I have said to people many times - your psychiatrist works for you. You pay the psychiatrist. They are your employee. That means you're the one who decides if they are hired or fired. But choosing a psychiatrist is no mean feat as someone who others consider "good" may not be "good" for you. So the only thing to do is to research and interview a doctor - just as you would any employee.

Recently a doctor stopped by my blog and asked about types of thoughts people with bipolar disorder have. Specifically, he was asking about "crowded" thoughts. Crowded thoughts are likened to "too many people jammed into this office." Crowded thoughts constitute the experience of having too many thoughts at one time. So it got me to thinking, what are the types of thoughts and what types of thoughts are typical for bipolar disorder.

If you have bipolar disorder or another mental illness it's easy to find yourself in a pit of self-hatred. If the depression doesn't get you there, regret over what you've done when you're manic might. Self-hatred is just all too common for those of us with mental health issues. And self-hatred produces all kinds of effects - like ignoring self-care. You might find yourself not eating, not showering, not exercising, not being kind to yourself or constantly hearing a voice of hatred in your head. And the trouble with all these things is that not only are they "not good for you" they make you feel worse both in the short and the long term. Making good self-care choices is a way of fighting back.

If you have bipolar disorder, self-care is so important because it's easy to find yourself in a pit of self-hatred. If the depression doesn't get you there, regret over what you've done when you're manic might. Self-hatred is just all too common for those of us with mental health issues. And self-hatred produces all kinds of effects - like ignoring self-care. You might find yourself not eating, not showering, not exercising, not being kind to yourself or constantly hearing a voice of hatred in your head. And the trouble with all these things is that not only are they "not good for you" they make you feel worse both in the short and the long term. Making good self-care choices is a way of fighting back against bipolar disorder.

Sex is a basic human drive. We want to eat. We want to sleep. And we want to have sex. These are the things that bring us pleasure in life. Almost everything boils down to those three things. But unfortunately, bipolar disorder and bipolar medication can affect all three. Bipolar disorder and its associated medication can make you eat. Or make you not eat. It can make you sleep. Or it can make you not sleep. And it can affect your sex life the same way. But for some reason, doctors often take the effect on your sex life least seriously.

I have been burdened with side effects since the day I took my first psychotropic medication some 13 years ago. At that time the medication I was on made it impossible for me to be awake, pretty much ever. I had no idea how much hell I was in for and my doctor didn't seem to believe me when I told him about it. So I did the responsible thing - I just kept taking the medication, hoped the treatment would work and that the side effects would go away. But that's mostly because I didn't know what I was doing. Today I know that severe side effects are something that we choose and are not something that is thrust upon us. We choose what we can live with, even tacitly, always have, always will.

I’m an independent contractor. This means I sit in front of a computer screen, working at home, alone and writing all day. While this is the dream for many a writer, I can tell you it gets lonely. It’s tough not having work in an office where there are coworkers to chat with at the water cooler. And this lack of socializing is particularly salient because I have bipolar disorder. I have a tendency to cocoon anyway, and then you take away the day-to-day interactions with people and I suddenly find that I haven’t talked to a person in real life in a week. So I have to schedule in a personal life – whether I want to or not.

Last week I wrote about how fighting bipolar disorder is like fighting an invisible enemy. And I suggested that creating an internal visual of an "enemy" was a helpful way of differentiating the sick person from the illness itself. I think stigma is similar. We can let stigma, or thoughts thereof, get into our heads. We can start to believe the ignorant judgements of others and we can let stigma bring us down. But we don't have to. We can fight. And while stigma is often something one feels, sometimes it is something one can see too. Like in print. Like in The Daily Athenaeum piece on depression that I wrote about on Monday. It was chock-a-block with ideas of stigma. But I chose not to believe it and instead I chose to fight.

I'm not a person who takes on a cause de jour - I simply have too much self-preservation for that. I have enough going on without worrying about the plights of the world. However, when someone tries to spread mistruths and tries to silence my voice, then I start to get peeved. Case in point. Recently, the West Virginia University's school paper, The Daily Athenaeum, printed an article about lifestyle factors and depression. And while I have no problem with that subject, the things they said therein were wrong and inexcusable. And when they tried to silence my criticism of that article, I got peeved. I will not allow the voice of mental illness to be ignored simply because someone doesn't like what we have to say.

One of the problems with mental illness is that it's invisible. As I've heard many times, "You don't look sick." Well of course I don't. You're not looking at an fMRI. And because we don't "look" sick, our illness moves into the "not real" category. Bipolar, the unreal illness, the imagined one. And it's even worse because others will tell you that mental illness doesn't exist. Other's will confirm your worst fears and tell you what the tiny, horrible voice in your head has been saying - you're just imagining you're ill. Really, bipolar disorder doesn't exist at all. But of course the voice is wrong and so are the ignorant people - bipolar is as real as it painfully, awfully, grippingly gets. But that doesn't make it visible. And its invisibility makes it all that much harder to fight.