There are some truly wonderful people out there who are loved ones of people with mental illnesses. These people want to help their loved ones with mental illnesses and many of them read this blog in an effort to understand what it’s like to have a mental illness and how they can help. It’s a beautiful thing. So if you’re the loved one of a person with a mental illness, here are some things you might want to think about during the holidays.

It’s the holidays. Some people love them, some people hate them, but as a general rule, it’s tougher for people with undertreated mental illness than for others. For people battling with the symptoms of bipolar disorder, holidays and hope may be the last thing on their mind. But, believe it or not, while the rest of the world glistens and twinkles, you too can find things to be hopeful about and things to feel grateful for, even if you happen to be in a black pit bipolar-wise.

Some time ago, I wrote about generic medications. I explained that generic medications are bioequivalent to brand name medications within a given margin. Generic medications may use binding and other inactive agents that are different from the brand name medication. All of this can lead to a generic being less effective than the brand name drug in a small percentage of cases. Usually though, the generic works just fine for people and the switch is unnoticeable. And all that information was correct. But new information has arisen. And it’s alarming information to me. It’s information on exactly how bioequivalence is determined for medication and in the case of one generic medication, the generic of Wellbutrin XL 300 mg, it caused an ineffective drug to be allowed on the market for many years.

You’d let them take an ice pick to your brain if you thought it would help. Bipolar disorder impacts different people differently. For some people, bipolar disorder is immanently treatable. These people find doctors, therapy and medication and walk off into the sunset with few bipolar symptoms left with which to contend. These people lead the same lives as everyone else and besides (likely) controlling certain lifestyle factor that contribute to stability, they don’t have to think about bipolar disorder on a daily basis. Then there are the people who are more affected by the illness. These are people for whom treatment partially works. They likely find doctors, therapy and medication too, but in spite of best efforts, they live with bipolar symptoms every day. These people might live your ordinary life or might live a life that is more affected by the illness, such as one where they can only work part-time. And then there are the people that are severely affected by bipolar. Even with treatment these people tend to have intractable moods and likely can’t work because of them. These people do not live average lives. They live lives dictated by the illness and the treatment. These people are in pain every day. And it’s only chance that places you in one of those three groups.

As I’ve mentioned, recently I’ve started volunteering for a local bipolar organization and what I do is give presentations to others. One part of the presentation is my “bipolar story.” It’s the story of my life before diagnosis, the process of treatment and whatnot. It’s long and, well, not that happy. But one of the things that stands out is that treatments have turned me around, but then they stopped working and new treatments had to be found. And these new treatments were extremely hard to find. In fact, successful treatments have been found through guessing as often as through any type of clinical judgement. And there’s a reason for this: bipolar disorder and bipolar disorder treatment are moving targets and our responses have to move with them.

Since I’ve started writing for HealthyPlace I’ve learned a lot about what you’re not supposed to say about mental illness. Some classics are the word “crazy” and not referring to oneself as “bipolar” directly. In other words, I’m not allowed to say I’m a crazy bipolar. There are many other things I’m not allowed to say too. “Mental health” can only be used in some cases whereas “mental illness” must be used in others. And then there’s “behavioural health” and the myriad of rules around talking about suicide. One could get permanent writer’s block worrying about ticking off some group of people who care about some specific word. So I have a rule. I do what I want. And I tick off some people. It’s not on purpose; it’s just that if I didn’t, how in the heck would I write?

Ah, the human brain. It’s a wondrous thing. It calculates, it categorizes, it makes connections and it remembers the square root of 144. I’m constantly awed by its power. But one of the annoying things that can happen to a brain is that somehow, a song gets stuck in it. Somehow, even though its great power and ability, the catchy hook of the latest pop song gets stuck inside some errant neurons and plays over and over. And this causes a lot more trouble in my bipolar brain than it does for others.

I wish someone had asked me before naming a class of drugs “antipsychotics.” I mean, I understand that to psychiatrists it might not be a big deal, but to the medication-taking public out here, let me just say that the stigma around medication is about 10-fold when you say you’re on something called an “antipsychotic.” Tell someone that you’re on “antipsychotics” sometime and watch them back away slowly. I’m not kidding. It’s like they think an axe is about to magically materialize and you’re about to use it to chop off their head.*

It should surprise no one that I consider mental healthcare an essential service for people. Now, I live in Canada and this means that I can get the care I need without paying for it, but people in the United States are not so lucky. I have to constantly hear about people who can’t get the care they need because of the limits placed on them by insurance companies. And this is wrong. Mental healthcare is as essential as any other kind of healthcare. If you have a broken leg, you expect treatment, and if you have a broken brain, you should expect the same thing.

One of the problems with psychotherapy (and, keep in mind, I like psychotherapy) is that psychotherapists try to look for a cause for every emotion. And this seems reasonable. Or at least it does, to a person without a mental illness.