What an Emotional Support Animal Actually Is

Emotional support animals (ESA) are constantly in the news. Does anyone remember the woman who tried to bring an emotional support peacock on a flight?

Pet owners are always trying to pass off their pets as ESAs to bypass laws and requirements. They make a mockery of the true need for ESAs. My ESA has saved my life countless times. And I’m not exaggerating.

Before I rescued Phoebe, my friends joked that I knew more dogs on our college campus than people (true). On my worst days, the only thing that made me smile was seeing a dog. I realized an ESA might be what I needed. A dog wasn’t going to cure my depression, but it would undoubtedly bring relief.

I rescued Phoebe nearly two and a half years ago while a senior in college. She was a neglected boxer mix who was missing small patches of fur from malnourishment and untreated allergies.

She was a dog who needed a lot of love and care, and I needed a purpose in life. I was diagnosed with bipolar 2 disorder around the time I adopted Phoebe. My emotions, thoughts, and life were too much to handle. I isolated myself in my bed. I missed classes, parties and everything else a 21-year-old is supposed to do.

Phoebe forced me to get out of bed because she needed to go outside. She forced me to eat because I had to go to the kitchen to get her food. She forced me to drive to the dog park because she needed a place to run. She added structure and routine.

On the days my anxiety was high or I couldn’t stop sobbing, she’d jump in my lap and put all her weight on my chest. This is a task some service animals are taught to help their owners who need help calming down or dealing with sensory overload. Note: ESAs are not service animals. Phoebe wasn’t trained to have this response. She does it instinctively.

When I had suicidal thoughts, she kept me here because she needed me. I still struggle with my mental illness, and Phoebe is by my side through it all. She makes me laugh when happiness seems impossible. She quite literally pushes me off the couch when she needs to go potty.Phoebe is my dog, but she’s also a lifeline. I used to roll my eyes at the bumper stickers that asked: “Who rescued who?” But it’s true. I rescued her and she rescued me.

I didn’t get Phoebe to have her in a no-pets apartment. Believe me, my landlords were horrible people who tried to get rid of her, and I had to fight like hell. I wouldn’t have tried so hard if I just wanted a pet, especially when I was moving out in a few months.

I didn’t pass her off as an ESA when I signed my new lease because I didn’t want to pay a pet deposit. I haven’t told an airline she’s an ESA so I can keep her in the cabin. She isn’t a loophole in the system.

She’s an ESA because she helps me function in day-to-day life.

What to Say Instead of ‘It Gets Better’

It’s often hard to know how to support someone who’s struggling with their mental health. You may worry you’ll say the wrong thing or be unable to help.

I’ve been on both sides of the conversation — the one needing support and the one giving it. I’m more sympathetic because of my experience with mental health issues, but I don’t always know how to help.

When I’ve needed support, it helped to have people by my side who were there to listen to me. There wasn’t much they could do aside from showing me they care and being there when I needed a distraction.

Support doesn’t have to be incredible insight or advice. It can simply mean being there. It may be hard to know how to be there, though.

A lot of people have heard the phrase, “It gets better.” It seems like a hopeful sentiment, but many in the mental health community, myself included, do not care for this phrase.

“It gets better” shrugs off the current pain and issues. While the phrase may be true, you’re not addressing the person’s concerns and troubles at the moment. Telling someone their issues may lessen in an arbitrary time frame means nothing.

For me, it was frustrating to hear this phrase because I had tried to feel better for years. I felt ignored when someone would tell me “it gets better” or to “wait it out.” That doesn’t validate the very real pain I experienced. It’s like telling someone to shut up because you don’t want to hear about their problems.

People don’t use the phrase to be invalidating. They don’t realize there are much better ways to support someone.

Here are some tips for helping a friend struggling with their mental health:

Validate their concerns and emotions. Let them tell you what’s going on. You don’t need to offer solutions or advice. Get on their level and let them know you understand. Sometimes people just need someone to listen. Here are some alternative phrases to “It Gets Better” that are actually validating:

“I understand you’re feeling _____. You have every right to feel that way.”

“That’s really hard to go through, so it makes sense that you would be struggling.”

“You don’t have to be OK all the time. It’s also OK to feel hurt or upset.”

What you say depends on the situation, of course. Validation may seem disingenuous when you actively use it but in my experience, I’m never trying to say the “right” thing. I’ve become more sympathetic, and I listen intently. I want to validate someone’s feelings because I care and believe them.

Let them know you’re there for them. Now and in the future. It takes a lot to open up to others. If you let someone know you’ll be there for them, you become a “safe” person. A safe person is someone whom they can trust or lean on when needed.

While it’s nice to provide support for others, make sure it’s not at the expense of your wellbeing. Your mental health is important, too. It’s one thing to put someone’s needs before yours in a moment of crisis or hardship. It’s another to constantly put another person’s needs before yours.

Ask them if you can do anything to help. They may not need anything from you (aside from being there). Asking is another way to show you care.

Check up on them. It’s a good idea to reach out to your friend, even if they haven’t reached out to you. Ask them how they’re doing, honestly. You don’t need to hound them, but people can pull away when they need support the most. Sometimes you may need to take the initiative.

Offer to help them find resources or help if needed. You can offer to look into resources if they decide to get professional help. Sometimes people aren’t ready to reach out, but if there’s a concern, you could ask them if they’d be willing to try. Don’t force treatment but make sure they know it’s an option.

Ask them if they’re thinking about suicide. This may seem extreme, but if you’re worried, it’s better to ask than to ignore your concerns. It shows you care, and you can help them find the resources they need.

At the end of the day, showing you care is more important than the words you choose. Don’t let the fear of saying the wrong thing keep you from helping someone.

What They Don’t Tell You About Surviving a Suicide Attempt

Content Warning: If you need support, you can reach out to the lifeline at 1–800–273–8255.

A few months prior to my attempt, my therapist told me that people who attempt suicide typically have tunnel vision. Suicide seems like the only viable option at the moment.

She said that most people who attempt suicide regret their decision. This is true. There are a number of suicide attempt survivors who have shared their regret, most notedly Kevin Hines, who survived jumping off the Golden Gate Bridge. Hines has said he felt instant regret as soon as he left the bridge.

What no one actually tells you about surviving a suicide attempt is that you can experience regret at not dying.

It’s irresponsible to push a narrative about surviving suicide without addressing the fact that many who do attempt still struggle. They may even attempt again. Forty percent of those who do die by suicide had a previous attempt.

While there were (and are) days I’m appreciative to still be here, there are days I regret being alive. Many times we hear survivor stories about gratitude. They share how they’ve since gotten better and no longer find themselves in that dark place.

This may be true for some, but it isn’t true for me or many others who attempt suicide. A previous suicide attempt is the “single most important risk factor for suicide,” according to the World Health Organization.

My attempt was three years ago today. May 16, 2016, was supposed to be the first day of summer break. Instead, I was finally giving into my thoughts and overwhelming emotions I couldn’t fight anymore.

The last five months of my junior year in college were hell as I juggled school and crippling depression. I thought things would get better as soon as I finished the semester. It was the reason I held out all semester, holding onto the last sliver of hope that I could get better.

When I didn’t feel better, I became completely hopeless. My friend/neighbor came over that day and found me distraught on the bathroom floor. (I will not detail the method I used because it’s proven to be dangerous to people at risk for suicide.)

Days after the initial numbness and shock of my attempt, I had moments where I realized the magnitude of the situation. I found myself grateful for dogs and mundane parts of life. This appreciation for life has come and gone over the last three years. I’ve cried thinking of how grateful I am.

But that’s half of the story, and the other half is just as important.

I’m not always appreciative. I think about all the pain I could have avoided had I died. My disorder is cyclical, so depressive episodes will be a part of my life forever. I still have suicidal thoughts, though not presently and not nearly as intense as they used to be.

This anniversary is both a blessing and a curse. I am stronger now than I was then, partly because of my experience. I can see how far I’ve come. It is a reminder, though, of emotions and worries I’d rather forget most days.

Thoughts of regret are just another version of suicidal thoughts, which I’ve learned to handle over the years. They come and go, which is why I know I can beat it. While one day may be tough, the next day might be better. The better days are worth it, and they will come. I hope you stick around to experience them.

Don’t Tell Me To Come Off My Psych Meds

Nothing puts people on a high horse quite like telling others what to do with their body (with the exception of telling people how to raise their children).

People love to talk about diets and weight loss. They like to give “advice” on what you should do. Lately, I’ve noticed the (maybe) well-intentioned yet unsolicited advice is more about psychiatric medications. Instead of telling others how to drop a few pounds, it’s how to drop their medications.

It’s insensitive to talk about someone’s weight, and many of us know this. It’s just as insensitive to talk about someone’s psychiatric medication usage.

I’ve found that there are three types of people who like to tell others to get off their meds. In their own ways, all of them are uninformed — partly because my body is none of their business.

The Testimonials

The testimonials are people who used to take psychiatric medications. They generalize their experiences to an individual. They tell you every med they used to take and how they’re “so much better” without them.

It’s true that some people can come off their medications and never need them again. It’s true that medications can make things worse for some people. But our brain chemistries might as well be fingerprints — they’re different for everyone.

There are also a lot of compounding factors when it comes to who can come off meds and be OK and who can’t. Antidepressants may be prescribed for situational depression, meaning there’s a particularly trying time in your life and your doctor thinks medication may help you come out of it more effectively.

Then there are patients who are prescribed multiple meds who end up feeling tranquilized or “out of it.” They taper off the medications and understandably feel better. Polypharmacy is a huge issue in psychiatry, but that is a post on its own.

If someone is able to stop taking psychiatric medication, that’s great. I’m a big proponent for doing what is right for you. This doesn’t mean I can come off my medications, so please stop with the patronizing.

The All-Naturals

The all-naturals may include some testimonials. These are the people who believe if you take this supplement or do that diet, you won’t need the medications anymore.

It’s true that your lifestyle can have an impact on your mental health. Multiple research studies have shown regular exercise has mental health benefits. I’m not minimizing the importance of taking care of your mind and body.

Assuming people who take medications haven’t tried nonpharmacological therapies is the problem. Most people who take psychiatric medication do so in conjunction with other treatment approaches like therapy or lifestyle changes. Our brains might need that extra push medication gives us.

Giving unsolicited advice might also hit an emotionally sensitive topic. Very few people who take psychiatric medications find the right medication the first attempt. Medications may also be the last resort for someone who has tried everything else (therapy, lifestyle changes, etc.) but still needs help.

If you must give your two cents, maybe suggest something you found helpful without making it seem like the Holy Grail. For example:

“I tried ____, and it seemed to help with my energy. I know you said your energy levels are a little low, so I thought I’d let you know in case you wanted to look into it.”

If the person doesn’t seem interested, back off. There’s a difference between being compassionate and demanding we try something to “help.”

The Conspiracists

Conspiracists like to talk crap on Big Pharma. I mean, I do too. It’s no secret Big Pharma cares more about making money than helping people. That’s why we have people pinching pennies to pay for their medications, even with insurance.

Conspiracists like to tell others that psychiatric medications were made up for people to buy pills they don’t need. They tell people that doctors are in bed with the pharma companies, so they’re more likely to push medications, even if you don’t need them.

Yes, psychiatric meds are some of the most prescribed drugs in the U.S. I’d even say some medications are overprescribed, but this doesn’t mean psychiatric medications aren’t beneficial for many.

Recent research shows that antidepressants do work, and researchers hoped the results would quell some of the wariness about the medications. The researchers did point out that we still don’t know exactly why antidepressants are effective, and there’s a great need for more research into this and other treatment options.

You can criticize the health care system, the lack of research funding and Big Pharma. Don’t criticize those of us trying to feel better.

My medications, along with therapy, have helped me rediscover myself after my diagnosis of bipolar 2. They don’t change who I am. If anything, the depression stole me from me, and the medications helped get me back.

Goodbye Queen Smurf

I made the biggest adult purchase of my life so far. I bought a new (used) car Saturday after driving my 2010 Nissan Sentra “Queen Smurf” for the last seven years. I loved that car but it was time to “Kon Mari” it and say goodbye.

Queen Smurf was with me through the last half of high school, all of college and the first couple of years after. Queen Smurf rarely had maintenance issues (or at least none that I could hear if I turned the music up loud enough).

It got me from Missouri to Florida. It survived a rear-end accident when a woman behind me wasn’t paying attention. It bravely stood by through all the bumps and scrapes, especially the time I misgauged the garage opening and broke my mirror. You could barely tell the replacement mirror had a black encasing instead of a dark blue.

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My friend, Max, scraping snow and ice off Queen Smurf.

It was there to take me on late night drives when I was depressed and couldn’t sleep. It heard more of my crying than any living being, and it suffered through my incredibly bad singing.

When I first got Queen Smurf, I decided I would drive it into the ground before I purchased a new vehicle. I came close to doing just that. I was young and not educated on the value of a trade-in, though I still managed to get a solid trade-in value. I thank Queen Smurf for being the best first car I could have asked for, but it’s time to move on.

I traded up for a 2016 Fiat 500X. I’m still learning about its gadgets and how to use a rearview camera. It doesn’t rattle or make weird noises like Queen Smurf. All of its hubcaps are still attached, and it has Bluetooth.

I look forward to seeing where my new car takes me (literally). I do not, however, look forward to the car payments.


Tired Friday and Are the Pretzels Worth It?

I woke up at 5 a.m. today. I wish I could say it was because I’m that person who wakes up early to do things morning people do. Instead, I woke up in a dazed panic because my phone (read: alarm clock) wasn’t on my bedside table.

I starfished on my bed in hopes of hitting it with one of my extremities. Eventually, I had to turn on my lamp to find it underneath my dog, who looked at me with red, tired eyes and on the verge of growling for waking her up.

Ever since I was a child, I’ve had some interesting sleep issues. I used to sleepwalk. I even drew a bath and got in fully asleep in the second grade. When I’m not walking, I’m talking in my sleep. Hell, I once called someone on Snapchat, and I didn’t even know you could call people on Snapchat.

So when I couldn’t find my phone, there was no, “oh, I’m sure it’s close, and I’ll still hear my alarm.” It’s more like, “I hope it’s not in my betta fish’s tank.”

My frantic search woke me up enough that I knew I wasn’t going to fall back asleep right away. I got up, drank a smoothie and browsed social media.

By 6, I grabbed my pillow and went to lie on the couch to watch “Friends.” I managed to squeeze out another hour of sleep before my dog barked in my face, demanding to go outside.

It’s now almost 4 p.m., and all I can think about is curling back up on my couch. My apartment complex is celebrating National Pretzel Day with free pretzels in the clubhouse tonight, and I haven’t decided if a pretzel is worth being social.

It always takes more effort for me to go to gatherings like these. I hate the unknown. And it’s literally a room full of people I don’t know. I also like to know the “schedule” of things and how things are supposed to go beforehand. Will they be warm, soft pretzels? TBH, if they aren’t, that’s a bust and definitely not worth my time. How long do you have to socialize before you can leave? Will there be drinks? Pretzels without drinks sound like a nightmare. Should I bring a drink just in case?

Socializing is exhausting. I just want the damn pretzel.

In addition to longer blog posts, I’m now writing daily, shorter posts about life happenings and whatnot. A post a day is my goal, but, really, how much is there to blog about on days I only binge Netflix and fall asleep at 2 p.m.?

Why I Still Go to Therapy When I Feel Well

(My fitting coffee mug this morning before therapy.)

In addition to longer blog posts, I’m now writing daily, shorter posts about life happenings and whatnot. A post a day is my goal, but, really, how much is there to blog about on days I only binge Netflix and fall asleep at 2 p.m.?

Therapy isn’t only for people who are in crisis or at their lowest point. I sought therapy three years ago during a severe depressive episode, but I’ve learned there’s a benefit to sticking with it, even when everything seems OK.

I haven’t been in therapy consistently since I started going. I’ve changed therapists, I’ve moved, and I’ve taken breaks when I’ve felt “stable.”

I started attending therapy again in September 2018 when I realized I needed help getting through my latest depressive episode. I saw her until December when she had to unexpectedly move. Now, I see someone else in the same office, but I no longer consider myself in a depressive episode.

Instead of once a week, I go every other week on Thursdays. Sometimes it feels like I have nothing to talk about because I’m still learning how to use my time effectively in therapy.

Honestly, I’m not used to going when I feel well because I’ve been more depressed over the last three years than anything else. But I’m slowly learning that therapy when I’m well is just as important as therapy when I’m not.

When I’m depressed, there are things I can’t address in therapy because they’re either too hard to talk about or there is a more pressing matter in the moment.

Therapy while I feel well gives me the space to address issues like how bipolar disorder has affected my life over the last three years. “Well Therapy” gives me a chance to more objectively analyze my thoughts and behaviors that bubble up during depressive episodes.

Therapy right now essentially helps me gain the tools and perspective I need in order to survive the next depressive episode or stressful event.

This doesn’t mean I’ll have to stay in therapy for the rest of my life. Depending on how long I feel like myself or “stable,” I might stop before my next episode. I might need to start therapy again after taking a break from it. On the other hand, my next depressive or hypomanic episode could be around the corner, and I’ll need to continue going. I don’t know.

There isn’t a time limit on healing and bettering yourself. Therapy is for whatever you feel you need it for. You don’t have to hit rock bottom to go to therapy, and you don’t have to stop going the moment you feel better.

Growing Up With a ‘Gross’ Skin Condition

I was a sophomore in high school, working on the school’s yearbook after the last bell of the day rang. Though Yearbook and Newspaper were separate classes, we all mingled in the journalism room after school.

A junior newspaper girl with her friend sat at the computer next to mine. I heard her mention psoriasis after an ad for a medication popped up on her screen.

Her friend asked her what psoriasis is, and for a moment, I thought about telling them about it and that I have it. The moment was short-lived, though. The newspaper girl shuddered and said it was itchy skin and “so gross.” People who have it should, like, shower more, she said.

I continued to act like I was focused on my work. I was angry at their insensitivity and ignorance. But more than anything, I was embarrassed.

I shouldn’t have felt embarrassed. Psoriasis has nothing to do with bathing, and I’m not gross for having it. But it’s hard not to feel embarrassed when classmates act like psoriasis is leprosy.

I’ve had psoriasis my entire life. I was officially diagnosed with psoriatic arthritis when I was 6, but psoriasis came before arthritis. About 15 percent of people with psoriasis develop psoriatic arthritis, according to the American College of Rheumatology.

Psoriasis is a skin condition characterized by red, itchy and painful patches of skin, according to the Mayo Clinic. Everyone sheds skin, though we can’t see it. In psoriasis, the “life cycle” of skin cells is sped up, causing them to build up (the patches of psoriasis).

Psoriasis is thought to be caused by an overactive immune system that attacks healthy skin cells. Your immune system fights off viruses and other infections to keep you healthy. In autoimmune diseases like psoriatic arthritis, the immune system mistakes healthy cells for foreign invaders like a virus or bacterial infection.

Some of my earliest memories are of my mom slathering my scalp in an ointment. Or shampoo. Or another cream. Or all three. I’d wear shower caps to keep the goo on top of my head as I tried to ignore the intense itching on my scalp. I imagined my psoriasis was screaming in agony from being bothered by the goo.

One treatment came after another. And then another. Though I was 4 or 5, I don’t remember anything working. I’d force myself to keep from scratching. Sometimes I’d scratch in my sleep and wake up with blood under my nails, on my scalp and pillow.

Anytime I went to the hair salon, my mom explained to the stylist that I had psoriasis, so she may see flakes and red spots. The stylist would nod in familiarity. I found most of my hair stylists were aware of the condition or had previous clients with it. They understood more than most.

After I was diagnosed with psoriatic arthritis at the age of 6, I began weekly injections of a medication designed to help both psoriasis and arthritis. I was one of the first kids to take the medication, so the doctors didn’t know what the short or long-term side effects would be. It had been approved for adults but use in children wasn’t established. My parents had to sign forms, stating they wouldn’t sue if I got sick or died.

After surgery on my wrist in high school (photo by Odi Opole)

At that point, my arthritis took center stage over psoriasis because it was progressing quickly. An autoimmune disease, like psoriatic arthritis, is dangerous if left unchecked. Though not fatal, damage to joints is irreversible and the pain gets worse. Mobility can diminish, and you’re more likely to develop a host of other chronic illnesses.

The medication improved my quality of life immensely. My pain diminished and my psoriasis mostly cleared.

Though I was doing better, the medication lowered my immune system response. I was more susceptible to sicknesses like the flu, strep, colds and everything else classrooms are a hotbed for. A common cold could keep me down for a couple of weeks instead of the typical four or five days.

Psoriatic arthritis is chronic, so I’ll have it for the rest of my life. I’ve had long periods of inactivity or “remission,” but I still have flares from time to time. Overall, my skin is relatively clear.

My medication has made it possible to pass as “healthy” to most people. This is why I sometimes hear ignorant statements from people like the newspaper girl in high school. What she and others don’t know is that I know what it’s like to have my body fight itself. Believe me, bathing is not the issue.

What Made Me Stick Around After My Suicide Attempt

My therapist in college told me most people who attempt suicide say they regretted it soon after. Most people realize the gravity of the situation and lose their “tunnel vision,” which makes them think suicide is the only answer.

Many of us have heard the inspirational stories of suicide attempt survivors who realized the preciousness of life after their attempt. There’s nothing wrong with this, but it wasn’t my experience.

I didn’t have an all-knowing, eye-opening revelation about life and its value after my suicide attempt. For me, the aftermath was much less divine.

I didn’t immediately find wisdom that you supposedly only discover at the brink of death. I’m not even sure what that “wisdom” would be.

No, my revelation was much smaller. I was lying in the hospital bed on the medical floor silently scrolling through Facebook while the nurse tech (AKA my suicide-risk babysitter) sat a few feet away on a computer.

I came across a photo of a pug on my feed. That’s when the gravity of the situation hit me.

Holy shit.

I would have never seen another dog again. I cried and quietly moved into the bathroom next to my bed where I could have a couple of minutes to myself, without my babysitter.

That was my “come to Jesus” moment. A dog picture on Facebook.

But I’m glad it was something rather minuscule in the grand scheme of life because what is life if not for the small things that bring us joy and comfort?

But I guess that’s the wisdom I received from that experience. Dogs are worth sticking around for.

18 Lessons About Bipolar I’ve Learned So Far

World Bipolar Day is March 30. I was diagnosed with bipolar 2 disorder in March 2017 at the age of 21. It’s only been two years since my diagnosis, but my symptoms began in childhood and became overwhelming in college.

Bipolar 2 means I experience depression and hypomania. Hypomania — or “under” mania — means I don’t experience full-blown mania.

Hypomania for me includes insomnia for a few days, racing thoughts, jumping from one project to the next or spending hours fixated on one thing. I don’t sit still and everything irritates me, especially sound.

My impulse control diminishes. I’ll shop. A lot. As in maxed out two credits cards in a short time. Hypomania can be both a blessing and a curse. Sometimes I get a lot done. I feel incredibly alive, which can be a relief when you spend a lot of time depressed. But it can also cause a lot of damage — on my wallet and in my life.

Most of my mood episodes are depression-related, though. It can be the lowest of the lows. Other times, it’s just lurking in the background of my mind, reminding me what it can do.

In honor of World Bipolar Day, which aims to raise awareness about the disorder, I’ve decided to share lessons, realizations and other tidbits I’ve gained along the way.

Disclaimer: No two people are the same. My experiences with bipolar will not be the same as another’s. These are my experiences and takeaways.

1. I feel emotions more intensely.

People with bipolar disorder feel emotions more intensely. Our lows feel lower and our highs feel higher. I can be overwhelmed with emotion.

Experiencing intense emotions has its upsides and downsides. While the negatives are unspeakably bad, I feel love, excitement, and happiness in their purest forms.

I know what it’s like to feel emotions that are almost tangible. On the flip side, I’ve learned how to mask my emotions (namely the negative ones). My emotional wall is made of concrete, steel, and poisonous thorns that is a bitch to break down.

2. Not every upbeat mood is (hypo)mania; not every bad mood is depression.

Everyone has a spectrum of emotions. No one feels content or happy all the time. I will have bad days but not every bad day is because of bipolar. Sometimes it means I need more sleep, or I’m a bit stressed with work.

Hypomania is a bit trickier to identify. Frankly, I don’t even worry about identifying hypomania unless it’s clearly going to be a problem. Who doesn’t want a few days of amazing productivity and euphoria?

Sometimes I’m just excited or motivated. I think happiness and motivation feel more intense for me because I spend so much time depressed and without either. This doesn’t necessarily make it hypomania.

3. My moods may be unreliable, but I’m not.

As a person, I make lists and fill out planners. I deliver on my work and am always trying to improve. I care immensely for my writing and work. I’d never let something intentionally slip.

As a person with bipolar disorder, I sometimes don’t care to get out of bed, let alone do something. I can’t rely on my memory because my brain is mush, and I can’t keep track of time.

When I’m hypomanic, I might get a lot done and then people expect that level of work from me all the time, which is an impossible level to keep myself at. Hypomania might also cause me to hyper-fixate on a research paper I’m reading. Hours will go by and it’ll feel like five minutes. There’s also the other side when I can’t focus on one thing, but everything is exciting and I spew multiple ideas that I can’t possibly follow through with all at once.

4. I don’t have to believe every thought I have.

It took a while for me to understand that our thoughts are not us. Sounds impossible, right? What we think, believe, say and do are the basis of who we are.

The thing is, the brain is really effing weird. Most of us experience intrusive thoughts — those thoughts that have you thinking, “Why did I just think that? That’s so weird/messed up/etc.”

Thoughts can also be irrational. Do I really believe if I don’t tap four times on the outside of the plane door before I board that we’ll all plummet to our deaths? No. Am I going to skip tapping on the door on my next flight? Also no.

I’m not a horrible person. I’m not worthless. Not everyone hates me or thinks I’m annoying. These are things my depression tell me.

I’m not being monitored (more than any other American). People can’t read my thoughts. These are thoughts my hypomania tell me.

5. Misdiagnosis is incredibly common.

I was first diagnosed with major depression. Misdiagnosis can happen to anyone, but it’s especially common for people with bipolar to first be diagnosed with depression. In my case, the hypomania wasn’t nearly as noticeable as the depression at first. It first seemed like good motivation and random happiness. It wasn’t until the other more troubling symptoms appeared that I was diagnosed.

6. Meds can make things worse.

The first medication I took did not help whatsoever. In fact, it was the worse thing for me. My doctor kept me on this antidepressant for a year, despite me telling her I felt worse and thought I needed to try something else. Her response each time was, “It’ll get better,” and “Give it time.”

I can’t say if the medication led to my suicide attempt, but I believe it was a factor. Antidepressants can ironically increase suicidal thoughts in people, especially young people.

Each time I told my doctor I didn’t feel any better, she’d increase my dosage. Eventually, the increase led to a hypomanic episode and my diagnosis changed from major depression to bipolar 2. I had experienced hypomania before but didn’t have a name for it. It only became extreme when the medication was increased.

7. Meds can make things so much better.

Though my first exposure to psychiatric medications was not a pleasant one, I have finally found a couple of meds that keep my highs a little less high and my lows a little less low.

I’ve gone through an antidepressant, a mood stabilizer, an antipsychotic, and a few meds for sleep and anxiety.

Sure, I’ve had to tweak my doses because of my latest depressive episode and physical side effects, but I currently feel like my medications are truly helping. I’m taking an antidepressant and mood stabilizer now. I also have an as-needed sleep medication.

When I finally got my meds figured out, everything got brighter. Literally. I could see vibrancy in life again. I was happy and content. My thoughts were not dark or suicidal. I felt like myself again after a year and a half.

8. I have to advocate for myself, especially with doctors.

Like mentioned in number 6, I had a doctor who did not listen to me. She made things worse, and I felt completely ignored. I lost more of myself each day while she just scheduled me for monthly appointments.

Through that experience, I’ve learned to take a stand. Doctors are authority figures, but it’s my body. I ask questions. I say no if I don’t agree with a medication change. If I feel like I’m not being heard, I let my doctor know. If I have to, I find a new doctor. They see me for 15 minutes. I live with myself 24/7.

9. Moving between episodes is extremely exhausting.

Depression is exhausting. Coming down from hypomania is exhausting. Honestly, exhaustion and fatigue are kind of my thing.

Brain fog is both hilarious and awful. I mean, when you circle gas pumps for a solid five minutes because you can’t figure out how to get your car to face the right way to pump gas, you have to laugh.

When you forget your phone number or PIN you have to make light of it in front of the cashier. I had to have my friend buy my groceries once because I couldn’t remember my PIN.

Fatigue is a part of depression, but when you shift between having all the energy in the world to no energy at all, there’s a whole other level to exhaustion.

10. Bipolar is more than highs and lows.

Depression and mania are the hallmarks of bipolar disorder, but there are hypomania and mixed episodes, too. Each mood state comes with its symptoms.

One of the symptoms people don’t usually connect to bipolar is paranoia. I’ve had paranoid thoughts, but I wouldn’t say it’s led to delusions. Bipolar disorder can also include psychotic symptoms like delusions and hallucinations. These symptoms are typically associated with bipolar type 1 because they’re more common in full-blown mania than hypomania.

11. Mixed episodes are a special kind of hell.

Mixed episodes are what they sound like: you’re given a mix of depressive symptoms with hypomanic or manic symptoms. It’s like the Vodka Redbull of mental illness. You get both the downer and the upper.

You experience the various symptoms all at once or in very rapid succession. It’s hard to explain what a mixed state feels like. For me, it feels like my skin is crawling. All I want to do is scream. It’s a lot of energy and no energy.

One night I texted my friend multiple times telling her I was coming to visit her in Kansas City. KC was two and a half hours from Columbia, Missouri, where I went to school.

It was already after 8, but I asked if I could visit. She said yes, and I became ecstatic and began packing for the weekend. Two minutes later I laid on my bed, feeling as if someone punched me in the stomach. I was too depressed to move. I texted her that I wasn’t coming after all. Two minutes later I was packing again and asking my roommate if he’d watch my dog. This went on for hours. I couldn’t get comfortable in my mind or body.

12. There’s intense fear about having an episode.

Bipolar is technically a chronic illness. This means that, for the rest of my life, I will fluctuate between depression, euthymia (stable mood), and hypomania. Medications can help. Therapy can help.

The first time I felt sad for a couple of days after spending over a year depressed, I freaked out. I feared those couple of days were the start of another lengthy depression. Turns out it wasn’t, but I will always harbor the fear of an episode.

Once you live through the worst of depression, it’s hard not to fear that again. It’s easy to think you couldn’t handle going through that again.

13. It’s possible to go months without an episode.

Before my last depressive episode, I had seven months without any issues. I felt like my true self again. I made strides in my professional and personal life. It seemed like the worst was behind me, but that’s the thing about bipolar, it comes and goes.

I was “unstable” for about a year and a half, shifting between depression and hypomania. Everything was a battle — getting to class or even getting out of bed, working, eating, breathing. Then one day, my mind became quieter, and I felt like myself again.

14. It’s possible to lessen the intensity of mood swings.

This ain’t easy, believe me. Many things help prevent mood swings for me. I talk to friends. I go to therapy. I journal and track my moods. I workout (kind of) and take my medications. Routines are important because predictability in my life is important when my moods aren’t.

Therapy and tracking my moods can help me notice when an episode may be coming. Then, I can be proactive with self-care and coping skills to lessen the impact.

I could be better at doing these things, but adulting on its own is hard enough without the added responsibility of mental illness.

15. Not every mood swing can be lessened.

While it is possible to smooth out the highs and lows at some points, it isn’t always going to work. Sometimes your brain and its chemicals are going to do what they want, no matter what you do or what meds you take. Maybe it means you have to change a medication or dosage, which I’ve done countless times.

Coping skills may help lessen the intensity, but sometimes coping skills become survival skills. It may take all my energy to keep my head above the water during an episode.

16. I don’t always feel like “myself.”

Depression takes me away from me. At my core, I am curious, determined, and passionate. Depression steals these away from me. I become a shell of who I am, and it’s like I’m living as two different people. I go from living and making strides in my life and career to treading water to survive.

17. People don’t understand bipolar.

It wouldn’t be a mental illness if it didn’t come with a heaping pile of stigma. People think you “snap” and become angry or depressed in a moment’s notice. In reality, most mood episodes last days, weeks or even months.

People try to understand, and it’s important that they do. But unless you’ve felt this, it’s impossible to get it completely.

18. I am not “bipolar.”

I have bipolar disorder. It is a part of me, but it isn’t me. Like anything we experience, bipolar has had its influence on who I am.

There are many negatives about living with bipolar disorder, but there are also lessons I’ve learned by having it. Without it, I probably wouldn’t have become passionate about mental health and advocacy. I’m also more compassionate and understanding because of it.