For my close friends,... instead of a suicide note

When I become acutely depressed, I need someone who loves me to be present with me. I need that person to communicate their love not only with words, but also by actions. Taking the time to see me in person, to check on me, is an effective way to communicate that you care. I realize that sometimes you will be busy, though as a close friend, it is presumed that you will take measures to help me when I am in need, even if it is not convenient for you. A demonstration that you are doing 'what you can' is better than nothing at all.

I am not always pleasant when I am ill. If, in the course of my illness, I feel slighted by you, this will be magnified tenfold. Be prepared for the possibility of harsh, critical words that truly hurt. I do this, because my editing function no longer works, and I am unable to process information, normally. Understand that when ill, I am under attack by the thought-demons. Wartime protocol is what you will encounter, because I am engaged in a fight for my life. You may not perceive the threat. You might even be correct in a given instance, that I am not in imminent danger, but the price everyone pays for a wrong judgement is my life. Please don't gamble with my life. I trust you to help me, especially when my behavior is out of control. This is the time of greatest risk.

I didn't ask to be born with this illness. I inherited it. It killed my mother. Yes, I am scared that it will ultimately claim me, too. I work incredibly hard at managing my treatment. Many people with bipolar do not take their medications consistently. I do. Many forgo the added expense of weekly therapy. I don't. Many do not make the effort to build a support system of friends and clinicians. I have. Many do not take the time to learn everything they can about this disorder. I have. I want to survive this illness, but the reality is, I cannot do it alone. If you are my close friend, then to some extent, you've taken on my illness, too. Sometimes that means your time with me will be very exciting (mania), at other times, it will be more challenging (depression). Please love me enough to persist through tough times, too.

Joan Esnayra, Ph.D.