MY JOURNEY

Writing and mental health advocacy can affect both personal and social change. I started blogging because the thoughts and words in my mind simply had to get out. I hope this blog offers support, educates, and fights stigma against those living with mental illness.

The following essays, excerpts from my upcoming memoir Balancing Act: Writing Through a Bipolar Life, recount my struggle with depression and bipolar disorder, the two decades it took to get a proper diagnosis, and how my journey has ultimately given me a sense of purpose.

There is hope. Your life has purpose. Everyone deserves respect, love, kindness, and compassion.

More than Bipolar

As a perpetual and proud geek, I always liked going to school. My brown-nosing and hard work got me a bachelor’s degree in legal studies from UC Berkeley, a master’s degree in psychology from New College of California (never heard of New College? well, it no longer exists and was never as prestigious as Berkeley), and twice I’ve attended Fuller Theological Seminary and twice I quit.

Though I’m a licensed Marriage and Family Therapist, I haven’t practiced in over twenty-five years. My varied career path has included working as a legal assistant, psychotherapist, and commercial real estate professional. Clearly, I haven’t stuck to one thing for very long. If you take a look at my LinkedIn profile, you’ll see that I was a job-hopper, shooting high, rapidly rising, then crashing and burning, over and over — fairly typical of someone with bipolar disorder.

When my parents introduced me as a child, they always said, “Kitt is going to go to Harvard Medical School and become a doctor when she grows up.” By the time I was in high school, I had aspired to become a neurosurgeon. I got almost straight A’s, allowing myself a B in physics, was a medical explorer scout, trained as an emergency medical technician, wrote for the school paper, and logged many hours in drama and dance. As a senior, I applied to the schools with the highest acceptance rates into medical school.

Despite my hard-earned achievements, I didn’t get into any of those schools. Receiving rejection letter after rejection letter hit me hard. As I grew up, my parents told me that I could go to school anywhere I wanted and could do anything I wanted. Wrong. Instead of attending an East Coast Ivy League school, I started my freshman year at UCLA as a biochemistry major. As the summer after high school graduation approached, I got a letter from UCLA saying I had to take remedial summer courses since my SAT scores totaled under 700. Back in the 1980s the math portion totaled 800, the verbal portion 800. My math score alone was 720 (yes, I was once a math geek). Apparently, the Educational Testing Service incorrectly reported my scores to UCLA. When I showed UCLA my scores, not only did I not have to do remedial work, but I was eligible for College Honors, in which I became active as a freshman.

– Excerpt from Kitt O’Malley’s upcoming memoir Balancing Act: Writing Through a Bipolar Life

As a freshman at UCLA I fell into a deep depression, believing that my parents, my sister, the whole world would be better off without me alive. When I told my friends of my suicidal thoughts, they made me promise to get professional help. I saw a UCLA psychologist, whose cognitive therapy saved my life by helping me rewrite my suicidal thoughts, and stop my suicidal impulses.

Cognitive therapy is also known as cognitive behavioral therapy or CBT, for short. As I was in CBT in 1981-1982, I asked my colleague Sarah Fader to help me identify the cognitive distortions, or types of inaccurate thoughts, I had back then. Sarah Fader and Simon Rego, PsyD co-wrote The 10-Step Depression Relief Workbook: A Cognitive Behavioral Therapy Approach (2018). If you are experiencing depression, I highly recommend this hands-on workbook.

If your symptoms are life-threatening, please immediately call 911 (USA and Canada), go to the emergency room, or contact the National Suicide Prevention Lifeline at 1-800-273-8255 (USA).

Depression involves distorted, negative thoughts and beliefs which are “automatic,” or outside of conscious awareness. In CBT, I learned how to identify these automatic thoughts and “restructure” them. Changing my thoughts changed the way I felt and behaved.

My CBT homework was to keep thought records where I separated my thoughts and feelings to determine whether those thoughts were true. If my thoughts were negative inaccurate cognitive distortions, I’d replace them with more realistic ones. Using these worksheets, I literally “rewrote” my negative thoughts. Doing so rewires our brains. The neural circuits in my brain used to short-cut to suicidal ideation. Cognitive techniques enabled me to identify the suicidal and depressive ideas as irrational, stop them, and rewrite (or reason with) them.

Here are the negative inaccurate cognitive distortions that I worked on in cognitive therapy:

“The world would be a better place without me,” which is an example of jumping to conclusions and fortune-telling. I did not have evidence to support that conclusion. At the time, I volunteered at the UCLA Medical Center Emergency Room. When I was in high school, I volunteered at local hospitals. Even if I didn’t volunteer my time to help others, the world would NOT have been better without me. My friends, family, and acquaintances would have been devastated. Unfortunately, depression lies.

In the same vein, I thought, “My family (or my sister) would be better off without me.” I believed that they’d have more resources available for my sister if I wasn’t such a drain on the family’s finances, time, and energy. My reasoning was emotional, not logical. As a Californian, UCLA in the early 1980s was a deal, especially compared to the Ivy League school I had wanted to attend. This might also be an example of a should thought. I thought I shouldn’t have any needs. That my family shouldn’t have to support me. I had to think more logically and get rid of those shoulds and shouldn’ts.

Using black-and-white all-or-nothing thinking, I believed, “This pain is unbearable. I need it to end.” Yes, severe suicidal depression hurts. In fact, it can feel like a living hell. But it’s not hell. Hell is permanent. The pain of severe major depression was temporary. Not only did I bear that hellish pain, but I overcame it.

Believing “I am unworthy of love,” I labeled myself negatively. Labeling involves making unhelpful overstatements, like “I’m a loser.” Of course I was worthy of love. We all are. Not only was I worthy of it, I was loved dearly. I just didn’t see it.

I thought, “I am a failure,” which involves labeling, overgeneralization, and personalization. An overgeneralization is when you take a single piece of evidence and then infer that it must always be true. I believed that I was a failure because I didn’t live up to expectations of attending an Ivy League university, and because I was depressed. I personalized not getting accepted into an Ivy League school and becoming depressed. I saw myself as responsible, when neither were my fault. I worked hard in high school to get into an excellent college. Likewise, depression was not my fault.

“I am ashamed of being depressed. I must be perfect.” I expected perfection of myself and was ashamed of my depression. Expecting perfection from myself involves both black-and-white/all-or-nothing thinking and that I should be perfect. No one is perfect. I was, and still am, imperfectly human. As for the shame, that involves internalized stigma (not specifically a cognitive distortion, but I’d argue it is) and personalization.

“I want to die.” This thought is an example of catastrophizing. Wanting a permanent, undoable solution, to a fixable problem. Besides, I didn’t want to die. I desperately wanted and needed help, which I sought and received.

I told my cognitive psychologist that I had fantasies of being hit by car and hospitalized. He responded, “You can be hospitalized right now.” My wish to be hit by a car is an example of a control fallacy, where I’m a victim of an outside force, a car accident. If I needed or wanted psychiatric hospitalization, the UCLA Neuropsychiatric Hospital was available; instead, I persevered in cognitive therapy.

Cognitive therapy helped me overcome severe suicidal depression and gave me a skill I still use today. Unfortunately, my underlying biologically based mental illness remained. Very active on campus, I volunteered in UCLA Medical Center Emergency Room, sat on the Executive Council of College Honors as Vice-Chair of their Social Committee (glorified party planner), and trained as a Peer Health Counselor.

For all but my closest friends, I hid behind a facade of competency and social skills. But I was miserable and felt that the biochemistry curriculum was more of a technical training than the well-rounded interdisciplinary education I craved. The August before my sophomore year, I came down with mononucleosis, and used that as an excuse to quit UCLA. I visited family and friends, worked, and attended community college part-time. Then I transferred to UC Berkeley as a legal studies major, a fabulous interdisciplinary program run out of Boalt Hall.

During my junior year at Berkeley, symptoms of depression returned. My mother was diagnosed with non-Hodgkin’s lymphoma. I was devastated to learn of my mother’s diagnosis. My mother and I researched lymphoma. At the time, studies indicated a five-year prognosis. She pointed out that the medical research we were reading was out of date by the time it was published, that cancer treatment progressed, and life spans increased. She is still alive thirty-five years later thanks to cutting edge monoclonal antibody therapy.

That same academic year, my maternal grandfather died. My grandfather always held a special place in my heart. He was a kindred spirit as a gifted orator (I’ve always loved the stage) and storyteller (here I am – a writer, a storyteller). The fall after I quit UCLA, I visited him and my grandmother. When he died, it hit me particularly hard. My mother’s family asked me to give his eulogy, which was a huge honor. In speaking at his memorial mass, I was carrying on his spirit.

On my way home from the funeral, as I was driving over the San Francisco Bay Bridge, I fell into a trance state brought on by the flashing reflections of the lane markers, and had an out-of-body experience, or more accurately, an in-the-body experience. I felt a tingling all over my body, an energy pushing out, and a warm cleansing energy replacing it. The fact that I was driving over a bridge at the time disturbed me. To test whether I could safely drive, or whether I should put on my hazards and pull over to the side, I put on my turn signal and changed lanes to the right. At the time it seemed safer to continue off the bridge than stop on the bridge.

When I got home, I described the experience to my roommates as a spiritual orgasm. We were interested in spiritual enlightenment, read Alan Watts and D.T. Suzuki, and wanted to experience enlightenment. After that initial spiritual experience, I willfully entered a series of altered states. I would stare into a candle flame, go into a trance state, and enter an altered state of consciousness. The states I entered fell into two basic categories – the light and the dark. The light I would describe as a loss of self that led to clarity – a cleansing. The dark was addictive, as if a siren called me, and threatened a loss of self that could lead to madness. I identified the two experiences as the call of God and the enticement of the Devil and related it to my reading of The Screwtape Letters by C.S. Lewis. The dark disguised itself as the light. It was deceitful and dangerous.

In retrospect, I can understand these mystic experiences as the beginning of a hypomanic episode, or mood cycling. At the time, given my history of depression, I knew if I went to a mental health professional and described the experiences, they would diagnose me with a mental illness. But I found them meaningful and did not want the meaning dismissed. I decided to stop entering the trance states and interpreted them as God calling me to the ordained ministry.

As I felt vulnerable and did not want to fall victim to a religious cult, I went to an ancestral religious home, the Roman Catholic Church. Unable to reconcile confirming my faith as a Roman Catholic with the belief that I was called to ordination, I ended up confirming my faith as an Episcopalian. I remain something of a Catholic apologist, despite my issues with the Church, and my involvement with other Protestant denominations.

Having graduated from Berkeley as a legal studies major, my first profession was as a legal assistant in Los Angeles and San Francisco. Working twelve-hour days six days a week, I crashed after a year on the job. What looked like over-achievement was a symptom of unrecognized, undiagnosed hypomania that came with a steep cost – my mental health and stability.

– Excerpt from Kitt O’Malley’s upcoming memoir Balancing Act: Writing Through a Bipolar Life

After working two years as a legal assistant, I quit, took time off, and applied for graduate school in psychology. While in graduate school, I worked as an administrator at a battered women’s shelter and completed my field placement doing play therapy with severely emotionally disturbed children in day treatment.

June 1990, I got a Master of Arts in Psychology from New College of California. Over the next two years, I worked hard to rack up 3,000 internship hours. Then I studied for and passed the written and oral licensing exams. As there was a strong demand for psychotherapists in the non-profit sector to work with high-risk adolescents, that was where I found my jobs, working with teens: pregnant and parenting teens, and severely emotionally disturbed adolescents in residential and day treatment. That briefly summarizes my five-year career, from ages twenty-five to thirty, as a psychotherapist. Though my career was short-lived, it influenced how I think about mental health and mental illness. Above all else, it taught me compassion.

At thirty, I had a complete major depressive breakdown, found myself unable to get out of bed, and had to stop working. For the first time, I turned to a medical doctor for medication. Up until then, I had managed my depression with psychotherapy alone. My internist treated me first with fluoxetine (Prozac), the first Federal Drug Administration (FDA) approved selective serotonin reuptake inhibitor (SSRI). Fluoxetine overstimulated me and put me on edge. I felt as if an electric current ran through me and wanted to jump out of my skin. To take the edge off this side effect of fluoxetine, my doctor added trazodone, another antidepressant, which acts to balance serotonin in the brain.

My parents urged me to get a second opinion from a psychiatrist. Unfortunately, the psychiatrist I saw was old school and did not believe in using SSRIs, for there was no data as to the long-term consequences of using them. First, he took me off fluoxetine, prescribing only trazodone. Then he switched me to a tricyclic antidepressant, which led to ramping and cycling. Not only did the medication he prescribed cause me to spiral out of control, he told me that I was stuck at an adolescent stage of development. As I was an independent woman who had put herself through graduate school and supported herself living in the San Francisco Bay Area, I was insulted.

The tricyclic antidepressant triggered mania. I ended up spending a week awake, thinking simultaneously at rapid speed in binary (with ones and zeroes streaming through my mind), about chaos theory (which I had never studied), and about Christian mystics (with whom I strongly identify). At the time, I wished that there had been a way to record my thoughts so that later I could decipher them and see if any made sense. The content involved topics with which I had some basic knowledge and interest, but the experience was that of channeling information beyond my comprehension, way above my pay grade.

Having suffered a week of full-blown psychotic mania, I decided that I was not fit to be a psychotherapist. Though I clearly had a manic episode, I was not yet diagnosed as bipolar. Those who knew me at the time still find this fact shocking. Since the episode was likely precipitated by antidepressants, I was not prescribed a mood stabilizer. My psychiatrist prescribed a three-day regime of antipsychotics, which stopped the racing thoughts in their tracks, and allowed me to sleep.

After I had my breakdown at age thirty, I was unable to function on my own. I would fall asleep driving to my temporary job. When at the job, I couldn’t even read. The words were all jumbled. However, I appeared competent. No one could see that I, a highly educated and articulate former professional woman, COULD NOT EVEN READ A SENTENCE.

To my parents’ home and care I returned. They were tremendously supportive and encouraged my recovery. They gave me work to do around the house, and as my mental health improved, charged me room and board. The rent was more than I could earn doing odd jobs. We drew up a promissory note with well-defined terms, including interest charged for the money I owed them.

While living with my parents, I received psychiatric treatment and psychotherapy. My new psychiatrist carefully calibrated my dosage of sertraline (Zoloft), another SSRI. I remained stable on a low dose of sertraline for almost a decade, with a couple of trials of bupropion (Wellbutrin).

Once I was up for it, I got outside employment, starting as a temporary file clerk for a commercial real estate firm. What followed was a decade-long career in commercial real estate. It was a welcome change, not emotionally draining as helping severely emotionally disturbed youth, and it used my analytic and problem-solving skills. Still, I continued my pattern of overdoing it, working long hours and neglecting myself, leading to repeated burn out and cyclical depression. As a result, my résumé lists numerous short stints at various jobs and in multiple career areas. Three areas, really: legal assistant, psychotherapist, and commercial real estate professional. I worked short stints — shooting high, crashing hard — time and again.

Soon after moving back home and starting work as a temporary file clerk, I met my future husband, a civil engineer who didn’t own a car, just three motorcycles and a small plane. Not your average engineer. Interesting. Complex. He even spoke Mandarin. Three years after we met, we married and later had a son. I found being home with an infant difficult. At the same time, I found being at work, away from him, heart-breaking.

– Excerpt from Kitt O’Malley’s upcoming memoir Balancing Act: Writing Through a Bipolar Life

Before becoming pregnant with my son, I thoroughly surveyed the medical research about antidepressant use in pregnancy and during lactation. Since I had a history of severe depression and suicidal ideation dating back to my late adolescence, I did not want the risk of experiencing depression during pregnancy. My review of scientific literature revealed that the antidepressant sertraline (Zoloft), an SSRI, had an extremely low serum level in breast milk, and an almost immeasurably low serum level in breast-feeding infants. Armed with this knowledge, and with my doctor’s blessing, I took sertraline when I was pregnant and nursing my son. At the time, I received no negative feedback from health care providers, but I did get questions from extended family members, “Is it OK to breastfeed him when you are taking medicine?”

After childbirth, and a pregnancy that kept me bedridden for five weeks, I returned to the workplace on a part-time basis. My job, as always, grew, consuming more and more of my time, while my son needed me home with him. When I worked first two, then three days a week, my sister and my husband cared for my son. By the time my responsibilities demanded that I work four days a week until 7pm, I put my son in a loving, home-based childcare setting. Every time I would leave my son at childcare, he would cry for a good one and a half hours. I would visit him during my lunch hour, which meant that he would cry again after lunch. It broke my heart. Finally, I decided to quit work and stay home with him full-time. But, this too, would not last.

Staying home with my son full-time lasted a year and a half. By that time, the symptoms of hypomania returned. I thought that God was calling to one Episcopal Church for spiritual direction and another church for Bible study. Though God could have been calling me to these churches, this time I recognized the euphoria as hypomania. I could not in good conscience raise my son without treating symptoms of bipolar.

I asked my husband to listen in as I called the advice nurse and described my symptoms. She told me to either see a psychiatrist immediately or go to an emergency room. Unable to get seen by a psychiatrist for the first time on a Friday afternoon, I saw our family doctor who put me on divalproex sodium (seizure medication that acts as a mood stabilizer) with the understanding that it was outside her expertise and I was to see a psychiatrist following the weekend.

When I became a mother, I didn’t know I had bipolar disorder. My diagnosis at the time was dysthymia (chronic depression). I knew I likely had, at the very least, cyclothymia (a mild form of bipolar disorder, also known as bipolar III). Once I got the diagnosis of bipolar disorder, my son was 27 months old and still nursing (he loved it and I was a pushover). I had to abruptly wean him, as the divalproex sodium (Depakote) I was prescribed as a mood stabilizer is not safe for nursing infants, or, in his case, a nursing toddler.

Fearing that I was now an unfit mother, I proceeded to put my son in daycare and reenter the workforce. Once my diagnosis changed from depression to bipolar, I believed that I could be a danger to my son and that he’d be better off in the care of someone else. I was the same person before my diagnosis changed. My stigma was internal: my own negative thoughts about what having bipolar meant, that I now had a serious, progressive mental illness, my belief that my son was no longer safe when in my own care. I was wrong. Despite the challenges of bipolar disorder — and those challenges are real — I’m a good mother. I work hard to be a good mother.

My son loved breastfeeding. He fed for twenty-seven months until it became clear that I was experiencing symptoms of hypomania and that I had bipolar disorder. To treat the manic symptoms, my doctor prescribed divalproex sodium (Depakote), an anticonvulsant commonly used as a mood stabilizer. Divalproex sodium is not recommended for use during pregnancy, for it may harm an unborn infant. This medication passes into breast milk. Consult your doctor before breast-feeding while taking this or any other medication.

Since divalproex sodium passes through breast milk, we agreed it was time to wean him. By this time my son was over two years old, and I was FED UP with waiting for him to “naturally” wean. Upon being prescribed divalproex sodium, I left my son with my husband for the weekend for cold turkey weaning while I went to my parents.

My son couldn’t believe Mommy wasn’t coming back home for the night. She had never left him overnight. Though it was raining, he insisted on sitting at the driveway, waiting for me to return, then my husband convinced him to sit under the walkway for cover from the rain, then sit in the front doorway, then at the foot of the stairs, then at the top of the stairs, then finally in the master bed with Daddy looking downstairs at the front door, until he finally fell asleep. Later, when I told this story to my psychotherapist, she found the story touching and indicative of how sensitive and caring my husband is.

The following week, I found a psychiatrist who would see me. Finally, at the age of thirty-nine with a highly active, still nursing toddler son, I was diagnosed with bipolar disorder.  I went back to work because I thought my son was better off in someone else’s care, now that I was diagnosed with a chronic, severe, progressive, degenerative mental illness. I had internalized stigma against serious mental illness. For some reason, I thought it okay to be a depressed mom, but not a bipolar mom. I was the same person before and after the diagnosis. The only change was my treatment. Instead of only taking an antidepressant, now I was taking a mood stabilizer.

Keeping with my history of hypomanic workaholism, I worked increasingly long hours until I once again fell apart. I broke down crying at work and found myself unable to pull myself back together and return to the office. I tried taking a mental health week off but couldn’t even make it through the weekend without succumbing to uncontrollable crying jags. To get myself stable, I had myself voluntarily hospitalized when my son was four and haven’t returned to work since.

– Excerpt from Kitt O’Malley’s upcoming memoir Balancing Act: Writing Through a Bipolar Life

Acceptance has been an ongoing process for me. Not just overcoming denial or stigma but owning my diagnosis and allowing others in to help me. I had been a high achiever, a perfectionist. Accepting that I have a mental illness has involved accepting myself as broken, as imperfect, as fallible, as human.

To that extent, acceptance has allowed me to forgive myself for not living up to early life expectations. I quit UCLA after my freshman year. Took a semester off. Attended community college part-time before transferring to UC Berkeley. I never became a doctor or a lawyer. But I did get my bachelor’s, a master’s in psychology, and much later even attended seminary twice after my hospitalization, but never finished my religious studies.

That I attended seminary twice AFTER I had been hospitalized indicates that my sense of calling never quite died. The psychologist I saw after my hospitalization asked me about my sense of calling. She had been raised in a convent by nuns, so she understood what I meant by sensing that I had a calling, a higher purpose, that maybe I was supposed to go to seminary and preach. That feeling had been validated over the years. I had been told that I had a gift for preaching.

At times, I was shocked that I could persuade people in debates. I enjoyed the challenge of debating the “wrong” side of an issue and convincing people that what I argued was true (even when it was clearly wrong). In junior high, I persuaded the class that we had been visited by aliens. Whether or not we have been, our scientific evidence of such a visit is lacking. In high school, as Scarlett O’Hara in a theatrical debate, I convinced the class that slavery was right. It’s NOT! That I can convince people of falsehoods scares me.

Similarly, given my history of mental illness, I’ve questioned my sense of religious calling, and whether I was suited for ordination and pastoral ministry. Still, after my psychiatric hospitalization, which I discussed openly with my pastor, he recommended me for seminary. I attended part-time for a year. While at Fuller Seminary, I wrote a Mental Health Ministry manual. As I explored what my calling was, it became clear that I was called to a mental health ministry.

My studies went well until we moved to Eugene, Oregon. The move to a rainy, overcast climate amid pines that block the sun, triggered a depressive episode during which I slept throughout the day, and had to set an alarm to pick my son up from school. I withdrew from seminary and focused on my mental health recovery.

We decided to move back to California – what my Eugene psychiatrist called the “geographic cure” – for my mental health. Later, when stable, I reapplied to seminary, this time to study theology for a career in academics, rather than my previous studies in divinity for ordination as a pastor. I did well academically and enjoyed studying Hebrew. Then the recession hit, my husband lost his job, and we had to move to the Mojave Desert for employment. When I decided to withdraw, Fuller Seminary reached out to me to offer financial assistance. I explained that the issue wasn’t just financial – the stress of unemployment and moving made it untenable for me to continue my studies. I tried to continue my religious studies online, but found that overwhelming when struggling with bipolar depression.

Now, I don’t even go to church. My husband and I talk about attending local small congregations, but end up cocooning on Sundays. When I become involved in group activities, like attending church, I get overstimulated, overwhelmed, and overextended. I tend to volunteer to do too much. I do better with solitude. Praying alone or with my husband. Both my religious and mental health recovery journeys have led to acceptance. Acceptance is essentially a spiritual experience. Whatever your faith, whether you believe in a higher purpose, to accept yourself is to love yourself.

I am not weak. I am vulnerable. I am not perfect and flawless. I am loved, lovable, and loving. My life has meaning. My life experience gives me purpose in helping others. I am grateful that I can write and speak to share my journey with others, hoping that it inspires others to accept themselves.

– Excerpt from Kitt O’Malley’s upcoming memoir Balancing Act: Writing Through a Bipolar Life

My treatment regimen and coping skills have evolved over time. At 18-years-old, I sought help at UCLA’s student health services. The cognitive therapy I got there helped me to identify my suicidal thoughts, stop them, and rewrite them into more rational thoughts. That skill stays with me to this day. In my twenties, I studied and sought therapy that explored the effects that alcoholism and family dynamics had on me.

Then at thirty, as a psychotherapist of severely emotionally disturbed teens, following the deaths of my grandmother and a friend from high school, I fell into a depression so deep that psychotherapy alone was not enough. From then on, I needed medication to maintain my mental health. Until I was thirty-nine, I remained stable on antidepressant medication and psychotherapy. At that point, experiencing elation and intrusive religious thoughts, I knew I was hypomanic and needed psychiatric treatment for bipolar disorder. From that point on, I’ve been treated by psychiatrists who have medicated me for bipolar disorder, a brain disorder which requires daily mood stabilizing medication. Medication treats, but does NOT cure, the underlying brain disorder. I still experience symptoms of bipolar disorder, albeit milder. Living well with bipolar means I must attend psychotherapy, use my hard-earned insight and arsenal of coping skills, and exercise self-care.

Honestly, it’s taken decades for me to develop excellent coping skills. I’ve always been good at asking for help and getting support from friends and family. My social skills have helped me to surround myself with loving and supportive friends and family. I’m honest and open about my symptoms and what support I need at the time.

That may mean that I have my husband get take-out or make dinner when I’m wiped out and not up to the task. I rely on my husband quite a bit. No doubt his role as my caregiver is tough. We are partners and help each other, but I make sure I express my gratitude for all he does.

I make sure I get a good night’s sleep every night. Regular sleep is essential to good mental health, especially when living with bipolar disorder. Every night before I go to bed, to quiet my mind, I read on a tablet using a dark screen with warm-tinted text. If racing thoughts keep me awake, I listen to a mindfulness app sleep story, or two or three. If that doesn’t work, I take medications approved and/or prescribed by my psychiatrist. I MUST silence those hypomanic racing thoughts to sleep.

I do what I can, when I can. I’ve learned to lower my expectations of myself. I change my mind. I cancel plans. I drop out of classes. I avoid commitments. “Failure” is always an option. I redefine what success looks like. I reject the need to be productive.

Some of the coping skills that work for me wouldn’t work for you. I avoid deadlines, for I ramp up to workaholic hypomania when faced with a deadline, especially when I’m working for someone else. You may have to meet deadlines for your job.

To manage my “To Do” list, I use my cell phone’s calendar app. I schedule modest goals. If I can’t complete a task, I reschedule, revise, reconsider, or delete it.

Not only do deadlines trigger hypomania in me, so do crowds, conferences, and loud noises. I avoid overstimulating triggers. I keep all social media notifications off. I pop in and out as suits my needs.

At times, it may appear as if I’m isolating, but I prefer solitude and find cocooning peaceful. Besides, unless I leave my house, I’m never alone, for I’m married and have a 19-year-old son living at home.

Years of therapy have given me insight. I’m aware of stressors that may make my mood go up or down. I avoid caffeine after noon. Screen phone calls. Write out thoughts that clutter my mind. During the day I write, blog, and use social media to connect with others in the mental health community.

Humor is a fabulous coping skill, both for me personally, and for my husband and me in our marriage.

– Excerpt from Kitt O’Malley’s upcoming memoir Balancing Act: Writing Through a Bipolar Life

To live successfully with bipolar, I’ve learned to be flexible. When I fall, when my journey is interrupted, I reassess and adapt. When I quit UCLA, I took a semester off and then went to community college before transferring to Berkeley. I had hoped to become a doctor, a neurosurgeon. That hope, that dream, that goal changed. I learned that I must take life as it comes, adjusting my goals as needed.

When I fell into a deep depression, and later a week of mania, I couldn’t return to work right away. I decided not to return to my profession as a psychotherapist, took time off, and then worked in a temporary job, which led to a decade-long career in commercial real estate.

When recovering from my breakdown, at what would seem to be my lowest point, I met my future husband. We married and had a child. We’ve been together now twenty-five years, married for twenty-two years. My baby boy is now a 19-year-old young man. My greatest success has been being a loving wife and mother.

My mental health journey has led me here, now. I am a well-respected mental health advocate, active online and in my local community. My success includes publishing this book and the writing I’ve done online.

Writing is therapeutic, allowing me to organize my thoughts. When I speak in person (not as a public speaker, but in person socially), I lack impulse control and don’t always say the “right” or politic thing. I basically speak my mind with no filter. When I write, my words are honest, but more carefully chosen. The act of writing slows me down, giving my jumbled thoughts a place to go. Then I rewrite and rewrite and rewrite. In rewriting, I organize, and I reframe those thoughts. It’s a cognitive exercise, retelling a story, reframing it, re-examining it. The story changes as we change, as our perception changes.

Now I’m getting requests to speak about my mental health journey. I’ve always hoped to be a public speaker, which I’ve done through organizations like the National Association on Mental Illness (NAMI) and the International Bipolar Foundation (IBPF). My training in high school as a drama geek, in seminary, and with NAMI has prepared me to realize this dream, this hope, this goal.

Right now, I’m living my dream by writing my story, by sharing it here in this book and on my blog, by telling my story aloud to others. I had hoped to be a published author and public speaker, and now I am. I have more to say. More to write. This is a beginning for me, yet another beginning.

My hopes and dreams for the future are continued public education about mental illness, overcoming stigma and discrimination, and better research and treatment for brain disorders. Much of my mental health advocacy is sharing information about the latest scientific research about brain health. I’m a science geek at heart. I will continue to share content from sources like the National Institute of Mental Health and the Brain and Behavior Research Foundation.

– Excerpt from Kitt O’Malley’s upcoming memoir Balancing Act: Writing Through a Bipolar Life