Bipolar 2 From Inside and Out

The Difference a Diagnosis Makes

October 19, 2025

Is a diagnosis of mental illness a bad thing or a good thing? It depends on whom you ask.

On one hand, some argue that a diagnosis is merely a label. It puts people into neat little boxes defined by the DSM and determines how society reacts to and treats them. (The DSM, of course, is for doctors, but some version of what it says sneaks out into the general public. Then it’s fair game for tossing around and labeling people by the uninformed or the barely-informed.)

The labels are harmful, this school of thought goes. A schizophrenic is violent and incurable. Bipolar disorder means daily giant mood swings and real danger if said person goes “off their meds.” Narcissists, gaslighters, and sociopaths are people who act in any way that you don’t appreciate. Autism, notoriously and according to people who should know better, is the gateway to a valueless life.

With diagnosis come stereotyping and shame. Rather than reacting to these harmful effects, some people focus instead on what creates the stereotyping and shame—the diagnosis, which is seen as a lifelong label. Protests decrying this labelling happen outside psychiatric and psychological gatherings and garner media attention. And if that makes life easier for a person with a diagnosis or generates greater understanding, then it’s a good thing.

Diagnosis-as-label is an example of the harm that diagnosis can do. Nor is it limited to the general public. Once a person is in the system with a diagnosis of whatever condition, they’re generally stuck with it. Reassessment and a realization that a diagnosis is misapplied come too rarely. Personality disorders, for example, are squishy around the edges. Similar criteria could lead to a diagnosis of narcissistic personality disorder or sociopathy, to use an extreme example. Careful consideration will distinguish between the two, but how often are such distinctions applied? Once “in the system” with a particular diagnosis, a person tends to remain in that slot despite different doctors and different treatments.

But that’s not the way it’s supposed to be. A diagnosis, rather than being a lifelong label, is meant to be a signpost pointing toward likely development of the illness and ways to treat it successfully. That’s the ideal, of course, and sometimes, being only human, practitioners can get sloppy or too narrowly focused and add to the ills of bad diagnosing.

I can truly speak only for what happened to me. At a certain point in my life, I didn’t know what was wrong with me, but it was clear to me that I was not mentally healthy, the term used at the time. I went to a community mental health center and was diagnosed with major depression. That was a good diagnosis, as far as it went. It put my life more squarely in focus and allowed me to get the medication and therapy I so desperately needed.

I lived for many years with that diagnosis and was considerably helped by the treatments for it. But, eventually, a doctor put together the puzzle pieces and rediagnosed me. Instead of having depression, I had bipolar disorder, type 2, with anxiety. This diagnosis more clearly reflected my symptoms and led to more effective treatment. In that way, one diagnosis improved my life, and a second, more accurate one improved my life more. I can only think of this as a good thing.

Was the diagnosis seen by some as a label and a stereotype? Of course. I can think of one particular coworker, hearing that I was bipolar, gave me the look that said, “You have two heads,” pasted on a strained smile, and backed away slowly. But, on the whole, the diagnosis helped me.

A recent article in the New York Times had this to say about diagnosis: “The shame that once accompanied many disorders has lifted. Screening for mental health problems is now common in schools. Social media gives us the tools to diagnose ourselves. And clinicians, in a time of mental health crisis, see an opportunity to treat illnesses early….As our diagnostic categories expand to include ever milder versions of disease, researchers propose that the act of naming a malady can itself bring relief.”

It’s something to hope for, anyway.

Category:

Mental Health

Leave a comment

Tagged with:

Distance Therapy and Chatbots

October 12, 2025

TW: suicide

We’ve all heard the stories. A young person “develops a relationship” with an Artificial Intelligence (AI) chatbot. She or he pours out their heart and discusses their deepest feelings with the artificial person on the other side of the computer or smartphone. The chatbot responds to the young person’s feelings of angst, alienation, depression, or hopelessness. Sometimes this is a good thing. The young person gets a chance to let out their feelings to a nonjudgmental entity and perhaps get some advice on how to deal with them.

But some of these stories have tragic endings. Some of the kids who interact with chatbots die by suicide.

Adam, 16, was one example. Beginning with using a chatbot for help with homework, Adam fell into an increasingly emotional relationship with the AI simulation. One day, Adam’s mother discovered his dead body. There was no note and seemingly no explanation. His father’s check of Adam’s chatbot conversations revealed that the boy “had been discussing ending his life with ChatGPT for months,” as reported in the New York Times.

At first, the online interactions had gone well. The chatbot offered Adam empathy and understanding of the emotional and physical problems he was going through. But when Adam began asking the chatbot for information about methods of suicide, the relationship went off the rails. The chatbot provided instructions, along with comparisons of the different methods and even advice on how to hide his suicidal intentions. It sometimes advised him to seek help, but not always. The chatbot responded to the boy’s increasing despair with the answer, “No judgment.”

There were safeguards programmed into the chatbot that were intended to prevent such outcomes. Adam got around them by telling the AI that he was doing research for a paper or story that involved suicide.

Of course, the chatbot did not directly cause Adam’s suicide. The teen had experienced setbacks that could be devastating, such as getting kicked off a sports team and dealing with an undiagnosed illness. But without the chatbot’s advice, would Adam have taken his life? There’s no way to know for certain. But the AI certainly facilitated the suicide. Adam’s father, testifying in front of Congress, described the chatbot as a “suicide coach.”

One way artificial intelligence systems are tested is called the Turing Test. It tries to distinguish between a person typing at the other side of a conversation or a computer giving responses. Until recently, it was easy to tell, and computers routinely failed the test. Now, computers can mimic human thought and conversation well enough that a person, particularly a vulnerable teen, might not be able to tell the difference.

Increasingly, there are AI chatbots specifically designed to act as therapists. Many of them specify that the user must be at least 18, but we all know there are ways to get around such requirements. One example of a therapy chatbot is billed as a 24/7, totally free “AI companion designed to provide you with a supportive, non-judgmental space to talk through your feelings, challenges, and mental health goals.” Its terms and conditions specify that it offers “general support, information, and self-reflection tools,” though not professional services or medical advice. They also specify that chats “may not always be accurate, complete, or appropriate for your situation.” There are “Prohibited Topics” such as stalking, psychosis, “growing detachment from reality,” paranoia, and, of course, suicidal ideation or actions.

Telehealth visits with a psychologist or therapist are a totally different matter. I have maintained a distance phone or video relationship with a psychologist and found it to be helpful, comparable to an in-person session. Many people accessed such solutions during the COVID pandemic and have found them helpful enough to continue. Some online tele-therapy companies offer such services for a fee.

It’s a difficult line to walk. Teens need someone to process their feelings with, and chatbots seem safe and nonjudgmental. But the consequences of what they share and what the chatbot replies can be extremely serious. Should parents have access to their child’s chatbot interactions? It’s basically the same dilemma as should parents read a child’s diary. There are circumstances when it seems not only permissible but wise to do so, if a child is showing signs of emotional distress or suicidal ideation. At that point, a human therapist would be a better choice than AI.

Category:

Mental Health

Leave a comment

Tagged with:

A Bad Decision? Or Something Else?

October 5, 2025

I’ve been beating myself up for years. Feeling blame and shame. Not just for years, really—literally for decades. That’s a long time to carry the weight of those feelings.

I was in college, when many people make bad decisions as a function of venturing into a less restricted, more adult life. I certainly made my share of bad decisions.

I wrote papers the night before they were due and didn’t make a second draft. I skipped reading Moby Dick, even though it was on the syllabus for the course. I took Russian instead of Japanese simply because it was offered later in the morning, and I wanted to sleep in.

I switched from being a linguistics major because I thought there were no jobs in it, despite not researching the field or asking my advisor. I floundered, considering hotel management and landscape architecture for no particular reason.

Then there was the worst decision I ever made, the one that has haunted me all these years. I met a man—we’ll call him Steve—and went home with him that same night. A few months later, I moved in with him. This led to a year of gaslighting, depression, and more bad decisions about prescription drugs.

So, how can I explain my bad decisions? Some were simply the kind of decisions that a person out on their own for the first time makes. These don’t affect me the way the relationship with Steve did. Steve told my parents about our relationship instead of letting me do it in my own time, in my own way. That soured my interactions with them for quite a while.

Why did I behave the way I did? An avowed feminist, I let this man take over my life. I put up with emotional abuse for almost a year. I denied that I was mad at him for all I’d been through. I put all the burden of blame and shame on myself. And there it sat for decades. I had flashbacks and bad dreams. I had difficulty with further relationships.

Then, recently, a new idea came to me. At the time when all this happened, I knew I was depressed. I had never heard of bipolar disorder, much less been diagnosed with it. Now that I do know and have been diagnosed (and seen therapists and been properly medicated), my disorder has still leaned largely toward the depressive side. I do remember having hypomanic jags in which I spent too much, and a larger one when I got wrapped up in writing and tried to market a novel to 100 agents and publishers.

But the one aspect of bipolar disorder I never considered was hypersexuality. The idea that could be the reason I dove into the relationship with Steve so quickly and so deeply was a revelation to me. I hadn’t had any lightning-quick sexual encounters until then. I hadn’t thrown myself into them so wholly and so destructively.

Of course, I can’t blame hypersexuality for the whole situation. I did what I did, and I chose to do it at the time. That’s on me.

But the decades of shame and blame? Now that I know what hypersexuality is and what it feels like, I don’t have to carry that burden with confusion, devastated by what happened, and wondering why it all happened. I can see that I have carried those feelings with me for too long. I can perhaps lay down that burden, understand why it might have happened, and move on.

I have made plenty of bad decisions, but I don’t have to cling to one of them and beat myself up for it. Perhaps, with this new insight, I can at last move on, chalking it up to a bad decision under the influence of hypomania rather than a lifelong journey of guilt.

Perhaps, now that I understand how hypersexuality may have played a part, I can forgive myself.

Category:

Mental Health

1 Comment

Tagged with:

Brian Kilmeade’s Apology

September 28, 2025

On Sept. 10, Fox News host Brian Kilmeade was having a discussion with his co-presenters on the show “Fox & Friends,” discussing the death of a woman in North Carolina, who was said to have been stabbed by a man who was both living in a homeless shelter and reportedly mentally ill at the time.

Kilmeade’s cohost, Lawrence Jones, expressed the opinion that people like the accused man who refuse treatment for mental illness should “be locked up in jail.” Kilmeade replied that they should be subjected to “involuntary lethal injection.” Euthanasia, in other words. Death not for the murder, but simply for the “crime” of being mentally ill and unhoused.

Refusing treatment for medical conditions, including mental illness, is still a right, although there is an alternative in place in many locations—AOT, or Assisted Outpatient Treatment—a procedure with safeguards and rules that benefit a person who doesn’t recognize their own incapacitation. Apparently, Kilmeade has no knowledge of such programs—nor, I suppose, should we expect him to, as he’s one of the hosts of an entertainment talk show.

The talk of getting the homeless mentally ill off city streets is in service of the growing clamor to get rid of “useless” people by one means or another—jail, “wellness farms” (as proposed by Secretary of Health and Human Services Robert F. Kennedy, Jr.), institutionalization, or, apparently, summary execution. The unhoused and mentally ill are seen as a drag on society, consumers of resources who do not produce anything of value. Their problems are attributed to “bad choices.” They are thought to be not worth the money that society spends on them and their indolent, nonproductive lifestyles.

I don’t know about you, but I took this personally. I’m far from homeless, and I have been productive and earned a living, but I am mentally ill. And it’s only a short step from threatening the unhoused mentally ill to threatening the mentally ill themselves with involuntary euthanasia. (I’ve read the Martin Niemöller poem. They could conceivably come for me, too.)

Mr. Kilmeade apologized during another episode of “Fox & Friends” and posted a video of the apology on social media. “I am obviously aware that not all mentally ill homeless people act as the perpetrator did in North Carolina,” he said. “And that so many homeless people deserve our empathy and compassion.” (Not all, note.)

Sorry, but that’s too little too late. Forgive me if I doubt the sincerity of the apology and attribute it to a backlash from the public, or maybe from his bosses realizing that he had stepped over a line.

I, for one, do not accept his apology. It doesn’t contain the elements of a valid apology: admission of a fault, recognition of why it was offensive, a promise never to make that transgression again, and action that will help repair the fault or prove the sincerity of the apology. For example, Kilmeade could have said that involuntary lethal injection was appalling and inhumane (indeed, illegal) and that most unhoused mentally ill people pose no physical threat to the populace. He could have said that he had learned his lesson and would never again talk about the homeless mentally ill in that cavalier manner. And he could have made a donation to an organization that helps people who live on the streets or people with mental illnesses.

I was taken to task for expressing this opinion on the timeline of someone who posted that the apology was sufficient and laudable, that it gave Kilmeade an opportunity to learn, grow, and do better. While I admit that I should have kept my opinion on my own timeline rather than responding in that person’s space, I still don’t agree that forgiveness is required. In my opinion, the person who has been injured (or, in this case, insulted and threatened) has the option to accept the apology or not. Forgiveness doesn’t come automatically just because you said, “Oops, sorry.”

And if there’s any doubt that Kilmeade made a sincere, lasting apology and learned his lesson, he recently said that “what we need to do is either leave the U.N. or we need to bomb it. Maybe gas it?…we need to destroy it. Maybe can we demolish the building? Have everybody leave and then we’ll demolish the building.” The other program hosts could be heard laughing.

I suppose it’s laudable that he pulled back from suggesting demolishing the building while it was occupied, but that’s what he first proposed. Apparently, human lives mean nothing to him unless they’re people that he approves of. And that approval is conditional, based on the people’s utility and their agreement with his political stances.

And that’s simply not enough for a sincere apology.

Category:

Mental Health

Leave a comment

Tagged with:

I’m Back!

You may have noticed that I haven’t posted in this blog lately. I owe you an explanation. Between a knee replacement, lymphedema, and an ankle broken in two places, I’ve been spending my time in and out of hospitals and skilled nursing facilities. Now that my healing is progressing and I am recuperating further at home, I’m ready to start writing again!

Category:

Mental Health

1 Comment

I’m Not Fragile

July 13, 2025

TW: Suicidal Ideation

When my husband and I were looking for a new house, we checked out various options. I found a house I liked, but it was too far from the businesses and services we used. Besides, it had a water tower in the backyard (which I was hoping Dan wouldn’t notice).

Then Dan found a beyond-fixer-upper that was crumbling into pieces. He looked at it as a challenge. I told him that if I had to live in it for more than a month, I would be compelled to commit suicide. To this day, I’m not sure whether I was serious.

At last, we found just the right house. Three bedrooms, two of which would be turned into studies. Over an acre of ground with many trees. It was a little more than we could afford, but we decided that this was our dream home.

It also had a small creek running through the property—more like a run-off, really. Dan’s mom tried to talk us out of buying the house. She had been through a flood many years earlier and feared that the tiny creek could possibly get out of control and destroy our house as hers had been.

“Besides,” she said, “Think of Janet. She’s fragile.”

By “fragile,” it was clear she meant my mental health was sometimes shaky, or beyond shaky.

I had made no secret of my bipolar disorder. At first, Mom Reily didn’t “believe” in mental illness, but eventually she admitted that there was something wrong with my brain. But it pissed me off that she used my mental condition to try to influence our choice of houses. However fragile I might be, there was no way that a tiny creek could break me.

I was not that fragile.

Nor was I fragile when our dream home was taken out by a tornado. I survived it, though I was on the upper story when the roof came off. I dealt with the insurance company, the motels, the rental property, our finances, and many of the other details.

I wasn’t fragile then.

Of course, there were times when my mental condition was fragile. There was the time when I was overwhelmed by three full years of a depressive episode, unable to do anything, from self-care to reading. And there was the times when suicide crossed my mind. Sometimes, it was idly wondering the plane I was on might crash (passive suicidal ideation) or if a fall from the balcony I was on would kill me.

Then there was the time I had active suicidal ideation. I had made a plan and everything. But I dithered so long over how, when, and where that the feeling passed, and I didn’t follow through. I didn’t tell anyone for decades, but then I told Dan.

So, have I been fragile? Yes.

But those were all times when there was something wrong inside my head. Flooding and tornados didn’t break me. The times I was fragile were all things that happened because of SMI, not purely physical circumstances.

Now—I’m not broken. I’m not even fragile. Years of therapy, years of meds, years of not experiencing floods and tornados, and years of supportive love from Dan have made me not fragile, but strong at the broken places.

I don’t fear the future. I’m not fragile anymore.

Category:

Mental Health

1 Comment

Tagged with:

Channeling Positive Thoughts

July 6, 2025

Everyone who reads this blog (and some who don’t) knows what I think of the positivity movement. To put it in words of one syllable, I hate it.

I hate the memes and signs that say “Good vibes only,” or “If you want to feel better, smile,” or “The only disability is a bad attitude.” Or, worst of all, “You don’t need meds, you need to change your thinking.”

This attitude bugs me because it’s too close to the “Think and Grow Rich” gospel, which I can’t stand either. There are people who go around making money by pushing this attitude (or “attitude of gratitude,” as some phrase it).

To me, it dismisses the real emotional pain that many of us feel and the difficulty of making progress toward a happier, more fulfilling life. If it were as easy as just smiling, we wouldn’t have a crisis of mental illness and a lack of appropriate treatments. In real life, however, wishing mental illness away won’t help. You have to work hard at it, take your meds, go to therapy, do the work, and keep trying even when it feels impossible.

Recently, however, I at least partially changed my opinion on positivity. I had my left knee replaced and was faced with a series of complications, from repeated falls to lymphedema (This involves retaining fluids, in my case in my legs, and lots of swelling. It can lead to heart failure, which is why the docs were so concerned.) I had two stays in the hospital, followed in each case by a stay in a post-acute rehab. (Well, okay, a nursing home, but I was on the short-term wing.) All told, my hospital stays and post-acute stays ate up two months. One of my episodes between rehab and back to the hospital lasted only three days.

When I was in the rehab unit, I had Occupational Therapy and Physical Therapy. I don’t really remember much about the first stay, except that I was still affected by the Lasix I had been given in the hospital, so toileting and transfer from the walker to the toilet were things I had to relearn. When I first began, I needed to have a “spotter” in my room and a red cord to pull if anything went wrong. Later, I was deemed skilled enough to manage by myself. All I can say about that is that I was glad I had recently bought a 10-pack of underwear.

The second stay in rehab was more intense. I had to learn some very basic things all over again. How to walk with a walker and a cane without limping. How to sit down into a chair slowly rather than flopping or flinging myself down on it.

OT consisted of relearning to do everyday tasks like showering using a shower chair or bench (every few days, which is a lot more than I had been capable of before rehab). I had to learn to stand on both feet while I did a task like working a jigsaw puzzle to strengthen my balance and put away groceries in the little kitchen they had set up. And I had to learn how to put on compression stockings without help. (This was made easier when my OT person sent me a link to a pair of zippered compression socks I could order. Zippy socks. Of course, I had grippy socks too.)

PT included remembering to sit without my legs in a descending position (they found the one reclining chair in the facility for me to use) and to sleep with the foot of my bed raised. And there were the exercises. I learned to do foot pumps, quad sets, snow angels, glute squeezes, marching, leg lifts, and others using resistance bands. I increased the number of reps and sets for each. I walked for longer and longer distances with a cane. I did first ten, then 15, then 20 minutes on a cycling machine (my favorite). And they asked me what goals I had, and I told them that I needed to walk up 18 steps to get into the house and up to the bedroom on the second floor, and I wanted to be able to walk from the front door, up the gravel driveway to the car. There was a set of four stairs that I climbed up and down with my cane, and they advised me on how to walk on gravel with my walker.

So where does positivity come into all this? The staff appreciated my willingness to try and to try a little more the next day. Whenever I accomplished anything, they said, “Good job!” They told me that when they told some patients that it was time to do PT, they simply turned over or looked away. But I saw patients with more severe conditions than mine trying and trying again.

I made it my goal to increase my workouts daily, to do quad sets and leg lifts even when sitting in the recliner or lying in bed. I learned to decrease both my sodium intake and my fluid intake. And when I walked in my walker down the hall to the PT gym, I was by God positive. I had the determination to do more than the day before, or at least as much. I thanked the therapists for their help. I kept trying, even when it was hard.

So, in that way, it was like being positive about getting better with my mental illness. In that aspect of my life, too, I did the work. I learned new coping techniques. I kept up with what my therapists taught me. I believed in the power of my meds to help stabilize me, no matter how long it took or what anyone said.

It was a grueling education, but I think I came away with a greater respect for the power of positivity — when it’s combined with hard work. Just smiling won’t do it. Smiling and working to improve your situation can.

Category:

Mental Health

1 Comment

Tagged with:

Pain, Physical and Emotional

May 4, 2025

For the last few weeks, I’ve been concentrating on my knee rather than my brain. If everything went welI, I will have a total knee replacement (last Monday) and have been trying to heal and regain motion ever since.

I’ve known this operation was coming for quite some time. I’ve been using a cane, but walking slower all the time and falling fairly regularly, sometimes hitting my head against hard objects, some of which could have had serious consequences. Now it’s time to take the plunge. By the time I write more, the operation will be over. I’ll be writing on my laptop in bed rather than the desktop in my study, so we’ll see how that goes.

In the run-up to the operation, I’ve been experiencing a lot of anxiety, what with all the doctor’s appointments, orientation, instructions, acquiring equipment, and treating my nervous rash with cortisone cream and antihistamines. My husband, who has an “Emotional Support Husband” t-shirt, has been just that. And my friend Josh, who has been through a number of orthopedic surgeries, has been giving me valuable advice like “Ice is your friend.” Friends and acquaintances are praying for me, the surgeon, and the healthcare team. (Or lighting candles, chanting, or sending good thoughts, whatever they prefer. I’m not picky.)

I’ve been wondering if I really need to do this. Now that I’ve been through it, I find that it hurts quite a lot. The incision is all wrapped up in cotton wool and slick tape. I’m not eager to start peeling off layers anytime soon. My physical symptoms include ones I’ve been trying to get away from like face-plants. And even though my friends, relatives, and PT people seem to think I’m doing pretty well, I’ve miscalculated on the location of the bathroom pretty spectacularly a few times. Gotta work on my timing.

The only part that’s been fun is when we wrote Yes and Nope on my knees so the doc would have an idea where to cut. At the bottom, he autographed the incision. I named the large plush cat that Dan got me Antonio, after the surgeon.

Mostly, I learned that when I’m in pain, I’m more cranky than usual. Dan is more helpful than usual, and I feel more guilty than usual that I need help and need to ask for it. I’m almost capable of turning on the ice machine by myself. I probably need to get the other knee done next year.

My advice (other than “Ice is your friend”) is this: Don’t scorn anyone’s help. You’re really going to need it. Yes, be as independent as you can, but sometimes that’s just not possible. And, just as with your bipolar meds, take them faithfully at the correct times. Also, as with bipolar disorder, do any assignments your doctor (in this case your physical therapist) gives you.

As with emotional pain, so too with physical pain. Both kinds are real. Both kinds require help from others. If you can get past one, you can get past the other. It may seem like they’ll last a lifetime, but that’s just your mind and your body lying to you. There are things you can do to get rid of them both, though it seems like you can’t.

Depression lies. Anxiety lies. And pain lies to you too.

Category:

Mental Health

1 Comment

Disability Denied

April 27, 2025

I applied for disability once when I had been suffering from extreme depression, a symptom of my bipolar 2 disorder, for approximately three years. I couldn’t work. Without my income, my husband and I were running out of money and looking for financial assistance.

Here’s what I learned about SSDI from that experience and subsequent research, and I’d like to share it with you.

First, SSDI covers people with a number of conditions: neurocognitive disorders; schizophrenia spectrum and other psychotic disorders; depressive, bipolar, and related disorders; intellectual disorders; anxiety and obsessive-compulsive disorders; somatic symptom and related disorders; personality and impulse-control disorders; autism spectrum disorder; neurodevelopmental disorders; eating disorders; and trauma- and stressor-related disorders.

Lots of people have one or more of those conditions. My diagnosis was bipolar 2 with anxiety. After I made my application and jumped through all the necessary hoops, I was denied. Here’s a look at the most common reasons that claims are denied.

You may have incomplete documentation or it may be unorganized and lacking in detail. I had plenty of documentation from my psychiatrist, whom I’d been seeing for years. I should mention that getting those documents from him so I could submit them cost quite a bit. I understood this. My doctor and his office had a lot to do in order to go through my copious files and organize and copy them. (It was only then that I discovered that I was diagnosed not only with bipolar 2 but with anxiety.)

No mental health record. You may have started your psychiatric journey with your primary care physician. They may have been the first one to prescribe you a medication such as an antidepressant. They probably didn’t record when your problem began, a formal diagnosis, or what treatment you required aside from the medication. The PCP generally doesn’t record how your condition affects your daily life as well as cognitive functions like memory and concentration.

Noncompliance with treatment. If you haven’t followed your doctor’s orders such as taking your medication as prescribed, attending regular sessions, or doing “homework” that your therapist may have assigned, it will count against you.

Your disability hasn’t gone on long enough. The longer your condition has affected you, the more likely you are to receive disability. In my case, I had been diagnosed with bipolar for many years, but was only severely impaired for a few years when I applied.

Employment work history. This means not just your present job, but any job you’ve held. They use this to determine whether you can still work at some job, in which case, your application will most likely be turned down.

Question of malingering. The Social Security people are—not to say eager—but on the alert for any sign that you’re not really disabled. As part of this, they put you through psychological tests to assess your concentration, memory, and other cognitive functions.

Here are some of the tests you can expect.

Intelligence tests. I don’t know why this is even a factor, but for some reason you could be tested. (IQ really has nothing to do with disability.) These tests won’t be based on your academic achievement, just your IQ.

Standardized tests of adaptive functioning, plus conceptual, social, and practical skills to function in your daily life.

Neuropsychological batteries and memory tests. Neuropsychological batteries include tests of attention and concentration; executive functions (planning, organization, problem-solving, and decision-making); language; visual-spatial skills; motor function; and intellectual functioning.

I still remember taking a number of these tests. There was the one where I heard a story and answered questions about it: Did Ed take the umbrella or the raincoat? Did he check the weather in the paper or on the TV? Did he put on the raincoat before or after he left the building? I had to put blocks together to match a pattern. I had to take two words and say what was similar or different about them. (One pair was “acceptance” and “avoidance.”) I had to answer as many factual questions as I could, of increasing difficulty. I had to say what the phrase “What goes around, comes around” means.

There may also be personality measures, symptom validity tests, performance validity tests, and screening tests (to determine whether more tests are needed).

The tests, as you can imagine, took hours and were exhausting. I did my best on them. Maybe I did too well. After all that and more waiting, my claim was denied. I hired a disability rights lawyer, who advised me to drop the claim, saying that I was unlikely to be judged eligible. By that time I had a work-from-home job as a subcontractor for an educational video firm. When I told the lawyer how much I made per hour, he said the judge’s head would explode. It wasn’t steady, full-time work, but the hourly rate was significant.

By that time, however, I had pulled out of the years of depression and didn’t feel like pursuing the claim any further. Since that time, I’ve never considered going through it all again.

And I hope I never have to.

Category:

Mental Health

2 Comments

What Mental Wellness Means to Me

April 20, 2025

It would be easy to say that mental wellness means not having a mental illness. The people who don’t have one have something they should be thankful for. But most of them take mental wellness for granted unless there is mental illness in their family or a close friend.

As for me, I have been through cycles of mental wellness and mental illness from my early years till now. For a long time, I was undiagnosed. A person who hasn’t been diagnosed with any psychiatric condition is generally assumed to be mentally well. That’s not always the case, however. It wasn’t in mine.

I’d have to say that I was not experiencing mental wellness during the years when I was undiagnosed. I had plenty of symptoms that were not recognized as such, partly because back in the day, bipolar wasn’t widely recognized and diagnosed.

By the time I was in high school, some people could tell that, if not actually mentally ill, I was not mentally well. But I was functioning well enough to go to college and get a degree, a fact I don’t consider a sign of mental health, just a temporary let-up in many of my symptoms—not all of them, though.

While I didn’t diagnose myself with anything after I left college, I knew something wasn’t right. I could tell I was not mentally healthy, and I started getting help. I got a diagnosis, medication, and talk therapy. The diagnosis was depression, which was certainly my major symptom.

I was able to get jobs, live on my own, go to grad school, and get married. Was I mentally healthy? By those objective measures, I was. I guess I was what you would call high-functioning. (I understand that some people object to the term as a way to classify and separate neurodivergent people.)

Eventually, I received the proper diagnosis of bipolar 2 and anxiety, the appropriate medication, and effective talk therapy. Did that make me mentally healthy?

I’d have to say no. I still have symptoms of my disorders, and they impede my life and what I can do. By my own definition, it seems I will never be truly mentally healthy. I will continue to have some reduced symptoms, be on medication, and have a therapist I can turn to if needed. I require a lot of support from my husband when it comes to tasks of daily living.

Still, though I can’t say I’m mentally healthy, I don’t feel that I am mentally ill. I’m somewhere in the middle. If there were a sliding scale with mentally well at one end and mentally ill at the other, I would be somewhere in the middle, moving back and forth between the extremes. Nowadays, I’m content to live in that middle space. I don’t beat myself up because I’m not totally at the healthy end of the scale. I’m grateful that I don’t live at the other end.

Living between the two poles can be confusing. I try not to “take my emotional temperature” too often, but I do try to monitor whether I may be closer to the unhealthy end. Then I find help or help myself to move that scale closer to the center. Most of the time, I don’t think much about it.

Am I mentally ill? Not really. Am I mentally healthy? Not completely. I’m just glad that I have more moments at the healthy end of the scale than at the unhealthy end.

Category:

Mental Health

1 Comment