Addiction to mania is one of the largest hurdles bipolar patients have to overcome. But not because of the addiction itself. There is no such thing. The very same DSM-5 Doctors tout does not recognize such an absurd amalgamation of symptoms. What is actually happening is that the bipolar patient is feeling better when the pills make them feel worse. That’s it. The addiction model has always been wrought with empty moralizing. The best clinicians understand this and adopt a more morally neutral approach to dependencies, but the addiction model is a useful bludgeon that places the onus of health on the patient and not the provider.
However, there are unintended consequences to conflating disease with immorality. Let’s dissect a bipolar patient’s encounter with such an issue. Let’s call them for the sake of anonymity “Player One” (I’m Player One). The first time this specimen discovered this diagnosis, there was an immediate weightlessness stemming from a newfound justification for such a string of destructive, self-centered and alienating life choices. Unbeknownst to Player One, there was a very real choice here: embrace medical opinions, relieve themselves of responsibility, and enter years “good for you” for being a compliant patient even when things begin to become unreasonable.
Some might say I’m being hard on the medical community. Unreasonable is a very anti-establishment comment. But unreasonable was being told to take SSRIs when they trigger manic episodes and suicides. Had I not rejected such treatment in my search for inner peace, I might not have lived long enough to bless you with my 2am thoughts. But eventually I drank the Kool-Aid. And I used it to chase the Lithium. And I was happy. Happy to find a path forward. Happy to find a reason to remain blameless of everything before that. And above all, happy to be good (until I wasn’t but that’s a story for another day).
In essence, I was happy because I was no longer to blame for my horrible past. I could mend relationships with the understanding that I had an untreated, hard to diagnose, disease. I know longer had to feel guilty. I could move on in my life with the understanding that anything that comes after I earned for being so good and taking the pills. But taking pills should never be about good or bad. If you have to indulge someone in your life by being supportive, so be it. But medication should be as benign as breathing oxygen.
Why might you ask? Because if your treatment goes badly, you are now bad again. And if you can’t get well soon enough, then your free past of no longer feeling guilty will be revoked. You will be back where you started. You will have to climb from the lowest lows after experiencing the highest of highs. You will revert to your old ways and then the cycle continues. Your new treatment plan becomes promising, and we go back to being good. And the people you hurt will allow it because the alternative will be letting them slip back into hell.
While bipolar may give us reasonable alibis for situations, the alibi itself should not be the driving force for your disease. You will be locked into mediocrity. Truth growth comes at the expense of falling on your face. To deny yourself that reality is to deny yourself any hopes for the future. But it’s okay to eat shit. You should eat it more often.