Entrance to Emergency Room

Dear Hospital Emergency Ward Staff,

When you see me in a manic high, wrestled in here by my father; or as you watch my mother, sitting with me in the waiting area, holding my hand while I ramble gibberish to an invisible friend, please remember this: I may be “crazy” but I can hear. I may be mad but I can see. I may be insane but I’m still smart.

I can see you rolling your eyes when my behavior is bizarre. I can hear you when you shout to the security guard to “catch the crazy woman” as I fly to find some scissors. I know you’re referring to me when you look at me but whisper to your colleague, then purse your lips and shake your head.

I don’t want to be running around the emergency ward in florid psychosis looking for God. I don’t want to be strapped to a gurney needing sedatives to calm the fire in my brain while I scream for the Mother Ship to beam me up.

Maybe it’s because you’re burned out, under-resourced, over-taxed, understaffed and over-stressed. But I am a human being before I’m a “frequent flyer,” the “nut case who must be on drugs,” that patient who can wait because “she’s non-compliant.”

I understand that I’m hard to understand and hard to manage. I know your job is trying; that you do your best; that you do care. But please don’t forget that just like you, I have a heart. A heart that hurts when someone judges me for something that isn’t in my control; when someone doesn’t see that really I’m doing everything I can to get well even though it doesn’t look that way.

Because I also feel when you, the paramedic who wheels me through the hospital doors, stream such soft compassion from your eyes and gently nod goodbye to me. I sense when you, the nurse whose name I do not know, rests your hand on my shoulder with such respect that dignity rises from my feet.

So please remember, even when I’m laughing like a drunken hyena, and my father paces the green linoleum while my mother strangles her panicked hands, and all three of us wait for the attending doctor, I am aware of the kind light in your face as you tell us (including me) that you wish there was more you could do but hopefully it shouldn’t be much longer. No matter how crazy I may be, I am aware. And when your heart remembers that, my heart does too.

This post originally appeared on Psychology Today. To book Victoria as a speaker, please visit www.victoriamaxwell.com

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You know they are out there. Those people who aren’t going to be helpful to you when you’re dealing with your mental illness. They do exist, and you need to be mindful of that.

I have dated a few men prior to marrying my now husband, and I learned over time different things I needed for my bipolar disorder in order to have the best, most supportive relationship possible. I didn’t even know I needed some of these things before I got married, but I think they truly help me combat my bipolar disorder. I wanted to share a few traits I think are important for your significant other to have in order to help you the most with your mental illness. They are good traits for anyone to have, as well, and they go both ways. Yet, I think it is helpful for people with mental illnesses to find a significant other with some or all of these traits.

1. They should have an ability to listen.  

This is a big one. If you are with a partner who doesn’t listen to you or try to understand what you are going through, it’s not a great sign. When I found my now husband, he would listen to what I had to say about how I was feeling. Now, no one is perfect, and many people want to be able to “fix” things. It took some time for my husband to realize he couldn’t necessarily “fix” me, and he had to be OK with simply helping me. Yet, after some couples’ counseling (while dating and married) and lots of long talks, we came to a mutual understanding that he didn’t always have to offer solutions. He could just listen and love me. This is important because oftentimes it helps to just be heard, even if there isn’t a solution.

2. They should have patience.

Having patience is critical, and I think this is the trait that is absolutely necessary in the person you are dating. They should be patient at all times: on the days when it isn’t getting better, when it’s getting worse, when you can’t get out of bed or when you’ve started 10 million projects over night. You need a partner who is patient enough to see you need help getting out of your mindset of mania or depression and that it might not happen quickly. You need someone who is willing to walk beside you, no matter how long it takes.

3. They need a willingness to learn and accept.

If your partner is willing to learn about your condition and if they are hungry for information on how to help and understand you, then this is fantastic. If they are open-minded toward what you are going through, then it will make it that much easier for them to help you in the long run. Your partner needs to accept you just as you are, good days and bad. If your partner stays with you only in hopes that you will eventually be “cured,” then this is not someone you want to be with. You may never fully come out of the episodes. You need to be with someone who guides you through them, instead of waiting for them to end. It is important that the person you are with not only wants to learn more about your illness as a whole, but also how to best help you battle it. Every person living with a mental illness has different ways that help them cope and heal. You should be with someone who can help you find it and learn about you along the way.

4. They should be honest.

This may seem obvious, but I find honesty (with a touch of being gentle) to be one of the most helpful things my husband brings to the table. He is able to gently question me when I’m in a bad place. He will tell me in a nice way (and we’ve worked on this) when he thinks I am starting to go into mania and that I’m taking on too much. At the same time, it is a delicate balancing act with the “listening” part. You can’t always think rationally. So sometimes honesty isn’t taken well. I do still think it is important that your partner doesn’t always cater to all of your ideas during mania or depression. Sometimes, that only fuels the fire. It is helpful to have my husband ask me directly, “Have you taken your medicine?” and things like that.

5. They should have love and devotion.                       

“I’m not leaving, no matter how hard it gets.” This is something you save for the person you decide to spend the rest of your life with. Yet, it is a trait you want to identify long before you get to the altar. Everyone says this, “through thick and thin,” but for people with mental illnesses, the thick can be much thicker and the thin can be much thinner than for other people. Having someone by your side, who will never leave you no matter how bad the days get, is a source of strength and stability as you fight through the hard days. It is challenging enough to battle your own brain without having to wonder if your partner will love you through it or if they will bail. My husband always tells me all the good days are worth getting through the days when I am not myself. He is my anchor. I owe him much of my recovery.

Dating or being in a relationship is challenging, even without a mental illness involved. Unfortunately, you may have to go through a few bad dates and relationships before you find someone worth sticking with. Once you find them, you’ll know. These traits are things to look for initially (although you can work on them once you’re in the relationship if the person is willing to learn). I’ve found them essential to keeping my marriage working while dealing with mental illness.

To all those battling a mental illness, I wish you love and happiness. Don’t settle for someone who isn’t willing to learn, understand and listen. Stay with someone who is willing to stick by you. Above all, find someone who loves and cherishes you exactly the way you are, mental illness and all.

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5 Traits I've Found in a Loving Partner as a Person With Mental Illness

People often have this misconception that mania is fun, that it is exciting, exhilarating and exceptionally productive. In reality, full blown mania is exhausting, excruciating and exceptionally chaotic. Hypomania, on the other hand, can be fun for me. So, for those of you who don’t quite understand the difference, please let me lay out for you what hypomania and mania look like to me.

Hypomania can be a precursor to mania. When I am starting to get hypomanic, I do feel good. My thoughts speed up, I’m productive and I have lots of great ideas. I can stay up late and wake up early. I enjoy planning things and executing those plans.

I make a bunch of dates to hang out with friends and get a little more daring in my daily life. I make rash and sometimes bad decisions, but they are based on reality in some way and not entirely out there in left field. I can cruise through books, write for hours and create beautiful pieces of art without having any symptoms of “writer’s or artist’s block.”

Hypomania seems like a good thing, right? Life just seems better, more efficient and more enjoyable. I am creative, alive and happy.

However, there is a catch. Hypomania is unstable. It can quickly turn into a deep depression, or, for me, it typically turns into mania or mixed mania. When I become manic, there are no more good ideas. They are out of control. My ideas come so fast that before I can act on one, I switch to another and another and another.

It gets to the point where sometimes I sit on the couch with my head clenched in my hands begging my brain to stop. Then, I get impulsive. I act without thinking about any thoughts for long. I don’t think. I just react to my mind. I get out of control and irrational.

In my last severe manic episode (thank God it was years ago), I slept with a few strangers a week. I tried drugs. I drank too much, sped too fast and bought too many things I didn’t need. I made terrible decisions, and I hurt people emotionally.

The entire time I’m manic, I know what is coming later. I can’t stop my mind from derailing. I am out of control. Yet, there comes a place in mania where you reach a turning point. Yet, there isn’t a “hypo-depression.” You don’t slowly fall out of mania and gently come back down. You crash, and you crash hard. Once the mania is through with me, it hurtles me into a deep depression. That is the other dark side of the coin.

Neither one is anything you would want to have. Both mania and depression are awful in their own right. I have often found people glorifying the manic side of bipolar disorder, as if somehow it is the opposite of depression, as if everything is great, fantastic and fun.

It isn’t. Mania is full blown chaos and catastrophe. I wish more people understood this part of bipolar disorder. When I say I’m manic or I’ve experienced mania, it doesn’t mean I’ve been on a joyride. I haven’t been to the epitome of happiness. No, far from it. Mania can be destructive and terrible.

Mania is not fun.

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The “ups” of bipolar disorder are typically referred to as hypomania or mania. Mania can be so severe it requires hospitalization or involves hallucinations and/or delusions. A diagnosis of bipolar I means a person has had at least one fully manic episode. In bipolar II, one only experiences hypomania, not mania. I have type II, which means my “highs” of bipolar disorder involve hypomanic episodes. I don’t speak for everyone with the disorder, but here’s what this is like for me:

There seems to be a misconception that hypomania is a very positive thing, and in some ways it can be. I’m happier when I’m in a hypomanic episode. I feel like I’m walking on air, like nothing could ever go wrong. I feel productive, and I want to accomplish everything ever in one sitting. I feel really good.

But there’s another, darker side to hypomania. That’s the intense, anxious energy I feel throughout my body. The jumping from task to task, never really being able to focus on or complete any one project. It’s being filled with lots of great ideas, but accomplishing nothing.

It’s drinking a cup of coffee and then feeling like I could run a marathon with the blood pumping through my veins. Couple this with intense anxiety, and imagine trying to sit still during a class to learn.

It’s the fear of waiting for a crash to come, knowing the high won’t last forever. Knowing a depressive episode is waiting right around the corner.

It’s being emotion-charged 24/7. It’s crying during a church service because you just feel too much all the time.

It’s the constant need to be around people. It’s talking up a storm, not letting anyone get a word in edgewise. It’s tripping over your words because your brain is thinking too fast for you to speak.

While hypomania or mania may seem like joyous highs, there are a lot of challenges that come with them, too. Everyone’s experience is different, but no one chooses to have a mental illness. Mania is just one more thing I have to learn to live with.

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Living with undiagnosed bipolar disorder can be a hard time in a person’s life. You’re experiencing symptoms that don’t have a name yet, and it’s really easy to believe there’s something wrong with you before you know you have an actual mental illness.

And even then, accepting you have a mental illness is not easy. Even with answers, comes confusion. You might feel hopeless and unsure of what the future holds.

That’s why we teamed up with the International Bipolar Foundation and their “Say It Forward” campaign to ask people to share what they wish they could tell their younger selves about living with bipolar disorder.

Check out their answer below, and join the conversation by using the hashtag #DearTeenageMe.

1. “Dear teenage me: I’m sorry things are tough. I’m sorry you don’t understand quite yet. I’m still trying to understand my thoughts. You can’t run from your problems, and you can’t curse them away by hurting your loved ones. Times are tough, but you’re important, you’re loved and you’re here for a reason.” — Alicia P.

2. “There was never anything wrong with you. All those nights you cried, self-medicated and drank yourself to blackness just to not feel… all it will get you is more darkness. Don’t be afraid or ashamed to ask for help, even if every one else makes you feel like you’re making it up. You’re you, and you are a beautiful soul. Your future is much brighter, I promise.” — Sara E.

3. “You will wait too long for help but, it will come — and life will be better than you could ever imagine now. Hold on!” — Helen B.

4. “You will find your illness does not have to be an enemy. You will learn it will give you amazing talents, perspectives and feelings. Don’t fight it.” — Alli M.

5. “Life is a roller coaster. Yours has higher highs and lower lows. Know there’ll be days of sheer hell, but the next day could be beautiful. You just have to remember that for every down there is an up if you can hold on until it gets here.” — Kristin Leigh

6. “Bipolar disorder may be what you’re diagnosed with, but that does not represent who you are! You are so much more than an illness. You will get through this, and be stronger for it. It is not a death sentence.” — Mary G.

7. “Don’t try to beat it on your own. It’s OK to ask for help. Go visit a doctor. Take your meds. Don’t panic. Stop trying to prove you’re normal. It’s all going to be fine. It’s a tremendous gift. Seriously.” — Michal K.

8. “The people you thought were against you will end up being the ones that make you stronger. Don’t give up on them or yourself.” — Soledad K.

9. “This is not your fault. You didn’t choose to have bipolar. Don’t feel scared to truly express what’s going on in your mind. The sooner you can catch your symptoms, the sooner you can do something about it.” — Shawna H.

10. “Dear teenage me: I am proud of you for who you are. You couldn’t ask for help for many reasons, but you survived and there you are. Keep your chin up, sweetheart, even when you are low. You’re not alone.” — Elsa R.

11. “Please don’t grow up thinking you need to ‘fix’ yourself. I want you to know that right now, you are a beautiful, caring person. And through the years that are going to be hard, you will gain more and more empathy for those struggling around you and you will be able to help them. Please remember, you have something important to give the world, just like everyone else.” — Denise H.M. 

12. “Dear teenage me: Have more confidence in yourself and trust your gut instinct. Be patient, things will work out even if you don’t know how, just keep heading in the right direction. Don’t be afraid to try even if you fail. It’s worth it. Don’t be ashamed of being different. Embrace it. Own it.” — Emma T.

13. “Even though there is stigma everywhere you look, don’t be too proud to get the help you need and deserve. Medications aren’t a crime. A therapist isn’t a punishment. Visiting the doctor several times a year doesn’t make you weak. Doing all of this actually makes you strong. Stronger than those who choose to close their eyes. Stronger than those who perpetuate stigma. More importantly, it makes you stronger than you were yesterday and it will have a better path for your future. Don’t be afraid to succeed.” — Chandreyee J.

14. “I know you don’t think you’re are strong. But you have strength beyond anything you could ever imagine! You are going to go through hell many times and you will feel like giving up. Don’t lose hope. It will be hard, but you can make it!” — Sherry W.

15. “Embrace who you are. Embrace the darkness and learn to cope, embrace the light but remember that’s the only time you can be happy or be you. Oh, and find a treatment plan that works for you, and stick with it. Even when you feel like you don’t need it/them.” — Tessa B.

16. “Accept with grace all of your beautiful imperfections — all those unique, quirky little intricacies that make you, you. And, above all else, have the courage to find your own truth.” — Rob F.

17. “Be open to others around you. Don’t be ashamed to talk about your problems, it’s not your fault at times. Remember you are made of stronger stuff than you think. You might slip up, but you can keep fighting a bit longer. You are loved and you matter to more people than you think.” — E.J. Hobbs

18. “Dear teenage me: Do not be embarrassed. You’re strong, you’re smart and your value is immeasurable! Negative comments and opinions are not meant to hurt you, they are only the result of the lack of information on our community… educate yourself, educate others. You’re loved!” — Jennifer M.

19. “Seek help sooner. Don’t be afraid of medication. It does get better. Try to wait out acting on impulses, don’t let your temper get the better of you. Stop apologizing. Think before spending. You don’t have to please anyone and it’s OK to withdraw to give yourself time to heal/realign. You owe no explanations.” — Holly J.

20. “The rage will settle, but not leave. The storm will calm, but not falter when you need it. If you work on yourself first, one day you’ll be able to work the demons you think live inside you to your advantage, and live without so much fear of what you’ll become.” — Maddi A.

21. “This diagnosis is not the end of your dreams. Also, you have bipolar, you are not bipolar…they are two different statements. Don’t let people define you as your diagnosis. It is just a part of you, it is not who you are!” — Anjae H.

22. “There’s not a thing in the world wrong with you. There is no definition of ‘normal.’ You are wonderfully made and the trick is to accept the disorder as a part of you, but don’t allow it to define you. There is no cure, there is only managed and controlled lifelong recovery. You can beat this and after awhile it will submit.” — Kristina M.

23. “When you went to your psychiatrist in 2010 and floated the idea that you think you could have bipolar, and then she dismissed the notion outright — you should have persevered and gotten a second opinion. Don’t give up on your mental health.” — Lara Cathrow

24. “Hold tight, things are going to get worse and this isn’t going to disappear. But you are a warrior and will keep fighting this terrible illness every day. As much as you want to, try not to give up.” — Lexi M.

25. “Even though it’s hard, try not to feel guilty about things you have no control over. When you find yourself feeling this way, ask, ‘Is this my fault? Could I have prevented this?’ If the answer is no, then you have nothing to feel guilty about.” — Lisa C.

26. “Find a good doctor, one you feel comfortable with, and take your meds. You are not your illness. You are stronger than the illness.” — Victoria K.

27. “You’re unique, girl, and it doesn’t matter if people get you or not — be yourself. Don’t be too hard on yourself. Ask for help, sweetie, you are not crazy.” — Heather P.

28. “Taking medication is not giving up. Keep positive, and you’ll learn to cope much easier. It will always be an uphill battle, but some paths are easier than others.” — Alanna-Marie M.

29. “When you’re manic, focus on the real, the scientific, the concrete. When you’re depressed, love people and feed them.” — Drak B.

30. “You have a voice! Keep talking until someone helps.” — Samantha H.

To learn more about the International Bipolar Disorder’s “Say It Forward” campaign, click here.

Before I tell you these things, I want you to know that at the end of the day I love you very dearly. You’ve contributed to much of my growth, and that is irreplaceable.

I want you to know some things about the mental illness I struggle with.

1. Bipolar depression is a little bit different than major depressive disorder. My depression is typically followed semi-closely after a hypomanic episode. There doesn’t necessarily need to be a trigger.

2. When I say I’m tired, I truly mean it. When the battlefront is your own mind, it is exhausting. I spend an inordinate amount of time shoving down the thoughts of hurting myself or the constant fear that I’m not good enough and that everyone would be better off without me. So when I say I’m tired, please meet me in the middle so we can accomplish what needs to be done.

3. Telling me to “just be happy” and “just get out of bed, you’ll feel better” is useless and invalidating. It hurts, honestly. When I hear those words, I hear a lack of support and a lack of encouragement. It’s similar to telling someone with the flu, “just get out of bed and get better! Your fever isn’t that big of a deal.”

4. My coping skills might not be like yours. I like small spaces. My closet. In between the wall and the bed. Curled up under every blanket in the house. Please don’t try to change my non-destructive coping skills. Some days they are all I have to hold onto.

5. You can’t fix me… because I’m not broken. I understand it must be confusing and painful to watch my highs and lows, but I promise you what means the most to me is when you’re still there when the clouds of depression dissipate.

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