In "An Unquiet Mind," [1] Kay Jamison explains the complexities of sharing her story of manic depressive illness while also being a Professor of Psychiatry. I will forever be grateful to the doctor who recommended this book, which became a lifeline for me. It helped frame this illness as something to be feared but also carefully harnessed and fully embraced. It empowered rather than frightened me. It explained parts of me that I had never understood despite how hard I had tried. In the prolog, Jamison quotes a question that provides her comfort about her decision to publish her story. The question, from the poem 'Epilogue', by manic depressive poet Robert Lowell is, 'Yet why not say what happened?' My sister is on the verge of being restrained in hospital. Her husband had her involuntarily hospitalized which is understandable because she has become a danger to herself and is no longer able to listen to reason. Though her story is hers alone to tell, I can't help but be returned to where I was 3 years ago. If this is anything to go by, my sister is currently experiencing her version of my most traumatic memories. I tried so hard to protect her from the harrowing process of being taken against your will, but that's not how this works. How this works is the people who love you watch with increasing helplessness as you are trapped by the wiring of your own mind and they are trapped by the whims and inconsistencies of an overstretched and uncomprehending health care system. My younger sister and I are both clinically known as Bipolar 1. Personally, I prefer the old school 'Manic Depressive' label. A label that I feel much more aptly and beautifully describes the gripping intensity of both the manic energy and the depressive void. My sister has been highly manic for almost two months. She has been hospitalized twice in the last month. Both hospital stays were far too brief and left her worse than when she went in. My baby sister, younger than me by five years, is strong and beautiful and smart and funny. She is physically active and the loving mother to an adorable toddler. With her as with me, she was okay, she held it together, until she wasn't and she couldn't, and now my mind keeps returning to where I was, and what lies ahead for her. Right now, at this very minute, the police are knocking on her door and there is nothing I can do. Nothing. So here I am. Not drinking through this feeling. Not numbing myself with pills. Just standing and staring into my backyard with the door wide open wanting to pounce. I want to listen to Rage Against the Machine and tear my kitchen to pieces. Instead, I am standing tall and strong with adrenaline in my veins that I do not know; this is not a feeling I am familiar with. They will be getting her down on the grass to cuff her because my sister, like me, ain't going anywhere she doesn't want to without a fight. The understanding that it's not up to her will come. This much I know. I can feel it in my bones and I know it from my own life. After half an hour of discussion with the two gentlemen officers at my door, I realized all at once that I couldn't talk my way out of going to a psych ward with them. This was happening regardless of how I felt about the matter. Upon this realization, I politely informed them that they would have to put the cuffs on me because I would not be going anywhere with them willingly. 'Come on, Miss,' one of them said, 'This is a nice neighborhood. You don't want your neighbors to see this, do you?' I think I responded something to the effect of, 'I don't give a fuck what the neighbours see. I'm not going anywhere with you, so you do what you gotta.' And that is exactly what they did. They placed me in the back of a cop car and drove me, kicking and screaming, to the nearest hospital. I pleaded with them to take me anywhere but that hospital. That hospital, where I ended up the night my ectopic pregnancy ruptured my fallopian tube, and I had to have emergency surgery so I wouldn't die but the baby already had. Please take me anywhere but that one, I pleaded. Maybe it's because I put up such a fuss. Maybe I wasted too much of their time trying to explain why I really was okay and didn't need to go to the hospital. Or maybe they chose that one just to punish me. Initially the plan had been to go to a specialized centre but that hospital, the 'anywhere but there' hospital is where I landed. When they put the IV in my arm to sedate me without my consent, I ripped it out and my blood went everywhere. And when I wouldn't change into the damn hospital scrubs, they had four men tie me down and threaten to 'change me themselves.' I screamed that I was on my period so I hoped they would enjoy it. This was a lie, but an effective one that I don't feel bad about because in the end they didn't forcibly strip me. Even in my state of insanity, I knew how to take care of myself. To comfort myself. To try and take away some of the shame I knew I would feel when this nightmare ended, to hold a claim on the familiar part of myself that is a mother, a teacher, a person who pays bills, buys groceries, makes dinner. I followed the rules and did everything I was supposed to do: had friends, was kind, tried hard, went to school, got a job, a husband, a house, a kid. Yet, this is what happened. I spent the following days locked up alone in a red room covered in the graffiti of previous inhabitants. It was during COVID, so I was isolated, food left on a tray outside the door. I didn't know cameras were there, watching me, until maybe day four. I didn't know what the medication was that they were giving me. I didn't know what day it was or if it even was day and not night. I didn't know how long I'd been there or was going to be there. But I did know, I could only walk if I held myself up by using the walls for support. After a week of this, I received a care package from my older sister. Among other things, it contained pens and paper, which I used to write to the doctor, pleading my case: I would behave, I would get better. Eventually he released me against his wishes, just as he had held me against mine. Right now, as I write this, I relive all of it as I watch helplessly while my baby sister fights the battle I had hoped to protect her from—the one that gets you in a red graffitied room at the beginning of a long, hard journey. The depression that follows a long manic high is so bleak and just so dark. I have no other words to describe it, but I do have a scent. I keep an empty jar of hand cream from that time in the bottom drawer of my bedside table. It is the scent of suicide. It is the scent of slowly stepping in front of the evening train that runs by my house each night. It is the scent of so many different pill combinations and too many doctors appointments. The scent of shame and self-hatred and guilt and total, numbing apathy. Sometimes I open the jar and smell it just to be reminded of how close I really was. All I wanted was death. I prayed for it: an accident or aneurysm. I couldn't kill myself because I have a son. Not that I thought I could add anything of value to his life, but just so that wouldn't be his story; his thing to never fully understand despite constantly trying. I thought I would stay around another night for him. The darkness of our minds can get us to a place where we think our children are better off without us, so we're actually doing them a service by departing. Keep away from the tracks, stay in the house. Night after night I made that choice. I think about all of these things while I wait to see how this will go for my sister. I think about what I can tell her about picking up the pieces of yourself and putting them back together, about how even if you're only staying alive for your child, only for one more day, then that's reason enough for now. Other reasons will come. Over the past few years, I have grown to understand that living with bipolar disorder is so much more than just navigating the extreme highs and lows that so many seem to focus on. Every facet of my life was and is affected by my bipolar brain. The continuous craving to not be in my head. The constant yearning for something to calm my own unquiet mind. This diagnosis and all that came with it has slowly taught me to be gentle with myself, to listen carefully, to slow down, to wait patiently, to ask for help, to look inward, to feel it all, to say no, to breathe deeply, to pray, to not be so damn afraid, and to create my own quiet beauty on the days not defined by those intense highs and lows. There are still dark days for sure, but at least now they hold some sense of meaning. I will share this with my sister when her world has brightened a little. And hopefully one day she too will feel well enough to say what happened. Many people with bipolar disorder have a family member that shares the same condition, often a grandparent, parent, or child. Clinicians commonly view these family histories in the context of risk for bipolar disorder and to provide a hint at possible response to treatment. Yet two family members with the condition share much more than genes, they share common experiences, knowing all too well what the other has dealt with or will need to face. Siblings in particular share a unique bond and may have overlapping time frames for their illness experience. This poignant and powerful narrative explores the complexity of seeing a younger sibling reach a difficult phase of the illness, what emotions and memories it elicits, and how it can shape the distinctive support that only a loving sibling can provide. To maintain the privacy of the family members discussed in this submission, Ms. Jacqueline W. has chosen to remain anonymous and not publish her last name. Thank you to Xochitl Benjamin for her thoughtful feedback on an earlier draft of this narrative. Data sharing is not applicable to this article, as no new data were created or analyzed in this study.

Jacqueline W

Ayal Schaffer

Bipolar Disorders

BIPOLAR DISORDERS 是一本国际期刊，发表与双相情感障碍和相关疾病的基本机制、临床方面或治疗相关的所有研究。它旨在为该领域的新研究提供一个单一的国际渠道，并涵盖以下领域的研究： 生物化学生理学神经精神药理学神经解剖神经病理学遗传学脑成像流行病学现象学双相情感障碍的临床方面和治疗双相情感障碍还包含形成这些疾病的新治疗策略发展的论文以及关于分裂情感障碍和抑郁障碍的主题，因为这些可能是与双相情感障碍重叠领域的循环障碍。该杂志将考虑在以下领域提交出版物：观点、研究文章、通信、临床角和思考。其中有多种类型的文章：特邀社论、辩论、评论文章、原创文章、评论、致编辑的信、临床难题、临床好奇心、临床护理和沉思。

Bipolar Disorders is an international journal that focuses on the fundamental mechanisms, clinical aspects, and treatment of bipolar disorder and related conditions. The journal aims to provide a single international channel for new research in the field, covering studies in the following areas: biochemistry, physiology, neuropsychopharmacology, neuroanatomy, neuropathology, genetics, brain imaging, epidemiology, phenomenology, as well as the clinical aspects and treatment of bipolar disorder. Additionally, the journal welcomes papers on new therapeutic strategies for these disorders, as well as topics related to schizoaffective disorder and depressive disorders, as these may overlap with bipolar disorder. The journal considers submissions in various formats, including viewpoints, research articles, communications, clinical corners, and reflections. There are multiple types of articles: invited editorials, debates, review articles, original research, letters to the editor, clinical dilemmas, clinical curiosities, clinical care, and reflections.

《Bipolar Disorders》是一本国际期刊，专注于双相情感障碍及相关疾病的基本机制、临床特征和治疗研究。该期刊旨在为该领域的新研究提供一个国际平台，涵盖以下研究领域：生物化学、生理学、神经精神药理学、神经解剖学、神经病理学、遗传学、脑成像、流行病学、现象学，以及双相情感障碍的临床特征和治疗。此外，期刊还欢迎关于新治疗策略的论文，以及与分裂情感障碍和抑郁障碍相关的研究，因为这些领域可能与双相情感障碍存在重叠。该期刊接受多种类型的投稿，包括观点文章、研究论文、通信、临床案例和思考。文章类型包括特邀社论、辩论、评论、原创研究、书信、临床难题、临床好奇心、临床护理和沉思。

Category	Quartile
医学	2
医学, 临床神经病学	2
医学, 神经科学	2
医学, 精神病学	2

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