I was recently having lunch with a woman who has a series of medical issues, including pain management. One of the medications she is on is oxycodone. She said she would like to get off of the oxycodone but when she has tried, the pain has been unbearable and no other pain medication would touch her pain. So I asked her, "if this medication is working for you and other medications don’t work, then why are you trying to get off of it?" She said it was because of the stigma attached to that medication. So I told her something important – you can’t let stigma make your treatment decisions.

There is a common refrain that if you looked in the DSM, everyone would have some mental disorder. And in point of fact, many symptoms are fairly generic and can be attributed to many. Fatigue, insomnia, thoughts of death, loss of pleasure and weight loss are part of the depression diagnosis. But the part no one seems to remember is what’s under that, The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Some people believe that being crazy makes you creative (perhaps brilliant) and being creative makes you crazy. Similarly, along this line of logic is that taking medication makes you uncreative and perhaps, un-brilliant. Well, pish-tosh I say.

Last week I waded into Charlie Sheen territory. It was, perhaps, a touch more eel-infested than I had anticipated but life is surprising like that. Yes, I said Sheen is going through a manic episode as part of a mental illness. (And no, I still haven’t become a doctor.) Let’s say for the moment, I’m right. Since I made my case for compassion for Sheen and mental illness, over scorn and ridicule, people have made the case back that it’s the media’s fault Sheen’s behavior is this out of control. I don’t think so.

I know this seems like an odd question, but I was considering it this morning (in my shower). It is a common problem for people with a mental illness. I have a tendency to avoid showering (really) and I know of others with a mental illness have gone weeks without showering. So, if all we’re talking about is standing in some warm water, why don’t we want to shower?

People throw around the word “depression” as if that word means only one thing. This is far from the case, therapeutically speaking. I would suggest there are mild, moderate or severe, relapsing/remitting or chronic depressions. Doing the basic math, that’s six types right there and we haven’t even taken into account treatment-resistant depression, or the depression subtypes noted in the DSM. Depression is not a disease; it’s a cluster of diseases.

I’m not known for my cheery everything’s-going-to-be-OK-puppies-rainbows-lollipops perspective. In fact, I’m against such perspectives. I find them disingenuous, phony, or seriously ill-informed. Save the rose-colored glasses for Sir Elton John, thank-you. I find smiling, being positive and telling people how great everything is to be just another chore on my list of things to do today when I’m already busy just trying to keep breathing and possibly pay rent.

My brain is a finite resource. Well, the grey, gooey thing in the skull is finite for everyone. But my brain’s ability to think reasonably is a finite resource. When I write it thinks, thinks, thinks, and then there is a dramatic thud. My brain then stops thinking.

Women are classic “I’m sorry” – ers. We’re taught to say “I’m sorry” from the time we can utter the words. We are the peacekeepers, claiming fault so no one else has to. We have to apologize for emotions because we’re “overemotional.” We have to apologize for our needs because we’re “clingy.” We’re sorry for our behavior, our significant other’s behavior and our children’s behavior. We are simply, sorry. And most women in 2011 realize this habit is one borne of the past and is no longer relevant in our everyday world. We realize we are not “sorry” at the drop of a hat or a glass of wine spilled by a drunken significant other. We realize there is a time to be sorry and there are times not to be. Unfortunately for me, I feel like I have to be sorry all the time, for every tear, for every thought, because if I’m not, people will leave.

I, like many, no longer work in an office; I work from home. My commute each morning goes something like: bed, to the bathroom, to the kitchen, to the couch, to the desk. Barring a traffic jam between my cats and me over the milk, it’s a pretty quick affair. And while working at home does have many advantages for someone with a mental illness, working from home with bipolar disorder also poses its own challenges.