Memories and Nightmares

yellow stethoscope and medicines on pink background

“Swinging by some shoelaces and weathered chains, my atoms rearranged, rearranged.”

– Tummyache, Median

Memories. I know this is something I have touched on several times in my 60+ posts over the last three months, but I can’t get away from it or all of the memories surrounding it.

This month marks the 20th anniversary of the suicide of a close friend. He hung himself in a tree in his backyard when I was in the 6th grade. We just so happened to be neighbors, so I was there and saw the whole thing.

I know the suicide of a loved one can affect people differently – many go through different phases or stages of grief, anger, understanding, acceptance. Not me. I never cried and I was never mad or angry, just in total shock. Disbelief. Numb isn’t the right word, either, but it felt like a punch to the gut I would never recover from. The memories of it all still and will forever haunt me.

Untreated mental illness is dangerous, and my friend Mark was a prime example of that. The statistics are alarming, but there are those who feel the statistics are meant to alarm. But I can’t seem to shake it. Without sounding “oh, woe is me”, it just shouldn’t be the case.

I was first diagnosed with bipolar disorder at age 15, again at 17, and then at 24, which is when I decided to seek out treatment. If I hadn’t I more than likely would’ve been just another statistic.

And instead of me regurgitating a bunch of facts, I’m just going to go straight to the horse’s mouth instead of spouting out memories of facts:

How common is bipolar disorder?

  • Globally, 46 million people around the world have bipolar disorder. (Our World in Data, 2018)
  • One survey of 11 countries found the lifetime prevalence of bipolar disorder was 2.4%. The U.S. had a 1% prevalence of bipolar type I, which was notably higher than many other countries in this survey. (Therapeutic Advances in Psychopharmacology, 2018) 
  • Annually, an estimated 2.8% of U.S. adults have a bipolar disorder diagnosis (Harvard Medical School, 2007).
  • Of all mood disorders, those with a diagnosis of bipolar disorder were found to have the highest likelihood of being classified with “severe” impairment (82.9%). (Archives of General Psychiatry, 2005)
  • The past-year prevalence of bipolar disorder is similar in females and males (2.8% and 2.9%, respectively). (National Institute of Mental Health, 2017)

Bipolar disorder statistics by age

  • The average age of onset is 25 years old. (National Alliance on Mental Illness, 2017)
  • People ages 18 to 29 years old had the highest rates of bipolar disorder (4.7%) followed by 30- to 44-year-olds (3.5%) as of 2001-2003. (Harvard Medical School, 2007)
  • People 60 and older had the lowest rates of bipolar disorder (0.7%) as of 2001-2003. (Harvard Medical School, 2007)
  • Only 2.9% of adolescents had bipolar disorder as of 2001-2004, the majority of which had severe impairment. (Archives of General Psychiatry, 2005)

Bipolar disorder and overall health

  • On average, bipolar disorder results in 9.2 years reduction in expected life span (National Institute of Mental Health, 2017).
  • The risk of suicide is high in people with bipolar disorder with 15% to 17% committing suicide. (Treatment Advocacy Center)
  • Up to 60% of people with any mental health disorder, including bipolar disorder, develop substance use disorders. (WebMD, 2006)
  • Of those with bipolar disorder, many report co-occurring health conditions, which are most commonly migraine, asthma, and high cholesterol. High blood pressure, thyroid disease, and osteoarthritis were also identified as high probability co-occurring health problems. (The British Journal of Psychiatry, 2014)

This particular stat suggests that up to 20% of bipolar subjects end their life by suicide, and 20–60% of them attempt suicide at least once in their lifetime. 

That sentence should scare the shit out of you. It should be cause for alarm. And it should be a wake-up call for those who judge or are ignorant to this illness.

Less than 3% of the United States population suffers from this disorder. We are by far outnumbered (not that I would wish this affliction on anyone) and it’s sad. Mental illness and mental health awareness in general has improved in this country to an extent, but nowhere near enough to make much of a difference.

I find it interesting that because I am bipolar, I have a decreased life expectancy of 9-17 years. Because of the possibility I may kill myself? Because of the dangers of mania? Why exactly?

Cognitively, I am slowly declining. That’s why reading and writing are so important to me. I want my mind and my memories. I always want to remember. I never want to forget

Self-care is super important, and fortunately I still manage in that department. I could exercise more and eat healthier. But other than that, and staying on a good medication regimen, what else can I do to maintain? And when that only helps to a certain point, what do I do then?

I manage, I guess. I may not do it well, but I never back down. But how long can that pretentious mentality last? Do you think the 20% of people with bipolar disorder who committed suicide were always suicidal? What about the 60% that attempt it?

This isn’t a cry for help, but a call to arms. March 30 was World Bipolar Day and I’m not sure how constructive that was, but it didn’t affect me one bit. No one called me or asked for my opinion. I didn’t receive any notice or information. I think it was just a day for fellow-bipolars to get together and be happy and spread “awareness” – amongst themselves, that is.

But I’m not happy because no one is truly aware. Not to the point that it makes much difference.

But when more than 50% of a certain population will attempt suicide and people are still hiding from that reality, continuing to stand behind the stigma that is so hazardous to those with a mental illness, bipolar disorder in particular.

Hopelessness. That’s the one emotion someone with any mental illness needs to avoid. In my opinion, many reach that hopeless state because of the stigma and lack of help available.

I am not suicidal and am in no way judging anyone who is. I’m just here to let you know that someone is on your side. I’m here and I’m pissed. This isn’t my battle to fight alone, but I’m tired of feeling alone so it’s time to stand up for change. If no one else will, we must do it on our own. If we do not take this disorder and all of its idiosyncrasies seriously (and not just us bipolars), we are looking down a dark, downward spiral of chaos.

I may be biased because I saw my friend with an untreated mental illness hang himself 20 years ago this month. I may be biased because I am bipolar, and I know the ins and outs.

It’s time for a change, though.

I’m tired of statistics, and I refuse to be one.

This month marks the 20th anniversary of the suicide of a close friend. He hung himself in a tree in his backyard when I was in the 6th grade. We just so happened to be neighbors, so I was there and saw the whole thing.


  1. Change absolutely needs to happen. When people are scared to reach out for help because of stigma, or people do reach out and get their asses kicked by a health care system that doesn’t care about them, our society is failing.

  2. I am grateful for this post, Josh, grateful to see you raising awareness. Growing up, I led a very sheltered life and I didn’t know much about mental illness (or addiction, which has played a huge role in my life). I will share with you that I have earned my doctorate in psychology, and am in the process of becoming a licensed psychologist. In graduate school, I read all the books… which, are helpful, to a small extent. But where the real learning and awareness happened, at least for me, was during my practicum and internship… working each day with people who suffer mental illness. My clients have taught me so much and shown me so much about what it is like to live with some of these disorders. I have a huge place in my heart for their suffering. I think that many people are able to see how privileged they are to not have some sort of physical disability… but that many fail to see that it is a privilege not to live with the sort of emotional pain you are describing here. Another thing that I have learned is that our “insurance model” of health care is very unhelpful, creating all sorts of obstacles to people seeking help for mental health. In any case, I just want to tell you that I am really enjoying your blog. Thank you for being so open with your readers… I admire you, my friend 🙂

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