Dear Sadie,

For three years after your diagnosis, you will tell the people closest to you that this is not the life you expected to live.

The first thing you will do when diagnosed and put on antipsychotics is read as much as you can about bipolar disorder. Most of this information will scare you. Divorce and employment rates, homelessness, incarceration, substance use, and mortality statistics will stare back at you from the computer screen, bad omens on top of the confusion you already feel, having just come down from the blissful energy of mania into a world far more stark and cruel than you remembered. You are not prepared to deal with the responsibility and frustration of a serious illness and the prospect of a life far different (and, universally assumed, worse) than the one you imagined. You are not prepared to face the harm that your mental health has caused others or face the judgment and misunderstanding of your peers. You are not sure you can survive depression again.

One thing you will do is read an ‘Unquiet Mind’ by Kay Redfield Jamison. A physician with bipolar disorder, Redfield Jamison was open about her condition long before it was acceptable to do so, and has spent her career researching the disease, writing books, and advocating for people with bipolar disorder. Reading this book will be so moving that your roommates will find you sobbing into your morning coffee as you read it several mornings in a row. She articulates mania and depression in exactly the way you have felt it, and in her story, she uses these experiences to do impactful and meaningful work in her community. This was the lifeline you needed, and you cling to the hope that your life could be meaningful in a similar way.

For a few years, you will dedicate yourself wholeheartedly to this goal, pursuing activism on campus, coursework on the housing and healthcare system, and internships in mental health policy. You will often find yourself excited and grateful to be doing meaningful and interesting work. However, you also hope on some level that you can trick yourself out of disappointment and fear if you focus on helping people who have it worse than you do, who do not have health insurance, housing, or familial support in the way that you do. You find that feeling angry on their behalf is a lot more useful than feeling afraid.

Anger is a double edged sword. It helps you feel powerful and confident at a time when control over your health and life feels stolen from you. It helps you do important work and find a career you love. But you also spend more and more of your time drunk in order to give yourself a break, and the anger sneaks up on you, seemingly endless. Though you learn a great deal about the issues faced by your community, you resist becoming a part of it. You feel very much alone.

If there is one thing I could tell you, it’s that you do not have to do this alone. You will learn this over time. When your second depressive episode leads to a partial hospitalization for three months and a recurrence of a binge eating disorder, this will be the first time you meet other people with binge eating disorder and talk openly about it with others. This behavior was such a source of shame and secrecy since it began in middle school, and hearing others talk about it will forever change how you feel about your younger self.

You will feel alone when you experience psychosis for the first time. Though you have the support of many friends and family, you will think that no one else you know can understand what hallucinations are like, how scary they are and how afraid you are now to fall asleep, only to relive the experience in nightmares. Only a few months later you will meet a friend at school who has schizophrenia, and you will laugh about these experiences in the bookstacks of the library together.

When you first have to be sober, you will worry that your youth is over. Six months later, you will step in to your first recovery meeting, and there will be people like you, young queer women, ready to welcome you enthusiastically into their community, a community full of radical honesty and riotous laughter, and you will feel truly stupid for ever thinking you were alone.

You will volunteer for a mental health helpline and listen to people going through the hopelessness and confusion you have felt. If they ask about your experience, you will share with them that sometimes recovery takes time. You will tell them that it took eight different mood stabilizers before finding the right one, that you liked some therapists more than others, that you took some leaves from school and ultimately graduated just fine, that you made some bad choices before you made the right ones. You will tell them it is ok to be afraid. Recovery takes a lot of courage.

It is true that you did not expect to live the life you are living now. Your job in health policy and volunteer work are interesting and rewarding, and they are motivated by love for your community and hope for the future, rather than anger and fear. You are healthy and will likely remain so for a long time. You have so many friends who have gone through the same things that you have, and they are funny and loving and kind.

You will find that this is, however unexpectedly, a truly wonderful life.

Love,
Sadie