Here’s my experience of living with bipolar disorder. Even when in flagrant psychotic flight I have an umbilical attachment to my identity before the illness. When the disorder is in remission, in so-called “normal” periods, my reality base is unencumbered by delusion and paranoia. Reality is in agreement with the collective; my psyche is aligned with the material of the earth.

The slide down the dark tunnel to psychosis does not happen in one day, and there are many twists and turns along the way before my thinking becomes warped and wrapped up in paranormal phenomenon. Thought becomes nebulous, unclear, and entirely subjective. Then insomnia bears down and I slip away.

The face that I present to the world holds no clue of my inner tumult. It is the shadow that is cast when light hits him or her at the back: it is dark, featureless, and looming in gigantic proportion to the sufferer. I am fortunate in that I do not experience psychosis for very long, and that I am rarely completely debilitated by it. I am also lucky because I face less stigma than some others do.

Stigma, the negative perceptions the public has of those of us diagnosed with mental illness, impacts the self-esteem of those who suffer from major mental illness. Poverty does as well and many mentally ill people are low in the economic stratus of society. The medications, always seen as the first line of treatment thanks to the monopoly of the drug companies, cause obesity related illnesses. Smoking is more likely in persons with mental illness, too. A study published in 2007 estimates that the life expectancy of those receiving treatment for a major mental illness is twenty five years younger than the rest of the population.

Suicide is a thinkable option when there seems no way out. If you were to reason to a depressed person that depression is not a permanent condition, it isn’t necessarily an antidote to suicide, for Life is not a permanent condition either. My argument for choosing life is not because life is so precious, but because people are.

I believe that the motivation for suicide is almost never anger at others. People who commit suicide generally love their families and friends and suicide does not negate their love. Fed up, the person contemplating suicide may feel that others would be fed up with them. It is an escape from the pain in the universe, not an escape from others.

Stigma suggests that mentally ill persons in crisis are dangerous, and there have been heinous homicidal acts carried out by some nihilistic suicidal people. These people are the exception, for the psychopathology that drives someone to kill is not present in most diagnosed with a major mental illness.

Contemplating the motivations of those who take the final step—jump off the bridge, take the lethal dose, pull the fatal trigger—both fascinate and disturb me. Suicide does not discriminate. It takes the rich, poor, beautiful, plain, young, old, educated, and ignorant. Suicide is a tragic end that I believe is almost always preventable. How is it that we become unmoved by the simple pleasures of good food, fond company, or a beautiful sunset?

I am an ordinary person who feels compelled to educate others on the dangers of keeping silent. Allowing stereotypes and stigma to continue is beyond a personal conviction, it is a civil rights issue. “Breaking the Silence” has become the banner for the National Alliance for Mentall Illness. Speaking out about mental illness is not merely an issue of social justice—it is potentially lifesaving.

I do not propose that suicide can be abolished; it is a mystifying anomaly that has existed for as long as humankind. (Even in the animal kingdom. Consider the lemmings). Were the public better informed, and, hence, less frightened by mental illness, the number of suicides, I believe, could be greatly reduced. Mentally ill people cannot continue to be alienated from the pulse of society and marginalized. The greatest antidote to the depressive feelings that may lead to suicide is support from others. The victims of such emotional agony, however, must feel free to get whatever help is needed and not try to go it alone. Stoicism is no cure for depression. None of us are invulnerable to agony and tragedy. Neither are we fixed, immutable organisms. We constantly resurrect and reinvent ourselves. It is this cycle of death and regeneration that is the great gift of life—making new life possible.

 Stigma is a huge problem. Stigma prevents sufferers from turning to friends, family, or professionals for support. Too many believe depression and mental illness result from personal weakness instead of what it is really is: a medical illness. No matter what a person accomplishes in life or has going for him or her, depression takes all the appreciation and joy away. Accusing the afflicted of self-pity will only deepen the guilt and shame help form the building blocks of mental illness. You can’t tough out depression.

Even those who are educated and know better fall prey to stigma. Consider that doctors commit suicide in large numbers and you may see that the self perception of failure may override the impulse to get help. The forces against those with mental illness are ancient and powerful.

Imagine the foundations of your life burned to the ground. How will you find the hope to imagine a brighter future? Can you picture starting over? Reinvent who you are? Can you imagine seeing the world in whole new way? For this is what you are challenged to do.

Change is needed in the way that we view mental illness and those who suffer from it. Not only is this change needed for those who suffer from mental illness, but also for the betterment of society. We need to stop treating people in terms of their pathologies, but by celebrating their strengths. It is time for sufferers from mental illness to step out of anonymity and join the rest of society in the struggle for fulfillment. For this should be the goal. Why should anyone who suffers from any disability be satisfied with marching along in a humdrum existence, happy only to be free from the worst effects of her symptoms?

I say that we should seek more from life. We are here, not to suffer, but to strive for fulfillment. For someone in the throes of an episode, the first goal may be to alleviate suffering and many do not move much beyond this first goal. Our mental health system encourages dependency in patients and discourages any risk taking, often without intending to. One problem is stigma, which dissuades mentally ill people from taking productive social roles, or relegated to jobs for which they fall far short of their personal potential.

The positive note here is that through the work of people like Dr. Patricia Deegan and the personalized recovery oriented services that have become standard practice in New York State, self directed treatment has improved treatment. I say we can do even better. It is my belief that we need to move beyond what currently exists. In the recent trend of emphasizing preventative medicine, there should be healing centers that include services for those financially underprivileged.

Alternative medicine and life coaches should be applied in addition to, or at the exclusion of, drug therapy and case managers. For those who live with disability, their goals should be as expansive as able bodied. It is a fundamental right to pursue excellence in work and love. Life is an adventure, meant to be lived to its fullest, lessons gleaned from the knocks and rewards that result from our poor as well as good choices. No person or entity should be unjustly stripped of their God given right to adventure.