First off, when you have a mental illness, it can be really difficult to tell something is wrong. The changes in your faculties can be gradual and subtle and, simultaneously, everything always looks "normal" seen from the inside. To clarify: you follow your own thought processes so your own logic tends to make perfect sense to you, no matter how flawed it may be.
With this in mind, I did not realize at first that anything was amiss. We are currently living through a major historical event and I am surrounded by people who have been convinced that vaccines are the magnetic, DNA-altering Mark of the Beast and that mask wearing is muzzling, a strike against freedom, and somehow is as bad as the Nazi Holocaust.
Some amount of situational depression might be expected. Anxiety, certainly.
I hope I can be forgiven for not recognizing the cycling of bipolar swings from mania to depression in light of current events in the last couple years. Either way, I did not at first recognize the issue. I have had some suspicions for some time as I've been on the same dosage for years and you can develop a resistance to any drug and sometimes things seemed a bit… off… from time to time. Unfortunately things were never quite off enough and, with all of the drama of life, the true cause of my increasing abrasiveness and decreasing patience was lost among the blood pressure spiking news stories of yet another story of the disgustingly wealthy predating upon the poverty stricken and the political cronies that enable them.
When depressed, I tend to videogame obsessively, read voluminous amounts of fiction, consume vast quantities of movies… escapist pastimes all. I want a release from my unbearable reality so I step into another one for a time where I might be part of a ragtag band fighting against evil corporate overlords with the powers of mass murder and dick jokes or maybe while away my time in more peaceful and calming virtual pursuits. That sure beats ceaseless misery, at least for a couple hours a day.
Bipolar I may involve periods of deeply unhinged thoughts (psychosis) during manic episodes and mania is inevitably followed by a period of depression, kind of the price of admission. Mania can be fun, for certain definitions of "fun", but depression generally is not. While I never made it back to a point where I lost contact with reality, I was certainly very "productive" for periods of time separated by a total inability to create for long stretches that I generally filled with escapist pursuits.
There is a difference between writer's block and depression, but it can be hard to tell if you just aren't in the mood or lack inspiration or if you simply cannot perform at a level easily reached on your worst days while fully medicated.
Even if you can convince yourself there is actually a problem, you then need to convince a doctor of the same thing. One problem with mental health treatment is that an x-ray of your head isn't going to reveal any purely psychological issues. There is no MRI for "crazy". While the actual occurrence of such fraud is minimal, people will sometimes fake a mental health issue for a variety of reasons, further muddying the waters. "It's all in my head," after all.
But let's look at another hard-to-find illness: the soft tissue injury. This is doctor speak for "we can't take a picture of that, yet" and so physical therapists and sports medicine physicians just kind of have to take your word that something hurts. Just like psychologists, these medical professionals have tests that they use to weed out fakers because, while not commonplace, people will fake a physical injury. Maybe they want drugs. Maybe they're trying to game the Social Security system. In any case, seeing this sort of thing on a regular basis as ER doctors do can make them pretty skeptical.
Now, is everyone with a physical injury that cannot be seen on an X-ray a big faker? Is it all in their heads? If you or a loved one has ever experienced this, you would probably say "No."
It is unfortunate the mentally ill are not more often taken at their word in this same way, but more progress is being made every day. You almost never get lobotomized or forcefully sterilized these days, but you are often still stigmatized and various forms of mental illness are portrayed variously as victim or villain in countless books and films which perpetuates the "otherness" of the mentally ill despite 1 in 5 people experiencing mental illness each year in the USA.
Oh my, how did I end up on this soapbox?
As I step down and wind this up, allow me to just say that I have had an adjustment made in my medication that I hope will see things improve. I am, in fact, feeling a bit better and have managed to do some work on a couple projects without doing so obsessively.