By guest blogger Ruth C. White, Ph.D., MPH, MSW


Manic depression can be hell and it can be war and it can be creative and intense but overall it can be destructive but though I may never really win the fight I can build walls to protect what most needs protecting and give it a forest or two where its flames can rage.

Every fall I spend several weekends trying to preserve the little sanity I have left and trying to find some more. It means lying in bed avoiding as much reality as I can because I have little energy or patience to deal with any of it. I preserve what I can to give to my job and my child. Fall is when I hang on to sanity with my knuckles about to split from the pressure of hanging on to the ledge; hoping for anyone to either put out the foam pads so I can let go, pull me back over the edge or at least prop up my legs to take the pressure off.

November is the time I call the on-call nurse begging for a hospital bed. It's also the time I get to know who my friends are. And I have great ones. Ones who will take my child for the night on a few hours notice. Ones who will take care of me on a few minutes notice. Ones who will walk with me, talk with me and get me through what the medications can't. I also have an awesome medical team, who listen to me, are there for me when I need them and without whom I would not have the sanity to get through the day.

Ever so often I think that the only place I will find peace from my own mind is being heavily medicated and lying in a hospital bed; Symbolically away from me, my life, my own thoughts and feelings. But even in the hospital, I must confront myself in order to leave, and I really dont want to stay in a hospital anyway. Because sooner or later I will be okay. But I never know how long 'sooner or later' is and the wait and see game is as much torture as the battle with my mind.

But last fall, with the help of a friend I tried to avoid the hospital and went looking for peace on Orcas Island in the San Juans (off the coast of Washington state between Canada and the USA): a peaceful place in the late fall/early winter when the summer hordes have departed. So a room on the water, hike in the woods, exploring Mt Constitution and a cold dip au naturel was worth a few Prozacs, a Zyprexa or two and at least 300mg of lithium.Maybe if I lived some place I could do that all year round, I may not need my gifts from the pharma gods.

To get to this weekend on Orcas, while i was right there on the edge, my friends, the on-call nurse at Group Health, my rational self (peeking through but still there) and my meds were all there keeping me from falling off the edge.

With everyone having my back and me being the best damn manic depressive patient I know, I feel assured that I won't have to end up like a Hemmingway or Woolf. Not that I wont want to, but I wont have to.

And therein lies the difference between living and dying with manic depression.

Ruth C. White, Ph.D., MPH, MSW, is assistant professor of social work at Seattle University in Seattle, WA.  She is the author, with John D. Preston, Psy.D., ABPP, of Bipolar 101: A Practical Guide to Identifying Triggers, Managing Medications, Coping  with Symptoms, and More.