Good topic, Miguel'smom. Thanks for bringing this up!

Without meds...

My manic behavior can become 'out of control" and "scary". It has led to the end of numerous relationships, prevented relationships, got me fired or threatened to be fired, made me quit jobs, affect my job performance, made me lose money, made me put my well-being at risk (in many ways), led to cops being called (or almost called), caused me extreme embarrassment and guilt after-the-fact, hurt and/or scared people I love/liked, put my life and others' in jeopardy, and more.

My depressive behavior has caused me to disappear from daily life, neglect my health and hygiene, be unable to do work/study or household tasks/chores, neglect people in my life, put my life in jeopardy, and cause extreme mental anguish for myself and those who love me,

Without proper medications, I not only experience all of the above, but have a tendency to self-medicate with alcohol. Alcohol abuse has its own large set of problems, including health issues, dangerous behavior to self and others, and some of the above-mentioned that come even from the alcohol abuse. Alcohol/substance abuse/addition is a very complicated combination that makes recovery often significantly harder.

When experiencing any of the above, I am not well cognitively. It can affect my brain in many negative ways. It is a well-known fact that untreated (or improperly treated) bipolar disorder can worsen the course of the illness. The more episodes experienced, sometimes the worse the episodes get. Or, the frequency may increase (kindling effect). The longer it is before treatment/proper treatment, the harder it may be to adjust one's lifestyle in a healthier way. Harder to teach old dogs new tricks. Plus, the brain may not "heal" as easily as it might when affected and then treated earlier in youth.

Though coping skills and healthy lifestyle do indeed help many people maintain stability and general mental wellness, it is often not enough for many people with bipolar disorder. If one is symptomatic with bipolar disorder and/or alcohol or substance abuse, as stated earlier, it becomes harder to practice coping skills and healthy lifestyle.

Basically, my functionality plummets when I'm mentally unwell. I not only owe it to myself to stay well, but also to those that love and like me. Taking proper care of my mental well-being brings comfort to others and helps rebuild trust. It is a show of love and respect for others. Not all about me, me, me.

Finding the right medication(s) is/are tough. Mastering coping skills is tough. Being tolerant of challenges/discomfort is tough. Giving up the more romantic aspects of bipolar disorder is tough. Putting in the work at therapy and processing psych issues is tough. Being patient and determined is tough. Working hard at one or all of these things is heroic!