What stability looks like so far (1 year on meds)

I started my medication in mid 2020 after my diagnosis, and I reached the full dose I’m currently on in August 2020. Thought I’d show what my mood has been like since then, and reflect a bit on the past year.

I have been tracking my mood using the Bipolar UK mood scale and my own spreadsheet (template here).


Mood graphs

Ongoing since July 2020
Last 12 months
Last 3 months

Some reflections in no particular order

Ups and downs still happen. I have relatively long periods of a consistent neutral mood, but I still have low days (and some high ones) here and there. But they became less frequent, less severe, less long-lasting (a couple days of feeling low as opposed to a couple months), and way more manageable.

Meds take time to kick in. Although I was in a much better place when I left the hospital after a few weeks titrating meds, it took me another six months or so to reach a point where my mood was stable and where I felt in control and confident in my ability to manage it.

The first few months are scary. Coming out of a mixed episode while inpatient after a suicide attempt was scary. Wanting to be alive for the first time is scary. Every slight mood change had me worried I was about to spiral out of control again.

Intrusive suicidal thoughts took a while to go away. I still have them sometimes, but rarely. They were more common at the beginning. I didn’t want to die, but after being suicidal for over a decade, it was just my brain’s go-to thought.

It took time to know myself. I didn’t instinctively know what my healthy range of emotion is. I had to re-learn what normal sadness and normal joy looks like for me, what’s a normal reaction and what’s a warning sign of oncoming depression or hypomania.

It’s not always the bipolar disorder. I have frequent migraines (not chronic, but close) and part of the prodrome for me is a depressed mood with increased anxiety. Many of the lows in my chart are migraine-related, which is something that took me a few months to identify.

It’s not just medication. I wouldn’t be alive without medication, let alone function without it. But meds alone don’t do all the work. When my mood goes up or down, it’s a lot less severe and more manageable than it would be without meds, but it’s up to me to use coping skills to get it under control and get back up (or back down) to something neutral.

My baseline leans more towards the low side. I’m more likely to have low than high moods when I deviate from neutral. This might be the nature of my bipolar, or it might just be the nature of my life circumstances (a crappy job atmosphere, migraines, some dysphoria as I sit on a long waiting list for surgery). But it’s completely manageable.

I haven’t fully come to terms with it yet. I fact-check and research most information I come across. I’ve read about migraines, about gender dysphoria, about why bright sunlight makes me sneeze, about so many things in my life big and small. I still haven’t read much about bipolar besides self-management strategies because I’m not ready to fact-check how much of a progressive illness it might be, or how likely it may or may not be that my meds will stop being effective or that I will have another episode. But I don’t like living in ignorance, so I’m working on it.

I don’t take stability for granted. I know I’m not cured or fixed. I know I’ll live with this for the rest of my life, and I have a few decades of life ahead of me if nothing gets in the way. I track my mood, I’m self-aware of my thoughts and emotions, I take my meds, and I avoid any known triggers to the best of my ability. I know stability is not forever guaranteed, so I’m grateful for it and I try my best to maintain it.


It will be interesting to see how things go as the years go by. They might get worse at some point, but I’m confident in my ability to handle them better than I was able to in the past.

Little achievements

Having to be late to an interview and keeping my emotions in line with my rational thinking, rather than having a panic attack.

Changing my shirt in a locker room without going into a stall because I don’t get anxious or scared if someone sees my scars anymore.

Letting toxic people go and having the confidence to not let them sneak back into my life.

Making a nice tea after a stressful day rather than grabbing a beer (and another and another…)

“The first step to getting better is wanting to get better”

I agree. You don’t get anywhere if you don’t want to get better. But at the same time, I think this has become a platitude that gets passed around mindlessly without really thinking about what comes after the first step.

I think it comes from good intentions, from wanting to give people a little push to have the will and the motivation to get better, maybe wanting to help them believe that getting better is something they can aim for. But when you’re in the depths of mental illness, this can feel like the burden of getting better is solely on you, like your recovery depends only on your will to recover.

I remember being told this. I remember wanting to get better, and I remember slowly losing all hope. It’s not that I didn’t want to get better, but rather, that I couldn’t get better.

The days leading up to my suicide attempt, people around me were encouraging me to get help. Call a crisis number, go to A&E, go to the GP. The last time someone said this, my reply was “you have to want to be helped in order to get help. I don’t want help. I don’t want to get better. I’m just hanging around until I decide to end it. Maybe in a year, maybe tomorrow. I’m just waiting for the day and I want to be left alone.”

And did I mean that? No. Not at all. I wanted to get better, and I desperately wanted to be helped. I was telling my GP and mental health nurse how I was feeling, I was going to A&E when I felt I was a danger to myself, I was calling the crisis number, I was using all the coping skills they suggested and none of them were working. It was the lack of appropriate help and support that led me to give up, to accept that wanting to get better wasn’t realistic, to then believe that maybe it was my own fault and maybe I just didn’t want to get better. After all, if I really wanted it, I’d be trying harder. Right? Not only was I thinking this, but it was also the message I was getting from professionals. Sometimes you stop seeking help not because you don’t want to be helped, but because no one is truly helping you.

I know the first step is to want to get better, but that in itself doesn’t get you better if you don’t have access to the resources to do so. It’s not just pure willpower that pulls you out of the symptoms of mental illness. The message is all good and well, but I think we also need more messages about what comes after the first step, and more acknowledgement that just because you have accessed help, doesn’t mean it’s actually helpful. Sometimes you don’t get better and you play a part in that, but so many times the lack of progress is mostly due to a lack of appropriate help and not a personal fault. And far too often we’re made to believe it is our own fault because we’re not trying hard enough or we’re not “truly accepting” the help we get.

I’m tired of the oversimplification of mental health and mental illness into platitudes and cutesy pictures about going for a walk and taking a bubble bath.