As I wrote, some people believe that if you don't have a mental illness, you can't understand someone with a mental illness. I'm not sure this is true.

I have been writing about mental illness for almost a decade now and part of the reason was to try and help people understand bipolar disorder and other mental illnesses. And I have succeeded in some regards. I get emails from people quite frequently that tell me how much more they understand about the disease now that they have read my writings. I am tremendously gratified by this. But, of course, I reach a tiny percentage of people and the issue of mental illness stigma still affects us all. And some people, no matter how hard we try to explain ourselves to them, never seem to understand mental illness. Which begs the question: can a person without a mental illness ever really understand what we’re going through?

I use the word “doctor” quite liberally and often use it interchangeably with “psychiatrist.” The reason is quite simple – psychiatrists are, in fact doctors, they are just specialists. Yes, that’s right, your psychiatrist has all the rights and privileges that any other doctor has and could probably remove your spleen, if the occasion called for it. Nevertheless, there are some crucial differences between “doctors” in general and “psychiatrists” in particular. And sometimes you need a psychiatrist and sometime any old doctor will do. So how do you know if you need a psychiatrist?

One of the challenging things about being a person with a mental illness who talks about psychiatry (and doesn’t hate it) is that all those people who do hate psychiatry perk up and get mad. These people often identify as “antipsychiatrists” and I’m not their biggest fan. While I consider it quite reasonable to question your doctor, psychiatrist, treatment, therapist and other treatment aspects, I consider going after an entire branch of medicine ridiculous. There is no “antioncology” faction in spite of the fact that a large percentage of people with cancer die (depending on the type, of course). And this manifests in many of our lives. It’s not that antipsychiatrists just attack me; it’s that people of that mindset attack your average person who is just trying to deal with a mental illness. It’s the people who say, “mental illness doesn’t really exist” or “psychiatric medicine doesn’t work” or many other things that many of us hear online and in our real lives all the time. So how do you talk to these people who have decided that your disease doesn’t exist and you shouldn’t be in treatment?

Earlier this week I wrote a piece about being scared of trying antidepressants and as one commenter pointed out, there are increased risks associated with treating a person with bipolar with antidepressants. In fact, some would say that treating a bipolar person with antidepressants can worsen the course of the illness (always contraindicated as monotherapy and possibly undesirable altogether). Now, when I wrote the article I was only thinking of unipolar depressives, but, as one commenter pointed out, being diagnosed, correctly, with bipolar disorder, in itself, can be a challenge. And this is absolutely true. Studies have found that it takes 5-10 years (from the time of the first episode) for a person with bipolar disorder to get an accurate diagnosis. There are many reasons for this, predominantly that people don’t get help when they have their first episode, but a major contributing factor is also misdiagnosis. People with bipolar disorder are often diagnosed with depression or schizophrenia first and this can have devastating outcomes.

I remember, before trying medication, I was terrified of it. I had the same misconceptions that many people do: Medication is for weak people Antidepressants are just “happy drugs” designed for people who can’t handle life Medication will ruin your brain Doctors give out antidepressants like candy whether you need them or not As it turns out, none of these things are true, but they sure seemed true at the time. So I get fear of antidepressants and other medication. Psych medication is scary stuff. But sometimes you have to face that fear in order to get better.

For some reason people like to come on here and tell me (and sometimes others) that I’m not bipolar. They feel, for whatever reason, that my writing is not that of a person with bipolar and somehow it indicates that I’m not bipolar. I’m not expressing the right emotions. I’m not writing whatever it is that a “real” bipolar person would be writing. And this happens in real life too. People somehow feel qualified to determine a person’s mental status simply by the way a person with bipolar acts in front of them. Well, for the record, I would like to say from me, and all the other mentally ill people in the world: bite me (or, you know, us).

Many people here have read Robert Whitaker’s Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America (New York: Crown Publishers). And some of these people will likely claim that the book changed their lives or, at the very least, their view of psychiatry and psychiatric medication. Well. Ho there. You would think with such a ground-breaking book I would be all over it. Guess again. I refuse to read Anatomy of an Epidemic. And yes, some people will fault me for this. But I have a good reason. I refuse to read Anatomy of an Epidemic as I have no desire to be outraged at a misunderstanding of science for 416 pages. The Poster Child: Robert Whitaker Robert Whitaker is the poster-child for antipsychiatry, which is his prerogative. If he enjoys talking to throngs of antipsychiatrists then I say, better him than me. And part of his criticism of psychiatry is well-deserved. I would say that being concerned with the use, and possibly overuse, of some medications and the prescribing of heavy psychotropic medications to children is quite warranted. I take no issue with the fact that debate and concern is appropriate here. What I do take concern with is his contention that psychiatric medication actually worsens treatment outcomes and causes disability. This is the reason why antipsychiatrits love him and it’s the reason I probably couldn’t stand to be in the same room as him.

I once wrote a post called, My Bipolar Symptoms Aren't Your Symptoms: I'm More Bipolar Than You. The point of the post is that two people can experience bipolar disorder very differently. Even when two people meet the Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic criteria for bipolar disorder, their individual list of symptoms can be quite different. One might be expansive when manic, the other might be irritable. One might sleep too much when depressed, the other might sleep too little. And so on and so forth. Neither one of them is the “right” kind of bipolar and neither one of them is “more” bipolar, they are simply suffering from the same illness differently. Similarly, treatments are also individual. What works for one person simply doesn’t work for another. And that’s OK.

The name “bipolar disorder” is seemingly self-explanatory. It’s disorder involving the two poles of emotion – depression and mania or hypomania. People often think of this as the poles of “sad” and “happy.” But as any person with bipolar disorder can tell you, mania or hypomania is not necessarily happy at all.