My intention in writing these posts is to share the experiences that I went through with my son, starting with the first manifestation of his illness and our journey through numerous subsequent episodes. It's also to provide commentary as a parent and psychiatrist on issues that these experiences bring up, such as how the diagnostic process works in mental health, and how to work with treatment providers and medication issues. My hope is that reading this may be helpful for people with mental health issues and also their families and friends.

In diabetes, the concept of a “brittle diabetic” refers to a patient for whom the correct dose of insulin is hard to find. If the insulin dose is slightly too high they can become dangerously hypoglycemic, and if they are under-dosed their blood sugar can rise sky-high, with ongoing negative health consequences, possibly even reaching a level of diabetic ketoacidosis with impaired consciousness. The analogies with Bill’s bipolar illness are apt. Finding a combination of a mood stabilizer and neuroleptic that he could tolerate, given the side effects of these medicines, was already quite difficult. In addition, the doses needed to keep him stable were quite large, which then incurred greater side effects,........

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