Category: Bipolar blog

Does ABC’s “Black Box” Portray Bipolar Accurately? Fairly?

For weeks people have been asking me my opinion of ABC’s new show Black Box. According to Wikipedia, about 6.9 million people watched Black Box’s series opener and it seems like about half of them have contacted me about it.

People are wondering about this show because Black Box’s lead, Catherine Black, (played by Kelly Reilly) is a neuroscientist who has bipolar disorder. In fact, the first episode of Black Box details the Black’s descent (ascent?) into mania after she stops taking her medication (which includes lithium, an anticonvulsant and an antipsychotic).

In short, I think Black Box tries for accuracy and they hit it here and there but, as with all television shows, it’s dramatized and so bipolar disorder isn’t terribly accurately, or fairly, portrayed.

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Dealing with an Uncertain Future Due to Bipolar Relapse

Earlier I wrote about the realities involved in bipolar relapse and now I want to address the question as to how to plan for a future when relapse of bipolar disorder tends to hang over your head.

I understand this question and this uncertainty. It’s very hard to live with a disease like bipolar that you know can bite you any day, any time and often without any provocation. And it can be very hard to see yourself as a serious professional, with a 24/7 career, when you know that relapse is almost a certainty, at some point.

It’s trite to say that, “no one knows what the future holds for any of us.” It’s true, but it’s hardly helpful, and it’s unfair to compare the uncertainty that the average person faces (ie, I might be hit by a bus tomorrow) to the uncertainty that a person with bipolar faces when, in his case, bipolar relapse is very likely.

So how does one plan, or even make big life decisions, when bipolar relapse means an uncertain future?

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How Likely Is a Bipolar Relapse? Avoiding Bipolar Relapse

Recently, I was asked about planning for the future with bipolar disorder considering the threat of immanent relapse. This individual was in the last year of medical school and wanted to know how to plan the rest of his life, knowing that, at any moment, he might have a bipolar relapse. He was on meds, and they kept him functional, most of the time, but the bipolar medication didn’t prevent two major relapses in the past.

So the questions in this scenario are: How likely is a bipolar relapse? How can I avoid a bipolar relapse? How can I plan a life with such uncertainty?

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What Keeps a Person Sick with Bipolar Going When Treatment Doesn’t Work?

Some people with bipolar disorder are lucky in that when they get treatment, they find something that works for them within some reasonable period of time (and this might be in a year or two, maybe not altogether reasonable, but on the whole, good). However, not all people sick with bipolar are so lucky. Some people with acute bipolar symptoms don’t find anything that works for them for prolonged periods of time. In fact, for many people sick with bipolar, it seems like they will never find any treatment that will work.

So if you’re in this latter group (and I am) what keeps you going? If you still suffer from acute bipolar symptoms and the treatment isn’t working, how do you keep trying to get better, day after day?

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Being Honest When You Have Bipolar

I am rarely honest with anyone about my bipolar disorder. I admit it. I think, on some level, my friends know it. Lack of honesty with bipolar disorder is just better. At least, it’s better if you want to keep your friends.

See, my reality of bipolar disorder is extreme. It’s severe. It’s brutal. It’s constantly life-threatening. And people can’t handle that. Going on about how painful bipolar is, is just a good way to wear someone out. It’s just a good way to make someone tired of you. It’s just a good way to make them walk away.

I have learned this lesson the extremely hard and painful way. I have watched people walk. Over and over. The people with whom I have been honest, in the end, couldn’t handle it. It was too hard to watch me being sick with bipolar so much of the time. Which, in a way, is a testament to how much they cared. Sort of. I would just have preferred they not express it in that way.

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Bipolar and Why I Can’t Focus

My bipolar brain and mind are interesting places to live. Pleasurable, no, but interesting, yes. At the beginning of the day my mind seems to start out like a blank chalkboard and then my bipolar brain screams at it as soon as I wake. And little by little the chalkboard fills up. Each scream takes up a line. Until eventually there is no room for working thought or working memory or anything all and all I can hear is my brain screaming, “I can’t do this.” It’s a feeling of stress and anxiety and it’s inescapable.

I’m not sure why my brain chooses to yell this particular phrase at me, but I can tell you, it’s impossible to focus through all the yelling.

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We Must Aim for Zero Bipolar Symptoms During Treatment

Raise the Bar on Bipolar Treatment – Hold Your Doctor to Task

Let me be honest. Even when my treatment is at its best, I never get to the place of zero bipolar symptoms. I’m well, I can handle the remaining symptoms with coping skills, I can be happy but there are always lingering symptoms of bipolar disorder.

And this may be an indicator of being difficult to treat because what we know is that the more you can successfully treat all the symptoms of bipolar disorder, the more likely you are to have fewer relapses. In other words, if you continue to experience bipolar symptoms during treatment, you’re more likely to experience future episodes and we really want to avoid that as each future episode tends to make your bipolar harder to treat.

For this reason, it’s critical to aim for zero bipolar symptoms during treatment, whenever possible.

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Children with a Mental Illness – Yes, It Could Be Your Child

I give presentations on mental illness in different places, and one of those places is in schools. Kids aged 12-18 get to hear about mental illness, stigma and my personal story of bipolar disorder. This takes around an hour. And after hearing an hour of me speak about my personal challenges and about how I have faced down bipolar disorder are a myriad of treatment failures, the teens often feel a certain closeness with me. I suspect it is for this reason that after the presentation, so many of them come up and talk to me. They talk about how they have been in the hospital or how they have a friend with bipolar or that they think they might have a mental illness.

And, of course, if a teen thinks they have the symptoms of a mental illness I always say, “Have you talked to your parents about this?”

And I always expect them to look at me like I just said something ridiculous because when I was their age, I sure would have found the notion laughable.

But they generally don’t. Many, many of them have, indeed, talked to their parents. And what have the parents done?

Nothing.

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Depression Makes the Pain of Your Past Worse

I have told this story before.

Once upon a time I knew a beautiful girl who we’ll call Jane. Jane was curvaceous, feminine, sweet and generous. Jane and I became lovers overnight.

And then life happened and we broke up. My fault, actually. I couldn’t handle having a girlfriend while being in the hospital.

But we remained friends while living our separate lives – very good friends and occasional lovers. It was pleasance punctuated with striking screams.

Then, when I went through electroconvulsive therapy (ECT), I turned to her for help. And help, she did. She stayed with me to help me through the first six treatments of ECT and for this I will be forever grateful. And when she left that day, to return to her life, I said something along the lines of, “Goodbye. I love you. I’ll miss you.” (At least I think I did. The ECT makes it all hazy.)

And she never spoke to me again.

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I write a three-time Web Health Award winning column for HealthyPlace called Breaking Bipolar.

Also, find my writings on The Huffington Post and my work for BPHope (BP Magazine).

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