Reconsider Everything

Photo by Larry Bridges Jr. on Unsplash

There’s a parade for the Eagles this Friday to celebrate their Super Bowl win, just blocks from my home, and I won’t be there. I have to work.

I cannot begin to relate how difficult things have been lately. Just when I think I’ve got bipolar disorder beat, just when a long time without an episode passes and I’m sure I’m over it, it comes roaring back to threaten everything in my life and, inevitably, my life itself. Spent, defeated, hopeless, and in pain; isolated, useless, and doubting of everything I’ve done and can possibly do, I’m obsessed with disappearing, giving up, committing some metaphorical suicide in which I cease to matter in order to avoid attempting the real thing.

Before anyone councils me with “you’ll get over it,” hell, before I say that to myself, I just wish we’d all consider how that diminishes the seriousness of mental illness. Because I haven’t gotten over it. It’s gotten over on me. We had a friend we lost touch with for a few months and we just found out he died of lung cancer. It was quick. We’re full of compassion for his family. And we’re unable to extend that same compassion to me and others with mental illness because our illnesses are ponderous, and upsetting, and go on and on and on without real resolution. But they can be just as fatal. I’m years past the average age of death of someone with bipolar disorder, I suffer from several comorbid conditions that threaten my health, I’m confronting very real cognitive decline, and my inability to deal with the stress of it all renders long days unbearable. Still, no one, not even people in my own family, not even me sometimes, thinks this is anywhere near as bad as something like cancer.

We do not put mental illness on the same level as physical illness. We do not give people with severe mental illness the same care and compassion we give to people who suffer serious physical illness. In fact, they kind of annoy us, and we sort of wish they would just stop with all the drama. Even those loved ones who sacrifice greatly for us eventually tire of the struggle and have to pull back to protect themselves. We are inevitably left to cope with it on our own as, if only they’d be honest and admit it, people who otherwise support us sometimes wish we would just go away.

So if left just to cope, as if that is all that life is, I must reconsider how I cope. Because all I’ve done, all I do, is not working right now.

I wrote a book on coping, and while I think the sections on meditation and movement are truly helpful and involve techniques that continue to save my life, and can save yours, I’m starting to question the book’s emphasis on work as a panacea, as if the very real human need and desire to do good things for others can be reduced to a few miserable hours a day and a paycheck.

Let me be clear that a person must do all they can to be as independent, financially at least, as they can. While this does necessitate work, as well as the reality of living within our means, it does not necessitate being subservient to some company or culture that places unhealthy demands on you. We can find true purpose in work. But work can rob us of true purpose, too.

This actually is difficult for me to write, because I’ve always been the one to give it my all at work, to show up on sick days, to put up with bad conditions and unfair bosses just glad for the chance to be paid, to take on the extra assignment, and set aside my dreams because there’s more to do for what little they give me to do it. Where does it get me? A place where, while I give it all, I am not safe to disclose or discuss my illness, lest such talk hold me back or worse, as it has before. Oh, if I had a physical disease the outpouring of care would be a given. But I don’t, I have a psychiatric disease that only makes people question me, all of me, and question any real opportunity they may have been thinking of giving me, as they squirm, feign concern, and as quickly as possible move on to something else.

Where else does it get me? At work on Friday while friends and neighbors, while my daughter and her friends, while seemingly the whole city comes together on Broad Street and on the Parkway to celebrate a rare, unifying event. And the terrible thing is I wouldn’t even think of calling out sick. I have responsibilities, after all. Responsibilities that bury the sickness, deny the ill health and, inevitably, make it worse.

It is interesting that illnesses like anhedonia and, later, manic depression, are first identified in the industrial revolution as if they are the result of work that is routine, soulless, and often degrading. It is interesting how labor is always considered a threat to order when it organizes and makes demands. It is interesting that much of what we work for is to buy more stuff, to the point where consumerism is so much a part of our culture that in mania one of the key symptoms is spending all your money on stupid stuff you don’t need, and never will.

But again, this is 2025 post-capitalist America and I do advocate for work. You simply must do it if it’s at all possible that you can. Take care of yourself. Pay your own way. All those slogans that, when well applied, really do make us better people. But it shouldn’t lead to so much stress that it makes you sick as my work does to me now.

Which brings me to the greatest irony. I’m working a job in which the most successful people in the office have no life outside of work because they’re always working, all the while resigned to the fact, laughing about it, that they just may die at their desks. I’m doing this for health insurance. I can go without a lot, but my family can’t go without health insurance, which for some inexplicable reason is tied to our jobs and is not freely available or affordable for all, and most people seem OK with that. But get this, this job that demands so much and rewards so little gives me health insurance that doesn’t even cover my psych visits. I get all my healthcare from this huge university health system in Philadelphia, my insurance is from a huge insurance company based in Philadelphia, and everything is covered. Except psychiatry.

So right now as I suffer, partially due to work, as I have to see the doctor more often, I have to pay it all out of pocket, which keeps me clocking in, which, right now, keeps me sick. Yes, my latest bought with mixed-episode bipolar disorder has me reconsidering so much, except for the fact that I’ll be at my desk on Friday as everyone wears green and fist pumps as the Lombardi trophy glides by, held high by a player on a flat bed truck. That’s just the kind of guy I am. And maybe that’s the problem.