It took me years to face the reality of having bipolar disorder.

I refused to get a diagnosis for a long time. I wanted to be strong enough to handle my moods on my own. With every cycle, I’d get better, spiral into hypomania, and crash into depression. 

It was an act of defiance leading me down a dangerous path. 

After the episode in 2018, I decided to change. My path to stability after this decision has been a long one that continues today. The key was letting go of the life I had imagined to create a life I could live that would keep me stable.

I choose a stable life.

Bipolar management is a conscious choice I make every day. I choose healthy sleeping habits over wild nights. My concept of a good time changed. The super-late nights of drinking with exciting new people had to end, or I knew it would eventually be my stability on the line due to the risks I was taking. I’ve replaced boozy benders with hearty conversations over good meals. I worked hard at managing stress and setting healthy boundaries. 

I make these adjustments for my health and well-being because life is better when I choose stability. 

Here are some tools and strategies that worked to help me maintain stability:

#1 I take a proactive approach to my mental healthcare.
I research my issues, keep notes and articles, and write down my questions and feelings. I chronicle my treatment experience, documenting my reactions to medications, the cycles of my moods, and possible triggers for high or low periods. I note each medication, the dosage, and when I take it. Working with my healthcare team, I learned to manage my daily care.

#2 I educate myself.
I look into not only my particular mood disorders but the various medications used to treat them and the other therapies and lifestyle approaches I need to make my treatment most effective. Because I’ve researched it in books, through friends, and on the Internet, I’m not surprised when talk therapy causes more stress than relief. I know that short-term frustrations turn into long-term progress and recovery.

#3 I use what I learn in treatment and take lifestyle changes seriously. 
I’ve realized that I can’t solve everything with a pill. I know that medication can be more effective when talk therapy helps me relax and acquire coping skills that lower my brain's cortisol levels (stress hormones). I understand that medication is more effective when, through talk therapy, I derive a sense of support and relief after discussing problematic past events or current struggles in my life. Talk therapy can be more effective when medication supports my mood swings enough to help me discuss issues. I know that talk therapy can be much more effective when ‘high’ moods are moderated enough for me to keep appointments and reasonably discuss my issues.

#4 I take other medical issues seriously. 
A body in good physical shape responds more effectively to medication and talk therapy. Many physical issues and changes can affect brain chemistry. Menopause, aging, sleep disorders, and medications for other medical issues can interfere with medications prescribed to treat mood disorders. Those who take their recovery seriously tend to understand their body and medical issues more clearly.

#5 I don’t self-medicate. 
I refrain from using alcohol or narcotics to treat my symptoms. Many often find alcohol and illegal drug use an easy, quick way to numb sad or extreme feelings. The long-term problems these substances create can be far worse than what life brings their way. I know these substances are inefficient ways to feel better and that they can intensify the negative effects of bipolar disorder.

#6 I don’t give up. 
I find the most effective treatment options that are available to me. I am determined to find structured ways to survive and create balance. I understand that recovery takes time and requires hard work. I also make an effort to maintain regular contact with my friends, I join supportive communities, and I get help when I need it.

#7 I practice gratitude. 
I am aware of the support and encouragement I receive from family and friends. I find it helpful to keep a daily gratitude journal to remind myself of what I’m thankful for. Changing my thinking from the burdens of bipolar to gratefulness for life’s blessings helps to improve my state of mind and allows me to approach new obstacles with a measure of perspective.

At times, I grieve over having an illness that limits my definition of fun. I grieved for my past “unaware” life when it seemed so easy to let mania take over, drink when I was depressed, use sex to feel better, and uproot when life got tough. Now I make it a point to remember how I felt after those manic episodes: the dangers, the threat of an STD or pregnancy, the hangovers, and the inevitable depression when I could not get out of bed.

My nostalgia is fleeting, and I can live with the grief. Every year, I am more stable. I still get sick, but not like before. Life is much better now because this is my real life, not one fueled by my mood swings. Do I wish to burn the candle at both ends and live an unconstrained life? Sometimes, but I know that life will not be a good one.

I am used to bipolar now. I understand it. Maybe prioritizing stability and creating a fulfilling, productive life that also allows for bipolar management doesn’t sound very exciting, but it opens a world of personal choice that is beautiful.

How about you?
How do you maintain your stability?

​Join the discussion in the community.

In 2002, Dr. James Kaufman of California State University in San Bernardino conducted a retrospective study of 1,629 writers that showed poets — specifically, female poets — were likelier than non-fiction writers, playwrights, and fiction writers to have some mental illness. He coined the link between creativity and mental illness as "The Sylvia Plath Effect."

Popular culture has long stereotyped poets as depressed and creative scientists as mad. The idea of a link between creativity and mental illness goes back to the time of Aristotle when he wrote that eminent philosophers, politicians, poets, and artists all have tendencies toward "melancholia."

Professor Kay Redfield Jamison is an international authority on the subject, both as a psychiatrist and as a person with bipolar. She observes that manic-depressives in their high or manic state think faster and associate more freely. When manic, people need less sleep and have unusual energy, remarkable focus, and an inflated self-belief, all of which may allow the production of original work. Depression may be the flip side of the creative manic state and the price artists pay for their bouts of productive work. 

There is no question that the writing processes of people in a bipolar episode differ from the typical processes of others. The differences are significant and complex. One is that writers who are symptomatic or undergoing treatments are forced into or barred from specific abilities despite their struggle not to be. If editing is needed, but the person is in a manic or hypomanic state, the editing might be over the top. If idea generation is necessary, but the person is depressed, such idea generation may not be possible. If drafting by hand or taking notes is usually the most effective for a writer and that writer is undergoing specific treatments, hands may shake too much to use, and vision might double or triple. In addition, ideas may be foggy, and chunks of memory may be erased.  

I’ve often experienced what I would come to call depression block. It's not writer's block. I've experienced writer's block, where I get to a specific part of the story or something else I'm writing, and I don't know how to continue. But no. When it just comes to a screeching halt, you know, it's the illness. And I can't get up on top of it for some reason.

With depression block, there is the sheer difficulty of putting anything on the page: difficulty finding even the most basic words, difficulty coming up with ideas,  difficulty keeping things together, difficulty mustering the energy to write, and difficulty mustering the energy to even sit at the computer. 

I'd get to the computer, sit, and watch the line blink. And I'd try to type and get a sentence in a half hour. Then I wouldn't say I liked it. It was so frustrating that I would go back to bed.  

Depressive symptoms such as apathy, anhedonia, low self-confidence, lack of thought, and low energy kept me from being able to write. As much as writing meant to me, I didn’t want to have a thing to do with words when depressed.  

I also experienced anhedonia, a loss of enjoyment in otherwise pleasurable things, including reading and writing. This loss of enjoyment was all the more pronounced because I wanted to identify as a writer. I felt like a fraud. Whenever I thought of picking up and writing, I felt unworthy, and it stopped me. You can't write when you're depressed. 

When writing is possible while depressed, such writing tends to be personal. Even if I did write, the work is never whole because I lack the energy and the ability to make something coherent and structured.  

In most hypomanic episodes, I had the feeling of flow. It was the feeling of everything, like your knowledge of words, your memory about your life, your analytical skills, and everything flowing together to make it come out to be just about as complete and sound as possible. Everything in the world was connected, beautiful, and had the utmost meaning, and everybody appreciated that meaning.

But, as the hypomanic episode progresses toward mania, the precise and swift connections and flow of hypomania can get more and more "out there" and more bizarre. The clarity becomes incoherent. Manic writings begin to have no substance to them. The pen keeps moving, and it doesn't make any sense. 

As mania progresses, the writing might become frantic and illegible, and one might be unable to keep up with one's thoughts. You can’t write as fast as you can think. Ultimately, psychosis can make the writing so disjointed - if the person can gather thoughts to write at all, the writing makes no sense.  

In The Midnight Disease, neurologist Alice W. Flaherty writes about hypergraphia, or "the overpowering desire" to write, which accompanies mania. Like writing in a depression, writing in a mania parallels manic symptoms. For example, people tend to be more verbose, have more thoughts, and have those thoughts at incredible speeds. In addition, they might experience pressured speech - a clinical hallmark of mania, which for writers can mean writing more and more.

You think you're writing the most significant thing ever when you're doing it. And it's very humbling when you go back and read it, and it's so broken up.

Artists often resist taking medication, fearing that losing the instability will also mean losing their creativity. But Jamison, who is on lithium for bipolar, says recent studies of artists and writers diagnosed with bipolar and taking medication found three-quarters were as productive or more productive on medication.

She says the destructive effect of depression on the brain, the progressive nature of bipolar, and the genuine risk of suicide argue against refusing treatment. “No one is creative when severely depressive, psychotic or in four-point restraints…Artists and writers tend to focus on the risks of treatment and not on the risks of no treatment.”

Treatment enables me to be more creative because I am more stable.  My medication affects my "creative impulses" but not creativity itself. The medication also provides stability for my everyday life and gives me an outlet to maintain better control over my creativity.

I'm unquestionably happier, more stable, capable, and competent on medication. So why should I biologically or neurologically punish my brain and body when I've been healed in so many ways? 

How about you?
How do you deal with your creativity?

​Join the discussion in the community.