Bipolar Disorder: Stages of the Journey

I’ve been putting in quite a few hours to get my third eBook ready finished, polished, and ready for launch. The subject matter of my next eBook centers around tearing down the barriers that separate Bipolar people, their Supporters, and loved ones when the situation is not toxic. A big part of working to tear down those barriers is to understand where the person is at on their journey.

Many advocates and Bipolar spaces around the internet trumpet the individual nature of mental illness loudly. That’s true, to an extent. Mental illness is a very personal experience. However, as someone who spent 5 years doing internet marketing work, it is very clear to me that niches exist in our overall demographic. I’ve spent a great deal of time reflecting on how I analyze the situations and people I interact with as a means to best communicate with and reach people.

As a bit of a teaser let me share with you the the niches that I’m referring to as the “Stages of the Journey” with some brief notes.

Stage 1: Lost (Toxic) / Lost (Aware)

Stage 1 is divided into two categories, Lost (Toxic) and Lost (Aware). A Lost (Toxic) individual may be undiagnosed and doing all of the awful things we do to ourselves and others, diagnosed but are unaware of the severity of the problem, or simply don’t give a shit. The Lost (Aware) person has caught glimpses of understanding that there is something wrong with them that needs addressed, but does not understand how to start confronting the problem. This is where we start our journey. Many of us bounce back and forth between the two due to instability and the chaos of life.

Stage 2: Novice

Stage 2 begins when the person understands and accepts that they have a problem, at least some of the time, and they are willing to confront it. Many people do struggle with the idea of having a mental illness. It is very easy for a person at Stage 2 to fall back somewhere into Stage 1. This person needs support, encouragement, and tangible goals to keep them in Stage 2 and looking forward. At this stage, the person is beginning to learn about their mental illness and themselves.

Stage 3: Learner

These individuals don’t struggle as often with their diagnosis. People in Stage 3 are most receptive to information. These people are active participants in pursuing wellness. They not only attend their appointments, but tend to act on whatever practices their mental health professionals are telling them they need to be well. These individuals still need support from time to time, but their needs are less pronounced than previous stages.

Stage 4: Adept

Stage 4 is the last stage. Adept is defined as someone who is reasonably skilled and proficient at a thing. The mentally ill person at Stage 4 has a firm grasp on their mental illness, management, and engages in the practices required to be healthy. This person has likely been through therapy, different doctors, different medications, and more. Ideally, this individual is living a fairly typical life.

I chose Adept to describe the final Stage for a specific reason. One would assume you would end a list with something like “Expert” or “Master.” Right? Not in this case. Because even if the person is an absolute expert on their own diagnosis as it pertains to them, that does not mean that the information is applicable to the next person. I’ve had more than a handful of advocates inform me they were an “expert” on Bipolar Disorder when I pointed out that they were giving bad or misinformation. They’re not, I’m not, you’re not; and you probably won’t be unless you decide to go into psychology and study the work of the doctors that have brought us to our current understanding of a mental illness.

The Adept often suffers from one very major drawback that I’ve seen over and over. They often do not understand that just because they take their medication and go through whatever practices are required to be well now, that they will continue to be well in the future. I’ve seen more than a couple Adepts backslide because they either didn’t know or forgot that the body can grow tolerant to psych medication, which can let the Disorder and an unwell cycle creep back in. The person is often convinced they are totally fine, because they have been fine for years and regularly take their meds. So how can they possibly be unwell now? And then the Disorder further convinces them that they are totally fine and it’s everyone else that is the problem, allowing the unwell cycle to run unchecked.

But What’s the Point?

Effective communication requires understanding one’s target audience. If I’m going to write a romance story, then I need to have a reasonable understanding of how women who read those books think and what they take out of the work. Similarly, I have never had a Lost person tell me my writing was too abrasive, I shouldn’t swear, or inane bullshit like “you should refer to yourself as a person with Bipolar Disorder instead of a Bipolar person.”

On the contrary, I instead get regular feedback like, “your writing is the first that really spoke to me.” Because I’m writing in the tones and language of the way that we think, but do not express, so we don’t have to listen to people bitch at us about it.

Anyway! In my next eBook, I go over these things more in-depth, in addition to methods I use to effectively communicate and build knowledge at the various stages to help people find their way up the ladder. It is my hope that this will allow supporters and their mentally ill loved ones to better dismantle the barriers that inhibit communication; in addition to providing a clearer road map and goals for we mentally ill who are trying to find our way.

The next eBook is still a bit out, but I will keep you posted when it gets closer to release time.


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The Post-Escalation Depressive Crash and What It Means to You

I was recently asked if I could find a decent article on the Depression one can experience after a person with Bipolar Disorder crashes out of an escalation. I couldn’t find one that I was satisfied with or that addressed this matter specifically, so here we are.

About the Post-Escalation Crash

Bipolar Disorder is characterized by the mood cycles it gives us. We go up, we go down. Right? Right.

An escalated cycle (mania or hypomania) is like putting our mind into overdrive for as long as we are escalated. Sooner or later, that cycle will end. The Bipolar mind typically snaps back hard into Depression because it has been in such a severe state of overdrive for the duration of that cycle.

How severe is it? Typically, it will be a far worse and deeper depression than we normally experience. In my case specifically, I go from being reasonably intelligent to not being able to do basic math in my head. The thoughts just aren’t there. I never drive in a post-escalation crash period because my mind won’t connect thoughts and actions. As an example…

My mind crashed out of an escalated cycle while driving once. I was escalated one minute and cratered into severe depression the next. I almost ended up rear-ending someone because my brain ceased to do what it is supposed to do. Consider the process required for braking.

1. The person ahead applies brakes and their brake lights come on.

2. Your brain sees the brake lights.

3. Your brain associates the brake lights of the car ahead with a need to stop.

4. Your brain sends the signal to your legs to apply the brake pedal.

That all happens in the span of a second or two. It’s just habit for people that drive on a regular basis.

Now consider what might happen if you insert 3-15 seconds of brain lag between each of those steps with no guarantee that your brain will connect the dots properly. Consider what might happen if your brain doesn’t pull the correct information about the scenario. “What are those lights for?” “I can’t remember which one is the brake pedal!” “That car is slowing down! What do I do?!”

The Difference Between a Crash and a Depressive Cycle

I want to preface this section by noting that this is heavily opinion and theory based on my interpretation of facts. Take it with a grain of salt.

I’ve met many people who feel that this deep crash is another type of cycle. I don’t believe this to be the case and there’s no real support for that belief, that I know of, other than the person having Bipolar Disorder and the low being depression. I don’t believe it to be a cycle of its own because it is often temporary. In most of the examples I’ve seen in myself and in the several people with Bipolar Disorder I interact with on a regular basis, it’s not unusual for the person to crash hard and then float back to their normal.

The crash is just different. It just feels and functions different than what my depression normally gives me. And it does the same thing in numerous other Bipolar people that I’ve been around. It can be frightening and intimidating, which is made worse by the depression, because we’re not used to it.

The other problem is that people who have been dealing with this for a long time often get used to how Bipolar Disorder affects them. “Well, my depression has done this for 30 years. Why would it change now?” It changes because Bipolar Disorder often gets worse with age, so it changes the way things can happen in your brain in addition to whatever other influences are at work such as stress, medication, general life situations, and more.

So, if you haven’t ever experienced it before and you suddenly are, it’s not unusual.

How do we deal with it?

As always, talk to your mental health professionals first and foremost. Communicate with them about what is going on, particularly if it persists for longer than a few weeks. In my personal experience and with other Bipolar people I’ve been around, it usually doesn’t take longer than 2 or 3 weeks to recover. If it takes longer than that, it’s very likely that a medication may need adjusted or added.

The “natural control” crowd often doesn’t want to hear that, particularly if they are in the camp of Bipolar people who aren’t so severe that they can manage with very little medical oversight. But the fallout from this type of cycle can be far, far more severe than what natural management practices can handle.

First, I would recommend revisiting the way that you look at a dominant escalated cycle. A lot of people look at it like this…


When really it looks more like this…


We need to account for he possibility of that extremely deep crash. We need to have a strategy for dealing with that as well.

Rest is an important part of recovery, in my personal experience and with many of the people I interact with on a regular basis.  A lot of times I’ll sleep 12-16 hours a day for about a week after I crash and then my brain will rebalance.

Sometimes, patience is the only way you can handle these things.

But, as previously mentioned, involve your mental health professionals as much as possible so they can look at your situation specifically. If it’s lasting more than a couple weeks, we may need a medication adjustment to pull us back towards our normal baseline.

A Theory About Post-Crash Depression and Suicide

Again, pointing out that this is just a theory based on my interpretation of facts and I have no way to substantiate it. I strongly suspect that a post-manic crash is when a majority of suicide attempts driven by Bipolar Disorder occur.

Consider the following.

Ben is well and balanced for years. His body becomes acclimated to the medication and he triggers into a manic cycle that he doesn’t identify because he doesn’t realize that medication efficiency doesn’t last forever. He goes from loving husband and father to manic monster over the course of a couple weeks, unloading verbal and emotional abuse on his family until he finally decides that his family is the source of all of his misery and walks out.

He quits his career, something he went to college for, to pursue his “lifelong dream” of being a rock star even though he hasn’t picked up an instrument in 20 years, shacks up with some random woman he met, files for a divorce, and tears his life to pieces as his brain is screaming through mania.

About a year later, the manic cycle comes screeching to a halt. Ben crashes hard into depression. His mind is no longer plagued by the delusional emotions and thoughts of mania. The love for his family is back, in full force, with the knowledge of what he did to them. Everything he’s built in his career is in shambles. None of the emotions he had for this random woman are present anymore. She becomes collateral damage in the cycle because Ben probably related his delusional thoughts and feelings about his family to her. And many people in her position are convinced by the “passion” and emotional instability a person like Ben is projecting; when in reality he’s just projecting manic delusion.

And he’s in the process of being divorced from the woman he wanted to spend his life with.

On top of all of that, now he has a severe, deep depression which is an entirely new experience; a depression that he is not used to navigating. And Bipolar Disorder, Bipolar-depression, is whispering in his mind on a nearly constant basis about how badly he fucked up. Delusional, incorrect thoughts and feelings plague his mind while he is drowning in the depression with all of the lies it likes to tell us. “It’s hopeless, it’s pointless. You’ve lost everything. You’ll never be able to fix this.”

What’s left for Ben? He’s burned the bridges to the people he cares about. Hopefully, he would reach out to an emergency service or his doctor. But I’m certain plenty of people do not. I think that this time period, when a Bipolar person swaps from the “invincibility” of mania to the most fragile emotional state we will ever experience, is the most likely time that we will decide we’re done with this ride.

What can we do about it?

The only solution I can think of is to plant a seed that will hopefully blossom after they crash. I would say something to the effect of, “If ever there comes a time when you realize how awful you’ve been acting, please reach out to me so we can get you help.” And that may be a real hard thing to do with someone whose brain is screaming through insanity with all of the chaos and misery that goes along with it. Hopefully, they will remember that when their brain finally crashes out and know that they can reach out instead of seeing suicide as the only option left.

That does not mean you make them promises or welcome them back with open arms or anything. Every situation is different. Every person has limits on what they are able to deal with. But, many of the people that are faced with this decision are sons, daughters, mothers, fathers, spouses; and so on. It could be the difference between just a serious life change versus needing to explain to the kids why their parent is gone. And if they do reach out, get them in touch with an organization that can help at-risk, in-crisis people that serves your area. In the United States that would be the National Suicide Crisis LifeLine 800-273-TALK (8255) and their site also has a chat contact option, which may be good for some.

How will I know if a toxic person is just trying to manipulate me?

Given that most of the people dealing with this will know the Bipolar person very well personally, you’ll know. It’s a night and day difference. Just pay attention to ensure they are acting on trying to get help. Don’t promise that they can come home or that there won’t be repercussions. Don’t promise to forgive and definitely don’t forget. Just focus on getting that person in contact with people that can help them.

And finally…

I want to take a final moment to point out that this article specifically points at a dominant escalated cycle and the subsequent ending of it, not general instability or Rapid Cycling. I’ve known Bipolar people who never really had extremely deep lows and highs. This information may not be 100% applicable to each of us specifically. Nothing is when you’re dealing with mental illness. If you’re in doubt, talk to your mental health professional. If this resonates with you, feel free to let your professional read this, get their thoughts on it, and develop a strategy for dealing with it that makes sense for YOU.


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A Book Review of Guide to Natural Mental Health: Anxiety, Bipolar, Depression, Schizophrenia, and Digital Addiction: Nutrition, and Complementary Therapies

As you may or may not know, I don’t do many review posts. The primary reason is that my website, my e-books, my work is designed to help people elevate and help themselves with realistic, actionable information. Most memoirs don’t do that. Most “alternative” anything books are poorly written or are fantasy. I don’t engage in the practice of trading reviews or promotion. Building trust with you, the reader, is a very important facet of what I’m trying to accomplish.

With that in mind, I was recently contacted by author William Jiang, MLS. William served as a Columbia University/New York State Psychiatry Institute Medical Library Chief for 7 years. He is the author of Guide to Natural Mental Health: Anxiety, Bipolar, Depression, Schizophrenia, and Digital Addiction: Nutrition, and Complementary Therapies. He is also waging a personal battle against Schizophrenia.

In the interest of disclosure, William did read one of my books and positively reviewed it before I read his. I made clear to William that I didn’t do any kind of positive for positive exchanges; that I would read his book and provide an honest review of it. Regardless of his actions, I would still be writing this blog post and review because I believe William created a fantastic resource that will be very beneficial to anyone who is interested in complementary means of better managing mental illness.

The Basic Gist of a Guide to Natural Mental Health: Anxiety, Bipolar, Depression, Schizophrenia, and Digital Addiction: Nutrition, and Complementary Therapies

The internet is absolutely flooded with garbage, misrepresented information on the treatment and management of mental illness. People regularly speak about subjects that they should not without any consideration to the consequences for the people reading them. William’s background appears to be that of a researcher and his book reflects that.

William describes this book as (paraphrased), “an annotated bibliography that picks from the “best” information from medical literature, including commentary, as well as the source, title, and abstract of the article from MEDLINE.” MEDLINE is a compilation of abstracts and citations regarding medical research.

So, what the hell does that mean in layman’s terms? You know how you can find information all over the internet about things like Omega-3 being good to combat depression, yoga and physical activity being helpful at reducing the severity of mental illness symptoms, and parasites in cat feces contributing to mental illness? William’s book is a collection of these complementary ideas with excerpts from the medical studies that help establish them as fact.

That is invaluable information to have. It is a helpful, compiled collection of realistic information that does not make false promises or aggrandize these concepts as THE SOLUTION. They are presented as neutral points of information that may or may not be beneficial as a pillar in your wellness plans and efforts.

How Should You Use a Guide to Natural Mental Health: Anxiety, Bipolar, Depression, Schizophrenia, and Digital Addiction: Nutrition, and Complementary Therapies?

William organized this book by subcategories. His words are italicized to differentiate it from the excerpts. Many important points are bolded to call attention to them.

Since this book does contain excerpts from studies, written by researchers and medical professionals, many people are going to have a hard time figuring out exactly what they are talking about in the excerpts. That’s okay though! Don’t be put off by the medical terminology. While informative and interesting, the actual text is not as important to a mental health consumer. What is important is that each of these points comes from accredited, verified resources where money, time, and energy was invested into analyzing them.

If you don’t understand the actual excerpts from the research, don’t worry about it. Gloss past it and keep reading; but do make sure to critically read bolded and italicized text. It’s okay if you don’t “understand.” People dedicate decades of their lives to understanding this stuff. It’s not reasonable to think that you will after reading a book or two.

How Should I Use the Information Presented Therein?

There’s a lot of good, complementary practices presented in this book. If any resonate with you that you want to try, the first step is to discuss the practice with your prescribing mental health professional. That way they can discuss it with you and identify any potential problems it might cause with your current treatment. I would also recommend making a call to your pharmacist to double check on potential interactions. Any discrepancy should be worked out with your professionals to ensure you don’t accidentally destabilize yourself. Do not just do whatever without talking to your mental health professional first.

About the Value of the Book

Guide to Natural Mental Health: Anxiety, Bipolar, Depression, Schizophrenia, and Digital Addiction: Nutrition, and Complementary Therapies is listed on Amazon, at the time of this writing, for $9.99 for the e-Book and $35.00 for the paperback. It’s about 130ish pages of quality information.

I know a lot of you are going to balk at the paperback price for William’s book. I know I did. What you need to bear in mind is that the knowledge needed to build this kind of resource is the result of years of education, experience, time, effort, and research. That is why textbooks and books like this do tend to run on the expensive side. Having read this book, I would spend $35.00 on it for a paperback if I had the $35.00 to spend on it.

The information is not only worthwhile, but it is worthwhile to me to support authors like William who are creating meaningful work for our mutual benefit. That being said, you’re going to know what you’re comfortable with spending on this work. Either way, I highly recommend adding Guide to Natural Mental Health: Anxiety, Bipolar, Depression, Schizophrenia, and Digital Addiction: Nutrition, and Complementary Therapies to your library. You can also find William on his website at

And remember, a lot of people don’t know that you don’t need to own a Kindle to read e-books off of Amazon. Just look up “Kindle Reader” on Play Store, Apple Store, or Google. Amazon offers a free reader so you can read your e-books on other devices if you would like to go that route.

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Bipolar Disorder and the Complicated Nature of Management

Misconceptions about the treatment and management of mental illness stem from incorrectly associating it with traditional treatments. That causes mentally ill people and their supporters to draw poor conclusions on how treatment will progress and what benefits management can provide.

As an example, consider a headache. You can down a couple over-the-counter pain relievers and it’s normally gone within a half hour. It’s pretty consistent for most people. Psychiatric medication, on the other hand, can be very random in the benefits it provides because it is dealing with a much more complicated problem.

A majority of mentally ill people that take psychiatric medication will not have a “perfect” experience with it. It may include side effects that are difficult to manage. It may make the person too numb to function or unable to think, essentially mirroring the effects of severe depression. It may only control a limited number of symptoms or not have as powerful an affect as needed. There are so many factors that influence how well psychiatric medication works that it’s just not possible to know ahead of time what exactly it will do from person to person. Brain and body chemistry are incredibly complicated.

Just swallowing the pills doesn’t mean they are going to fix everything or even eliminate it completely. Effective mood disorder management usually includes several other facets, like reducing stress, changing diet, giving up other chemical substances, exercise, and a consistent sleep schedule. And even after all of that, the person can still have bad reactions to certain situations and triggers.

Balance is an important choice as well. Some of us choose to stay on medications that provide a great deal of benefit with minimal side effects rather than pushing for an ideal solution that may bring more severe side effects with it. Why? Because there is no guarantee that we will ever reach that ideal place with our medication.

It’s all trade offs. Are these side effects worth the benefits I’m receiving? Should I keep pushing for something better or settle for how I feel now?

Mental health wellness can be a very messy affair. Even when taking medication, the person may still experiences symptoms of their mental illness that can be disruptive to their life. It’s rarely as simple as just taking a pill.

It’s important to maintain reasonable expectations. We, as mentally ill people, cannot just assume that our mental state and the damage resulting from it is going to be fixed with medication cocktail. Supporters and loved ones of mentally ill people need to understand that wellness is a marathon, not a sprint. It’s a long-term endeavor in which there can be many obstacles and bumps in the road.

There are times when the only choice you have is to ride out mental unwellness, whether you’re on medication or not. And for a supporter, that may mean needing to have a bit more patience as the waters calm in the mind of their mentally ill loved one, even if they are taking medication.

Sometimes all you can do is have patience.


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Updating My Bipolar Manifesto Blog

Just a short note, don’t be concerned with changes you’re seeing in my blog. I’m working on getting a better mobile experience set up for visitors as well as streamlining some things I view as inefficiencies.

Thank you for your patience!

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5 Universal Qualities of Bipolar Disorder Recovery

I’ve always enjoyed troubleshooting and trying to find solutions to problems. I find it to not only be fun, but a great exercise for the mind. Well, finding a solution to help with Bipolar Disorder and Depression is far less fun, but it is a worthwhile endeavor. That is why I’m presenting to you five qualities that I feel are essential building blocks of Bipolar wellness. Every mentally ill person I know of that attains a high degree of functionality and long-term recovery possesses these five qualities.


The people I interact with regularly tell me how important my lived experience and wisdom gained is. I often counter this point with the importance of book learned knowledge. You see, mental illness is mostly a giant gray area. It is very easy to confuse one mental illness for another in the course of trying to be correctly diagnosed. And frankly, that’s not necessarily the fault of medical professionals. It is often the result of the consumer not understanding that certain facets of their personality are bad or symptoms.

Personal knowledge is important because it helps a Bipolar person separate themselves from their mental illness. Once you understand what is the real you and what is the mental illness, it makes it much easier to spot when medication isn’t working, unwell cycles, or destructive actions.


The other side of the Knowledge coin is Understanding. Understanding relates more to the wisdom of knowing how to apply the knowledge that a person has. There is a universe of information on mental illness out there; and only a fraction of it will actually apply to each of us individually. We must reflect and understand how our mental illness applies to each of us, specifically.

Question 100 Bipolar people and you will come up with a 100 different examples of the manifestations and beliefs about the mental illness. We each must figure out how our diagnosis applies to us. A therapist is very helpful for this process.


All of the knowledge in the world doesn’t mean much if a person can’t meaningfully communicate what is going on in their mind. I’ve known quite a few mentally ill people who could not make the most of their professional appointments because they would lie or misrepresent the truth. That does absolutely no good. The only people that get hurt in that scenario are the consumer and their family members.

Meaningful communication between consumer and professional, consumer and supporters is necessary to find and maintain wellness. If you have a hard time saying certain things, write it down and hand it over that way! I did this a lot when I was still struggling with my instability and mind.


Trust, but verify should be the mantra of everyone in life, really. The mind and mental health are complicated, vast subject with a lot of room for interpretation. Many people view the DSM as a “Bible” of mental illness; and when it comes to symptoms it may very well be. But, it doesn’t exactly add any kind of personal perspective or understanding in how behaviors are interpreted.

That means that mental health professionals can make mistakes if they make a bad judgment call on what they’re seeing, if they are assuming previous experience will be the same as the present experience, or if they simply aren’t that knowledgeable on a subject. No one can or should be expected to know everything. It’s just not possible.

So always; trust, but verify.


No one recovers from mental illness without Desire. Period. Mental wellness is a marathon, not a sprint. Each of us must find the Desire to want to be better, to do all of the tedious garbage work that goes along with being mentally well. Sooner or later, things are going to go bad. Medication stops working. Motivation is hard to find. Depression can come in and derail the progress we’re trying to make.

Desire may not be able to carry us through the overwhelming nature of Depression, but it can help us get back to our feet when the burden becomes to heavy to shoulder. A person must find their desire, find their passion, wherever they can get it, in a way that makes sense to each and every one of us.

Find a way to build on these five qualities. It will make your journey in life and towards wellness much easier.


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Are Unexpected Side Effects Derailing Your Bipolar Wellness?

Periodically, I will present information from accredited, professional sources to help you further your understanding of managing Bipolar Disorder. I would like to once again state, like I do all over my website, blog, and email signature, that I am not a mental health professional of any kind. The information I present is to enable you to identify problems and know which questions to ask your mental health professional. Take everything you read on the internet with a heavy dose of salt, including my work.

I will point out that I purposefully cited links that point to information provided by organizations that would be viewed as viable resources, not just random internet garbage.

Unexpected Side Effects

That being said, we need to talk a bit about the introduction of new substances in our bodies and the potential side effects. You see, there are quite a few substances that can cause unintended reactions that impact the effectiveness of medication. Sometimes, they are things that you wouldn’t expect.

Let’s look at a relatively innocuous substance. This Consumer Update from the FDA points out the potential for grapefruit juice to have an affect on the absorption rates and efficiency of several different drugs, including the anti-anxiety medication BuSpar (buspirone). Ideally, your doctor or pharmacist would warn you that adding grapefruit to your diet may not be a good idea.

But what if they don’t? As much knowledge as these folks need to retain, some things are going to slip through the cracks. No one is perfect. People in these positions are held to an impossible standard to not ever make a mistake or risk getting sued.

But mistakes will happen and important points can slip through.

How many Bipolar people out there enjoy Green Tea? How many of those people know that Green Tea has been linked to the reduction of lithium levels in the blood stream? Lithium is an incredibly common mood stabilizer that’s been in use for over fifty years. I would venture to guess that there is a decent overlap. A reduction in lithium levels in a Bipolar person gives the antidepressant room to push the person into escalation.

Another unlikely culprit is varenicline, otherwise known as Chantix. Chantix is a prescription medication that is meant to help people stop smoking.

Chantix has been found to have antidepressant-like affects in testing. It has also been found to increase activity in certain classes of antidepressants. Chantix is reported to have side effects that included suicidal ideation, aggression, and delusion.

Let’s consider a hypothetical. Let’s say there is a Bipolar person who visits their professionals regularly, takes their medication as directed, and has their life relatively well put together. The medication regimen they are on is in balance with a mood stabilizer and antidepressant.

The person talks to their primary care physician (PCP) about quitting smoking and wants to try Chantix, not knowing that it can drastically alter or have antidepressant-like affects in their body. The PCP overlooks the potential interaction. The patient never bothers to relay that they are starting Chantix to their prescribing psych doctor because they don’t think it’s important.

Many PCPs choose to not deal with serious mental illness treatment because it is a specialized knowledge. There’s no reason to assume that the PCP would necessarily know about the interaction. The psych probably would, if they were aware that Chantix was being prescribed. That essentially leaves the pharmacy as a final safety net. We simply can’t assume that they would catch it. Hopefully, they would, but we can’t count on it.

What can potentially happen if the mood stabilizer is not strong enough to counter the amplified or altered affects of the Chantix? Well, what happens when an antidepressant is put into a Bipolar person without a strong enough mood stabilizer? The Bipolar person will likely launch into an extreme hypomanic or manic cycle. Quite often, a cycle driven by incorrect medication or a third party substance can drive a Bipolar person’s mind to extremes they don’t usually experience.

Consider the following analogy.

You have a scale. On one side is the mood stabilizer, on the other is an antidepressant. Traditional Bipolar medication strategy would weight down the mood stabilizer side until the upper end of Bipolar Disorder is under control. Then, weight is gradually added to the antidepressant side in the form of gradually increasing dosages until both sides are in balance, in a therapeutic range, and all symptoms are under control. Once both sides are in balance, the Bipolar person’s mental state would stay in a healthy, functional range.

Adding Chantix could be like doubling the weight on the antidepressant side, throwing the balance completely out of whack, and force a Bipolar person’s mind into a severe manic cycle. Being on lithium and drinking Green Tea could gradually remove weight from the mood stabilizer side until the balance is upset and an unwell cycle is imminent.

Intercepting Potential Problems

How can we actually tell when this is going on? Delusion can play a significant role in keeping us from seeing the truth. The mental illness can tell us that the people we normally trust are actively working against us or lying.

First, we must stay aware of what is going on in our mind and body. Any time I am going to put anything new in my body, I consult with my prescribing doctor or pharmacist to ensure that it is not going to have a negative affect. Optimally, I’ll talk to both before actually doing it. That way if one overlooks it, there is a chance that the second may help me catch it.

Second, we must listen to the people that we normally trust. An unchecked Bipolar cycle can easily alienate us from the people that we care about. We must always be suspicious of any unexplained changes in our mentality until we can confirm that it is not an unwell cycle.

I believe it is vital to occasionally look back and compare. How am I doing today versus how I was doing three months ago? Six months ago? Am I more depressed? Am I feeling fine? Am I feeling invincible? What about my loved ones? Are they expressing anything different? Is my support network telling me that something might be off that I can compare to the last time I knew I was feeling okay?

Whether it’s your parents, girlfriend, boyfriend, siblings, spouse or whoever it is you trust; you need to listen to them and try to hear them if they tell you something is wrong. Because if you changed something about what you put in your body and miss an unwell cycle, it can be really hard to see when you’re the one experiencing it. Listen to the people you trust.

The Takeaway

I know I’ve covered a lot of ground here, so let me tie this together into a couple thoughts that you can take with you and use.

You never know how a new substance you put into your body may affect you. It could cause extreme unwellness because of some obscure detail that you or your professional does not necessarily know.

The easiest way to identify this kind of occurrence is to monitor what your mind is doing whenever you add anything into your body until you can confirm that nothing weird is going on. Once you’ve confirmed that, you can move forward.

Listen to the people that you normally trust. The Disorder can tell you a lot of things that aren’t true. It can convince you that everyone else is the problem. But if you have multiple people that you normally trust telling you something is off, it’s a good idea to really try and look objectively at the situation to see if there is any real merit to what is being said.

And finally, talk to your medical professionals. If you get even the faintest glimpse that something might be wrong, do not be shy about bringing it up. Details are very important in the management of Bipolar Disorder and other mental illnesses.


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About Doubt and Mood Disorder Management

In my last blog post, I discussed some future plans I had for wanting to push my body of advocacy work to a new level. The type of feedback I received on that post could be neatly fit into two categories; encouragement and “are you manic?” On the first point, I appreciate the kind words and encouragement that many people gave me.

On the second point, I’m a Type 2 Bipolar. I don’t experience mania, I experience hypomania. I realize that most people use the two interchangeably, but they are different things. Mania requires psychosis. Hypomania does not. Technically, I’m not manic. Also technically, I’m not hypomanic either.

How do I know that? Doubt and self-doubt.

Understanding the way unwellness manifests gives us a great tool for identifying when Bipolar Disorder or Depression is trying to drive our thought processes. In my case, hypomania brings with it arrogance, impatience, and anger. The thought that I could be making a bad decision never crosses my mind because Bipolar Disorder just shoves my brain ahead at 1000 miles an hour without any consideration for consequences.

The ideas and thoughts I shared on pushing towards forming a venture of my own are not an overnight creation. It’s something I’ve been thinking about for the past two years, off and on. The list of doubts and cons is about the same length as the list of ideas and pros.

That is a good thing, because it heavily infers that I’m not now or have been escalated. A major decision like that is an almost guaranteed unwell cycle trigger. That doesn’t mean that I will or have triggered, it’s just that the potential is there. Anything that can bring major stress or incite passionate emotion should be counted as a potential trigger. That means increasing the amount of self-assessment that I would normally do to ensure that I pick up on any shift towards unwellness before it becomes a major problem.

Awareness gives me the power to unwind the unwell cycle before it really gets going. My methods of management are derived from personal reflection and strategy learned through Cognitive Behavioral Therapy.

These points are something that anyone can learn to be aware of. It may sound exhausting to need to think about mental state on a daily basis, but it really is the best way to keep a firm grasp on potential unwellness. Though it is kind of annoying at the start, regular practice and effort turned it into a thing that I just do without actively thinking about it.

That leads me to one of the more common misconceptions about Bipolar Disorder. Just because we’re not unwell at the moment does not mean that Bipolar Disorder is not lurking, waiting. An unwell cycle can trigger from anything and come out of nowhere.

The only way to head those unwell cycles off is to treat Bipolar Disorder like it is a companion that is always walking beside us: not behind us, not sitting at home on the couch, not as that thing in our past. Even when we’re medicated we need to keep a close eye on it to make sure it does not run ahead and away.

Even though my doubts have been strong, I view them as a good thing. Doubt means I’m sane and balanced. Doubt means I’m thinking critically of my choices. Doubt means I’m still in control of the Disorder, it is not in control of me.


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On Anger and Future Plans

This is pretty much just going to be an update post on the direction I’ve been contemplating for myself and body of work.

It’s coming up on the four years anniversary since I launched my website and began my advocacy work. Every year, around this time, I contemplate the past year and how I want to advance my missions in the coming year. I used year too many times in that sentence, but screw it I’m leaving it.

The first point is a slight change in the way I deliver my message. The only real critical criticism I’ve ever received on my body of work is my casual swearing. I opted to preserve that tone of speech in the hopes of breaking through to other people like me who are turned off by the sterile nature of a lot of mental health material. I felt that preserving my authentic language of anger and frustration would help others who are of similar mentality to identify and hopefully take action.

I’ve finally decided to change that, except when I’m writing examples of unwellness. I feel it is super important to preserve the tone and feeling of what unwellness cycles can look like, because they can be very brutal.

Simply put, I feel the decision is hurting more than helping. While I, personally, think the idea of bad words is stupid and ridiculous. My opinion isn’t the one that really matters here. Writers and other artists often push the importance of staying true to your own voice of expression. My voice of expression isn’t what’s important to me. What’s important to me is reaching people and ensuring they are receiving quality, actionable information. If that takes a hard approach, that’s what I use. If it takes a soft approach, that’s what I use.

It really doesn’t matter to me either way because my work isn’t really about what I need to express about myself. I don’t NEED to express any of this really. I’m expressing it solely for the benefit of other people. But I’ve come to find that there are several regular or high-functioning people who just see it as a demonstration of undirected anger and instability. I’m not either of those things, but that really doesn’t mean squat if that’s how I’m being perceived.

It would be really stupid for me to hamstring my efforts just because I feel like that particular social standard is idiotic. (So, you were half-right, mom. Half a point to you on this issue.) I mean, it’s not exceptionally hard to make “good” words bite the same way. You just have to know your audience and which buttons to push. But, I feel like I’m never going to push to the next tier of scope unless I do it in a more socially acceptable way.

The next announcement is a change in how I do what I do. I have decided to pursue the angle of establishing a one man limited liability corporation, branding myself as a “Bipolar Coach”, and pushing towards a profitable model that will allow me to turn this passion into my career and discontinue the need for donations. This seems to be the best path for legal, personal, and profit driven reasons.

It’s been challenging trying to find a model that will work for me. I’ve read hundreds of page on Coaching models in the past six months and none of them really fit what I do and want to accomplish. I believe I will be creating some form of priority-based model. I am still clinging very tightly to a promise I made myself when I first started writing my Bipolar Manifesto.

That promise was to ensure that anyone, regardless of economic situation or belief, could have equal access to quality, actionable information to better understand and deal with their mental illness.

This is a contributing reason to why I utilize Amazon for distribution of my ebooks. Amazon allows me to offer them for free, periodically. And it’s the reason I’m heavily considering a priority-driven model.

So, what do I mean by priority? Well, A LOT of people send me emails and leave me blog comments. As anyone that has ever written to me will know, I make it a point to write meaningful answers to each and every one that does. That takes a fair amount of time.

At this point, when I take a day off from it I fall behind. A priority-driven model will simply allow me to slide the people who are willing to pay for my services to the front, rather than just saying “Oh, you can’t pay? Well, bye.” I’ve been regularly told that my service was well worth paying for; so I think this will let me whether or not that is true and still help people of very limited resources.

The other challenge is finding an appropriate price point. I looked at several other life coach-type service providers to see what they did. There is absolutely zero chance that I am going to charge people $50 for an email, $150 for a 30 minute phone consultation, or $400+ dollars for a monthly retainer. My target demographic are not primarily businesses and people with tons of disposable income.

My target demographic are regular people dealing with difficult circumstances; many of whom have very limited resources. I can’t imagine asking for more than a $100 a month retainer for unlimited emails and a Skype conversation.

Frankly, I didn’t even like a majority of the life coaches I looked at. “Unlock your inner potential!” “Attain spiritual peace!” “Heal your mental pains!” With their fake, plastic marketing-friendly smiles. (You can insert some expletives here, from me, if you’d like.) You know, this should really tell you something – doing marketing work has jaded me more than being mentally ill has. What’s up with that?


A further addition that will soon be coming to my website is a t-shirt shop that I intend to populate with funny and inspirational shirts. That will hopefully bring in a few additional dollars on top of services provided and ebook sales.

That provides another unique problem. When you think, “t-shirt from a business” you usually expect it to be branded with that business’s logo and be a marketing vehicle. I can’t do that with my offering because branding “Bipolar” on them could most certainly prevent people from buying them or causing customers uncomfortable conversations that they don’t want to have with relative strangers; or strange relatives, as the case may be.

I will offer a few, I think. And some awareness oriented shirts. But by and large, I can’t see actually branding them in a traditional way being good for my customers and followers.

Anyway. It’s been a couple of years since I’ve actually done a focused fund drive. I believe I will be running a GoFundMe campaign within the next couple of weeks to defray some of the costs associated with the direction I want to take my work. I hope you will consider contributing if it is within your means.

Thank you all for your support and for reading my work. I’m excited for this new direction and hope it will provide me the means, resources, and time to help more people understand, cope with, and overcome mental illness.

I know there are many people out there from a lot of different backgrounds and professions; so if you have any thoughts or suggestions, please feel free to drop me a comment or message.


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Should We Be Concerned with the Label, Bipolar Disorder?

Labels, labels, labels. There is an unending narrative on how bad labels are. We shouldn’t label people, we shouldn’t be judgmental. We should just accept people how they are.

Contrary to that opinion, labels are pretty important, especially when it comes to identifying, treating, and recovering from mental illness.

The most common example I can cite is the misdiagnosis of Bipolar Disorder as Major Depression. The distinction between these labels is vitally important. Why? Because if a doctor treats a Bipolar person as though they had Major Depression, there is a strong chance that person’s brain is going to run screaming into instability and chaos. How can people know which is which? By looking at the label and analyzing the behaviors of the person in question.

Time and again, I hear people scream about how the DSM is awful because it tries to categorize mental illness. “I’m not my mental illness!” “I can’t be defined by a book!” This narrative misses the point. It’s so medical science is on the same page in how they are working towards treatment.

“But these labels are used for people to point the finger and look down on us!” So? If it wasn’t your mental health; it would be your sex, religion, race, economic background, or political background. I don’t know when the last time you cracked a history book was; but humanity has always found reasons to hate and look down on one another. The idea that we can all get along, all be accepted, is ridiculous. There are literally tens of thousands of years of precedence that demonstrate this.

The world can’t be changed because it does not want to be changed. This is why we celebrate great and kind thinkers. This is why we quote Gandhi, Dr. King, Mother Teresa, and other humanitarians. They stand out because they are a light in the bleak sea that is humanity.

What we can do is change the way we view others and relate to ourselves. It’s not the label that is trying to do harm to another person when used in anger. It’s the person using it. Forcing people to stop using a word we don’t like does nothing to address the actual problem of the person using it.

I can’t tell you how many times I’ve been told by other Bipolar people that I shouldn’t say “I am Bipolar.” Even though “am” includes the definition of “having the quality of,” as in having the quality of Bipolar Disorder. These people are often struggling to find their own identity, to separate themselves from their mental illness. Quite often, they have life experiences where those words were used as weapons against them. They think they are helping to end stigma by trying to alter the words people use. And more than a couple of them expressed I would feel better about myself if I did.

The assumption is that because I use a phrase, I must not feel good about myself. That isn’t about me. I know they are transposing their own journey, suffering, and pain on to me. I think they normally have good, if not misguided intentions.

I’m at peace with myself because I understand myself. I don’t have the internal conflicts that racked up massive casualties in my mind like I used to. I understand Bipolar Disorder. I understand how my mental illness affects me. I know how to respond to the problems it gives me. And I use my pain for something positive, which makes it worthwhile in my eyes.

So, no. We are not our mental illness. Our mental illness is just one facet of who we are. Putting the responsibility of our own happiness and peace of mind on everyone else is a sure recipe for failure. That’s a lot of responsibility to put on someone else.

The final thing I would like to point is that the waters are typically gray and murky around these labels. Many of the loved ones of the mentally ill that reach out to me believe that they can look at the label for a mental illness and understand how that person functions.

Sort of, but not really. Essentially, it can serve as a rule of thumb for what the person could possibly experience; but the way it comes through is going to entirely depend on the mentally ill person. It’s a circumstance where things look one way on paper but function differently in practice.

As an example. The difference between Type 1 and Type 2 Bipolar Disorder is psychosis. I identify as a Type 2 Bipolar because 99% of my unwellness and unwell cycles have not included psychosis. However, the time immediately after the Disorder started emerging in me and the time that actually prompted me to get screened for mental illness would have fit Type 1 psychosis criteria.

Similarly, I had a full-blown anxiety attack while I was coming down with the stomach bug I recently got over. I’ve had about 3 full-blown anxiety attacks in the past 20 years. Would that qualify as an anxiety disorder? No. It’s not really affecting me enough to warrant the need for medication or therapy to cope with it. Anxiety attacks are an anomaly for me.

I regularly see people put more importance on Type than is warranted. It’s not really that important because the DSM is mostly a general guideline to get a medical professional in the ballpark. Medication and treatment addresses the symptoms of mental illness that are out of control in an individual.

Let me give you an example.

The first is myself. I’m a Type 2 Bipolar with a severe Depression component. I spend probably 80% of my time in some form of depression – mild to severe. A mood stabilizer to cap the top end and an antidepressant to bring up the bottom end is a typical treatment.

On the other hand, I have a friend who is also a Type 2. But the way that person’s Disorder manifests is that they spend 80%+ of their time either fine or mildly escalated. The only time that person really swings into a depression is after a post escalation crash, which happens about once or twice a year. For that person, a mood stabilizer makes sense but an antidepressant may not be necessary.

We both have the same diagnosis but the Disorder functions differently in practice. We both require different treatment regimens to address the problems Bipolar Disorder specifically causes.

This why it is so important that we understand how our diagnosis and mental illness affects us as individuals. We each need to find our own peace with the circumstances we were given and not require others to feel good about ourselves. A lot of fear can be dispelled with knowledge. Each of us should learn everything we can about the Disorder so we can identify how it manifests and meaningfully communicate that to our professionals and loved ones.

As for labels used as weapons – shrug and move on. They only have power if you let them bother you. Responding with anger just feeds the ego of the person using it and gives them control over your emotional state.


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