Tuesday, February 21, 2017

What doctors fail to tell you about bipolar disorder

What does the DSM V say about bipolar disorder? 

It says many things, like you must have at least 3 behaviors from a list of symptoms in mania, lasting a week or longer. It says you must have 5 behaviors from a list of symptoms for depression lasting 2 weeks or longer. These behaviors include a markedly diminished  diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day with depression, and an inflated self-esteem or grandiosity (ranges from uncritical self-confidence to a delusional sense of expertise) for mania. 

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

That's all well and good, but they don't tell you what to really expect with your disorder. 

They rarely tell you that mania doesn't always look like a euphoric high, that it can look like your worst nightmare with major irritability and lashing out to loved ones, and you not knowing why. 

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

They don't tell you that the minimal effects like weight gain or drowsiness affect more people than usual, and are real and life altering. For example drowsiness is a side effect of Seroquel, and it doesn't just make me tired, it turns me into a non-functioning zombie for days at a time.

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

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

This sounds gloomy af, I know, but there are benefits to being bipolar that they don't tell you. 

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

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

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

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

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

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

So those are some things that your doctor might not mention. 

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

Tuesday, February 14, 2017

Loving someone with bipolar disorder

How do you love with someone with bipolar disorder?

It's hard af.

I struggle to love me, and I have bipolar disorder.

I've got friends who love me though. I asked them what makes me so appealing, and they had some surprising answers,

One of my friends told me she loves me because I'm funny, I'm creative, and I'm kind. She loves me because I genuinely want to do good in the world.

My other friend had similar answers; I'm funny, honest, and compassionate.

I was once told that even though I'm a difficult person, there's still something innately likeable about me, and well, my friends' answers prove that's true.

My daughter loves me because she relates to the mood swings, and understands when I'm struggling.

My husband shows his love for me by being kind, compassionate, and understanding.

What does that compassion look like?

He knows I love Robert Downey, Jr, so when I'm in a funk, he'll turn on movies with him in it. I just recently watched Sherlock Holmes, and snuggling my husband and enjoying the movie really helped me know I'm loved.  He forces me to talk when I want nothing more than to clam up. He takes me out on dates when I want to curl up in bed and sulk, He surprises me with trips for just the two of us, to help me get out of my head, and to have something to look forward to.

So loving a person with bipolar disorder isn't easy. We're unpredictable, there's a chance we might hurt you when we're hurting too. I inadvertently hurt a good friend of mine with my last suicide attempt, and I'm having to suffer the consequences of that right now. But I'm still innately likeable. I'm still a good person, even though I do have mood swings, even though I have rages, even though I cry and sulk.

I also delight in making people happy, and serving others. And people see that about me.

I'm loved because I'm quirky.

So to love a person with bipolar disorder, you have to be willing to be hurt, you have to take a chance, You have to be prepared to roll with the punches (not literally, I hope). But there are so many good sides to loving a person with it. We're usually quite creative, and can help you get your house beautified, or help you with a DIY project you're stuck on, We can chatter your ear off for hours, and yet we can also turn around and listen when you need someone to lean on too.

Loving someone with bipolar disorder is chancy, and can be scary, but the person behind the disorder is usually worth the trouble. Like an ogre, (and an onion), there are layers to a person. And peeling back the layers and starting to love someone with bipolar disorder is a beautiful thing.

Like people say, if it's difficult, it's usually worth it. And a friendship with someone with mental illness can be difficult, but is so worth it. 

Tuesday, February 7, 2017

What is Mania Like?

I think many people relate to depression. Lots of people have been sad before. Many people have fallen into the dark pit of despair and managed to climb out of it. But I don't think people really have a grasp of what mania is like.

Mania is incredible. Mania is destructive. Mania is the highest high of your life, yet it's also a cliff and you just jumped off into the abyss.

People think mania is just happiness, giddiness, and euphoria. While those emotion can happen at the beginning, it doesn't stay that way.

Mania also includes psychosis, grandiosity, and delusions.

The less commonly noticed symptoms include less need for sleep, rapid speech, inflated self esteem, poor concentration, racing thoughts, risky behaviors, and excessive energy.

I've suffered from mania, and I've done incredible things while manic. I have created amazing things, yet while in the throes of mania, I've destroyed relationships.

You become another person while manic. You're high, you feel like you can control the world, you're going to accomplish great things. You become delusional, and can't see reason anymore.

You might feel like creating an online business and spend your life savings buying things for it. Or you might decide you need a brand new wardrobe for the new you. You might decide your partner isn't enough sexually, and go on the prowl for a new one. Or you might just become promiscuous when you're usually not.

The worst thing about mania, is the hypo-manic phase, when you truly are amazing. When you can still listen to reason, when you feel on top of the world, and you have ideas that are brilliant. This phase usually doesn't last long, and before you know it, you're into full blown mania.

And then there's the crash. It usually feels like you've literally hit a brick wall going 100 mph. You might wake up in the psych ward, you might wake up on the streets, you might not wake up at all. But it's there, and there's usually the deep depression that follows, where you're in a shame spiral because of all the incredible things you did while manic.

I remember the last manic episode I had, I was convinced I was going to start a jewelry making business, and sell my wares to my friends. I bought necklaces, and lockets, and trinkets with money I really didn't have. I was obsessed. I was crazed. I was fixated on this one thing. I felt amazing. I was in control. Until I wasn't. I couldn't tend my kids because I'd flown into psychosis, and wanted to kill myself because I wasn't a size 6 anymore. I was barely holding onto reality, and it was terrifying. I finally went to my doctor sobbing that I needed help, and I was admitted to the hospital.

I know a lot of my bipolar friends miss the mania, and struggle with medication compliance because of that. I miss the hypo-mania, but not enough to risk full blown mania. It's fun for awhile, but it becomes horrific very quickly.

Mania is an uncontrolled beast that resides inside every bipolar person (well, bipolar I person), and it is something that will never be tamed, at least, not without proper medication and therapy, IMHO.

So although there is some 'fun' included in mania, it's doesn't stay grins and giggles, which is an excellent reason to try and keep it tamed. Even when it's hard because you miss the euphoria, you have to remember that it's not just that, there's also usually a side of remorse and embarrassment included with it. 

Tuesday, January 31, 2017

The is Hope After Addiction

I'm an addict. There. I said it. I'm saying it to the world. Not only am I an addict, but I have bipolar disorder as well.

Why am I telling you this?

I'm telling you this to give you hope. I was once a trainwreck. I hit rock bottom. I was homeless. I was selling myself on the street to get by. I had no real friends, no one to turn to for advice, comfort, support. All I had were my drugs.

Oh, I denied being an addict for a long time. I couldn't possible be one I rationalized. My meds were prescribed by a doctor. I didn't get them from a dealer off the streets. I got them from a pharmacy. Legally.

But the drugs were ruining my life. I managed to claw myself up from rock bottom, even with the drugs as my support. I went back to college, I got a job, I won back custody of my daughter. I got married. I had more kids. But I was only a shell of my former self.

I denied that there was a problem so well that I even believed it myself. I totally rationalized the needing of more meds than prescribed. I rationalized the burning desire for 8 PM to hit every night so I could take my Ambien. I rationalized everything away.

I explained away my odd behavior to everyone. The falling asleep at inappropriate times. The slurred speech. The glazed over eyes. It was all a side effect of perfectly legal substances. Legal substances that I was abusing.

I struggled. My bipolar disorder didn't help me at all to get over my addiction. In fact, the two disorders competed with each other for my attention. I was having an anxiety attack? Pop a few Xanax. My back was hurting? Pop a couple roxicodone.  I couldn't win for losing.

With each drug of choice, there was tipping point for me to quit it. My pain specialist prescribed me suboxone finally for my pain, and on the package it came in, it read 'to be taken for opioid addiction'. What the hell? How dare they accuse me of being an addict! Fuck them. I quit the suboxone and roxicodone there and there. I'd show them. I could manage just fine with Motrin from there on out. And I did. I've taken oxicodone a handful of times since then, and only for extreme situations (read: kidney stones).

But the addiction was still there, and I was still in denial over having it. So I continued to take the Xanax. I mean, it was prescribed, right? There was finally a day when I was super late to pick my son up from the bus stop, because I'd popped a few too many of them, that I realized things were out of hand. I still couldn't quit though. It took a hospital stay because of an overdose on them that I was finally able to stop them.

But the addiction was still there. And I still had my beloved Ambien. Oh Ambien, what a nightmare you are. I would have never quit the Ambien, until my husband left me over it. He had begged for years for me to quit taking it, but I couldn't. It wasn't until he finally left that I woke up from the foggy haze I'd been in to quit.

I quit that shit right then and there again, Cold turkey, never again. It took a few months for my husband and I to work through the varied issues at hand that we'd both contributed to the dysfunction in our marriage, but we did it.

I can now say that I've been clean from everything for 18 months. I don't even have a desire to take anything addictive. I refuse to have it in the house. I take naltrexone for my weight, but also for the added benefit that it is an opioid blocker, which discourages me from even trying to get meds I don't really need.

So what's happened in the last 18 months? I've gotten my life back. I'm in tune with what my children need. I'm able to enjoy my children more fully. We're close as a family unit. My husband and I are closer than ever. We've been married 8 years, and this past year has been our best year ever, even with the dysfunction we had to work through. I got into treatment for my bipolar disorder, and yes, the addiction as well. I thrived there. I graduated from it with a good handle on myself, and had everything in check.

Life is amazing now. I would have never realized just how wonderful life can be without struggling in the depths of hell beforehand. I just want people to know there is hope. You can rise above the addiction and be more than just an addict. You can be a writer. A mother. An aunt. An advocate. A person with worth and value. I know this is all true because that's me now. I'm all of those things and more.

I'm not saying it's easy. It's harder than hell to rise above the shame and guilt over being an addict. It took me a lot of intensive therapy and the support of a loving family to do it. And you'll need support. I definitely did. It takes a village to help an addict recover. But it can be done. I know this is true because I did it. And I know others can too. 

Monday, January 23, 2017

Why the justification?

Why do people feel the need to justify their medication usage? Is there some shame involved there? Shame of having to be on those particular meds? Shame of really being what they call you? If a person were on Metfomin for diabetes, no one would bat an eye. But the second you mention lithium, Prozac, Ativan...people lose their shit. 

They seem to get especially mean when you mention the drugs Valium, Xanax, Klonopin, Ativan, etc. Why is that? Hmmm, I wonder.  These are in the 
benzodiazepine family, and they're great drugs, but also super dangerous. 

What I feel so many people are overlooking, is that benzos are addicting...and that many people who start out taking them as prescribed, then start struggling with the the med not being effective, and then suddenly find themselves locked into taking more than prescribed. Unfortunately, I can absolutely relate to this scenario.

I've shared this story before but I feel it bears repeating, even with the risk of being told, "It's people like you that make me furious because I can't get my drugs because of you." 

I was once a happy-go-lucky 20 year old who happened to have crippling anxiety (and undiagnosed bipolar disorder among other things). My doctor tried the usual cocktails; SSRI's, buspar, vistaril, etc. None of them worked. Finally, my doctor tried me on Valium, and oh my gosh, it was as if the seas had parted and I was set free. It did that much good for me. I was able to go out in public, I was able to sleep, I was able to raise my children. 

But. (There's always a but isn't there?) But, fast forward 6 years, and I'm not on one dose daily of 5 mg anymore. I'm now on 2 mg of Xanax 3 times a day. And frequently took more than that to keep the edge off. I was a wreck. I finally had my wake up call, and realized I was, indeed, an addict. I'd gotten hooked from perfectly legal drugs, all perfectly prescribed by my doctor, for perfectly valid medical conditions. I started out taking the meds as prescribed, until they weren't working at optimal levels anymore, and that's when I started taking too much. 

Sooooo, these drugs are dangerous af. I've now been clean for almost 2 years, and you know what? My anxiety is better controlled by Neurontin than it ever was by Xanax. I'm so much happier at this point in my life than I thought would ever be attainable. Without benzos. 

Now, in regards to other psychiatric meds, I'm on 9 different ones, and I don't care what people think of them. Because of my experience with benzos though, I advocate heavily for people to work on coping mechanisms in therapy. I once thought coping mechanisms were bullshit and refused to even try learning them, and thought, 'well, why should I? I can take a pill and it'll go away', and that's 100% true...popping a pill is days more easier than learning ways to deal with anxiety, but ultimately, life is better when you're not dependent on a crutch like addictive substances. 

Before anyone starts out with torches and pitchforks to find me, I don't have problems with people taking meds for psychiatric conditions, but I do have concerns with people who take addictive substances for psychiatric disorders. 

These drugs are dangerous. They are lethal. They can hurt as well as heal. And I feel that the people who get so furious about your medication usage simply care, and they know just how dangerous these drugs are. I know how dangerous they are, and I advocate heavily for people to only use them as a last resort, and not the first line of defense. 

This is just one woman's experience of course, but after living that experience, I don't think I'd go near benzos again, not even with a 39 1/2 foot pole. 

Tuesday, January 17, 2017

Bipolar disorder isn't real and other fairy tales

There's been a lot of awareness about bipolar disorder these last few days, what with Carrie Fisher's passing and all. With all that awareness there's been a slew of misinformation as well. Seeing as I am a fan of correct information being spread around, I'd like to dispel a few myths that are floating around at the moment.

Bipolar disorder isn't real.

I've seen it said that bipolar isn't a real disorder, instead, it's just a conglomeration of symptoms that cause a person distress. Now, last I checked, a conglomeration of symptoms that caused a person distress was usually considered a disease/disorder/condition. I understand the thought process here, that all bipolar disorder entails is some ups, downs, and mood changes, so why call those things bipolar disorder? I think it's useful to b able to categorize symptoms, and to have a name for what's going on. I know a lot of people don't like labels when it comes to mental illness, but personally, I prefer them. I'd much rather be able to tell a person a short blurb about my diagnosis versus an essay long version of describing words.

Bipolar disorder isn't caused by chemical imbalances

According to the Mayo Clinic "An imbalance in naturally occurring brain chemicals called neurotransmitters seems to play a significant role in bipolar disorder and other mood disorders." Yes, stressors, and ACE (adverse childhood events) can help trigger an episode in some people, but neurotransmitters have a critical role to play as well.

Bipolar disorder doesn't kill people

This argument is supposed off the thought 'bipolar disorder isn't real'. If it's not real, it can't kill someone. I saw an example that compared a headache to causation of head pain instead of the manifestation of head pain, and stated that bipolar disorder is no more the cause of a person's death than a headache is the cause of head pain. I disagree with this entirely. According to various studies, people with bipolar disorder are 15% more likely than the general population to kill themselves. To me, this says that bipolar disorder does, in fact, kill people. This isn't including the studies that have linked cardiovascular problems to patients with bipolar disorder as well. 

These are just a few of the myths that are floating around the word 'bipolar disorder'. What this shows me is that more education is needed of the general public, and possibly even people within the mental health field as well. It shows that we can't grow lax in our mission to fight stigma, and fight misinformation. I know this is an uphill battle, but I believe if we all stay committed to promoting only evidence backed science, we can help fight and win this battle. 

Monday, January 16, 2017

Why I can't just 'get over' my mania

Doesn't having an elated mood, possibly for weeks at a time, sound wonderful? It certainly doesn't sound like anything you need to see your doctor over, right? What about having a sense of confidence in yourself? That you are born to succeed, and can't fail. That sounds like it'd be a great trait for an entrepreneur to have. But what about impulsivity? Or racing thoughts? These sound less fun, don't they? How about engaging in risky behaviors, such as having unprotected sex, gambling, or going on huge shopping sprees? That doesn't sound fun at all, does it?

Out of any of these, which do you think I can control? Which do you think I can just 'get over'?

Moving past a manic episode is almost a Herculean task. You do stupid, shameful things while in a state of mania. It's easy to hold a grudge towards your manic self because of all the suffering it brings on.

And why should I have to 'get over' it? Being bipolar is who I am. Yes, I want to control my mania, just as I want to control the depression, but do I really need to 'get over' it? That's  like telling me to 'get over' my arm, or my left pinky toe.

I understand that people want me to get better, but I'm not going to get over bipolar disorder as easily as one gets over the cold.

It's impossible to 'get over' some of these things. Maintain and control yes, but eliminate completely? Not likely.

Mania has such little good to it, yet many people with bipolar disorder are addicted to that sliver of goodness. The rush you feel, the on top of the world high, those are difficult feelings to voluntarily banish. The colors you see, the creativity you have, why would anyone get rid of these things? Because there's more to mania than just that high. And I can't get over it without help.

I can't regulate my sleep cycle, eat this diet, and take those herbs to feel at optimal levels. It just doesn't work that way.
It also doesn't work by using sheer willpower to control the symptoms. If it did, everyone would be doing it, and bipolar disorder wouldn't be considered a serious mental illness.

For me, staying sane includes therapy and meds. It includes getting enough sleep, and eating regular meals. It includes having a support system to rely on. I have to know my triggers, and learn to cope with my stressors.

There's no 'getting over' mania, but there is 'living with' mania. And thriving. 

Thursday, January 5, 2017

What not to say to a bipolar person

I've had some incredibly touching experiences in the midst of my struggles with bipolar disorder. Unfortunately, it's also par for the course that I've had some really shitty ones too. Over the last decade, I've heard so many things, like 'There's nothing really wrong with you, you're just an attention whore" or 'It's all in your head", and to that I cheerily reply, "Of course it is happening inside my head, but why on earth should that mean that it is not real?” I feel like Dumbledore would be proud.

I've come up with a list of phrases I've heard over the last 20 yeas or so that you should never say to someone with bipolar disorder, and why it shouldn't be said.

"Snap out of it."

I really hate this expression because it insinuates I'm choosing to act this way, whatever way that might be. That I have a switch I can flip to go back to 'normal'. Fighting the struggles of bipolar disorder is an all encompassing job, and to imply that I'm not doing all I can to feel better is insulting. Sometimes all I can do is make it from my bed to my couch, which is the equivalent of a hike up Mount Everest when I'm depressed. When walking 20 feet is too much to handle, 'snapping out of it', is an even more impossible task. 

"Why are you doing this to me?"

Talk about a guilt trip from hell. I really despise this because the person is making you feel even worse about something you can't control, by implying that yo're doing this on purpose, to be vindictive, or for any other reason. They're trying to make you own their emotions, and give you weight to carry that you don't need to carry. 

"Happiness is a choice."

Oh. Ohhhhh, This one really gets to me. Yes, there are choices you can make to lead to happiness, but there is more to it than that. There are other people that can affect your path to happiness. There's neurotransmitters that affect your happiness. There are situational factors that affect it as well. I'm a fan of Viktor Frankl, who was able to find happiness in the most extreme of circumstances, the concentration camps of Nazi Germany. He even created a school of thought from what he learned there, called logotherapy. He knew that you couldn't just choose happiness, you had to work for it. Albus Dumbledore once said, "Happiness can be found in the darkest of times, if one only remembers to turn on the light." I love this quote because it reminds me that what I focus on is what I see best. If I'm dwelling in the dark, I'm not going to find happiness. 

"Have you thought of trying <insert random herb here>?" or "You should get off all those pills."

I know this one is well meaning, and usually brought up in a loving manner, but to me, it's still patronizing AF. It hurts because I have a doctor, and 99% of the people in my life know I have a doctor, and we work quite well as a team to keep me stable. I'm not going to risk my stability on an herb that could have grave consequences should I try it. And quitting my meds? I've burned so many bridges that the people suggesting me didn't know me when I was off all those pills. They wouldn't want to see that, ever. I know I don't.

"You've got it so good, why are you depressed?"

This one hurts, probably the most to me right now. I am fully aware of how incredible my life is, how blessed I am, and everything I have to be grateful for. I still cry big tears of sadness, and feel like I don't deserve any of it. It's possible to have a great life and still be depressed when you're bipolar. Pointing out everything great doesn't make the depression go away, it just makes me hate myself more for being an ungrateful brat. 

So, what CAN you say to someone with bipolar disorder? You can say, "I see you've been struggling lately, what can I help with?". You can say, "I see you, and am here with you.". You can even just be silent, and sit, and give your presence as a show of solidarity with the person struggling. You can just listen, instead of talking. You can offer a hug. I know for me, I had one experience in the psych ward where I was just devastated, and the tears wouldn't stop coming, and the nurse on duty just came and sat with me. And listened. And just her presence was enough to calm me down. She then gave me a hug and gave me an encouraging platitude, and it was enough. I've never forgotten that, even though I'm sure she doesn't remember this at all by now. Never underestimate the power of silence. 

We just want to be accepted as we are, warts and all. Treat us as you would want to be treated. And remember this above all; in a world where you can be anything, be kind. 

Friday, December 16, 2016

A Stranger’s Act of Kindness Towards Me and My Bipolar That Surprised Me

I hit rock bottom in life a little over 10 years ago. I lost everything that was important to me, from my child, to my car, to my house...to my dignity.

This is when I was finally diagnosed with bipolar disorder, and ended up spending 6 weeks in a short term psych ward. The average stay there was 5-7 days, I blew that average right out of the water.

I made a lot of poor choices before that hospital stay, which ultimately cost me custody of my child, and for a time it lost me my family and friends.

When I was staying at this hospital, I had no friends or family to come visit me, everyone had written me off. I had no one to call during open phone time. I had no one to bring me money to get a soda, or something besides the semi-edible hospital food.

That kind of isolation will wear on a person, until they begin to truly believe that they are nothing more than a mouth breather taking up space. This being a very difficult point in my life, I actually contemplated ways to end my life while in the hospital. I hated myself, and felt like no one should waste their time on me.

And since I had that attitude, several of the nurses and techs treated me as such. There was one who didn't though. He treated me as if I were a person. As if I mattered. He was always subtle in his approach to letting me know I had value, but it was always there. It was the little things like getting me a soda every week or so, or buying me french fries from the cafe downstairs because he knew I wasn't getting that stuff any other way. He would let me choose the radio station and encourage me to rock out.

These don't sound like huge things, but they were life altering for me. I was able to slowly come back from the brink of the dark abyss because of his actions. I started writing while in the hospital, to get the words that were poisoning my soul out. I started trying to live again, even though every day was like having a glass shard in my heart.

I learned a valuable lesson from this man's treatment of me. I learned that you never know how much of a difference you can make in a person's life by being kind, so be kind, always. He'll never know that he helped save my life, just by treating me as a person. Now I try to pay that forward whenever I can. Random acts of kindness are my favorite things to do. If you're ever in a position to either be kind, or say something hurtful, always try and choose the higher road. You never know when you'll be saving a person's life by doing so. 

Wednesday, December 14, 2016

Three Resolutions of a Person With Bipolar Disorder

It's the end of the year, and what does that mean? It means it's time to start thinking of New Year's resolutions.

My resolutions tend to stay the same every year, none of that 'I want to lose 30 pounds by bikini season' crap, or 'I'm going to run a full marathon by the end of winter' phooey. Good on everyone else who makes those promises to themselves, but it's not my scene. Though, it could be because I don't run - unless a zombie is chasing me.

No, my resolutions are a little more serious, and have far more lasting consequences if I don't see them through. You see, I have bipolar disorder, and I have to think carefully on my resolutions each year.

Take my first resolution for example, it is to stay medication compliant all the times. This is way harder than you'd think. I'm on 10 different medications; two of them cause weight gain, and with one of them I have to go in and get my blood checked frequently. I get so sick of taking 5 pills in the morning, and 5 at night, plus 15 more over the course of the day. When you have a hard time swallowing pills, 25 of them gets to be a bit much. And this is every day. I don't get weekends off, or holidays, or sick days. But I do it. I've had so many epic fails when I've decreased dosages without my doctor's knowledge, or just straight up quit meds without my provider's blessing. I've learned the hard way, again, and again, and again, about messing with my meds without my doctor knowing about. So, medication compliance, that's resolution number one.

Resolution number two is to put myself first, always. Many people think self care is selfish, but it's the most important thing you can do to help keep yourself stable. I have to take time every single day to make sure my needs are being met. I love to color, or crochet, or be able to take a long enough shower to have time to shave my legs. (With 4 kids, this is harder than you'd think.) Self care also includes reaching out to friends or family if you need to talk. There's an age old analogy that I share, about airplanes - if the oxygen masks come down, who's do you put on first? Yours or your child's? You put on yours first of course! Because if you pass out, you're of no use whatsoever to that child. This is an excellent analogy to life, you can't properly care for others if you don't care for yourself first.

Resolution number three. I have to be resolute in my decision to see my doctors and therapists regularly. I hate seeing my doctor every month, he's out-of-network, and it's pricey to see him every month, but we've tried pushing my visits out to every 2 months, and I decompensate every time. So, I go see him. I also have to stay regular with my individual therapist because I start to go downhill when I begin skipping appointments with her too. And then there's marriage counseling; we see him PRN, but I have to be honest with my husband about how I'm doing. So if my individual counseling isn't being effective on its own, my husband and I can go in as a team to our counselor and get extra coping skills from him.

I have to say, keeping these resolutions is not as easy as you'd think. There are months that I don't want to pick my meds up from the pharmacy because of how much they cost, which would put me out of compliance with them., Putting myself first isn't always easy, I have a history of low self esteem, and learning to care for me has been a challenge. And honestly, I get sick of all the doctor and therapy visits I have each month; I get tired of going in and seeing them so frequently. I feel like they're probably sick of seeing me so much or something.

But I keep those promises because I have to. My good health is one of the most precious things I have, and stability is worth the price of feeling like I inconvenience people. (I also recognize that this is probably a negative thought distortion, and I probably don't really burden people.)So if you live with bipolar disorder, and you haven't figured out what resolutions you want to make for 2017, maybe my list will be a springboard for you to jump off of and find some ideas that fit your situation too!