Since I was an eighteen-year-old college student, I have lived with mental illness. My eighteenth year was a living hell. That’s how I’d describe the severe suicidal depression that overwhelmed me. What I Learned When I Was Eighteen 1) I want to live, even when the pain of depression was so severe that I thought that the only way to end it was to die. 2) I can and will ask for help when I need it. 3) I’m not alone. My friends, my dorm resident assistant, and a cognitive psychologist at UCLA supported me when I sought help. 4) Therapy works for me. The cognitive therapy I received helped me to rewrite negative depressive thoughts. I believed my parents, my sister, the whole world would be better off without me alive. That thought was irrational. I learned how to stop negative thoughts, question if they were rational, and replace them with rational positive thoughts. The world would NOT have been a better place without me. My family and friends would have been devastated by my loss. At thirty, I experienced a deep depression, in which I was unable to get out of bed, take care of my cat, or go to work. I was so depressed that I didn’t notice that fleas had infested my cat and my apartment. That year my grandmother died, a close friend from high school died from AIDS, and one of my clients threatened to rape me during a session. The day after the attempted rape, I couldn’t get myself out of bed or face going back to my job. My body felt like a huge weight was on me, a weight I couldn’t overcome, a weight that immobilized me and glued me to my bed. I called my parents sobbing that I couldn’t do it anymore. At first, I turned to my internist for antidepressant medication. Then I sought a second opinion from a psychiatrist who told me that I was in the adolescent stage of development – which I found insulting. I was a thirty-year-old psychotherapist who worked in nonprofits for low pay; yet, I managed to put myself through graduate school and years of internship while supporting myself in the San Francisco Bay Area, an expensive place to live even back in the 1990s. The psychiatrist mismanaged my medication. The first change made me sleep all day every day, too incapacitated by the overwhelming fatigue to care for myself. The second medication change triggered mania in me. I was unable to sleep for a week due to three simultaneous racing streams of thought about mystic saints, chaos theory, and binary code (ones and zeroes). From the outside to those who couldn’t see my thought process, I was clearly manic. For a week, I didn’t sleep at night. During the day, I catnapped in the backyard on the grass. I took on a huge project, rehabbing the cottage I rented. Though unemployed, I told my friends that I wanted to buy the cottage. Jumping from one idea to another, I spoke rapidly and excitedly. My speech was expansive and grandiose, discussing how God, Christian mystic saints, physics and mathematics were connected. (Actually, I still think they are.). What I Learned at Thirty 1) I’m not alone. My friend called my father and my priest, telling them I needed help. My father flew up from Los Angeles. My priest rushed over with someone who lived with bipolar disorder. They suggested I contact my psychiatrist to describe my symptoms. I called my psychiatrist and described my manic symptoms and psychotic thought process. He prescribed three antipsychotic medications, which stopped my thoughts and allowed me to sleep. 2) Doctors make mistakes. My internist and my first psychiatrist disagreed on medications. The psychiatrist warned me to never disclose that I had been prescribed antipsychotics. Whether his warning was to prevent a malpractice suit or due to stigma, as I was a licensed psychotherapist, I don’t know. Clearly, I needed a new psychiatrist. 3) A support network is key: friends, my priest, and my parents rescued me. I had been taught in graduate school and in therapy that my depression was the result of parental abuse. Clearly, my parents loved me. As a psychotherapist for children, I had worked with families who clearly loved their children. Many of those parents struggled with mental illness, substance abuse, physical and emotional abuse. I could see that they still loved their kids. Against the advice of my psychiatrist, who considered me an adolescent, I moved back in with my parents until I was stable enough to move back out on my own. 4) If at first, you don’t succeed, try, try again. Just because I had a horrible reaction to the first round of antidepressants, didn’t mean that antidepressants wouldn’t help me. My second psychiatrist listened carefully to my reactions to antidepressants. Rather than tell me that I was an adolescent developmentally, he assessed if I had bipolar disorder or a severe reaction to an antidepressant. He carefully increased my dose of a new antidepressant. When my thoughts raced, I’d call him. He’d decrease my dose and more slowly bring me up to a therapeutic level. Since Thirty-Nine At thirty-nine, I was diagnosed with bipolar type II. Since receiving that diagnosis, I’ve been hospitalized and participated in months of partial hospitalization. After trial and error, I’m “stable” on medication. After my hospitalization, my psychologist asked me to discuss if I felt like I have a calling. She didn’t dismiss my passions because I had a mental illness. Since I was twenty-one, I felt that I was supposed to do something, but didn’t know what that something was. I turned to the church to try to make sense of that feeling. I believed that I was called to ordination. Twice after my hospitalization, I attended seminary, graduate school for the study of divinity or theology. In seminary, I wrote a mental health ministry workbook. I decided, after all these years, that my purpose now is as a mental health advocate and writer. Since then, I’ve embraced my early training as a psychotherapist. I maintain my Marriage and Family Therapist license, enabling me to volunteer as the licensed mental health provider for the National Alliance on Mental Health’s (NAMI) Provider Education. The Provider Education course teaches mental health providers about the lived experience of those living with mental health issues and their family members. Often panel members have experience in both roles, as do I. Since 2015, my parents have struggled with the vagaries of age: stroke, dementia, and death. The insight I gained through my mental health journey has helped me to help them. My son, a migraineur, has struggled with comorbid anxiety and depression. As someone who lives with a mood disorder, I have compassion for him, as I encourage him in his development as a young man. Every day, I am active online promoting mental health. I write about living with bipolar disorder both on my website kittomalley.com and in my upcoming memoir, Balancing Act: Writing Through a Bipolar Life, to be published September 19th. In Balancing Act, I describe my mental health journey and include my writings on my bipolar thoughts, purposeful writing, mental health advocacy, and caretaking. Everything in my life has led me here. I’m satisfied with my life. I’ve crafted a meaningful life out of the experiences I’ve had. If it weren’t for my struggles, I wouldn’t be who I am. I love who I am. At eighteen, I hated myself. Having a meaningful life and loving myself is a win. HUGE WIN!