(DES MOINES REGISTER) -- On New Year's Eve 2007 I arranged the pill bottles in a neat row and considered my options.
I could take one brand at a time. I could swallow them all at once. I could take them individually or by the handful. With wine or beer.
My neighbor was having a party and I could hear laughter and music through the shared wall. How could anyone have fun when I felt like this?
The orange bottles loomed. The names of the drugs I was prescribed for bipolar disorder stared back. Cymbalta. Lamictal. Xanax.
I marveled at the power we place in the hands of our most at-risk patients. The power in my hands.
I took a deep breath and called a suicide hotline.
I can't remember what the woman on the other end said, but she listened as I talked. And talked. And talked. About how I didn't like my job, about my recent breakup, about the depths of my loneliness, and about my desire to die.
The official term for what I was experiencing is "mixed state," a combination of mania and depression, which explained my nonstop rambling and thoughts of suicide in one fell swoop. The imbalance of chemicals in my brain was trying its hardest to work overtime.
It was the most scared I had ever been in my life.
I'd never called a suicide hotline before. I'd usually call one of the few people I call in this situation, but I'd done that a lot lately.
I had been depressed for weeks and knew sympathy was wearing thin. I was embarrassed about my behavior and ashamed I couldn't deal with it myself.
This time, I left my family and friends alone -- family and friends who slept with phones at their bedsides in case I called in the middle of the night.
That's what friends do for friends with mental illness. It's also what moms and dads do. Husbands and wives. Daughters and sons. And there's more of them than you think.
Each year, about one in four adults -- 57.7 million Americans and 750,000 Iowans -- will experience a mental health disorder, according to the National Institute of Mental Health. Of the people in America with mental illness, I'm among about 3 percent diagnosed as bipolar.
I was in high school the first time I got depressed. I was an honors student, captain of the cheerleading squad and editor at the newspaper with a caring boyfriend of almost two years. I wasn't the most popular kid in school, but I had a good group of friends and a part-time job at a record store. Life was (supposed to be) good.
Yet there I was crying every night.
When my mom asked what was wrong, all I could say was, "Nothing. Everything."
My parents sent me to a counselor who was probably used to seeing kids with "real" problems. She kept trying to find a tangible reason for my melancholy, so I gave up and waited for the feeling to go away.
It always did. But over the years, it also always came back.
My particular brand of bipolar is classified as Type II: Deep depressions punctuated with bouts of what's called hypomania, literally "before mania." In between, I'm theoretically normal.
People with bipolar II do not experience full blown manic episodes, but we have the elevated mood or irritability that comes before it.
Regular manic depressives, those classified as bipolar I, will say hypomania is the best part of the disease. You're confident, interesting, entertaining and witty. You're full of energy and feel productive.
I've experienced this, but my hypomania usually manifests as rampant irritability.
Recognizing my hypomania is difficult. When I'm depressed, I know it. The climb to mania is just that. It's a gradual change rather than a steep plunge.
It's easy to lose sight of the fact that your "normal" baseline is changing at all.
It's only after they're gone that I've been able to identify these moods. When I snap out of them, I have waves of memories of things I thought or, worse, things I said.
It's similar to drinking too much and waking with a fuzzy memory of the night before. As things come back into focus, I'm overwhelmed with embarrassment and shame.
Did I really say that? Did I really do that?
I can't even begin to think of all the co-workers, strangers, friends and family to whom I owe an apology for something I barely remember doing.
Have you ever believed that someone was out to get you? What about the entire world?
People with strings of bad luck say, "I just can't win." But they recognize a series of events that got them there.
When I just can't win, it's mostly imaginary. Total paranoia.
Someone suggesting I try something different at work means they want to ruin my career.
My boyfriend forgetting to tell me he loves me in the morning means he's going to dump me.
A perceived wrong tone in my mom's voice when she asks how I?m doing is a sign she's disappointed in who I have become.
I feel constantly judged and can never measure up.
Some stories of mania are riveting, filled with wild spending sprees or drug-fueled sexual binges. I don't have those stories.
I have tales of being a raging bitch -- repeatedly paranoid, angry and irritable -- and I've lost at least two jobs because of it.
One employer simply told me it wasn't working out. The other was disguised as a layoff.
But the bottom line is no one wants to work with an uncooperative meanie whose moods can turn on a dime no matter how talented they are.
And we're a talented bunch, us bipolar folks: Vincent Van Gogh, Patty Duke and Kurt Cobain, to name a few. Some, like Van Gogh, became notorious. Others, like Duke, used their stories to help others.
I hope I'm helping.
It was an article about depression that prompted me to seek help 10 years ago, though years passed before I found the right mix of medication and treatment to get my life in order.
Articles in The Des Moines Register about a man with bipolar disorder who shot a deputy sheriff last year is one of the reasons I?m writing this.
I want to dispel the myth that all people with mental illness are unproductive cop killers.
Maybe someone will see this and find hope, rather than fear, in their lives.
We recently wrote about Jeff Paprocki, a 23-year-old autistic who is confined to a psych ward at Iowa Lutheran Hospital because no other facility in Iowa will take him. While Jeff's story is a compelling one, it's also rare.
The majority of people in need of state mental health care are like me.
People with illnesses that would be manageable with just that much more help. That is why I want the Legislature to take mental health reform seriously.
In 2008, about 13 percent of Americans sought treatment for a mental heath problem, according to the National Institute of Mental Health. That's about half the number of people experiencing a mental condition. Imagine if only half of all cancer patients received treatment.
At least 75,000 Iowans are using the current state system. These people often have to navigate unspeakable amounts of red tape and don't have access to quality care because of a shortage of psychiatric professionals in the state.
And that's a lot to deal with when your brain is rebelling. When it's all you can do to keep it together on a daily basis. It's one more bump in the road to getting better, a road already paved with worry or anxiety or depression.
I didn't take the pills in 2007.
I talked to the suicide prevention counselor until I felt confident I could make it through the night. I took the prescribed doses of my medication and fell asleep.
Yet, fears remained. My biggest worry is finding myself in a state of suicidal depression or unmanageable hypomania again.
Even at my most stable, I evaluate whether my reactions are within "normal" range. Did I get too angry about the way my groceries were bagged? Did that song on the radio make me too sad?
When you live your life in emotional extremes, identifying the middle ground is harder.
So where am I now? Better.
One part of the answer was finding the right drugs for me. "Give me three months and you'll feel better than you have in years," my psychiatric nurse, who writes my prescriptions, promised me last summer.
I was skeptical.
As far as I could tell, there was no relief, only resignation. This cycle, this diagnosis, was who I was now. What made this lady so confident she could do what the other drugs and doctors couldn't?
But she was right.
I started sleeping regularly, which I hadn't done in years. My self-confidence returned, along with renewed interest in my job.
The other part was gaining a true understanding of my diagnosis. When the next bout of depression came -- and it always comes when you are bipolar -- I made an appointment with my therapist.
"Is it possible," I asked, "for me to miss the mood swings?"
"Of course," she said. "Why do you think people go off their meds?"
I'd never before considered needing my highs and lows. I spent so much time feeling with such intensity that life at a normal level seemed mundane.
It wasn't as exciting as I thought. But I promised myself I wouldn't stop taking my meds, and I haven't.
I found balance.
Where to get help
National Alliance on Mental Illness: The Iowa chapter is the most prominent group supporting people with mental illness and their families. The group has many local chapters and support groups.
Website: namiiowa.com
Phone: (515) 254-0417
Call: 1-800-273-TALK to reach to someone 24 hours a day. Based on your phone number, calls will be routed to a call center in your state and the person on the other end can help direct you to local resources. This service is for people contemplating suicide as well as family and friends who are worried about a loved one. It?s also a veterans? crisis line.
Emergency: If you are in serious trouble, call 911.