The National Alliance on Mental Illness (NAMI) has a Stages of Emotional Responses chart that traces the emotional path people generally travel in coming to terms with their loved one’s mental illness. I’m pretty much at the final stage, Stage III: Moving into Advocacy, but I’m still sort of stuck at Stage II: Learning to Cope, which is characterized by Anger/Guilt/Resentment, Recognition and Grief.

Yes, we’ve been living with bipolar disorder for about 12 years now, and I’m still angry and resentful. Now, though, I’m not angry at my wife who has bipolar disorder. I blame bipolar disorder. It accosted my wife, tried to ruin our marriage, emotionally traumatized our children, ruined my wife’s career, and stole tens of thousands of dollars.

45 Comments to
Bipolar Disorder: Blame the Illness, Not the Person

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  1. Joe: I admire how open and honest you are about what you are going through – this illness brings a lot of collateral damage with it. However, I can’t agree here. Manic Depression is chronic – it will not go away or be cured – it is in my DNA, my mind, my soul. To blame the illness is to blame part of me, and that leads to shame. Acceptance is the answer, 100% acceptance. The illness is not the enemy, ignorance is the enemy. The ignorance did not single you out, or her. Over time this illness gave me more than it ever took. Remember; keeps your friends close and your enemies closer. Good luck to you both – Alistair

  2. should have read — the “illness” is not the enemy. sorry!

  3. Alistair–

    I disagree. The illness gave us nothing. God’s ability or the human ability to turn something bad into something good is what spun all the crap bipolar dealt us into the few nuggets of gold we’ve reaped from bipolar. I suppose this is true in your case, too. Your soul and ability to not only overcome adversity but make something good of it is not a gift from bipolar disorder any more than any tragedy of life can be considered a gift.

    I do agree that bipolar (manic depression) is chronic, but it is also treatable. I don’t think blaming the illness is to blame part of the person any more than blaming heart disease is the same as blaming someone for having a heart attack. Sure, I accept the fact that my loved one has bipolar disorder… not that we really have much of a choice in that, but I still blame the illness for the bad stuff we’ve had to deal with as a result of it.

    If bipolar disorder weren’t the enemy, we’d have no reason to try to make it go away, no reason to pursue symptom relief. I’d like to see a cure. In the short term, we try to treat the symptoms. I like having my wife back… and she certainly likes to feel more like herself.

  4. I embrace mine… and I do not blame it. Bipolar does not decision for me, I do decisions for me. I am sometime overemotional and not myself… but I don’t fall into this moder devil possesion. I know my trigggers, I know when I am in an episode. I know I need to sometimes to slow down. I know I have to sometimes use all willpower i have to do so. Sometimes, it does not work. Never ever would I use the bipolar card. I did it, I face the consequences.

    and medical intervention is not a mean to end it all. It maybe helpfull, but it is a small part of “recovery”. It seems to give false hope to people. Pill to make us the person you always wanted to be… forget, will power, your illness is to blame… Seems horribly enabling to me.

  5. Venus–

    Playing the bipolar card? Would anyone say that about heart disease, diabetes, or cancer? Perhaps in some mild cases of bipolar, thought-therapies or “will power” can keep mood episodes at bay, but to think you can just will away bipolar disorder is as inconceivable to me as willing away any serious physical illness.

    Yes, medication is “enabling.” It enables one to function when the illness makes it impossible to do so. Medication isn’t always effective and it can have negative side effects. And you’re right, it may not be the entire solution. Other therapies can help, including mindfulness, CBT, and IPSRT (Interpersonal and Social Rhythm Therapy). I think the best approach is to use everything at our disposal that works. You can’t do CBT and mindfulness when you’re in the grips of full-blown mania or depression.

  6. Joe, diabetes does not mean you snap at people unreasonably, make decisions that effect other’s lifes in a bad way. Hence, no diabetus card. I never made anybody claim that their medical condition made them do anything.

    I was not talking of medication as enabling, I was talking about the medical approach (aka blaming everything bad on chemical imbalance). It may help, but i have yet to meet a person who took pill and life was wonderful. It does not work that way, so let’s not delude ourselves.

    and as for willing away… You cannot will away the condition, but you chose what to think. You can level your moods to a degree. To claim that one cannot do so, just because of their conditions… is disrespectful and does nothing to reduce the stigma. One can learn to manage, to observe, to expand their comfort zone. I did it… and many others did as well.

  7. Venus–Sometimes diabetes does make one snap at people unreasonably, as when the blood sugar is out of whack. Unfortunately one of the symptoms of bipolar disorder can be extreme irritability. Just because the disease has behavioral symptoms doesn’t mean it is any less a disease than others.

    I have met people with bipolar who are much improved on the proper medications — changing from completely irrational and aggressive to rational and caring. It does work that way… not always, but in many cases. I am not deluded.

    It’s not disrespectful to say that a brain illness can eliminate a person’s ability to control what they say or do. That’s the nature of the illness. It has nothing to do with stigmatizing someone any more than saying a person who had a heart attack did so because they had clogged arteries.

    What’s stigmatizing is to imply that someone has control over their thoughts, behaviors, and what they say when they really don’t and are merely too weak of character to control what they say and do as a result.

    I am always happy to hear about you and others who are able to maintain mood stability without medications. I’m not saying it can’t be done. What I am saying is that everyone is different and there are different degrees of the illness. During acute phases, medication can be a lifesaver and get a person back to a point at which they can start reaping the benefits of other therapies.

  8. Thanks Joe! I very much agree with you. I have recurrent depression, and recognizing that the depression is a beast that invades my mind and body helps me conquer some of the shame and fight through those times when I have a bit of breakthrough.

    I think what people who have not suffered from depression don’t always appreciate is that it really is a full-body illness. The fatigue, sleep disturbances, and cognitive problems all take a toll as well as the psychic agony.

    Effective medicine has been the biggest part of bringing me into remission. The difference it has made is enormous. Therapy helps a lot too, although it is not effective if I am not on medication. I’m grateful to have had very competent care. It makes it possible to have a life with much more normal human ups and downs. I have to watch my stress levels and be alert for when I start to slip. The illness isn’t gone, but I can go about the business of living and pursuing my goals. On the whole, good treatment has done well by me.

  9. I find it insulting when people imply I do not suffer, just because I can cope and because I believe in myself and in capability of humans to overcome things.

    I just don’t see how believing that humans are strong is stigmatizing. I think that telling person in vulnerable place “you need to take meds for this and if they don’t work, too bad, because your brain is broken and your capability to think was ELIMINATED (seriously, why not go back to demon possesion? This is much much worse!),” is a very cruel thing to say. I would rather be told that I CAN work it out, that I CAN push and have people who tell me to push and struggle on. I don’t discard role of medication, although it’s not what I chose.

    I think this is about attitude. I believe humans are responsible for themselves and their actions. If I screw up, i try to attone for it. I don’t blame chemical imbalance ex machina for my decisions… because it does not help people who were involved.

    what does sound better “I am bipolar, blame the disorder” or “I am really sorry, is there anything I can do for you now?”.

    • Hi, Venus–

      You’re right. Believing that humans are strong is not stigmatizing. What is stigmatizing is the belief that some people are weaker because they need medications or some people are stronger because they don’t. I’m not saying that you said or implied this, but I know that this is what many people think, and I want to make it very clear how wrong I think this is.

      I know many people with strong characters who need medication to help maintain mood stability. It takes an incredible amount of strength for some of these folks to remain on their meds and do whatever else is necessary to keep major mood episodes at bay. This is their way of being “responsible for themselves and their actions.”

      When I say “blame it on the illness,” I’m suggesting focusing one’s efforts on treating the illness instead of blaming the person. I can tell the difference between when my wife is talking and when mania is talking, and I can’t hold her accountable for what mania makes her say or do. Blaming her does absolutely no good. Encouraging her to will her mania into submission would be futile. Seeing that bipolar is at work enables us to take action to treat the illness and put my wife back in control.

      Some people feel it necessary to apologize for hurting others during a major mood episode, and that’s fine, if it makes them feel better about it. Personally, I see no need to apologize for what results from having an illness.

  10. “I find it insulting when people imply I do not suffer, just because I can cope and because I believe in myself and in capability of humans to overcome things.”

    Umm…Venus…if that was directed at me, I wasn’t talking about you.

  11. Joe –
    I would like to comment to this, as a person with both psychiatric (Schizoaffective Disorder, Bipolar Type – among others), neurological (tic disorder, and later medication-induced movement disorder), respiratory (asthma), cardiac (medication induced arrhythmia) and blood glucose (hypoglycemia) illness and disorder. Though the list may seem a bit long, only two have been coded as severe, and they are the two most relevant to this conversation: my mental illness and my hypoglycemia (aka, low blood sugar).

    You are correct in saying that blood sugar imbalances can cause irritability, mood swings, depression, anxiety, alcohol abuse and other psychological symptoms. For a person who is unaware they have such an imbalance, they feel horrid and are often helpless to fix the situation. The emotions are strong, and can often seem a bit overwhelming. Yet, in most cases, a person will eventually be diagnosed as having either too high or too low of blood glucose levels. It is then their responsibility to make amends to any damaged relationships or burned bridges, and learn to manage their blood sugar and prevent relapse. In my case, with low blood sugar, I can choose not to monitor it, eat healthy, carry/eat snacks when needed, alert others when I need help, and so forth. If I do not manage and take care of the illness, and my blood sugar goes and stays out of whack, then yes – I can be blamed for that.

    The same goes for my psychiatric illness. Now that I am diagnosed and have been in treatment for quite some time, it is my responsibility to manage my illness – keep track of triggers, be aware of an episode, use all possible tools to manage it, and, if all else fails, to reach out and say “I need help”. I can have the most intense impulses and urges, and it is still my choice to act or not – and my responsibility not to. For someone who is not treated, does not have a good support system and does not have the necessarily tools, this can be near impossible; however, I have been at this for most of my life. If I feel I can no longer control myself, it is my responsibility to take steps to gain that back – from simple psychological tools to an intensive hospital environment, depending on the situation. More so, abusive behavior is *never* acceptable. If a person loses control and harms someone, it is their responsibility to make amends, and that goes for any illness.

    There are a few exceptions to this rule – psychosis or mania with lack of insight; younger children and adolescents who are still learning to manage, and may not have the maturity to do so; and those that have not been diagnosed/treated, those new to treatment and those whose treatment is not working/needs to be adjusted. In the midst of an episode, we should be kinder and/or gentler with a person, and we should prioritize; but mental illness, or diabetes, or cancer, does not excuse a person in the majority of cases.

    And this does come from a consumer and patient, not an ignorant lay person. To be honest, I have heard stories from many who claim that professionals who excused all their behavior or habits only prevented them from leading a fuller life, and prevented them from learning to best manage and take control of their illness. To say that, ‘because you are ill, you will not be able to learn to manage or control your behaviors’ can be damaging in many cases.

    Just my two cents.


  12. I think what Joe is saying (correct me if I’m wrong) is that we don’t expect a person with severe heart disease to run marathons. We don’t ask people with Cerebral Palsy to “get with it” and use their arms to dig ditches. People with physical disabilities are much more accepted than those with brain/mental disorders. Bipolar disorder definitely causes certain behaviors: wild mood swings, over-spending, over-sexualization, rages, delusions, hallucinations…the list goes on. Yes, it’s good to take responsibility for our “fits” & apologize. But to imply that we can help others(“what can I do for you?”) while in a psychotic state is absurd. This is a very very serious mental disability. It’s not the average person’s depression.Which is what I think you have, Venus. “Normal” people get down in the dumps & snap at others but are able to get out of that state after a few days. Bipolar causes people to be absolutely unable to move or to be in such a frenzy of mania, they simply cannot think straight & leap from one wild action to another. Psychosis is common, especially after long-term insomnia caused by manias. I cannot imagine, Venus, how you think we can control this.
    Venus, I tried all sorts of methods to fight manic-depression. Cognitive therapy, positive thinking, primal scream therapy, long walks (which I still do), Yoga, prayer, being prayed for, etc. until a severe breakdown (one of many) in my mid-40s. That’s when a psychiatrist, an MD & a neurologist all worked With me & found a combo of meds that really help. The change is amazing! People like me, who have tried every other avenue, to no avail & so use “pill” for mental stability, should not be put down for needing medications. Just as people who have lost legs should not be put down for using prosthetics rather than re-growing their limbs. Venus, you say you got your manic-depression under control by force of will. How? You don’t go into any detail, just smugly state that you have done it, as many others have. I’d be interested in your description of your methodologies.

  13. First, i am glad somebody else feels the same way. Erika is right, people do have responsibility… or at least should have. Even when one does hurt others by accident, they should apologize and try to help with the consequences if possible. It is human decency. As much as it is unpleasant to know we done something wrong… others cannot be expected to apologize our behaviors forever. They too have stressful lifes and their issues. I expect to be treated well… and try to treat others the same.

    Dixie, I did not know it was an requirement to share here your whole life story. I am not being smug. I am just appalled by some implications here. That bipolar overrides your entire personality (it doesn’t), that bipolar person can max out family account and should not stand up the consequences, as their illness is to blame, not them.

    Thanks to my mother I practiced yoga and meditation since very young. I had not people in my life to enable me, which I believed helped in the end. Yes, I have a support, but not enablers. I know natural remedies (herbs mostly), try to eat well (sounds simple, but i know too many people who complain about moodswings yet they won’t give up their ramen noodles and other toxins that can send your mood out of the whack), meditate each day, stay connected with the source… and I don’t do this in a shallow fashion. My spirituality is not a pop spirituality. I have people in my life who help me to keep my feet on the ground…

    and again, I said I don’t have anything against people who try medical approach… as long as they do other things as well and don’t blame their actions on “well, my meds stopped working, it’s not my fault”.

    And yes, you can still help others. After all, we aren’t in episodes all the time. In meantime, we can do good in the world. That is another thing that helps me. Having purpose… yes, it is a responsibility. But it feels wonderful and it contributes to one’s well being.

  14. Dixie –
    I know your comment was to VenusH; however, I hope you do not mind me commenting on what you have said, as I think you are misinterpreting some of what is being said, and I know that your post did not target some of my points (I assume this is because you submitted your comment before mine was approved).

    First off, what you are saying about how Venus likely only has the ‘average person’s’ depression because she has been able to manage it well without use of the medical model, is a common response from many people that I have seen. If a person defies what most consider fact, or what does something that is outside mainstream psychiatry, people commonly respond with a) your case must not have been that bad, b) you were misdiagnosed or don’t truly have Major Depressive Disorder/Bipolar Disorder/Schizophrenia/etc c) you will eventually fail and need X or c) you are lying. I want to point out that those of us walk a different path – one that is not quite medical model, or without medication, or with alternative therapies, etc – well, I want to point out that we are not an enemy here. Most of us truly want people to recover and, if someone recovers best within a medical model/philosophy, then most of us would encourage us. Once again, the grand majority of us are not seething, anti-psychiatry zealots. We just want our pain to be respected and validated, and freedom to be able to pursue recovery and/or survival in a way that is best for us.

    Secondly, though I refuse to claim to speak for anyone else, I do not think anybody here is claiming that talk or behavioral therapy, and other psychological coping tools, can somehow completely ‘cure’ psychological afflictions. I certainly would make no such claim. All I, and I am pretty sure VenusH, is saying is that you can – and, in fact, it is your responsibility – to learn to effectively cope with your symptoms. Once you know there is a problem, it is your responsibility to take ownership of your mistakes, help mend bridges, and ensure that you do not harm someone – especially those you love – again. All that I am saying is that, yes, these emotions and experiences are painful are overwhelming; but, even if you can’t make them go away, you need to learn to respond to them in healthy ways. More so, I am saying that this is possible. One negative impact I have seen come from the medical model is that, not only does it relieve people from responsibility of harm they may done during an episode; but it tells them that they can’t control it, and limits them from being all that they could be in this world. Telling people this – and you do, indirectly, many times with the medical model – is actually very stigmatizing and offensive to a person’s true ability and/or potential. I have seen this happen and I have experienced it on a personal level. People need to know that, except in a very few cases, they can take control of their mental health, learn to manage their emotions and experiences, respond in healthy ways, raise their functioning and take greater responsibility for their life. Even if they have a relapse, and feel out of control of their emotions, they need to reach out and seek help, or make arrangements so that they can receive help if they cannot themselves seek it out. That is their responsibility, to themselves and to others. And, if they do hurt someone, it is their responsibility to make amends.

    You mentioned psychosis specifically and, as someone with Schizoaffective Disorder, I would like to comment on that. The psychotic episodes that I experienced were some of the most painful and terrifying experiences of my life. I look back on it now and, truly, the only thing I can feel is sadness for my younger self – at certain points, much younger self – and the horror that she felt and experienced at the grips of her own mind. That is not pity – just genuine sadness. Yet, even in the midst of those breaks, and especially the ones after diagnosis, I still had a choice: I could hurt others, and/or myself, or I could resist what was at times a constant auditory assault of violent commands. It was the hardest thing I ever did; but I resisted, for months, years, I resisted. And when I could no longer resist or control myself, I reached out for help, told someone and went inpatient.

    And that is the point that I, and I think Venus, was trying to make. You cannot magically make the symptoms go away, no; however, you can – and, in fact, it is your responsibility – to learn to manage them and minimize the impact on your life. Either this be with or without medication; with or without the medical model; or anything else, that responsibility is still yours. And, in fact, when that responsibility is owned, life improves. You become someone who survives, copes and manages, instead of a helpless victim. As, we don’t ask someone with heart disease to run the marathon; but we do ask, and expect them, to take every precaution and step to maximize their health and minimize the risk of serious injury. That is their responsibility. Those with psychiatric disorders have the same one.


  15. Venus, thanks for sharing more info’ from your life & how you deal with the bipolar. It’s not a requirement to share “your whole life’s story” but it’s helpful to others, especially if you are making claims of finding a cure.
    I have a very deep spirituality but that doesn’t heal a brain disorder. It helps me feel better but can’t cure it. Yoga didn’t help me. I do have an extremely severe case of manic-depression. If you read the literature, you know that each deep depressive & manic episode causes brain damage, so being diagnosed late in life (as I was) results in less & less ability to control one’s emotions.–ssb050603.php
    I agree, apologies are good when one has behaved badly. But it is also necessary for people in your life to understand this very complicated illness.”Normals” who throw fits are much more in control of themselves & should be expected to behave better than someone with a brain disorder. People in a psychotic episode are truly not in control & should not be expected to be in control.
    I have worked with adults, teens & children who had all sorts of disorders, from Autism to schizophrenia. None of us who worked with those people expected them to behave like “normals.” We worked to help them function better in society but it’s absurd to put the same requirements on everyone.
    I was raised by an RN who was very strict about our diets, no candy allowed, fresh food only. We picked our own veggies & fruits. But that didn’t lessen the symptoms in me, which I’ve had from birth.
    I’ve never had an enabler in my life. I wish I’d had more support. My husband is wonderful but my parents basically ditched me when I was 20 & in a severe psychosis. The attitude, “pull yourself up by your bootstraps” is what causes many suicides by people who are suffering terribly & without any support systems.
    It’s good that your symptoms are under control by diet, Yoga & so forth. But it’s wrong to expect all sufferers to be at the same place you are. Many people have tried the same methods you have & gotten no results. Medications have helped me & people in my therapy group. I would never expect them to go off meds which are helping them fight a very real & painful disorder.There is a tinge of pride in your postings, as if you have the key to good mental health & we peons need enlightenment. That isn’t helpful, it’s adding to the stigma.
    Of course, we can do good in the world. As I said, I was a carer for adults/teens & children who suffered brain disorders. I was a teacher. I worked very hard in the 1960s as an anti-war activist. I was jailed for my actions. Later in life, I produced brochures & pamphlets for various societal causes. I am a well published poet/short story writer. But I accept that I have a damaged brain & need the medical help that I get. If you sense anger from me, it’s because I wasted a good 40 years of my life listening to people like you, my parents, other family members, therapists, doctors, spiritual leaders, all telling me to “get a grip” & to “behave better” when I was helpless to do so until I got on the proper medications. The difference in how I slept & felt was a complete 180 after finding the proper meds. My family notices it & so does my husband. As do I. If someone with the right knowledge had stepped in before I was 10, I’d have had a much, much better life. I pray that people reading these posts will go for help & get the right meds. Diet helps, exercise helps, meditation & prayer help but many people absolutely need medication.

  16. I see this theme repeatedly over the years….that people with mental illness need to take responsibility for themselves and their lives. What puzzles me is why anyone would think people with mental illness would do otherwise.

    Besides myself, I have several friends with depression or bipolar disorder or anxiety disorders and ALL of them try very very hard to work with their conditions and live fulfilling lives.

    Now maybe I know an exceptionally diligent group of people (lots of studious nerds), but from my experience, the folks with mental illness are more responsible in monitoring and treating their conditions than many people I know with other illnesses.

    It makes me wonder if people with mental illness are not held to a different standard. Are people with other chronic conditions expected to apologize for the stress their friends and family experience when their health worsens because they didn’t follow medical advice? I don’t know the answer to that.

    If I’m cranky when I’m depressed, I apologize. But I also know the people around me understand when I’m in pain and don’t take it too personally. They know I am always doing the best I can and I usually do pretty well.

  17. Erika:
    “We just want our pain to be respected and validated, and freedom to be able to pursue recovery and/or survival in a way that is best for us.”

    This. No wonder some of us “alternatives” tend to be bit too defensive. Our sufferings are lessened… and often just because we don’t cause havoc. I don’t need to be patted on the back for being such a strong person… in fact I wish I was more strong and more serene… I am not gonna give up on becoming the person I wanna be just because of some “brain disorder” (for which there are currently no tests).

    what I am saying here is that giving in to your symptoms makes it much worse to deal with the aftermath. If there isn’t much damage caused, it is easier to recover than if you maxed out your bank account and cheated on your husband or lost your job in midst of episode. It is one’s responsibility to created roadblock to stop themselves, whatever it is, whatever works for you.

    Throwing hands up and saying “I can’t” is not gonna help you achieve the life you want to live. Hoping that magical med combo by itself will help you get there, while doing nothing else in meanwhile… this approach is dangerous. You can do it.


    You are not getting my point. It is preciselly illustrated by blaming “people like me” for your misery. What is it with our society that we no longer accept freedom with all the responsibility it carries? Why do we always need to find someone else to blame?

    I don’t expect much from people than live and let live and not intentionally hurt me. If they hurt me unintentionally, I expect we can sit down and talk it out. And no… blaming your brain is not enough. I think I am relativelly forgiving, but I have my limits. I am quite vulnerable and I need to protect myself first. At the same time, I don’t expect any special treatment in the society. I know my limits… and I try to respect them. If I screw up, I own up to it.

    (not so long ago I had a debate where somebody claimd Gaddafi is bipolar and unmedicated, hence we need to keep that in mind. Now, if we are to accept the “blame the illness and not the person” premise and this rumor is true… the implications are scary).

    “There is a tinge of pride in your postings, as if you have the key to good mental health & we peons need enlightenment. That isn’t helpful, it’s adding to the stigma.”

    and I think “NO YOU CAN’T” is adding to stigma.

    As i said, I am quite hardcore in my spirituality. I mean it. Not saying everybody needs to become like me, but I think for many the whole spiritual approach does not work, because they approach it in selfish manner. “I will become spiritual to get better… and get better now”, instead of embracing it truly. If you are not at peace with yourself, nothing is gonna help. And I think that is where “blaming the illness” gets in the way… you cannot be at peace with yourself if you believe you absolutelly have no control over your doings.

  18. Hi, Venus–

    “I am not gonna give up on becoming the person I wanna be just because of some ‘brain disorder’ (for which there are currently no tests)” sure sounds to me like it’s coming from someone who’s in denial that bipolar disorder is an illness. Arguing with someone who doesn’t accept that fact really is futile, so this is the last comment I’m going to post here.

    Furthermore, nobody here, absolutely nobody has said “NO YOU CAN’T.” Yes, people with bipolar and other serious brain illnesses can and almost always do succeed in managing their illness – with medication or therapy or both.

    We need to remind ourselves that people are individuals and that no single approach is effective for everyone.

  19. Joe –
    “We need to remind ourselves that people are individuals and that no single approach is effective for everyone.”

    Yes, and you see, that is what we have been trying to say. We don’t mind if someone uses the medical model, or takes medication for Bipolar Disorder. We are asking our stories and experiences to be validated, to be respected.

    ““I am not gonna give up on becoming the person I wanna be just because of some ‘brain disorder’ (for which there are currently no tests)” sure sounds to me like it’s coming from someone who’s in denial that bipolar disorder is an illness. Arguing with someone who doesn’t accept that fact really is futile, so this is the last comment I’m going to post here.”

    That sounds like awful debating technique!

    If she is in denial, then it is far from a harmful one. She may not believe it to be a disease (and, just to note, I have a recent medical dictionary that uses a mental illness – PTSD – as an example of something that makes someone ill/is an illness; but is not a disease); but she takes steps to manage it, and is successful at it. If she were “in denial” – and I don’t see it that way – and she were failing or struggling, then I might see that as supporting evidence to the disease model. But she isn’t. She’s coping and functioning – without the medical model.

    Once again, nobody here is anti-medication, anti-psychiatry, or any other such thing. We want people to recover, and to have a full life. We want people to be allowed to pursue this any way they feel is best for them. Recovery – functioning, life, happiness – it does happen without medication, though Your response – “you’re just in denial” – is one I have commonly seen from people when this fact is presented to them. When you say that medication helped you or a loved one, and that the medical model was a right fit for you, we don’t say “you’re in denial about it not being an illness” (More so, there is a difference between an illness and disease).

    “Furthermore, nobody here, absolutely nobody has said “NO YOU CAN’T.” Yes, people with bipolar and other serious brain illnesses can and almost always do succeed in managing their illness – with medication or therapy or both.”

    I realize that nobody said this; however, I was pointing out that using a strict medical model can create such attitudes, even if they are not conscious. If you tell people that you have a disease, and should not have to take responsibility for harmful or negative behavior, you are telling them they cannot learn to control such behavior. You are telling them they will always struggle to function, and when overwhelming emotions do strike, the only thing they can do is up a dosage or switch medications. Telling people that no, they can’t necessarily always stop or prevent these episodes from happening; but they can learn to respond in healthy ways, learn to control their behaviors and take control of themselves, is – in my opinion and experience – much more empowering, hopeful and helpful.

    Yet, as I said, if the medical model helps someone more than any other philosophy would, then they should use that. They should also, however, be able to explore all methods of recovery without being criticized, judged or told they are “in denial”.

    I want to highlight, once more, that I am not blaming anyone for their mental illness, or saying that people can necessarily control their emotions. I don’t think people should “pull themselves up by their bootstraps”. People need support, and treatment. But, and I’m going to quote what I said before:

    “People need to know that, except in a very few cases, they can take control of their mental health, learn to manage their emotions and experiences, respond in healthy ways, raise their functioning and take greater responsibility for their life. Even if they have a relapse, and feel out of control of their emotions, they need to reach out and seek help, or make arrangements so that they can receive help if they cannot themselves seek it out. That is their responsibility, to themselves and to others. And, if they do hurt someone, it is their responsibility to make amends.”

    Personally, in most cases, I do lean towards biopsychosocialism. Yet, as a person diagnosed with Schizoaffective Disorder, Bipolar Type, Severe, Recurring, I am off medication. I have had severe episodes; but I have managed to cope, and respond – without hurting anyone, myself or others. And, if I do feel like I am about to lose control, it is my responsibility to reach out for help. This has, just to note, all been with the support of my psychiatrist.

    I’m not in denial, either. People just need to be shown all their options, and supported in whatever they take.


  20. VenusH and Erika, I really identify with what you have written. I can tell you that finally finding a mental health professional who actually believed I could be well had a profoundly positive impact on me.

    For so long I heard “chronic illness,” “severe mental illness,” severe, severe, severe. Multiple hospitalizations. They had given up on me, and I had too. Where was I supposed to find any hope in all of these dire predictions about my future? When I heard the word “chronic,” I gave up. Chronic meant I was always going to live in hell, and I wasn’t remotely interested in that. I needed some hope that I could be well.

    I don’t care whether people take meds or not. It’s not my business. I chose to come off of them, and that was the right choice for me. I do think that the mental health professionals who kept insisting I accept their dire predictions about my future, fueled my hopelessness. Glad I found someone who thought differently.

  21. anon –
    Exactly. Every word of it.

    The fact that my psychiatrist believes I can actually become well – not “managed”; but, truly *WELL* – has made all the difference for me. He was the one that proposed we taper off medication, actually. I hadn’t even realized it was an option, and nobody had ever suggested that I could actually be *ME* again. That my symptoms were not things that could only be controlled or managed by upping the dosage or changing the prescription – that I could actually take control, and learn to manage and cope. The process has been a struggle at times; however, I have few regrets about doing it.

    “I don’t care whether people take meds or not. It’s not my business. I chose to come off of them, and that was the right choice for me. I do think that the mental health professionals who kept insisting I accept their dire predictions about my future, fueled my hopelessness. Glad I found someone who thought differently.”

    Once again, exactly. Every word.

  22. This discussion is going in circles. One person says “I am doing well on meds.” Then another person says “You can do well without meds.” No you can’t, yes you can.
    No MD, no psychiatrist ever told me that due to having manic-depression, I could not “do anything.” I was never given an “it’s useless, you have a brain disorder” attitude or any other “dire prediction.” Not sure where you live but there are very enlightened people in the medical profession. Perhaps you (Erika, Venus & anon.) live in places where you do not have access to highly informed doctors?
    The people on this message board who keep saying they are not against “the medical model” certainly use negative terms whenever they speak of doctors, psychiatrists, medicines. That’s conflicting, mixed messages. Either it’s OK or it’s not.
    Venus, you say “I am hard core in my spirituality” as if someone is questioning your spirituality. Nobody has done that. I am also deeply devout & believe that God,Jesus, the Holy Spirit, the Virgin Mary helped me through a lot of bad times.
    Thanks to God, I have never been hospitalized, even in the deepest depths of psychosis b/c my husband & family chose to help me at home.And prayer has helped me very much.
    So people who use meds can also have “hardcore spirituality.”
    Doctors tried to help me first with therapy (cognitive, biofeedback training). But since those didn’t work (after 5 years), we went the meds route.
    My therapist told me 3 years ago “you are graduated!” In other words, I am AOK without her help.
    Yes, I take meds & get blood tests to be sure they aren’t messing me up. They aren’t. I go to group therapy 2-3x/month. It helps to check in with people who are also working on how to deal with the ups & downs of this disorder. They are good friends.
    Erika, this definitely is a physical brain disorder, unlike PTSD. PET & CAT scans show differences in the brains of people in manias & depressions, in the limbic system & amygdala. That’s a scientific fact.
    I have read numerous books & articles about these physical changes of the brain in people with bipolar, schizophrenia & etc. Anyone can find these books/medical journals in the library, if they are interested in self-educating.
    The fact that this is a brain based, physical difference doesn’t make us more or less human or able than anyone else. In fact, there are more poets, painters, musicians with some form of brain “disorder” than those with normal brains.
    A disorder is different than a disease. A disease damages organs. A disorder affects the organs,making them perform differently.
    Since getting on the right meds I have not had one psychotic episode in 15 years.
    What do I do to help myself besides take Rxs? Have a lot of alone/down time after being in noisy places. Hike in Nature, one of my joys.When I lived near an ocean, I swam every day. I read for fun & to be updated/informed on manic-dep. Dance often. Laugh a lot. Go to plays my husband is in & socialize with theater people. Enjoy writing clubs & Poetry groups.Pray. Write a lot & celebrate when my poetry & stories get published. Am happily retired. Watch goofy monster movies with my husband & friends. Avoid negative people.
    I will always speak up for people who have mental differences. It should be OK to get treatment for this, just as it is OK not to get treatment.

  23. Dixie, I’m really glad your doctor didn’t make dire predictions about your future. Mine did, though.

  24. Erika, it sounds like you have a great doctor. I think it shows how open minded he is that he is willing to look at both options.

  25. Anon, your MD obviously isn’t up to date about manic-dep. No MD or pyschiatrist should make dire warnings. They should give good information, let us know where we can go to read more & encourage us to be informed. The more information, the better we can make our decisions about our health

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Candida Fink, M.D. and Joe Kraynak are authors of
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