I’ve written about this several times, but never said it quite this directly: No one is a diagnosis. No one fits the criteria for “bipolar” or “depression” exactly. No one is a “Patient Like You.” It’s why someone only has to have five out of eight characteristics to be diagnosed with depression. Because there is recognition within the medical community that “depression” isn’t a single thing, much as “bipolar” isn’t a single thing. Those words represent diagnoses that exist along a spectrum. In writings elsewhere I have suggested what I call a “dimensional” diagnosis. (And this is probably because I’m a computer science-y kind of gal.) Basically you have symptoms and diagnoses that exist along multiple axes. Then, depending on where the dots cluster, you essentially have a Venn diagram of diagnoses. It’s OK if you didn’t quite follow that. I know. It’s complicated. But humans are complicated creatures. I like chocolate ice cream, you like vanilla. Humans are a heterogeneous bunch. Why then, if we understand this, do we have names in the first place? Is the term “bipolar” really even useful? In short, yes, it is. And yes, we need those labels, even if they are ill-fitting.

If you’re in treatment for depression and have ever mentioned a desire to die, you’ve probably heard these questions: How would you commit suicide? Have you make a plan to commit suicide? And others. So a commenter recently mentioned that this is just a way of “covering their backs,” and “. . . if I were serious about killing myself and had made a plan, why on earth would I tell them?” This is a logical question, but an uninformed one. In studies, we know that people who attempt suicide do reach out for help and do not really want to die.

In response to some of the comments I see here and elsewhere, here is my response to another ten myths about bipolar disorder.

Antipsychotic medications were so named as they were initially used to treat psychosis in disorders like schizophrenia. Antipsychotics include medications like Haldol, Thorazine, Seroquel, Abilify and Zyprexa. These medications are now being used, more and more, in the treatment of other disorders like bipolar disorder and major depression. One of the major problems with these medications is a side effect called tardive dyskinesia. Tardive dyskinesia is a disorder involving involuntary muscle spasms and can be (but isn’t always) permanent – even if the medication is discontinued. How can you and your doctor look for the signs of tardive dyskinesia?

I hate shrinks. Shrinks should die. Shrinks are evil. (Thank the commenters (not an individual) for that.) OK I get it, you don’t like psychiatrists. Personally, I would find a more intelligent way to express an argument, but your point is clear nonetheless. You’re ranting. I get that. I rant. We all do. It’s a healthy expression of the frustration seen when dealing with so many things outside of our own control. But at some point you have to stop hating, wishing for murder and committing moral condemnation and actually do something useful.

I get asked quite a bit for specific treatment recommendations. People will tell me a few medication details and then ask what to do, or someone will ask what my experience has been on a certain treatment. My answer is always the same: only your doctor is qualified to talk to you about your treatment as they know your personal history and health. My experience is only one person’s and cannot be generalized to any other person. And that is the right answer. But unfortunately, it’s one people don’t want to give (or get). A clear example is seen on Patients Like Me, a web site designed for patient-to-patient communication.

I write at HealthyPlace about the problems associated with living with bipolar disorder, and let’s face it, there are many. I also talk about the problems with the treatment of bipolar disorder, and yes, there are many of those too. But just because I recognize issues, discuss genuine, painful emotion and make loud an inner voice that among most people is strangled, doesn’t mean my treatment has been a failure. Just because I’m not “all better,” that doesn’t mean treatment doesn’t work.

In the times when I've had prolonged periods of wellness, I don't particularly think about bipolar disorder and I don't feel its implications. I just get up, get out of bed, say 'hi' to my cats, and go about my day. True, the med-taking is a reminder, but bipolar isn't necessarily top-of-mind. This does not mean, however, that I can forget about the bipolar disorder. Forgetting about bipolar disorder is one of the most dangerous things you can do.

Many sites on the internet dedicate themselves to serving up health information, but you should always question the source of that information.

I take a lot of flak for what I have to say about mental illness. My positions are often blunt and sometimes unpopular. This is fine with me. I’m an opinionated girl. Not everyone enjoys that particular charm. But one thing that gets said every once in a while is I’m, “playing the victim.” And not only that, but I’m encouraging others to be victims. Contagious victim-ness I suppose. This, of course, is just a slur designed to make me and others feel bad about what we have to say. Well, I say this: Admitting to having a mental illness doesn’t mean you’re “playing the victim.” Talking about mental illness isn’t “playing the victim” either.