My Experience Only. YMMV.

Just as a general rule, I dislike commercials for any drugs. They impede the doctor/patient relationship. (I’ve often considered saying to my doctor, “I’m supposed to ask you if Latuda, Humira, Prolia, Viberzi, Lunesta, Cialis, Trulia, Trintellix, Keytruda, and Boniva are right for me.”) TV – and to a lesser extent print – ads encourage people to act as unpaid drug reps. And they only advertise expensive drugs until they go generic, which is when they stop being expensive and the drug companies stop making so much money.

(If you want to read more on the issue, go to

But there are other things about TV drug ads that make me more than a little cranky. Like where are the ads for drugs to treat bipolar disorder?

Oh, there are ads for drugs to treat bipolar depression, as well as ones for treating non-bipolar depression. You’d think that with approximately 2.8 million people who have bipolar in the U.S. and Canada (, there would be a market for bipolar treatments.

Also, the ads for depression treatments don’t always get it right. A few of them say that depression is more than just sadness, or that it lasts for several weeks at least. One even says that depression is a “tangle” of symptoms, which is certainly true. (Although the tangle is shown graphically in primary red, yellow, and blue, which don’t really say “depression” to me.)

Most, however, treat depression simplistically, with hidden depression represented by a smiley face mask hiding a frowny face mask. (The colors in that ad are muted during the “before” scenes and more vibrant during the “after” scenes, which is an old advertising trick.)

The ads also make it look like the most important thing about depression is not spending time with your family or not enjoying it if you do. While that certainly is one symptom of depression, it is by-and-large irrelevant to people like me, who don’t have 2.1 school-age children to take on picnics. And it’s pretty much a guilt trip for people who do.

Then there’s how the people in the ads are represented. Oh, they almost always show one POC and one slightly older person (frolicking with the grandkids). But all of them are attractive. All of them are models. Are we supposed to identify with them? Or just expect to look like them when our depression lifts?

I wouldn’t be so annoyed by this issue if it weren’t that ads for other kinds of drugs – those for psoriasis and diabetes, for example – have actual people with the disorder in them. Testimonials from those who’ve been there, as it were. Even real-life cancer patients are now featured in ads for treatment centers.

What’s up with that, I wonder? Surely they don’t imagine that only pretty people get depression or bipolar. It can’t be that they can’t find any well-spoken, real-life people who can relate their own experiences. I for one would feel more reassured if I heard about a treatment from someone who’s lived with the disorder instead of from someone selected at a casting call. Are we all homely and illiterate? (I meet the qualification for literacy, at any rate.)

Instead of trying to convince us what medications our doctors might prescribe us, the airtime would be better spent on ads that educated the public on depression and bipolar disorder. But those would be PSAs, of course, appear only at 3:00 a.m., and not make anyone any money.

Update: I have finally seen an ad for a drug to treat bipolar 1 mania. Everything else I wrote here remains the same.


Mass shootings and the public reactions to them are pretty predictable among the mental illness community.

One thing you hear after every mass shooting – and after many smaller ones – is that the mentally ill should not have access to guns.

Fine. But I have bipolar disorder, as well as some guns that I inherited from my father. I occasionally go to a gun range and fire them, but not often since I’m not the gun aficionado my father was.

So what am I supposed to do? Sell the guns? Give them away? Turn them in to the police? My therapist? I was taught gun safety from a young age by two certified pistol and rifle instructors (my parents) long before I received my diagnosis.

The further you go into the debate about guns and the mentally ill, or about whether the mentally ill are a danger, the deeper you get into fundamental constitutional, legal, and medical issues, as well as considerations of simple practicality.

Some advocate locking up the mentally ill. This is irrational. What the proponents really mean is “Lock up the dangerous mentally ill before they become mass shooters.” And that is impossible.

First, there’s the matter of due process, which is as much a part of the Bill of Rights as the vaunted Second Amendment is. You can’t just lock people up without a trial or at least a hearing.

Second, there’s no way to determine whether a mentally ill person is likely to become a mass shooter or any other kind of danger. The only generally known predictor of violent behavior is past violent behavior. In fact, there’s no way to tell whether any given individual is going to become a mass shooter. That’s because it’s really hard to predict the future.

Third, there’s the consideration of medical decisions and the right to privacy. HIPPAA has gone a long way toward protecting the privacy of patients – including the mentally ill. At the moment, a mentally ill person can only be held for 72 hrs., and then only if the person goes to the hospital voluntarily or is determined to be a danger to self and others. That’s a high standard, and it should be.

Fourth, the mental health system is already understaffed, underfunded, and overwhelmed. There are long waiting lists for beds in hospitals and treatment facilities. Are we to build new asylums to accommodate all these supposedly dangerous persons? Train more counselors to treat them? Or just lock them up and get them out of sight, out of mind?

Fifth, the idea that mentally ill persons can be forced to accept treatment and take their medication as prescribed violates several basic rights. My mother, who was not mentally ill, hardly ever took her medications as prescribed. She would quit taking one after a few days “because it wasn’t helping” or “it caused sores in her mouth” – without telling her doctor. Should she have had a caregiver to monitor her compliance? Who would monitor all those potentially noncompliant mentally ill persons as they take their psychotropic drugs? I see, we’re back to putting them in asylums.

Besides, refusing treatment is a right that patients have – even mental patients. Physically ill patients, for example, can choose to forgo chemotherapy or dialysis or medications that cause side effects worse than the condition they’re prescribed for. And mental patients have the same right. They can stop taking a medication because they fear side effects like tardive dyskinesia or even weight gain, though we hope they consult their doctors first.

But forced treatment and forced medication, as some have suggested, brings us back to the question of who, how, and where. Asylums? Court-ordered treatment? Medications that must be taken in the presence of a doctor or a therapist (who is not qualified or licensed to dispense medication)?

Take all those arguments against forced treatment of the mentally ill and add the fact that the mentally ill are far more likely to be victims of violence than perpetrators of it, and where are we? Admittedly, the mental health “system” is broken, or at least badly fractured. But is the answer really to take away the civil rights of people who have broken no laws?

The press and the public are quick to focus on the mentally ill as the culprits in mass shootings. But even if they were correct, taking away fundamental rights would not only be no real solution, but would chip away at the rights of other disenfranchised or minority populations – the homeless, for example.

If there’s a solution to this problem, I don’t know it, but locking up the “crazies” isn’t it.


If you want to read more on both sides of the issue, see the L.A. Times article by Paloma Esquivel at

This post started for me when I read a headline that said “What Made Mental Illness a ‘Sin’? Paganism.” It was by the staff of Christianity Today.

The article spoke of an evangelical women’s conference where “speaker Rebekah Lyons, in telling about her daughter’s anxiety attacks, suggested that mental illness could be healed through prayer.”

That’s a subject that I took up not long ago in this blog . In that post, I said, “In my opinion, what you can’t do is ‘pray away’ the bipolar disorder. If you’ve got it, you have to find a way to live with it. If prayer helps you do that, more power to you.” I stand by that.

But the CT article did not really explain how paganism was involved. To get a grasp on that, it turns out that you should go to the podcast “Quick to Listen,” episode 94, on Apple Podcasts. There Amy Simpson, author of Troubled Minds: Mental Illness and the Church’s Mission, explains that by paganism, she means the early Greek and Roman civilizations and their many deities, who saw some physical and psychological conditions as punishments from on high.

This link between mental illness, sin, and spirituality “isn’t really a Christian or religious idea,” says Simpson. “It’s really rooted in superstition and a misunderstanding of what mental illness is.”

The Christian Bible betrays some misunderstanding itself, when at least some of what we would today consider schizophrenia, other psychoses, or even epilepsy are defined as demonic possession. The Catholic Church, it should be noted, still – though rarely – performs exorcisms. And there are definitely still churches that equate mental illness with sin:

The bible makes it very clear that insanity, depression, anxiety, stress, paranoia are the punishments for living a sinful rebellious life contrary to the moral pattern revealed by God in the Bible. Remember, insanity is not a bodily disease, it is a behaviour choice. The only “cure” of insanity, is repentance of the sinful lifestyle and the sinful behaviour choices to solve the problems such a sinful lifestyle creates.

Leah Godfrey wrote an article that appeared on It was titled “5 Unhelpful Things Fellow Christians Have Said About My Mental Illness (and My Responses).” In it, she addresses the complicated topic of mental illness and the sometimes insensitive reactions of Christians to it. For example, to those who represent prayer as a power that can heal mental illness, she responds:

Yes, I do believe in God’s healing, that’s why I’m taking medication… because I’m blessed with enough resources to get help to be healthy again. I understand that some people … heard a sermon and *poof* they were healed; I am not that case.

And on the subject of suicidal thoughts, she says:

Yes, you can be a Christian and have suicidal thoughts. We all have thoughts of things we shouldn’t do or won’t do….I don’t believe anyone has the right to take a life, including their own. I’m a Christian who has had years of suicidal thoughts or thoughts of self-harm… Suicidal thoughts are lies we tell ourselves.

Such issues are not limited to the Christian community, however. In researching modern-day paganism (which is what I thought Christianity Today was going to talk about), I found a number of interesting resources. One talked about problems of sexual and emotional abuse within pagan groups and among their leaders, a subject hardly exclusive to the pagan community.

In fact, in my reading, I was interested to learn that pagan communities and Christian communities sometimes address mental illness in similar ways, and how one could benefit from the other’s perspective.

For example, I found this statement:

Many religious communities have support groups and other resources for members who suffer from mental illness. These kinds of services are desperately needed in the Pagan community. We need to learn from other religious communities and adapt to the needs of our own community.

Another pagan author, Luthaneal Adams says:

Can a person find that paganism is beneficial for their mental health? Certainly.  I’d say that spiritual fulfillment is one element of mental wellbeing.  If Paganism is what helps you find that spiritual fulfillment, then great. However, that is not the same as saying that Paganism (or things within Paganism) are themselves tools for achieving better mental health…. When it comes to mental illness, we’re talking about major, chronic illnesses.  No single ritual or ceremony is going to make that just go away.

Other fascinating subjects regarding Christianity, paganism, and sin are the multiplicity of sects and practices and beliefs in both forms of spirituality; the circumstances for excommunication and disfellowship as regards “sin” or disruption of the community; the question of “sinful” behaviors caused by mental illness; and so on.

I don’t have the theological background to address these points. But, to sum up what I found: that mental illness is or is not a sin, depending on whom you ask; that paganism, as well as Christianity, concerns itself with the mental health of its practitioners; and that many spiritual traditions advocate compassion for the mentally ill and an understanding of their suffering.

Certainly there exist both Christian and pagan communities that are more judgmental or less inclined to minister to the sinful or the mentally ill, rather than rejecting them.

These are things that all faith communities need to address.







I love reading. Always have – except for the period when a major depressive episode stole it from me – I’m never more than two feet away from a book or, at this point in my life, an ereader. Reading is how I explore the world.

So naturally, in trying to better understand my disorder, I read about it. And because I’m interested in psychology in general, in addition to books about bipolar disorder, I read about other mental illnesses as well.

Let me share some of my reading with you.

For sheer delight as well as profound insights, try Jenny Lawson’s Furiously Happy: A Funny Book About Horrible Things. Amid the hilarious stories of life in her other-than-typical family are insights into depression and social anxiety, along with a manifesto of defiance – the will to be, well, furiously happy.

The other easily approachable book is Allie Brosh’s Hyperbole and a Half: Unfortunate Situations, Flawed Coping Mechanisms, Mayhem, and Other Things That Happened. What started as a humorous blog grew into a book (with quirky illustrations) featuring two chapters in particular, “Adventures in Depression” and “Depression Part Two,” which are about as good as writing about depression gets. A second book, Solutions and Other Problems, was scheduled but has been postponed indefinitely.

And while we’re on the subject of funny books about mental illness, there’s Surviving Mental Illness Through Humor, an anthology edited by Jessica Azar and Alyson Herzig.

Perhaps the best-known book in the field of bipolar disorder is An Unquiet Mind: A Memoir of Moods and Madness, by Kay Redfield Jamison. In it, Jamison deals openly and honestly with bipolar disorder, particularly with mania and psychosis, along the road to becoming a doctor herself. She has also written Robert Lowell, Setting the River on Fire: A Study of Genius, Mania, and Character, about the famous modern poet, but I haven’t read it yet, so I can’t comment.

Birth of a New Brain: Healing from Postpartum Bipolar Disorder, by Dyane Harwood, is another recent book that I haven’t read yet, either. But I know Harwood’s writing and expect it to be a stand-out, as well as the only book I know of on that particular topic.

Other books on bipolar disorder include Lost Marbles: Insights into My Life with Depression & Bipolar by Natasha Tracy.

For books about depression, the definitive work is The Noonday Demon: An Atlas of Depression, by Andrew Solomon. A thorough examination of depression, including the author’s own, it is practically a reference book on the topic, though much less dry than that makes it sound.

Darkness Visible: A Memoir of Madness, by William Styron, is another classic on depression that I really ought to read, but haven’t yet because I’m not that fond of Styron’s writing. (Sophie’s Choice is his best-known work.)

For mania, I recommend Just Like Someone Without Mental Illness Only More So: A Memoir, by Mark Vonnegut, M.D. The son of Kurt Vonnegut, Jr., the author deals less with his celebrity father, instead focusing on his saving-the-world-style mania during his pursuit of an M.D. degree.

Other books that I can recommend include:

  • My Lobotomy, by Howard Dully, a memoir of a boy who was lobotomized for no particular reason other than the fact that his stepmother hated him, and the difficulties he encountered in and out of institutions.
  • Ten Days in a Mad-House, by Nellie Bly, early undercover journalism at its finest. (I wrote about her experiences in one of my earlier posts:
  •  Shrinks: The Untold Story of Psychiatry, by Jeffrey A. Lieberman, a history of the development of the field from the buried memories days to the biological understanding of today.
  • The Man With the Electrified Brain: Adventures in Madness, by Simon Winchester (who also wrote The Professor and the Madman, about the making of the Oxford English Dictionary). Despite the title, this is not about electroshock treatment, but rather dissociative states.
  • Rebooting My Brain: How a Freak Aneurysm Reframed My Life, by Maria Ross; and My Life Deleted: A Memoir, by Scott Bolzan. These books, about a cerebral accident and amnesia, respectively, don’t speak directly to bipolar disorder, but I found them interesting as accounts of rebuilding one’s life after a significant mental condition.

And for an opposing point of view, if you must, there’s Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, by Robert Whitaker. Once you’ve read the title, you pretty much know how the book’s going to go; I don’t recommend this anti-psychiatry screed.

What books do you recommend? Which have helped you?

The Question I Hate the Most

There are many things you shouldn’t say to a bipolar person: Cheer up. Smile. What have you got to worry about? We all have mood swings. Calm down. You’re overreacting. You don’t look depressed.

Each of these remarks contains a hidden assumption, from simple – you can choose your moods; to dismissive – your anxiety is not as severe (or as important) as mine; to possible gaslighting (see,,

I’ve gotten all of those and more. Once I revealed my disorder to a coworker and she’d ask me, “How are you?” with a concerned look several times a day, taking my emotional temperature. But the question I hate most is a simple one.

Are you off your meds?

Let’s unpack this, shall we?

First, the underlying message is that, to the speaker, you are acting in a strange, inappropriate, frightening, incomprehensible, or otherwise “off” manner.

The second assumption is that you must be on medication in order to appear “normal” at times.

Third, that since you do not appear “normal” to the speaker, the only explanation is that you must not be medicated at the moment.

Fourth, that the speaker has the right to give you advice on how medicated you need to be in order to appear “normal.”

And, finally, that “meds” are the answer to all your problems. If you want to fit into society you must be on your guard at all times and medicate until you are acceptable to them.

There is a slightly less offensive version of the question: Have you taken your meds today?

This might be marginally acceptable from a loved one, who knows that you take medication for your disorder and also knows that you are sometimes forgetful.

But really. Most psychotropic medications build up in a person’s system over time and leave the body over a long time as well. Missing a single dose is not likely to have an appreciable effect on a person’s moods or actions.

There are some anti-anxiety medications that have short-term effects, and a bipolar person might have forgotten a dose or two.

But unless the speaker is the bipolar person’s caregiver, official or unofficial, it’s still rather parental and demeaning – suggesting that we aren’t competent to handle something as vital as our own medications.

Of course, sometimes it may be necessary to help a loved one remember to take medication, whether that person is bipolar or not. On a vacation, for instance, when one’s normal routine is disrupted, a gentle reminder may not be amiss. When one has just started treatment and the routine is still unfamiliar. Or if the person actually is a child.

You wouldn’t ask an adult with the flu “Have you taken your antibiotics today?” You wouldn’t say to a blind person “Now, don’t go out without your service dog.” Most people, most of the time, are deemed competent to know their needs and take care of those needs themselves.

But bipolar disorder and other psychiatric conditions, being largely “invisible illnesses,” seem to invite meddling. Everyone else knows what’s best for us, from a different drug to herbal medicine to a walk in the park to prayer.

They know a little bit about the disorders, perhaps, largely through television and celebrities. But they don’t know your particular version of the disorder (bipolar 1 or 2, rapid cycling, dysthymia, hypomania, anxiety, etc.)

So if I snap at you, or seem anxious, or don’t want to go out, don’t assume. I have regular “normal” moods too, even when I’m on medication. Sometimes I get annoyed if my husband has lost his cell phone for the third time this month. Sometimes I feel sad if my picnic is rained out. Not every mood is pathological.

So don’t assume you know what’s going on inside my head. Unless I ask for help, refrain from putting in your oar.

And don’t ask me, “Are you off your meds?” It’s an insult, not a question.

I know it’s common when hypomania or mania hits for the bipolar person to go shopping.

The thing is, I hate shopping. Always have. Probably always will. I don’t like to shop for clothes or groceries or shoes. I don’t like to go out to stores.

Ah, but there’s always the Internet (I hear you say). You can shop without ever leaving your house, or for that matter your desk chair.

The problem is, I don’t have any money to spend on online shopping. And that’s one of the reasons I don’t have a credit card. It’s too easy to spend non-money.

What I do have are a debit card and a PayPal account. If there’s no more money on my debit card, too bad – I have to reload it (or more likely ask my husband to reload it). This requires taking money out of the bank account.

The PayPal account is where I usually get paid for the bit of writing and editing I do from home. I really should roll that money straight into the bank account.

But sometimes I don’t.

In fact, when the PayPal well is dry, it reverts to my backup payer – which is my bank account. It does this automatically. My husband never knows about it, since I’m the one who handles the online banking.

You see the problem here. I could shop to my heart’s content, and pay with PayPal/bank account as long as there was money available. Theoretically, I could bleed it dry.

Even with my meds working and all the progress I’ve made, I still get hypomania occasionally. I try to keep the shopping under control as well as I can.

There are several dresses in my closet that I never wear because I hardly ever go out, especially to places where a dress is necessary. I even have a party dress that I bought recently. It’s really becoming. But I never go to parties. I was just overwhelmed with the butterfly pattern and how cheap it was ($20).

But still, five dresses in two or three years isn’t bad, considering. (I once actually hyperventilated over a dress, and often do over amber jewelry.)

The real problems I have always had are books and music.

When I was still going out to malls and shopping centers and the like, the bookstores were always my downfall. My husband would take my arm and steer me past them, unless he was jonesing for a book too.

I’m trying to keep my online book-buying to a semi-reasonable level, too. I buy full-price books only when they’re absolutely essential – the last book Sue Grafton ever wrote, for example, which is not going to be discounted anytime soon.

For the rest of my ebook purchases, I subscribe to various newsletters that present me with cut-rate book choices every day. (Early Bird Books and Book Bub, for example). These books sell for $.99 (rarely), $1.99-$2.99 (usually), or $3.99 (occasionally). Once in a while I can even get a free classic – for instance, Tess of the D’Urbervilles or Ivanhoe (which I don’t recommend) or Journal of the Plague Year.

Back when I was going out, in the days when I did that, my other hypomanic shopping thrill was the used CD shop. I had a strategy for curbing my hypomania there, too, even though I didn’t know that hypomania was what I was feeling at the time. I would fill my little basket with everything that caught my eye.

Then I would weed. I made three piles – must haves, can pass on, and maybes. Then I would angst over the maybe pile, juggling price, artist, essential tunes, and the like until I had the piles down to something more manageable. Under budget or just a wee bit over. I can do the same with my online “cart.”

Again, this is a thing that could get me in trouble on the Internet, but since I have all those CDs and have loaded them all into iTunes, I seldom get the music shopping urge anymore.

So, yes, I do hypomanic shopping and no, I don’t let it break the bank. Just chip away at the edges.

Why are there no 12-Step groups for persons with bipolar disorder?

There are a number of support groups, both online and in local areas – and even a Facebook page called Bipolar Anonymous ( – though it’s not a 12-Step group and seems to consist mostly of posted memes of encouragement. They describe themselves as:

a group page for people who suffer from a Mental Illness, or are having a rough time of things, to seek out people with like problems, for support and a place to vent.

My short answer is that a 12-Step program would not work for bipolar disorder.

It’s not that people with bipolar don’t need AA. Some do. As James McManamy says at Health Central (

One-half of those with bipolar experience alcoholism at some stage in their lives, far more than the general population. Four in ten experience other substance use issues. This extra burden comes at a huge personal and family and social cost. As if bipolar weren’t bad enough, already.

However, at many 12-Step meetings, according to David Oliver (, alcoholism is the only condition discussed at meetings. Bipolar disorder is considered an “outside issue.” However, he also notes that for those with a dual diagnosis:

Part of the program of Alcoholics Anonymous is to get a “sponsor.” A sponsor is a person who will help the member through the 12 steps of the program, to help them stay sober, and to help them deal with the issues surrounding their alcoholism.

Hopefully, the member with bipolar disorder can find a sponsor who is sensitive to the fact that bipolar disorder is one of the issues that does, in fact, affect their sobriety.

Another facet of AA that can be applicable to those with bipolar disorder is Reinhold Niebuhr’s Serenity Prayer: God, grant me the serenity to accept the things I cannot change, Courage to change the things I can, And wisdom to know the difference.

But as to the 12 Steps themselves, only a few are likely to be helpful to bipolar sufferers, and several apply not at all. Let’s take a look at a few:

  • We admitted we were powerless over alcohol – that our lives had become unmanageable.
  • Came to believe that a Power greater than ourselves could restore us to sanity.

These, the first two steps, are problematic if you replace alcohol with bipolar. We are not powerless over bipolar. There are treatments, involving therapy and/or medication, that give us power to manage how bipolar affects us. And that Higher Power so essential to AA – often expressed as “God as we understand Him” – will not restore us to sanity, through prayer may help us get through the difficult times associated with the disorder. (

On the other hand, a few of the 12 Steps may be relevant:

  • Made a list of all persons we had harmed, and became willing to make amends to them all.
  • Made direct amends to such people wherever possible, except when to do so would injure them or others.

Few would deny that bipolar disorder has often been a factor that affected our relationships with others. We can certainly acknowledge that we have hurt others as well as ourselves while in the grip of mania and/or depression, and we can offer or try to make amends.

But, overall, it seems that 12-Step programs are not for us.

What is there to suggest instead? Here are two places to look:

  • Therapist-led support groups in your area
  • Depression and Bipolar Support Alliance (DBSA), which offers online and in-person peer support groups or chapters

DBSA has a page that helps you locate support groups in your area. Unfortunately, there are none within a reasonable distance of where I live.

However, I could always start one. And so could you.

Also, I invite you to write any number of steps that would be appropriate for a support group along the AA model.

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