Mental Illness and Cognitive Dissonance

It’s no secret that the spectrums of mental illness come fraught with confusion, anxiety and fear, whether it be depression, bipolar disorder or schizophrenia. In some cases, the illness is the anxiety and confusion itself – a deep-set emotional displacement that has no reasonable cause behind it. There exists an endless number of factors that influence, weave in and out of, and cause mental illness, and it can take decades of therapy and medication to root out the reasons behind it, never mind help resolve it.

One of the biggest pain points for me – and for many people I know – is that there exists a discrepancy between what they see and what they feel, or between what they believe and what they’re told to believe. It can be as simple as feeling worthless when everyone around you tells you how great you are; it can be as complex as believing that you don’t physically exist, despite being able to touch and feel your own body.

Cognitive Dissonance Theory

The concept of cognitive dissonance dates back over sixty years, when psychologist Leon Festinger proposed that humans need a kind of internal consistency between belief and perception in order to function mentally. The basis of his work came from a phenomenon in the 1930s after a severe earthquake in India. People who felt the earthquake but suffered no damage began to believe that worse disasters were yet to come – not because there was evidence to justify their fear, but because they needed a belief to justify their fear.

This is something that can be seen throughout the world today; perhaps the most obvious example is theology. People believe in the existence of a deity or deities not because there is evidence to make them believe, but rather because the existence of those deities is necessary to support their beliefs.

The thing is, when there is a contradiction between belief and perception – or simply between two beliefs – people will go to extreme lengths to justify both beliefs. Historically, the geocentric model of the solar system is another example. Despite evidence to the contrary (the motion of planets, stars, etc.), astronomers came up with increasingly complex systems to keep the earth at the center of the universe, because it was necessary to support their belief.

Subjective Dissonance

One of the greatest challenges to psychology is the subjectiveness of the field; whilst chemical and behavioral studies can help, and large data sets balance things out for clinical trials, when treating individual patients it can be difficult to isolate a particular illness for the purpose of a diagnosis, simply because the treating psychologist is reliant on the subjective description of the symptoms by the patient. Observationally a person may appear depressed, but internally they may feel content or happy.

This disconnect between objective fact (what a person does or says) and subjective reality (how the person really feels) is often at the heart of many mental illnesses. For myself, a day in bed might be genuine exhaustion from a hard week at work, or perhaps a low-level illness; to my family, who’ve seen me like that frequently, it’s just depression. And of course, the behavior often begets the emotion – the longer I stay in bed, typically the worse I feel.

For someone in the manic phase of bipolar disorder, it can be even worse: to the sufferer, the world is on their side, everything is going amazingly, and nothing can bring them down. To the observer, they are erratic, nonsensical and in some cases outright dangerous.

Belief in Treatment

The key to surviving with mental illness is to get help; to find treatment. It can be in the form of therapy, medication, meditation … all these things are proven to help balance an unbalanced mind. But dissonance can be a challenge here, as well. To start with, it can be difficult to admit you need help – you don’t want to believe you have a problem, despite observable evidence to the contrary. Alcoholics suffer from this; the pile of empty bottles in the garbage simply don’t equate to a drinking problem. They find ways to justify the drinking – even in the most absurd ways – because they don’t believe they have a problem.

On the flip side, someone in the throes of depression may not believe they can be any help – that there is no point seeking treatment, because it won’t make any difference. I’ve suffered this for most of my life.

And then, of course, there’s the behavior changes associated with treatment itself. The classic example is the schizophrenic patient who goes off their medication, because on the medication they feel fine and believe they don’t need medication. Another is when I stop taking my own medications because I’m running low and I don’t want to run out.

Logical Fallacies

To anyone on the outside, this simply doesn’t make sense; it isn’t logical. But logic is the enemy of cognitive dissonance (or perhaps the other way around). In my mind, it all adds up: if I run out of medication I will feel worse; therefore if I stop taking medication, I won’t run out.

My friend at work was talking to me the other day and mentioned a similar experience; he suffers from extreme anxiety, and is on medication to help cope. But once he was on the medication he didn’t feel anxious, and when you don’t feel anxious, you don’t need medication. So he stopped.

These sorts of logical fallacies are the loophole for cognitive dissonance. I can use a kind of “When A is true then B is true; B is true so A must also be true” reasoning to connect the disparity between my thoughts and my perceptions. The subjective truth is that I meed medication to keep a constant chemical balance in my brain, but the objective truth is that I simply feel better.

In the end, cognitive dissonance isn’t going anywhere, and nor is mental illness. But an awareness of this problem can help a lot of people – it certainly helps me – to push through with something that might not immediately make sense, because in the long run it will help. Keep taking the meds, even when you feel fine, because the meds are the reason you feel fine.

And if the problem is that you simply can’t believe in your own worth, use this to look around you. The people who still talk to you, who live with you, who put up with you – they wouldn’t, if they believed what you do. You might not be able to change your belief, but you can change your behavior – and that’s sometimes the first step towards changing yourself.

Changing the Domain Name Here

This blog post is not “mental health” update. Instead, this is an update for The Bipolar Writer Collaborative blog and its writers, readers, and collaborators.

As of today, the domain name for this blog will change to thebipolarwriter.blog

You will still be able to find the blog under jamesedgarskye.com but I eventually that will be moved to a created author site.

Thank you for continuing to use The Bipolar Writer a “safe place” to share your mental health journey.

Always Keep Fighting

James

Photo Credit:

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Subjects to Discuss in September

All that we see or seem is but a dream within a dream. – Edgar Allan Poe

What to Talk About on The Bipolar Writer Blog

I have gotten a lot of positive feedback in the past when asking the followers of my blog what they would like me to discuss, so I am opening up this once again as we head into September. I love this time of year. Outside of the central coast, the leaves change, and it starts to get colder in September.

It is a crossroads of sorts for me. It is usually the last month before my depression worsens. The regular season in baseball is coming to a close at months end, and there is always the hope of the postseason for my favorite team– the Los Angeles Dodgers.

September is a particularly good month because it marks the one year anniversary since I started this blog (I will be publishing an individual blog post to commemorate this big event.) So, if you have something mental health related, and I have an opinion on that subject, drop a comment down below. Let’s have a fantastic September!

Always Keep Fighting

James

P.S. I will be opening up four spots for contributor writers in September to bring the total up to 30. If you are interested, please email me @ jamesedgarskye22@gmail.com

 

Please Donate to Bring The Bipolar Writer to the next level

Photo Credit: Mehdi-Thomas BOUTDARINE

A New Kind of Stigma

My writer’s ink has literally dried up in the last few weeks.  At first it was a “I’m too busy” thing, then it was a “people are helping me access treatment” thing, then it was a “I’m too happy” thing and then, believe it or not, it was a “I am accepted” thing.  And like the things that are peculiar and do everything in the opposite in Cat in the Hat by Dr Seuss, I do not know how to speak or write happy, treatment access, acceptance stuff.  No.  I can write volumes about what is wrong with mental health services, how people are not accessing the life-saving support they need, how discrimination and stigma crush and damage the people who are living with a chronic illness that changes the course of their lives forever.

Yes.  I can describe depression, psychiatric wards and healthworkers who are as sensitive as I am after taking my Serraquel and heading for bed (that’s not very).  And I think I have done that within this very space on The Bipolar Writer.  Amazingly, many of you wrote back and said what can we do, how can we help.  My response a few weeks ago, was that people with mental illness globally should stand up, talk, talk, talk, take action, scream and shout, document and show what’s really happening EVERYWHERE until we see the changes that need to happen.  And we are assured that those changes would be sustained.  I still think that needs to happen.  But my experience – and these niggly things I’ve come across – make me want to add a lot more.

Not only do we need to highlight the darkness, the human rights transgressions and anything that fundamentally affects mental health – we also need to celebrate, and shout loudly about people, organisations, companies, communities that are accepting, that help, that accommodate, that assist people with mental illness.  We need to show that it can be done.  And that the results are awesome where it works.  That we can “function” just as well as our environment allows us to.  No, I don’t believe functioning is on a scale of 1-10 – but rather what is best for a particular person at a particular time, and BUT a lot of that depends on how they’re treated and received.  What they are provided access to.

One example of the acceptance I received was in a job interview.  After a great discussion (which is generally how it goes) I decided after a heave ho in my mind that I needed to disclose that Bipolar lives with me.  For the first time since I was diagnosed a good long decade ago.  That I would only be prepared to work in an environment that was accepting of that.  And that Bipolar wasn’t a matter of running between two poles of sadness and happiness, as I’m built for comfort not for speed (and that would be exhausting).  More seriously, I said that my wellness at work was dependent on the relationship with the employer, and not “special allowances” but rather an understanding of where I am, what I need, and what would contribute to wellness going forward.  That my treatment team could participate (obviously without disclosing anything) in analysing and assessing what contributes and detracts from staying well.  That it was possible.  And even more importantly, that I was so, so, so worth it.  I have never believed that a day in my life.  Never.  Until now.

I don’t know if I got the job yet.  Maybe they were just being nice… I am, based on experience, skeptical.  But they have given me something I could not pay for already.  The belief that that a world where I – and people like me – can be accepted, loved, happy.  What can we do?  What can we change?  Our minds, our behaviour, our reception of people who are vulnerable, of people who need help, no matter what affects or ails them.  And, maybe, just maybe, we can do that with a smile on our faces.  I’m going to.   Be part of those who support us as opposed to those don’t.  I am 4M’s Bipolar Mom.

Olena Sergienko

Thank you! 7,000 Followers!

It is a great feeling to reach another milestone for The Bipolar Writer blog– 7,000 Followers. When I started this blog about eleven months ago, I had no idea where it could go. There were ideas in my head of where this mental health blog could go, but it turned out to be the most fantastic experience. From this blog, I was able to write my memoir and create a collaborative blog that others struggling with mental illness could find a place of solace writing for this blog.

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In honor of this fantastic occasion, I will be opening up more spots on my collaborative writer positions, and giving more access to those current writers already on the roster. If you are interested in becoming a mental health/mental illness collaborator on this blog, please email me @ jamesedgarskye22@gmail.com.

Again thank you!

Always Keep Fighting

James

Photo Credit: Aaron Burden

Voice for the Voices

I have an older brother who is just under a year older than me.  My mother always reassuringly tells me how she felt suicidal when she found out she was pregnant with me when he was that little.  That never mattered to him or I.  He used to come and lay down underneath my cot, tap for my bottle, take a sip, and pass it back.  When we got a little older, “we” levelled up, and he would go and exchange the milk for guava juice.  When we went to pre-school, he boisterously protected me on the playground, sealed my juice bottle after lunch, and dutifully sat me down in my row when the bell had gone.  But that was a very long time ago.

Since then, we’ve both been diagnosed, and tried to live with our mental illness, as best we could.  Sometimes it wasn’t best.  But I think what’s common is that we both didn’t know how.  No-one in my opinion has written a definitive guide on how to deal with scary hallucinations, voices, moods, anxiety, and all that other glorious stuff the mental illness Pandora’s Box throws your way.  Oh yes, and then there’s that practical thing of needing to eat chocolate, cigarettes and food (in that order) which you have to pay for, with a job, with mental illness.  And neither him nor I are able to do that at the moment for very, very different reasons.

He is currently in prison for a crime, well, he so painfully regrets that he cannot sleep, eat or be himself anymore.  I walked into the prison waiting room, and saw him there, saw my little brother with the badly knitted cable jersey my Mom had made, ready to close my juice bottle – and he shouldn’t be in prison.  Not him, not anyone with mental illness.  I asked him a little about the conditions and his eyes glazed over slightly.  What he did tell me was a refined version.  Was a version that I could not stomach, but that he had watered down for me.  I think tried to water down for him.

He has access to a psychiatrist once every three months, a psychologist once a month, and a social worker who monitors his progress (but with a view to discussing whether he is eligible or not for parole).  He has access to medication sometimes.  And that medication makes him sleepy which means that he cannot protect himself at night.  So they take turns to keep watch in the cell and hopefully so thwart some of the impending violence that looms every minute, of every hour, of every day in prison.  They are allowed access to sunshine once a week if at all, and even then it’s for a few hours.  Exercise is walking around the cells for a while, and even then you have to be on alert.   Supper is six slices of dry bread, and if you can get money from outside, you can buy meat (from the Government supply) and hopefully go to the tuckshop.  It’s not guarenteed though that you will actually eventually consume what you buy.

And all this screamed to me that it was not about rehabilitating him,  It was not about promoting his mental health and goodness knows the human rights of any and everyone in that prison.  If people really understood mental illness – I can almost naseously laugh – they would know that we need no other bars, no other punishments, no other deprivations.  In closing, I saw an awesome picture.  It said: “You don’t have to be a voice for the voiceless.  You just have to pass the Mic”.  And I thought Yeah!!  After having seen my brother, understand what he and others go through I’ve changed my mind though.  I’ve got news for you.  Where they are – where I am – where people with mental illness are who are discriminated against and hurt – there is no voice, and there is no mic, there aren’t enough eyes, ears, and hearts that are dedicated to stopping what is happening.  Please help me change that.  Be part of those who support us as opposed to those who don’t.  I am 4 M’s Bipolar Mom.

Bipolar Disorder is Part of My Mental Illness Life but It is Not My Life

A few days ago I wrote a post titled “You Don’t Have Bipolar Disorder” which are the words my new psychiatrist told me after seeing me three times. He also told me I had borderline personality disorder, PTSD and generalized anxiety disorder.

After I was given my bipolar 1 disorder diagnosis 25 years ago, I researched it extensively. I did not want to have a mental illness and especially not bipolar disorder. I tried to fight it every step of the way as long as I could and was in denial far too long. Believe me if there was something I could find to prove to my doctors that I did not have bipolar disorder I would have found it. I couldn’t find anything to disprove my bipolar diagnosis. There was no mistaking it. I had bipolar 1 disorder. After many years I finally accepted my bipolar disorder and then began the long winding road to recovery.

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The anti-depressant Prozac given to me to treat my postpartum depression increased my anxiety triple-fold. I also had symptoms of mania, hypomania, mixed episodes and rapid cycling. I will never know what came first—the chicken or the egg. Did the psychotropic medications cause me to mimic bipolar 1 disorder symptoms or did I always have bipolar? The problem and the answer are the same. It doesn’t matter at this point. It is what it is and it was what it was. The point is that I had bipolar symptoms. I will never know all the answers for sure.

I am happy with my new psychiatrist and welcome his positive comments and new school knowledge. I am not positive if my new P-doc’s diagnosis is correct and it doesn’t really matter right now as I am not taking psychotropic medications. I am over five months psychotropic medication free and am still doing very well. He is monitoring my progress closely and I will stay medication free as long as I am feeling well. I think after taking psychotropic medications for over twenty years and having so many ECT treatments possibly somehow it has transformed my brain positively.

Nothing is cut in stone in the mental health world. There is no scientific proof, x-rays, cat scans or blood work to determine an absolute unfailing diagnosis. When I was given my mental illness diagnoses I was already taking a psychotropic medication that changed my brain chemistry causing severe side effects of increased anxiety, mania and insomnia. Antidepressants can cause bipolar like symptoms. Plus, bipolar disorder and borderline personality disorder have many similar symptoms and characteristics making it more difficult to make an accurate diagnosis.

Unfortunately, Psychiatrists do not have all the answers and sometimes it is a guessing game at best. They do the best they can with what they are given. I don’t have bad feelings for my diagnoses as they occurred. There is nothing I can do about it today. I can’t change the past. I refuse to visit the what ifs. If I did I could put myself at risk for developing depression and that is the last thing I want to happen.

I have lived with mental illness for over 25 years and nothing can change that. Bipolar is only a label to help treat a mental illness. Bipolar is not who I am but it is a part of who I am and will always be. I feel relieved and feel a little lighter without the bipolar diagnosis if it is true. It lightens my load a little but it is only a word—only a label. It does not change my past or who I am.

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Mental illness diagnoses and labels are given and are necessary to help doctors treat patients, improve their mental health and ensure an optimal quality of life. My mental illness diagnoses and labels from the past helped me survive then. Currently, they increase my awareness of possible triggers, help me understand the cause of my symptoms and which symptoms to watch closely for and have taught me how to cope effectively and reach my optimal mental health and life.

Being diagnosed with mental illness does not always mean forever. Maybe it is like cancer in the sense that we go in remission. Maybe it never goes away completely, but the brain can change favorably over time and mental health can improve. Recently, I read an article that said people diagnosed with personality disorder can reduce their symptoms as they age. This improvement can be caused from changes in the brain chemistry and other treatments such as dialectical behavior therapy being effective for personality disorder. As we age we learn better coping strategies and skills that teach us how to overcome obstacles and struggles in our lives. Surviving many different life experiences helps transform brains and gain necessary inner strength. Maybe the same holds true with bipolar disorder as well. We just don’t have all the answers yet.

I believe I had bipolar 1 disorder and may still have it. Maybe my brain chemistry has changed over the years because of the natural aging process, many different psychotropic medications I took for 25 years, ECT treatments and God. All of the above combined and blended well together with my life experiences and brought me to where I am right now.

I write optimistically not because my life is perfect but because my life is perfectly unperfect. Surviving so many struggles helped me turn my wounds and blemishes into beauty marks.

“Look for beauty in the blemishes of life.” ~Susan Walz

“Turn life’s blemishes into beauty marks.” Susan Walz

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Copyright © 2018 Susan Walz | myloudbipolarwhispers.com | All Rights Reserved

Mental Health Detective

Hello Dear Friends and Blogging Community – I am writing this as I am about to undertake – well in the next few days – a DANGEROUS pursuit.  It will be filled with ups and downs.  Highs and lows.  I will need to wait.  I will need to move up a seat or hardwood bench in a too cold room, for far, far too long.  I will confront enemies, perhaps a friend or two, and I may need to come back, again, and again.  And I will feel like giving up.  Feeling like I can’t crawl to the bitter end.   Yes, my dear friends, I am going to go for my mental health treatment in the PUBLIC SECTOR.  I am going to subjecting me and my very fragile self to the primary healthcare system in a country probs with developing country status in any and all mental health related service and I am AFRAID.

Now you might say, what on earth is she going on about?  That’s no problem?  The biggest majority of people with mental illness go through the public health system.  And my answer is NOT BY CHOICE.  I had private healthcare, but I worked my butt off to have it.  And not just for me, but for my children too/   I paid for a psychiatric hospital that had clever lighting, placed quotes etc to not demonstrate that you are like I dunno, hospitalised.  The public health system in my country, is BLATANT about the fact that you are NOT ok, and they WILL openly stigmatise through something as simple as the appointment system.  For example there is “psychiatric day” i.e. the people on  that day, you want to avoid, draw air spirals around your ear in front of the patient to describe to co-workers what they have, mad day.  The other way is putting the mentally ill in the “green sticker” line which ensures “confidentiality”.  For no-one.  Because all the patients who go to the clinic know what the sticker colour means or you will end up getting a good dose of anti-retrovirals for your Bipolar.

I have decided that I will go to to the first appointment armed with things will assist: my mother so she can keep my space in the line (and perhaps people will think I’ve brought her instead of the alternative) while I go and smoke, snacks, a book and cellphone data so I can imaginery bullet journal and get lost in beautiful stationery on psychiatric day.  I will report back on the experience of being in the green sticker line.  And what mental health has been like for people with mental illness in my country who are a lot more in need than me.  And hopefully in so doing, I can make a suggestion or two about the colour they gave us.  I’ve never looked good in green.  Mentally Ill I can do.  Be part of those who support us as opposed to those who don’t.  I am 4 M’s Bipolar Mom.

Journey to a Diagnosis, Part III

Today I will write the final chapter in my Journey to a Diagnosis series.  Find the rest of the story here and here.

When I got home from the inpatient facility my house was empty of children.  My mother in law ended up bringing the kids to her own house for the last half of my stay.  I was grateful to have a little time to adjust to being home before I was thrown back into normal life.  When they finally came home, I felt really out of my element.  The high doses of medication I was on left me feeling less than energetic and “off my game.”

We had some great friends who did some renovations in our townhouse while I was away.  They painted some walls and our kitchen cabinets.  They also bought us a new tv and gave us some really nice furniture.  It was such a lift and helped me feel like I was going home to a fresh start.  I will be forever grateful for their kindness to us during this difficult time.

As glad as I was to be home and to be free of mood swings, I soon became aware of new difficulties that arose due to the medications I was on.  I was taking high doses of Lithium, Tegratol and Geodon.  The side effects were terrible.  I was on so much medication that I felt and behaved like a zombie.  My movements were markedly slow, I had digestive issues, and I felt almost completely devoid of emotion of any kind.  My mom and my closest friend both told me later that they felt like I had lost all of my personality.  It was difficult to talk to me as I never had anything to say.  I would just sit off to the side, my mouth literally hanging open.  I was overly sedated and everyone could tell.

In addition to these unpleasant realities, I was even more sedated at night, which was when I took my medications.  I would fall almost instantly asleep.  My husband found it impossible to wake me.  He just had to wait until I awoke on my own.  This meant he had to wake with our baby at night and couldn’t leave for work or school in the morning until I woke up.  Thankfully, this all worked out alright.  Our baby mostly slept through the night and Ryan’s schedule allowed him to be around in the morning.

The hardest part of all of this for me, was processing the reality of what I had been through.  I had been inpatient for my mental health.  I had “lost my mind”–or so I told myself.  I was so afraid of having to face the people I knew.  What would they think?  Were they all talking about it?  I felt like I may as well have had a flashing neon sign on my forehead that said “crazy.”  I felt that if people knew what had happened that I would lose all credibility as a teacher and mentor at church.  I felt like others would judge me harshly.  I didn’t think they would understand at all.  I certainly didn’t feel like I could talk about it openly.

To make matters worse, I felt that I was being excluded from activities that other young moms in my church community were doing.  I was likely putting a negative spin on events.  It is hard to know at this point.  But, at the time, I felt really left out.  And I thought it was because of what I had been through.  I felt they thought it was easier not to deal with me and my strange issues.  Again–in hindsight, this probably isn’t true, but such were my feelings and perceptions at this time.  This made a hard situation more difficult.  If only I had someone to confide in, it may have helped me better understand what had happened.

I was, however, very thankful for the amazing outpatient care I received from Dr. Holland.  He was kind and compassionate.  When I told him of my side effects, he helped me switch from Lithium to Lamictal.  This was a very positive change.  He also switched me from Geodon to Abilify.  Lastly, he took me of off Tegratol, due to some negative changes in my labs.  All of this helped me improve immensely.  I still had excellent symptom management, but I felt more like myself.

Sadly, Dr. Holland decided to close his outpatient practice and go exclusively inpatient.  I had to switch doctors.  I ended up with another great doctor.  As I continued to improve, he began to wean me down off the higher doses I was on.  This helped me feel even more like myself.  But this doctor went inpatient as well, and so I had to switch again.  I ended up going through a few more doctors for similar reasons.

I started doing so well, that doctors began telling me that they thought my initial diagnosis of bipolar was incorrect.  I was overjoyed to hear this, of course.  I was weaned off all of my medications until I was only taking a tiny dose of Abilify.  I was able to stay here and be well for a period of years.

If you’ve been reading my posts, you know the rest.  I weaned off my Abilify, became pregnant with my last child and everything fell apart.  Postpartum, I finally found myself sitting across the desk from a new psychiatrist–the one who could fit me in the fastest, as she told me in no uncertain terms that I most certainly did have bipolar disorder.  She passed me the box of Kleenex as I started to sob.

Coming to terms with this reality was very difficult for me.  I wanted to talk my way out of it: “But what about last time?  I got all the way better!  This can’t be real.”  The longer my depression went on, the more accepting I became.  “This is real.”  I was finally able to tell myself and I could believe it– and feel peace about it.

Whenever I am tempted to think I am home free and everything is fine.  I think back on the last 17 years and I know that I am fooling myself.  It helps put things back into perspective and reminds me that I still need to take measures to protect my mental health.

I am deeply grateful every day that I can function in my life.  In my mind, It is nothing short of a miracle to go from where I was to where I am now–and to realize I have been through this twice!  Two trips through hell, and back.

I have a special place in my heart for people who suffer–with anything, really.  This is because I have felt suffering.  When I think of others enduring agony, I can empathize, because I have felt agony.  I especially feel for women–mothers, who struggle with mental illness, all while trying to raise their families and get through all that that entails, day after day after day.

I also acknowledge that because I have felt deep pain and suffering, my gratitude for the good times runs deeper than ever before and my joys are deeper as well.  I am grateful for all the good that can come out of suffering.

So, yes, I have bipolar disorder.  It is a part of my journey.  I have learned to affectionately call this condition my “tutor”–because it has been through my experiences with it that I have learned and grown so much.

Where are you in your journey with mental illness?  Are you just starting and trying to figure things out?  Are you in the hard times right now, trying to get through?  Or are you enjoying a period of rest and peace in your life?

Wherever you are, thank you for being a part of my journey.  I’d love to hear from you!  Share your experiences below.