “START” to 741-741. Head here for a list of crisis centers around the world.

The Crisis Text Line is looking for volunteers! If you’re interesting in becoming a Crisis Counselor, you can learn more information here.


Dear me,

Remember your favorite quote? “The greater your storm, the brighter your rainbow.”

Right now you’re in the middle of another storm, another depressive episode that’s part of your bipolar disorder. You’ve been through a lot of these — so many that it’s become a routine. Part of that routine is forgetting how to pull yourself out of the dark, so I’m going to remind you.

It’s OK to be sad. Keeping your feelings bottled up will only make you feel worse. Cry if you need to, stay in bed a little longer and skip your shower for a day. You can sit in the dark for a little while, but remember not to let the darkness sit on you for too long. At some point during this storm, you have to pull out your umbrella and your galoshes and walk through it.

You need encouragement right now, and I’m sorry those close to you don’t always realize that. I wish you could ask them for what you need: comfort, conversation and kindness. But asking for help has always been hard for you. You try to weather the storm alone even when the wind is strong and you need something to hold onto. I encourage you to reach out this time, and grab hold of whoever is there.

Don’t forget what you’ve learned in counseling. You have coping skills to use to help you get through this: journaling, coloring and playing with your cats. Don’t forget to eat. I know you don’t feel hungry, but if you want to feel better, your body needs nourishment. I know it’s hard, but don’t sleep too much. I know your bad thoughts go away when you’re sleeping, but you know how important it is to be awake and face those thoughts and do what you can to replace them with positive, more realistic thoughts. You know cognitive behavioral therapy (CBT) and even have an automatic thought chart. Use it! You keep it for times just like this.

You’re getting better at staying safe during the storm. You take your medication, you don’t miss any appointments with your counselor and you try to remember your coping skills. You still have a lot to work on, so you feel better sooner and don’t sit in the dark for so long. You are learning to put on your raincoat and step outside, but you haven’t begun to walk in the rain yet. You will get there. You can do it. You may get a little wet, but that’s what your raincoat, your coping mechanisms, are for.

This storm will pass, like the others do, and you will feel better. You’ll pull yourself out of the darkness and into the light and get better and faster at doing so every time. You are stronger than you think, smarter than you let yourself show and more beautiful than you realize. You have four kitty cats who love to snuggle, a daughter who consistently makes you smile and hobbies you enjoy. When the storm is over, you will return to those things a happy and bright young woman, stronger now than you were before this particular depressive episode.

I want you to reread this letter the next time depression hits, and the time after that, and the time after that. There’s no shame in needing reminding of these things because one day you won’t need the reminder. You’ll keep getting stronger, grow better at identifying your triggers and you’ll stop the darkness before it stops you. I have faith you can do this. I know you can. Just don’t give up, and remember you are not alone. You are fully equipped to weather the storm now, galoshes, raincoat, umbrella and all. Just don’t forget them the next time there’s a storm.


If you or someone you know needs help, please visit the National Suicide Prevention Lifeline. You can also reach the Crisis Text Line by texting “START” to 741-741. Head here for a list of crisis centers around the world.

The Crisis Text Line is looking for volunteers! If you’re interesting in becoming a Crisis Counselor, you can learn more information here.

I decided to start writing to help people like me, but I didn’t really pursue it seriously until my sister passed away unexpectedly last year. I needed to transfer my grief into something productive (that’s just my personality) and so here I am, writing to help others with a diagnosis succeed. I want to give hope, but I also want to share the harsh realities of mental illness, especially since I’ve struggled so much this past month.

It seems people think navigating through this bipolar life is easy for me. Well, I wish that were so. Most days it’s a battle. Seriously, a knock down, drag out fight with only one winner standing on the other side. I could share example after example, but I’ll try to keep it to a few. With a mental illness, there are a lot of things you don’t see. That’s what people don’t get because if you talk to me any day of the week, you’d be surprised (and honestly most people are) I have a mental illness.

Here are some things about me you might not know:

1. I need more sleep than most people.

People don’t see all the times I go to bed early on a week day (like 8 p.m.) or sleep in late on a weekend (always on a weekend because of work).

2. I need to constantly be aware of my emotions.

They don’t see how hard I have to hold back emotions (I’ve gotten really good at hiding it). They don’t see how many times I have to check in with my body and my feelings. I have to be so in tune with my body, it’s sometimes ridiculous.

3. I need to constantly distract my mind from obsessive thoughts.

Obsessive thoughts for me are constant worries. I have so many worries. Mainly worries something bad will happen or someone will die. I have to constantly refocus my thinking. I have to continually analyze and talk myself out of obsessive thoughts. I’ve had to become an expert at distracting my mind from negative thoughts.

4. I have to be cautious with alcohol.

I learned the hard way it’s best not to drink with a disorder like mine. Not only is alcohol a depressant, it also interferes with the medication I take. Nowadays I only drink alcohol on special occasions and even then, I limit my alcohol intake to one or two drinks.

5. Crowds are scary for me.

I can’t be around huge crowds because I start getting anxious. My anxiety increases when I feel I have no way out. I have to avoid places that have a lot of crowds because it just isn’t a pleasant experience for me and could cause a shift in mood.

6. I have stay on a pretty strict schedule.

Routines are very important for managing my bipolar disorder. Going to bed at the same time every evening and waking up at the same time every morning is key to keeping mood swings at bay. Also with the medication I take, I have to get a solid eight hours of sleep or I’m so groggy I can’t operate a vehicle. A set schedule also mentally prepares me for the activities I have to devote my energy to. With bipolar, my energy level fluctuates based on the activities I do. I have to make sure I have sufficient energy to engage in the tasks I need to do, whether it be work or play.

7. I need to be vigilant of triggers.  

This has gotten easier over time. One of my triggers is violence. I don’t do well with violence and steer clear of violent shows and news stories. Sometimes, it’s inevitable. So many shows depict violence. There are some where I can just look away, squeeze my husband’s hand and he’ll tell me when it’s over. But some shows the violence is never-ending and I just can’t handle watching. These are the shows I no longer watch. One such example of a trigger: My husband and I were watching “The Walking Dead” mid-season premiere and I couldn’t finish it because I was having flashbacks. I literally couldn’t breathe. If my husband hadn’t been there centering me, I think I would have passed out.

But you don’t see these things. I show you only what I want to show you. I’m always waiting for the next tragedy, the next shoe to drop.

You never know what someone is battling.

A version of this piece originally appeared on the International Bipolar Foundation’s blog.

The Mighty is asking the following: Create a list-style story of your choice in regards to disability, disease or illness. It can be lighthearted and funny or more serious — whatever inspires you. Be sure to include at least one intro paragraph for your list. If you’d like to participate, please send a blog post to [email protected] Please include a photo for the piece, a photo of yourself and 1-2 sentence bio. Check out our Submit a Story page for more about our submission guidelines.

In 2011, I was diagnosed with bipolar disorder. That means when I’m depressed, I’m in a deep, dark hole with no foot holes to climb up and no rope to pull me out. When a depressive episode hits me like a UPS truck, I go through the motions of just trying to scrape my way through the day. If I get out of bed at all, I force myself to shower, coax myself to eat and push myself out the door. During my depressive bouts, I try to use the coping skills I’ve developed through therapy and learned during my inpatient stay in a mental health ward. One of my favorites, and the one I think works the best is making lists.

I arm myself with lists to battle depression. There are no cons to keeping lists, only pros. The lists I keep when I’m depressed give my seemingly messy life a little bit of order. Every thought, every task is neatly written in columns of a neatly lined page. When I’d rather sit in darkness and do nothing, lists help me prioritize. They’re handwritten letters of encouragement, and each word is a cheerleader on paper. Crossing off individual tasks, big or small, brings me a great sense of accomplishment that immediately boosts my mood. Depending on the list I make, doing so gives me something to look forward to. Whether it’s a list of goals or dreams or plans for tomorrow, there is always something to look forward to.

I have several lists I keep to get me through my depressive episodes. I like them all, and love how they make me feel. The first list I fill out is my Gratitude List. As I number the page, I recall everything in my life I am thankful for, and my spirits are lifted. The second list is a basic To-Do list. This list is full of daily tasks I would normally find daunting during a depressive episode. They may be big, they may be small, but they are all equal on my yellow-lined paper, and I feel equally satisfied when I cross them off. Another list I keep is an I Want to Remember list. This list helps me take a break from my negative thoughts to recount memories and write down which ones I wish to remember always. An obvious list to keep while depressed is a Joy list. I list everything that makes me happy, even little things like warm rain, a child’s smile or the softness of my kitty’s fur. Finally, I keep a list of my Accomplishments. As I write and then reread this list, my confidence goes up and my negativity goes away.

Keeping lists is my favorite way to cope. I feel order in my life, success when I cross off a task and have hope for the future. I read and reread these lists as many times as I need to until I feel better, and then I throw them away so I can’t cheat the next time. I list my way through depression not only because I actually enjoy it, but because I need to do it. When I’m down, I lose and forget the other coping skills I’ve learned throughout my battle with bipolar disorder. I arm myself with lists because they’re easy; just grab a notebook and a pen and get started. I’ve thought of adding some humor to my lists because laughing is a great medicine for depression. The list of lists I could make is limitless, but it always keeps my mind focused elsewhere instead of on my despair. And that’s the goal of list-making. To move your mind in the direction of a comforting fortress that will protect you from the dangers of depression and help you fight.

The Mighty is asking the following: Create a list-style story of your choice in regards to disability, disease or illness. It can be lighthearted and funny or more serious — whatever inspires you. Be sure to include at least one intro paragraph for your list. If you’d like to participate, please send a blog post to [email protected] Please include a photo for the piece, a photo of yourself and 1-2 sentence bio. Check out our Submit a Story page for more about our submission guidelines.

To my selfless, patient, empathetic soul mate,

I have so much I want to say to you, and then I have nothing at all to say to you. What I mean is, I want tell you every single thought that processes through my mind, but sometimes I can’t put them into words you’ll understand.

But you try. Don’t you ever for one second think I don’t know you try, because I do. I see it, I hear and I feel it. Every single time you pick me back up when I’m shattered into pieces on the floor. Every single time you bring me back down when I’m fighting through a trembling and breathless panic attack that makes absolutely no sense to you. Every single time you embrace my stable days when I’m the peachiest version of me you ever get to experience. And especially, every single time you pick up my slack with house work and parenting when I haven’t the energy to pull myself out of bed, much less to function as a “normal” wife and mother should.

I honestly don’t know how you do it. Let me be clear… as horrific as this stigmatized and exhausting disorder is to have, being the one who loves someone with that disorder is hard, too. I realize, even though I don’t tell you, you go through so much with my illness. You can’t vent to me most days because I start to hate myself for not being better for you. You can’t vent to other people because they will probably say things like “she’s crazy” or “she’s a bitch” just because this whole illness is stigmatized to no end.

I know I treat you unfairly sometimes. Usually it’s because I need an outlet to be my real self. Hardly anyone knows the real me. And only you know the realist version of me there is. It’s exhausting to wake up every day and pretend to be just like everyone else. To walk around with this huge secret on my shoulders I want to scream from a roof top.

I know there are times my diagnosis creeps its way into our conversations, and I’m sorry for that. I know you don’t want to always talk about it like it controls my life. But here’s the thing — it does. And when I talk about it more than usual it’s because I need to talk about it and can’t with anyone else. In fact, anytime I have to tell someone else, it feels like I’m coming out of the closet. How will they react? Will they be scared of me? Will they treat me differently? All of these, and more, are thoughts that race through my mind while I hesitate, sweating and trembling, to spew this news to someone new. Sounds dramatic, right? That’s because it is.

I often wish you could experience my moods swings just once so you can truly get it. But then I realize I wouldn’t wish this disorder on my worst enemy, much less my spouse. There are times I can’t tell the difference between normal moods swings and bipolar mood swings. Is how I’m feeling about blah blah blah a true and justifiable feeling, or is this the unreal reaction to an unreal situation? Is how I perceived or am perceiving this scenario real, or is my brain trying to tell me it is? There’s a blurred fine line, and it’s difficult to distinguish between false perception and reality. That’s where you come in like a knight in shining armor to tell me that nothing is different and to let it pass.

Also, there are times when I’m being so paranoid I think every exchanged whisper within ear shot of me must be pertaining to me. I overanalyze every look or reaction from people around me. I worry and stress about every thing I say, wondering if I gave anything away of my illness. I walk on eggshells all day long, every single day, and it’s exhausting.

But with each time you rescue me, I worry you’ll wake up one day and think “I can’t live this way anymore” and you’ll pack your bags and go. Then like always, you remind me you’re my rock and stability. You’re with me “in sickness and in health,” no matter how many times I alternate between the two.

Thank you, from the bottom of my heart, for everything little and massive thing you do for me, and us as a family. Thank you for being the strongest link.

The Mighty is asking its readers the following: Write a thank you letter to someone you realize you don’t thank enough. If you’d like to participate, please send a blog post to [email protected] Please include a photo for the piece, a photo of yourself and 1-2 sentence bio. Check out our Submit a Story page for more about our submission guidelines.

Being a somewhat newly minted (as of September) 21-year-old and a college student and as someone who attends parties… things get tricky when you make the choice (yes, technically it’s a choice) to abstain from drinking alcohol.

I’m trying this no drinking thing. How long will it last? I don’t know. How long should it last? I don’t know. Why am I doing it? That much I do know. Also, has it been easy for me so far? No. But I’ll tell you why it’s so important right now as someone living with mental illnesses:

1. I’ve never had a good history with alcohol. Ever. From my first sips at 15 while living in Europe to a negative experience in high school to drinking to numb before medication and then drinking post-medication… yikes. It’s been bumpy.

2. Nine times out of 10, the fun doesn’t last for me. Usually I drink and my mood goes up and I catch an intense high, higher than most (and people tend to think I am drunker than I actually am because of this). Then, after having what feels like an insane amount of fun, I crash harder than most. I cry or feel worthless and empty. I question things. The pain is loud.

3. Bipolar disorder does not always go well with alcoholHence why reason #2 happens for me more than most people. Every single time I drink.

4. On that note, my psychiatric medication, particularly mood stabilizers/antipsychotics, do not go well with alcohol either. The alcohol reduces the effect of my medication quite a lot. I learned last semester, after going a few weeks where I would drink every weekend, that one drink (with or without medication) would set my mood off for the entire week – depression, hypomania or mixed, as well as rapid cycling. It was rough, and I finally realized that maybe it isn’t worth it for me.

5. Addictive and obsessive personality. That’s me. Between having an addictive personality (hence eating disorder history) and having obsessive compulsive disorder, I know drinking is a very, very fine line for me. I always want more and never feel satisfied. I feel like I need to achieve a certain feeling or high, and I have enough self-awareness to realize that for me this could go too far very easily, as it did with food and exercise in the past.

So now that you know why, I’ll tell you how I got there: negative experiences adding up, strong encouragement from a therapist and friends, medical encouragement from a psychiatrist etc. I don’t want to be an addict. And I’m not saying everyone with bipolar or everyone in college or everyone who drinks is going to become an addict. I just know myself, having gone through this mental health journey in the past year. I don’t want to take that risk. I’m going to struggle during certain moments at parties when the temptation is high, but I’m going to do my best to fight it. I figure telling people I am sober is the best way to start – accountability is super important with things like this (my prior experience having been with my eating disorder).

On the positive — I have awesome, supportive friends and family, as well as my mental health team. I just have to tell people so I can hold myself accountable.

Follow this journey on Obsessions, Words and Everything in Between.

The Mighty is asking the following: Create a list-style story of your choice in regards to disability, disease or illness. It can be lighthearted and funny or more serious — whatever inspires you. Be sure to include at least one intro paragraph for your list. If you’d like to participate, please send a blog post to [email protected] Please include a photo for the piece, a photo of yourself and 1-2 sentence bio. Check out our Submit a Story page for more about our submission guidelines.

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