"I have no idea what the long-term effects of discussing such issues so openly will be on my personal and professional life, but, whatever the consequences, they are bound to be better than continuing to be silent."

– Kay Redfield Jamison

author, "An Unquiet Mind"

With the recent suicide of Robin Williams, a lot of attention has been focused on depression.

Perhaps the focus should be placed, instead, on bipolar disorder, which Williams was rumored to have.

According to an article published in March in "An International Journal of Psychiatry and Neurosciences," 19.9 percent of people with bipolar disorder will attempt suicide compared to only 9.2 percent of people diagnosed with clinical depression.

I mention this because I have bipolar disorder and I think it's time to talk about it.

Robin Williams, tragically, has opened a window for some frank discussion.

"Those with bipolar disorder, sometimes also called manic depression, are especially at risk for suicide. Statistics are sobering. As many as 15 percent of people with bipolar disorder will die by their own hands, half will attempt to, and nearly 80 percent will contemplate doing so," says the everydayhealth.com article "Bipolar Disorder and the Risk of Suicide" by Michael Bloomquist. "For those with bipolar disorder and their families, the threat of suicide is very real."

In fact, the suicide rate among bipolar people is 20 times that of the general population, according to a number of sources.

I've never attempted suicide. But I have thought about it and I am familiar with the kind of despair that comes from considering the possibility that death is the only way out.

Bipolar disorder is primarily characterized by periods of extreme highs and lows. I was diagnosed Dec. 3, 2013, as bipolar II, a form in which the highs are not so high but the lows are lower.

I'm in good health now but the pathway here was filled with bumps.

I was actually diagnosed with clinical depression for most of my life. This is not unusual because, especially with bipolar II, the highs often are not problematic. I felt creative, energetic, driven and motivated. Because I was being treated for the depression side of the equation, I thought the bipolar highs were just a part of a strong personality.

Things began to unravel for me last fall. I found myself feeling restless and getting cranky. I thought it was just that I needed to change antidepressants, but it turns out there was more to it. After seeing several doctors, I received my diagnosis.

I wasn't particularly alarmed. I thought I would just get a new medication and everything would go on as before. It wasn't that simple, however. It got worse before it got better. I ended up having to take a six-month medical leave from work. I couldn't function because of what felt like rage, despair, frustration and anxiety. I couldn't concentrate. And, yes, at times, I thought about death.

I know talk of suicide makes people uncomfortable. But talking about bipolar disorder without mentioning suicide is like talking about diabetes and not mentioning sugar.

Part of the problem, I think, is the limitations of treatment. Effective treatments do exist for bipolar disorder, just as they do for depression, but they're much more subjective than treatments for other kinds of diseases.

For example, blood tests assist doctors treating diabetes. But no blood tests exist to help doctors treating depression or bipolar.

Although the exact causes of bipolar are not known, experts do know that it has to do with the brain's neurotransmitters not functioning properly.

Unfortunately, without any medical tests to determine which medications or what dosage is needed to correct the problem, treatment begins with trial and error. The doctor simply tries one medication and you come back in a month to say how it's working. If it's not, the doctor tries something else. In a month, the patient reports how it's working. And so on. It takes an average of six months to get stabilized.

It took me nine months to feel good again. I admit sometimes I wish I could go back to when I could be treated for depression and take back my high phases.

The problem is with each manic phase – called "hypomanic" in bipolar II – the danger is an even deeper depression will follow.

I'm still struggling to understand this on a complete level. I have often wondered if my creativity and work skills would be lost because they were just a symptom of the mania.

My husband, Sean, and I actually contemplated my not coming back to work. But as the medication started working, I gradually began to feel better. Not good, just better. I felt restless and realized that I felt better when I was around people rather than when I was home alone.

I needed my family and friends but, as silly as it may sound, I also needed to be with my colleagues. And I needed to reconnect with my sources in the community.

It's good to be back. Although I am healthy again, my diagnosis means I still face a certain stigma. The tragic death of Robin Williams gave me the opportunity to bring bipolar disorder out in the open and I hope it will undo at least some of the stigma.

Going forward I will just keep dreaming of the day when people can talk about mental illness without the need for the untimely death of a celebrity to make others stop and listen.

Johanna S Billings

editor

Whitehall-Coplay Press

Northampton Press

Catasauqua Press