doctor using digital tablet on gray background

What does the DSM-V say about bipolar disorder?

It says many things, like you must have at least three behaviors from a list of symptoms of mania lasting a week or longer. It says you must have five behaviors from a list of symptoms for depression lasting two weeks or longer. These behaviors include a markedly diminished interest or pleasure in all, or almost all, activities most of the day nearly every day for depression, and an inflated sense of self-esteem or grandiosity (ranging from uncritical self-confidence to a delusional sense of expertise) for mania.

So once you’ve displayed these behaviors, you can be diagnosed and treated. The doctors often tell you side-effects of medications and how often to take the meds, but in my experience, they rarely explain what your diagnosis means, perhaps instead offering you a handout on bipolar disorder, or advising you to check a reputable website.

They don’t tell you what to really expect with your disorder.

They rarely tell you mania doesn’t always look like a euphoric high, that it can look like your worst nightmare, with major irritability and lashing out to loved ones without you knowing why.

They don’t tell you that you can have mixed episodes, which involve a mixture of depression and mania.

They don’t tell you the “minimal” effects, like weight gain or drowsiness, affect many people — and can be real and life-altering. For example, drowsiness I’ve experienced as a side-effect of Seroquel doesn’t just make me tired, it turns me into a non-functioning zombie for days at a time.

They don’t tell you there’s no silver bullet when it comes to meds, that what you try first will rarely work. That you’ll be playing medication roulette until you find the right combo. Yes, that’s right “combo.” It’s not often you’re only put on one medication to control your symptoms.

Nowhere was it mentioned to me that you might miss your highs and struggle to stay medication-compliant because your creativity is gone and you hate it.

This sounds gloomy, I know, but there are also positives to a bipolar diagnosis they don’t often tell you about.

They don’t tell you you’re joining the ranks of awesome people, like Carrie Fisher, Vincent van Gogh, Catherine Zeta-Jones, Russell Brand and Demi Lovato — oh, and myself.

They don’t tell you just how awesome it can be to finally have a name for what you’re going through.

They don’t tell you how wonderful a night of sleep can be once you’re on the right dose of medications.

They don’t tell you how wonderful life can be once you’re free of the demons in your head.

They don’t tell you being bipolar is not a death sentence, that you can live and thrive with it, no matter how you feel at the time of diagnosis.

They don’t tell you there is hope of recovery and remission of your symptoms. Well, maybe they do tell you that, but you might have missed it, reeling from everything else they told you. And it never hurts to be reminded of that.

So those are some things your doctor might not mention.

It never hurts to do your homework and research your diagnosis, because knowledge is power. The more informed you are as a patient, the better you can advocate for yourself. And that’s really the best thing a person with any illness can do.

Image via Thinkstock.

Editor’s note: Any medical information included is based on a personal experience. For questions or concerns regarding health, please consult a doctor or medical professional.

Follow this journey on Ramblings of a Bipolar Mess


I was recently hospitalized for suicidal ideation for the fourth time in two years. I was really struggling with myself, with my identity, my values and my beliefs. I didn’t like myself. I honestly thought the world would be better off without me, and especially that my family would be better off without me. I live with bipolar disorder type I, and I go through some extreme mood swings because of it. I had also made the poor decision to quit my medications because I was sick of the way I looked. I was doing phenomenally mood wise, but I hated the way I felt about myself physically.

I was rather bitter about this hospital stay because my individual counselor had sent the sheriffs out to find me. (I sent her a suicide note by text, and she responded appropriately — by doing a welfare check.) I didn’t want to be found though, I really wanted to be dead; at least I thought that was the case. So I spent my first couple days sulking about how miserably unfair my life was. The therapist in the hospital was amazingly kind those first few days. I thought he was great until we had a therapy session with my husband.

He told me in no uncertain terms I had a problem with always having to be right, that I was annoying and that he thought I’d be almost impossible to live with.

He also told me though, I had something innately likable about me, something that made all those other qualities seem to diminish, and that made me a wonderful person. He also said that even though I’m an incredibly difficult person, there was something charming about me, that radiated from me, even when I annoyed the hell out of people.

Of course, at first, all I heard was that I’m a terrible person who doesn’t deserve to have anything good happen to her — but eventually it dawned on me that he had basically seen my soul, laid it bare, put words to it and still found me a good person.

It changed my life.

Once I finished processing the hurtful things he said, I realized he had said some wonderful things about me as well. And that was incredibly freeing.

The shocking thing was that I believed him. I honestly believed what he told me, because he was one of the most genuine people I’d ever met. I knew he wouldn’t say something if he didn’t believe it to be true. Because of that, it sank in.

I changed because of that comment. I began to believe I have value, that I have worth and that I’m a good person. I know deep inside that although I can be an incredibly difficult person to handle at times, I’m still innately likable. And that’s enough for me. It doesn’t matter if everyone doesn’t like me, I still believe and hold on to the thought that I’m charming. Of all things, charming! I’m someone who deserves to be treated with respect, because I am worthy.

I don’t know if this therapist will ever know how much of a profound effect he had on me, and how much he’s changed my life, but I want to thank him. I want to thank him from the bottom of my heart for seeing me, the real me, the me hiding behind my layers of sarcasm and mean words. He had the audacity to tell me straight like it is, and I admire that kind of bravery. He has given me the backbone to be myself, in all things, at all times and in all places. I don’t have to people please anymore. I know that I’m enough, just as I am. And his words helped make that a reality for me. And I am so grateful. So grateful.

Thank you, dear therapist, for giving me the courage to be authentic myself.

If you or someone you know needs help, visit our suicide prevention resources page.

If you need support right now, call the Suicide Prevention Lifeline at 1-800-273-8255. You can reach the Crisis Text Line by texting “START” to 741-741.

Imagine a desert. A hot, empty desert. A hot, empty desert full of sand and mirages. Nothing else.

And you’re there. Struggling to find the oasis. But there’s all these mirages throwing you for a loop.

What do you do?

Do you curl up and assume all is lost, or do you press on, trusting one of those mirages will end up being the water you so desperately need?

This is my life with bipolar disorder. And those mirages are the voices in my head telling me I have no one and I shouldn’t even try reaching out, because even if I did have someone, no one cares anyway.

When I’m feeling alone and like I need to reach out for help, suddenly I’m thrown into the desert. I can’t find an oasis because I’ve curled up and assumed all is lost.

Fortunately, I’m not really alone. And people do care. A search party has been enlisted to find me in that desert, and the oasis I need is super close by. Even if I’ve laid down belly up, the people around me haven’t.

Isolation in the real world, desert aside, often doesn’t look like it does in the movies. There’s no freedom there, no moving image of me high in the mountains, all alone, breathing in that crisp mountain air, being rejuvenated. In all actuality, I feel trapped. Trapped in my head, with the negative thought distortions there to make sure I stay put. And to stay trapped, my body cooperates with those evil thoughts telling me not to reach out. I become a recluse. I stay under the covers of my bed all day reading Orson Scott Card novels. I listen to Tori Amos. I don’t hold my morning socials at my house. I stop doing the chores that need to be done to keep my house clean. All minor things in and of themselves, but when combined, it’s a sure sign I’m isolating.

How can I stop this from spiraling from simple isolation to full blown depression?

1. For one, people notice when I start isolating. And they don’t let me mull with my thoughts very long. My support team, the one consisting of my family and close friends, force me to go out and do things, even when I’d rather do anything else in the world than be with company.

2. For another, I reach out in small ways. I don’t lie when people ask me how I’m doing. I let them know I’m struggling with the “voices” in my head.

3. My one random thing I do is when I start isolating and feeling like I don’t matter, I read this list of wonderful things about me that a friend and I compiled several months ago. It makes me smile every time I read it, and it reminds me I do have worth and don’t deserve to be alone.

4. And lastly, I accept people’s concern for me and recognize that even if I don’t want to do what everyone is inviting me to do, deep down I’ll feel better for having gone out and done it. So I force myself to do hard things.

Letting people close to you know that when you start isolating, it is a red flag for a greater downward spiral can help a lot. It’s what I’ve done, and now my husband is very vigilant in helping keep me afloat, even when I want to submerge below the cool waters. I know for a fact he’s helped keep a minor hiccup from turning into a major episode.

So when you find yourself in that desert, hold on fast to the knowledge that there is a search party that can be deployed. And you will be found.

Image via Thinkstock.

Follow this journey on Ramblings of a Bipolar Mess

When the seasons change, what do I do as a person with bipolar disorder?

Seasons changing can be a dangerous thing when you live with a mood disorder. When the weather gets colder and it starts getting darker earlier, there is a good chance your mood may shift as well.

I know this because I live it every year. I don’t struggle with fall, or spring — but I’ll be damned if I don’t get knocked down every summer and winter… especially winter.

For me, there’s just something magical about the dark nights, the bitter cold and the holidays arriving. Something magically dark and dangerous, much like the “Nothing” from “The NeverEnding Story.”

I do wonderfully up until Halloween, and then on November 1, it’s like a switch goes off in my brain that says, “Holy sh*t! You’re doing awesome! Let’s wreak some havoc!” And then I spiral downward in a rapid succession.

How can you prevent a tragic spiral during the winter months? I don’t have all the answers, but I have discovered some techniques that have really helped me during the last three years.

1. I discuss it beforehand with my therapist.

We know what to watch for with me months in advance. I don’t surprise her with my internal struggles once they’re at a crisis level.

2. I have a game plan my entire support team is aware of and on board with.

My therapist knows what my psych is thinking, and my husband knows what everyone is thinking. And vice versa. There can’t be deep, dark secrets when it comes to staying safe during a potential time of difficulty.

3. I make time to do things I value, and I decide (before the crisis hits) that I will do them no matter what obstacles I may throw up.

For example, it’s very important to me to take my kids to see the lights at Temple Square in Salt Lake City each year. It’s a tradition my kids and I both treasure. We make the journey no matter what. Since that is such an important tradition to me, I make the decision beforehand that no matter how I’m feeling, or how my husband is feeling, the kids and I will make it there.

4. I extend myself some leniency from the hustle and bustle that can happen during the winter months.

I know I’ll need to take it slower than others might, and I might have to risk offending someone by turning down an invitation. But that’s OK. It’s me practicing self-care.

5. I try to go with the flow.

I can’t control everything. And that’s OK. I want to control everything; that’s something I’m aware I struggle with, so I fight it. The kids don’t want to go caroling around the neighborhood? I’ll sit down with them and color some cute pages out of our coloring books instead. I can’t get my 4-year-old into her adorable new Christmas jumper? I’ll softly sigh “Let it go” to myself.

Although these might not work for everyone, following these suggestions kept me out of the hospital last year for the first time in three years. It was beautiful. I fully plan on doing this again this year. In fact, preparations for my sanity have been underway for the last month now.

Of course, if you find yourself in a crisis situation, seek medical care immediately. There are people who care and want to help. Seek them out.

I wish all who struggle with mood disorders the best of winter seasons. Let’s all make this year the best one yet!

Image via Thinkstock.

Follow this journey on Ramblings of a Bipolar Mess

Mania can be hard to understand. This poem aims to bring to life some of the images I associate with my own experiences of being manic, as well as my feelings towards being manic or hypomanic.

Bruise Days

Did you ever feel that murky film lift and
your chest swell with all the new colors —
rub your eyes to see the world in this new light —
a world like a carnival,
until you saw the clowns’ faces start to drip,
their smiles of hot wax melting fast onto the ground?

Any sensation is good news, at least at first.
It starts with a purple bruise —
those nerves, that extra feeling.
Tell me, honestly: Did you want to hold onto it?
That strange vortex in your chest, most definitely blue,
intangible and transient, but still…
I bet you tried (just like me)
to clamp your hands around an entity.

Does it become an engine in your insides?
Do you wait for it to pass as it grates you like Parmesan,
and tell yourself as you flake apart
that this is only what you asked for?
Sometimes I can be reassured:
Machines have parts that crack or rust and
pain is part of my machine.

Sometimes, there is no bruise.
Sometimes, this world is mine.

But please, tell me this:
Do you ever wait for the bruise days to come back?
Rolling up behind you, your legs seem ready to mount it.
You seem ready for the danger, your eyes too wide,
too blue and too soon to pop and splatter like jelly
out into public and on the sidewalks,
out to dirty your now starched-clean clothes.
Do you recall how you used to laugh as you went blind?
Or remember the green orb of joy you thought you were,
burning out through the sky on your way back down to Earth?

Because I do. It’s hard to say I blame you.
We like to watch things burn out fast; we call this tragic beauty.
We don’t remember what it’s like to turn back to gray,
to turn back to dust and ash.

When I went gray I would go under my flannel covers,
and when my eyelids went black, so did the bed
and the room, and then the sheets vacuum-sealed.
I’d squint to try and figure out if
things had really turned back to black and white,
or if certain objects still had hints of color.
And maybe you wondered, in a world no more than tinted —
You couldn’t remember: Had it been like this forever?

But it won’t be forever.
We will peel the film back again.
We will buzz from the inside, 24/7, be our own alarm clocks.
We will subsist off anything, even exhaust fumes.
We will swell as fast as we deflate,
become too tired to be anything permanent.

They teach us to fill up, to deflate, more gradually.
This is good practice.

But tell me, do you miss it?
Because I do.
There were nights when I held the world, new again, in my hands.
Nights the world erupted into view and I would sit there, stroke it,
tell it how soft it was, how crystal clear —
tell it how I would never lose focus.
Not this time.

We forget. Has it always been like this?
Is this the full spectrum? Is it sepia?
Are there dust speckles obscuring my vision and
am I seeing the world through a plastic, orange-bottled tint?

You are like me.
You know the world both with a plastic bag over your head
and in colors nobody else has seen.

So maybe we do forget.
But life is paradox.
We can remember how it could feel:
It felt like we owned more of the world
than the world ever owned of us.

Image via Thinkstock.

Only three years ago, I was hospitalized for being suicidal. For years before that, I had no idea what wellness was. All I knew was depression, hypomania, suicidality and psychosis.

Today, I know what wellness is and fight for it every day. Sometimes, I actually succeed.

When I try to explain what it’s like to be bipolar, I talk about trust, the one thing I think makes us different. It’s hard to trust a mind that has betrayed you. It’s hard to trust a body that feels broken. It’s hard to trust that people will understand. It’s hard to trust you’ll be well again. All this doubt, and no wonder the path through bipolar is filled with anxiety and uncertainty.

One thought that haunted me once I felt what “well” was: when will it return? I wouldn’t make grand plans to accomplish things because it was all just going to fall apart again. I gave up. I thought better not to try, but a life like this felt empty. It was hard to suppress the drive to create a better life. I had to trust I could accomplish something, despite the recurring mood fluctuations.

I’m a writer and an artist. I’ve always known this. When I say that, I mean more than a vocation or an interest. It is deeper than that. I have dozens of poems and drawings in me that have never been made because I can’t trust myself or what will happen with my disease. I can’t trust that what I have to say is worth it. I can’t trust that it makes sense. I can’t trust that anybody wants to hear it. I can’t trust it won’t land on the pile of undone works, derailed by another episode.

For people with bipolar disorder, those who are sometimes rejected and stigmatized, whose minds have fooled them more than once, whose lives are like a maze of detours, it’s tough to put yourself out there. Every day, I promise I will try. I will trust that I am a beautiful specimen of a being even if I am imperfect. I won’t let the dull routine of staying safe and quiet become the status quo. I will write that poem and draw that drawing to the best of my ability.

I have come a long way in my recovery, and I have a story to tell. Trust in your voice, and tell your story. The world needs to hear it.

Image via Thinkstock.

If you or someone you know needs help, visit our suicide prevention resources page.

If you need support right now, call the Suicide Prevention Lifeline at 1-800-273-8255. You can reach the Crisis Text Line by texting “START” to 741-741.

Real People. Real Stories.

150 Million

We face disability, disease and mental illness together.