What Is Madness?

I’ve been asked what the difference is between mental illness and madness. I absolutely love language, and words are important and fascinating to me. While some people find the term madness to be outdated or even offensive, with me it is a word that resonates deeply. I do not want to step on anyone’s toes here, because there are many valid ways to view mental illness, especially if you have it yourself. My answer is mine alone, meant to reflect my own experience and opinion.

I have mental illnesses, and I sometimes experience madness. Madness feels like the world is burning down around me. I can see things others can’t, I know truths others never will, and I can feel the source of universal pain flowing through me and out into the world. Madness is powerful. Madness is bold.

If I experience madness in a grocery store, I can hear the thoughts of all the shoppers, and I know deep within myself that they are all in danger, and I cannot save them. I weep as I walk the aisles because surely they don’t all deserve the fate that only I know awaits them. Some of them stare at me, my red eyes and snotty nose, and one even asks if I’m okay. That makes me cry harder. In the produce department, I feel hope when I see the oranges because they came from the earth. I realize that all the fruits and vegetables came from the earth, and a calm settles over the department. As soon as I turn away from the produce, waves of hostile anxiety rain down on me, and the other items in their bright-colored cardboard boxes and plastic containers are more toxic and threatening than ever.

Madness, for me, happens during psychosis. Not all of my psychotic experiences feel like madness, but madness only happens when I’m psychotic.

Words are very important to me, which is why I wanted to address this concept. I identify with the word madness because to me, madness is a concept that goes back into ancient civilizations as a common experience among a small minority of people. I know how some of the ancient prophets, shamans, and mystics felt. I can feel the rich inheritance of my insight, regardless of whether it is currently productive or not. Geniuses, artists, and mystics down the ages have experienced madness. Some were revered for it. Others were executed. Madness is as old as human history.

The difference to me between madness and mental illness is timing. Mental illness is something that is with me all hours of the day and night. Even when I have no symptoms, mental illness is with me; it’s just resting. The goal is for it to rest as often and for as long as possible, but it’s always there, waiting for me to falter so it can wake up again.

Madness only happens sometimes. I do not feel I have gone mad just because I’m currently psychotic. There is a specific feeling that I identify as madness. It happens when I’m having hallucinations and delusions (psychosis) that are particularly intense. During madness, my emotions are overwhelming. I am at the mercy of my episode. There is no calm inside of me to hold on to while my world spirals out of control. I need my partner to watch over me because I have no reasoning power left. My mind is madness. The world is madness. I cannot differentiate between my thoughts and reality. I am very frightened but unwilling to back down from the chaos around me.

My psychosis during normal mental illness, the psychosis that happens outside of madness, is easy to manage. I’ve had 12 years to learn how to keep myself safe during episodes, and I’m fairly competent at self-care. I can use coping strategies effectively, and I can self-soothe. I still suffer and hurt immensely, but I have skills now. Psychosis doesn’t have to disrupt my entire day. It may just be a couple of painful hours of self-care while doing nothing externally productive before returning to real life to wash dishes and nag my partner to pick up his socks.

Madness for me is much further removed from my control and subjective reality than most of my psychosis. There is an intense feeling inside of it that contains vast knowledge and deep pain. Everything else is just mental illness. Mental illness, I cope and manage. Madness, I merely observe.


By Emily Harrington, The Goldfish Painter


My disclaimer:

I am not a doctor or any sort of mental health professional. I am a psychiatric patient with multiple mental illnesses that I have survived for 12 years now. My secondhand knowledge comes from doctors, psychologists, therapists, books, college courses in psychology, and the internet. My firsthand knowledge comes from the feelings, experiences, thoughts, symptoms, problems, and solutions that I have lived through. I know myself well, but again, I am not a professional. The information on this site is not a replacement for getting an actual diagnosis or professional help. Coping skills are fantastic, and I hope you learn some here and that they help you, but please seek and continue real medical treatment if you are struggling with mental illness. I wish you the best. You can do hard things.

How Mental Illness Affects My Life

I am disabled because of my mental illnesses. I have bipolar II, major depressive disorder, and generalized anxiety disorder. I was diagnosed when I first presented my bipolar symptoms at age 19, 12 years ago. I also dealt with major depression as a child.

I am disabled because I have mixed-state, rapid cycling episodes with psychotic features. That means I have episodes with severe depression, mania, and anxiety all at once, in addition to having hallucinations, paranoia, and delusions. What an episode looks like for me is here: What Is a Mixed-State Episode? – The Goldfish Painter

One way my mental illnesses affect me is by reducing the number of things I can do successfully. I cannot work a job, because my episodes are not safe or appropriate for a workplace. I frequently need monitoring if I’m trying to complete tasks. At home, during an episode, there is a long list of things I can’t do, including driving, using knives, mowing the lawn, washing dishes, and lighting any of the gas appliances, because if I make a mistake with any of these tasks I can accidentally hurt myself or others. I have no desire to burn down the house. If I have an episode in public, I need help from a loved one to Continue reading

What I Didn’t Tell My Therapist

There is only one thing I have held back from a therapist in the past, and even that would have been far more beneficial to have said than to have kept to myself. That one thing was “I am actively planning my suicide.”

I held this back because I know that the only two pieces of information a therapist is legally allowed to report (other than child abuse) are 1) if you are planning to hurt yourself or 2) if you’re planning to hurt someone else. If they find this out, they can work to have you held in a hospital for 72 hours to assess your mental health and try to make you safe again.

I held this back because I didn’t want to be stopped in my progress toward suicide. I had already decided and was putting the necessary steps in place for a successful exit. Long story short, I lived.

Now, I tell my therapist everything, because I need her feedback on Continue reading

Can Two People with Mental Illness Be Friends?


It can be excellent for people with the same mental illness to be around each other or be friends. This is beneficial is because those two people will have something in common that most people are not familiar with. They will be able to share coping skills, insights, affirming words of wisdom, and empathy. Because of having a shared perspective, mentally ill friends are more likely to feel less alone in their struggle because they have a friend by their side who has struggled in the same ways they do.

For example, during my last stay in a psychiatric hospital (in 2008), seven of the other nine people on the ward were bipolar like me. We had a very good and helpful time with each other by sitting around sharing our stories. I think I healed more from spending time with them than from the daily group therapy sessions. There was no infighting or hostility. Some bipolar people are mean or hostile, but it is not a symptom of bipolar. Those people would be mean and hostile without bipolar. Basically, some people just suck, and some of the people who suck happen to be bipolar (or blonde, or Chinese, or left-handed, or optimistic… get it?). It was incredibly helpful to me to be around all these vastly different people who shared my struggle. Some of them were people I never would have talked to on my own, but since we had this massive thing in common, I gained wisdom from everyone there, even those who had very different opinions, levels of education, and political leanings than I do. Continue reading

What Is An Episode Like?

I’d like to explain what a typical bipolar episode is like for me.

I have rapid-cycling, mixed-state episodes with psychotic features. A mixed-state episode can lean one way or another so it can be helpful to refer to them as manic or depressive for purposes of communication, but every mixed-state episode has features of both mania and depression. I get hallucinations as well as paranoid delusions during mixed-state episodes, and those are what the “psychotic features” part of my diagnosis refers to. I do not get harmful, hostile, violent or dangerous, I just experience things that the people around me are not experiencing. My episodes are also rapid-cycling, which means that they are short and intense, usually between 4 and 7 hours, and I have them three days in a row at about the same time of day. I am sometimes able to stop this process if I get 14 hours of sleep in a night, which interrupts the cycle and prevents an episode the next day. I am an atypical bipolar person in terms of my episodes, and also have co-morbid diagnoses of major depressive disorder and generalized anxiety disorder. They sometimes hit all at once. I have met many bipolar people, Continue reading

My Suicides, and How I Got Better

Dealing with mental illness has been a beast from the beginning. In 2006, Bipolar II Disorder first presented in my brain. It is typical for a person to develop bipolar between the ages of 18-23 because the brain continues to change and mature through and past this time, up to age 25 for women and age 27 for men. For me, it happened at 19.

In 2006, after only five months of college,  I had my first severe psychotic break and had to have two stays in psychiatric hospitals. During the second hospital stay, I tried to hang myself, unsuccessfully. I was in one of my first psychotic episodes. It was mixed-state, rapid cycling, which means that I had aspects of severe depression and severe mania at the same time. This is not happy mania, and it is actually clinically referred to as “dysphoric” mania. “Dysphoric” is the opposite of “euphoric” and it means that my mania is characterized by the same amount of energy as traditional mania, but I also feel extremely physically and mentally uncomfortable, with hallucinations, delusions, paranoia, severe depression, racing awful thoughts, irritation, anxiety, excessive energy in my body and physical agitation. When I started having episodes and did not have the medicine, self-knowledge, or coping skills to help me feel better, I would have suicidal impulses as soon as the episode approached its peak. With no resources, my first episode confined in a hospital was literally unbearable, and suicide was the only option available to change the way I felt. I used it; it was the only solution I had. I tried to hang myself from a tall bathroom door with a cord when I was unsupervised. My neck did not break when I kicked the chair out from beneath me and jerked downward, but I could not breathe at all. I felt the complete relief Continue reading

What is the Cause of Mental Illness?

All mental illnesses are sicknesses involving changes in thoughts, emotions, beliefs, or behaviors, and they stem from a combination of chemical imbalances in the brain, brain structure abnormalities, and personal history/environment. It is not something you choose to have, and we’d all cure ourselves if that was possible. No one would choose this.

Something qualifies as a mental illness if your thought processes, beliefs, perceptions, emotions, or feelings cause you so many problems operating in daily life that they preclude you from living normally. Mental health, like so many other things in the human condition, is a spectrum (gender identity and sexual orientation are good examples of natural human spectrums), so having a few symptoms of a mental illness does not automatically make you mentally ill. If the symptoms you are having are severe enough to get in the way of normal functioning, you then have a mental illness. An example:

If you are depressed for a week, but can still operate well enough to shower, drive, converse, feed yourself, sleep, and go to work, then you are depressed, but not disabled by depression. You still may be in a lot of pain, but this is not enough to diagnose you with clinical depression since it’s only been a week and you’re still functional. You are having symptoms of depression, which sucks very much, but you are not technically mentally ill.

However: Continue reading

Can Mental Illness Ever Get Better?

Most mental illnesses cannot be cured, but treatment has the goal of putting the illness into remission, which means you are healthy for a while, sometimes a long while, before you relapse. I am currently in remission for Major Depressive Disorder, which means that depression is not preventing me from functioning, and I’m in partial remission for Bipolar II, meaning I have some episodes, but not every day, and between episodes I am functional. My generalized anxiety disorder is in full swing, but at this point, even that can be managed enough to keep me functional.

Being in remission from MDD is so wonderful. I eat on time, I shower every day, I can do dishes, I can converse normally, etc. And partial remission of bipolar isn’t too shabby either. I’m not in excruciating pain every day anymore.

There are several fronts on which I have attacked my mental illnesses. The first, and most foundational, was finding the right mix of medicines. Often it takes a lot of trial and error on the part of your psychiatrist to find the right medicine or mix of meds. The bad news is that sometimes this takes years. The good news is that if you persist through the extremely sucky process of trial and error, you will eventually find medicine(s) that work for you, and that is worth the wait because you are paving the way for the rest of your recovery. Many people cannot recover from severe mental illness without chemical help. By the way, don’t be ashamed of taking medicine. All it means is that you are trying to get better. Who cares if you take a pill for the rest of your life? Only ignorant people would judge you for that. You would take insulin for diabetes if you needed it, and you wouldn’t think you should stop just because you started to feel better. You feel better because of your medicine. DO NOT STOP TAKING YOUR MEDICINE. Many people make this sometimes-lethal mistake.

The second front I attacked my mental illnesses on was learning as much as I could about myself, my symptoms, which actions I could take to help me feel better, and which actions or situations made me feel worse. I kept a mood journal for years to help me learn my patterns, as well as to show to my doctor at appointments. After my second suicide attempt, only two years into my treatment (I am currently in year 12, and have not been hospitalized or attempted suicide since 2008.), I made a contract for myself in my journal. This contract stipulated my required behavior for getting better. What I remember from the contract is as follows:

I, Emily Harrington, dedicate myself to taking the following steps to stay alive:

I will take all of my doses of medicine, every day and on-time.

I will not skip any doctor or therapy appointments.

I will not let my blood sugar get low, and I will eat immediately if it does.

I will write down all relevant information on my mood journal, and show it to my doctor in every appointment.

I will tell the whole truth to my doctor and therapist.

I will maintain a sleep schedule, and if I mess up, I will recommit myself the next night.

I will tell my mom and come to the hospital if I plan my suicide again.

I will be kind to myself by taking care of all of the needs listed above.

I will live.

Signed, Emily K Harrington

The third front I attack my mental illnesses on is therapy. At this point in my recovery, I have mastered medicine and self-knowledge/self-care, and I’m moving forward further with therapy. I have been seeing my current therapist for three years, and I’m starting to internalize the questions she asks me whenever I present a problem emotion or problem situation. Those questions are “What can you do when this happens?” and “What has worked to make you feel better in the past?” With these questions, I am forced to answer her or myself with concrete solutions to my problems, and these concrete solutions are my coping tools. When I develop a coping tool through use, it becomes a coping skill that I can use for the rest of my life. I keep them all written down on index cards in a shoebox, that I refer to as my “toolbox”. I rifle through them during episodes or times when I just need comfort, because in an episode my memory is weak, and I need to be reminded of what coping skills I can use. I recommend writing down coping tools and skills to anyone who has a mental illness.

Using these three things in conjunction, I have not attempted suicide since 2008, and I can function fairly normally as far as taking care of daily needs. I am not well enough to work because I still have severe hallucinations, but I deal with them with grace now, instead of abject terror. I still struggle very much, but I am very rarely suicidal and have improved tremendously from a very dark situation. I even made this website with all my hard-won knowledge that I try to share with other mentally ill people because it gives my life meaning to know that what I’ve been through can lessen the pain of others.

It is possible to improve enough in your mental illness that you are in significantly less pain than you started with, and that’s a goal worth working toward.


By Emily Harrington, The Goldfish Painter


My disclaimer:

I am not a doctor or any sort of mental health professional. I am a psychiatric patient with multiple mental illnesses that I have survived for 12 years now. My secondhand knowledge comes from doctors, psychologists, therapists, books, college courses in psychology, and the internet. My firsthand knowledge comes from the feelings, experiences, thoughts, symptoms, problems, and solutions that I have lived through. I know myself well, but again, I am not a professional. The information on this site is not a replacement for getting an actual diagnosis or professional help. Coping skills are fantastic, and I hope you learn some here and that they help you, but please seek and continue real medical treatment if you are struggling with mental illness. I wish you the best. You can do hard things.

Continue reading

My Paranoia, Delusions, and Hallucinations

As far as delusions, hallucinations, and paranoia go, I can only speak to my own experience. During the delusions of grandeur during mania that I’ve had, I felt really, really good about myself and thought without a doubt that I could achieve very difficult things, like using a chainsaw to illegally cut down all the trees on a road near my house overnight because the trees had grown to block the formerly beautiful view of the lake, and I was outraged. I believed that was a good idea, and that it was achievable. Fortunately, I got distracted from that plan. I also had a recurring delusion that I was going to write a book about bipolar and publish it. It would be so meaningful, insightful and true that it would become a best seller, and I’d go on a book tour to publicize it. I’d end up telling my story to Oprah herself. I started that book about five times and didn’t get far, but now I have a website about bipolar that has all my best wisdom in it, and I’ve had a lot of people reach out to me lately to share their stories and tell me that my words have helped them. Educating people about bipolar was always a goal, but during a delusion of grandeur I took it to the extreme, and I felt good about my future.

Now, what is it like to have these delusions of grandeur in the first place? All I can explain is how it feels to me. In the very few times that I have had pure mania with delusions of grandeur (almost every episode I’ve had is mixed-state, with features of both mania and depression at the same time. I get dysphoric mania, the opposite of euphoric) I have buzzed with energy, felt like I could lift a car, been quick to make witty remarks, laughed often and too loudly, talked too fast and believed I could do many different extremely difficult things if I just put in the effort. I also believed that I could put in that effort, ignoring the fact that my illness precludes me from even having a job, because keeping myself alive is a full-time job itself. It was such a positive headspace that anything felt possible. I was just along for the ride, trying to have as much fun as I could. Of course, this has only happened to me a handful of times, since most of my episodes suck very much, even manic. Continue reading