In year 2, I was getting desperate; the various medication combinations, I had been trying, weren't improving my moods.  I was sick and tired of being low, sobbing, and having negative thoughts of finding peace.  I had done some research on Electroconvulsive Therapy (ECT) on various internet sources and even watched several ECT procedures on YouTube.  

   At me next appointment, my psychiatrist and I discussed my eligibility for the treatment (as I was med resistant and remained mainly in a severe depressive state), what the potential side effects were, and how it was going to be administered.

   He referred me to the head psychiatrist, who performed the ECT treatments.  I was scheduled for an initial trial of 8 treatments, on an outpatient basis, with a reassessment after the 4th treatment to check for any impact or side effects.

   Here's my experience.  I fasted prior to each treatment (like any surgical procedure).  Hubby and I would drive to the hospital, as I required a driver after the general anesthetic, and I would gown up.  I laid down on the gurney and was hooked up to an IV, blood pressure cuff, and the heart monitor.  Through the IV they would eventually administer the muscle relaxer and general anesthetic.  At the first session, the Dr. explained, step by step, what was being done and why.  He then attached the wires to my head.  Once I was all hooked up, the anesthesiologist started the drip and the Dr asked me to start counting backwards from 100.  

   I may have got to 97 when I realized I was awake and finished!  The treatment only takes about 3 minutes from start to finish.  I was then wheeled into the psychiatric unit to recover from my anesthetic, was allowed to each lunch, then was released to head home until the next treatment.

   I had 4 treatments that were painless and uneventful.  I already had cognitive impairments prior to receiving my ECT treatments, due to my Bipolar Disorder, but unfortunately the ECT made it worse.  Typically, people that have the treatments may have short term memory gaps surrounding the day of the treatment or around that time frame, which gradually returns over time.  Mine however were more extensive and the 4 treatments had not resulted in any positive improvements of my depression.  So, unfortunately, any further treatments were cancelled as the risks outweighed the benefits.

   In my opinion, the general ECT process was not painful and I had no physical side effects.  It just wasn't right for me.  I can say though, that if it had made a marked improvement in my depression, I would have gladly put up with a little more cognitive impairment.  

   Before you make up your mind about Electroconvulsive Therapy, please do research the topic, the procedure itself, the benefits and the risks, and watch a few YouTube videos.  Get educated!

What was your mom like when you were growing up?

My mom was always there for me.  She was very social, good at balancing work, friends, volunteering, and still have all the time in the world for her family.  She's pretty much the same as she was except she can't work at the moment and personally struggles with her Bipolar Disorder.  No matter what life ever threw at my mom, she was still always the happiest person in the world.  In fact, she almost raised me and my sister by herself and we would do multiple multiple activities together.  The kind of mom everyone should have growing up.

What are your fondest memories of you and your mom?

My favourite memories are camping, fishing, and throwing me the best birthday parties in the world!  I've watched how hard she worked when she balanced work, volunteer, going back to school (making the Dean's list) and still giving us everything under the sun (but not material things).  It's great motivation for me to think about and continues to make me smile.

What was life like after your mom's Bipolar onset?

Stressful at first because we didn't get along for awhile.  I had entered my teen years and was a little handful so my new emotions and hers tended to collide.  It was hard feeling like I had to walk around on eggshells to avoid confrontation.  It was time consuming to learn about Bipolar Disorder however, learning about it made it that much easier to rebuild our relationship.  I think the hardest part was her not being her old self anymore and seeing her struggle.  Now that I'm older and more mature, it's a lot easier to cope with and be able to be there for her because I am more knowledgeable on Bipolar Disorder.

What would you like to say about the stigma surrounding Bipolar Disorder and other Mental Illnesses?

I absolutely fucking hate the stigma!!! Sorry, but it's true!  I do not understand how some people can be so ignorant, disrespectful, and stereotypical.  I have seen my mom lose many friends because they think she is "crazy" (I don't like that word) and I think that is what irritates me the most.  I do not understand how people can be so insensitive to a person who has a mental illness.  If my mom had broken her arm or got diagnosed with cancer people would treat her differently.  She would receive get well cards, flowers, or even a signature on her cast, but because her brain is sick, people distance themselves from her and forget who she is as a person.  It makes me sick.

What are your mom's best qualities?

Strength.  Being strong enough to admit her weaknesses.  Motivation.  Her constant drive to return to work is amazing.  Her ability to take care of herself but still take care of everyone else.  There are sooo many things that I can only name a few because she is the best mom and my hero.

What have been the major factors that have contributed to your mom's constant improvement?

My mom always envisions herself going back to the "Old Laura" and I think having that goal in mind is probably the biggest factor.  Also, if it weren't for her psychiatrist, she may not be where she is today because he is the best of the best.  I also can't forget about family.  It is very hard for a husband, in today's society, to stick around and my step dad has been her rock and is a stand-up guy.  It's also important that she keeps busy and she does that about 6 days a week so she doesn't lose her motivation.

What is one piece of advice you can give to a child who's parent has Bipolar Disorder or another Mental Illness?

A piece of advice I could give to a child with a parent who has a Mental Illness would be to educate yourself on the disorder and never stop being there for them because having a very strong support system, who understands Mental Illnesses, is a major part of their healing.  Just never give up and love them unconditionally.

   After my onset, I went through a lengthy period of deep depression.  Many days were spent either curled up in bed crying or on the couch with the inability to do the simplest of tasks.  Personal hygiene flew out the window and I had to be reminded when to shower (still do occasionally).

   I can't remember who's bright idea it was to get a puppy but the discussion came up.  Everyone was excited to get one and everyone promised to help take care of it.

​   It had to be a hypoallergenic dog as I had allergies.  We knew we wanted a small dog as our home and yard weren't very large. Also, due to my mental and physical state, at that moment, I didn't feel like doing multiple marathons a day to meet the requirements of a larger dog.  Everyone did agree that they would help me with walking it though.

   We knew we didn't want one from the pet store as around here the stores are provided with their dogs from puppy mills.  We started looking online and found an older gentleman, living 4 hours north of us, that had Yorkie puppies for sale.

   I was actually EXCITED en route to see our potential new addition to our family!  When we got there, the gentleman was walking around his yard; 1 beer in his hand and 1 in each of his side pockets haha!  The pups however were in great shape; needed a bath and grooming but were well fed and happy.  I saw a tiny male Yorkie and he said, "You don't want him, he's a dud".  At that moment I knew he was MY dog! A dud?  All because his right ear was bent?

   It was love at first site for me; I had a little man to take care of.  We brought him home and while sitting around the dining room table with him ON the table, we all threw out names until we unanimously chose "Boomer".  

   Now when everyone left in the morning for school and work, I HAD to get up and bring this little guy out for his business and I HAD to ensure he had food and water.  Boomer is a very sensitive and emotional dog.  Not only does he sense and respond to my emotions but he visibly displays his own.  He has become a true companion animal for me.  I can't help but not laugh over the silly things that he does.  I can't help but not melt over the unconditional love that he gives me.  I can't help but not be forever grateful that he is in my life as he truly gave me the motivation and the reason to get up.  I love Boomer to pieces!

   One final note:  the family promise to help out with him never happened!!

   I was blessed right from the get-go.  
 
   After my admission to the psychiatric unit, I was assigned a psychiatrist.  He was very thorough with his assessment of my bipolar disorder, even going to great lengths to interview my husband, daughters, and parents to determine if there were any previous indicators.  He not only sent me to 2 other agencies for confirmation but scheduled extensive blood work up, at CT scan, and a neurologist, to rule out any other medical conditions.  In my opinion, that was Point #1 for him, as it showed he didn't have an ego and based his diagnosis on ALL findings.

   His office is a sterile environment and has little photos and objets d'art from around the world.  He detests fluorescent lighting so his office is illuminated by a soft white desk lamp and a light box. Oh, and 1 half-dead poinsettia!

   He is an old-school type of psychiatrist that still uses pen and paper to maintain his notes and does not have a computer in his office,  He knows my husband and both my girls by name.  Surprisingly, he remembers where both of them live and go to school.

   When it comes to his treatment of me, he is always caring and empathetic.  Not once has he undermined my symptoms or frustrations.

   I know I am very lucky as I am aware of the new style of psychiatric care in which a patient would see their psychiatrist for either a prescription change or if their episodes have worsened, their General Practitioner for maintenance, and a therapist/counselor/psychologist for their talk therapy.

   I really don't like that 3 tiered approach as I truly don't believe that ANY of them have the opportunity to get to know YOU!  3 different people, 3 different views, 3 different approaches, 3 different spread out appointments?

   When I'm in the waiting room, where all the psychiatric offices are, some of the psychiatrists come out EVERY month and ask if I am so-in-so.  THEY don't even know who their patients ARE!

   My psychiatrist is typically great on his 1 hour scheduled slots but I don't mind waiting as I know he is providing QUALITY care to someone that needs it.  Sometimes we are done in less than an hour, other times, when I am having difficulties coping, and we go over an hour, he doesn't kick me out, he LISTENS.

   I've been with him for over 6 years, actually since my onset, and I've never seen another (nor do I want to).  He has been relentless in supporting me through my trials and tribulations with the multitude of med changes.  He doesn't play Dr-knows-best when I suggest something I've researched and will either try it or tell me it isn't really beneficial for my set of circumstances.  You know why?? Because he knows ME.  We've always worked as a TEAM towards my Mental Wellness.

   I don't know how many times he  has told me that I'm one of his strongest patients yet most confusing, not only with my med resistances and sensitivities, but with my ever-so-present bipolar symptoms.  Over the last 6+ years, we still haven't found a combo that provides me with relief.  I am very lucky though as he is like me, very patient and persistent, we keep trying.  He hasn't thrown in the towel and neither have I.

   I have become very anxious however, over the last year, ruminating over the day he announces his retirement.  I will be assigned one of those pill pushers, who are clueless to who you are and can't remember, from appointment to appointment, where you stand mentally, emotionally, and physically, without referring to their notes.  I will no longer be Laura who has Bipolar Disorder II, but will become a case file in the system.

   I'VE ALWAYS WORKED!!!   From the age of 15, I've been in the workforce.  Even after I had my 2 girls I've worked.  Not only did I work but I volunteered on various committees and fundraisers!

   Until 6 years ago.

   Until 6 years ago.

   Until 6 years ago I had striven to be a productive member of  society.

   Until 6 years ago I could hold my own if need be.

   Until 6 years ago I was very VERY happily employed, had a circle of friends, and had the ability to juggle everything that life threw at me.  My life was well balanced.

   6 years ago my life changed.  I very suddenly and unexpectedly got sick.  Reality check; I was diagnosed with Bipolar Disorder II then signed off on Short Term Disability.

   6 months later, I did try and return to work, on modified duty, but due to my significant cognitive impairments, I had great difficulty performing my duties.  Thus, the next process of being approved for Long Term Disability.  I was approved but the process as to be be reviewed annually, which kind of depresses me, as my psychiatrist has to fill out the lengthy paperwork, reconfirming my diagnosis, symptoms, impairments, and treatments.  To me, it's like slapping a label on my forehead each and every year, although I do know it just part of the process.

   To this day, I still struggle with the fact that I can't work at the moment.  I've considered volunteering, at our local Community Living Center, working with adults with Developmental Disabilities, as that was what I was initially trained to do, BUT...I NEVER know how I'm going to wake up every morning so I can't commit to a schedule.

   I was resigned that I had to be content with being the best homemaker/mother/wife that I could be. Making sure everyone's needs were met, cooking, cleaning, baking, laundry, yard work, paying bills, etc.  The first few years I was happy with that but over the past year, I no longer felt I had a "purpose" in life.  I was going through the "what's-in-it-for-me" phase.

   Don't get me wrong, I am EXTREMELY grateful that I have Long Term Disability benefits!  Missing work however has become a major sore point for me.  I just feel like it isn't fair, but, it is what it is, so I have to make lemonade with my lemons.

   Again, as I mentioned in a previous post, it was my hubby's idea to become "engaged" in social media and to construct, write, and maintain my website as I had become very perturbed with the stigma surrounding mental illnesses.  Not only would I get my voice heard but I was also rewiring my brain with the strenuous work of learning computer work and writing.

   With this work however, comes periods where some days I just can't simply work.  My brain just won't cooperate with my demands.  I become infuriated with myself then depressed that I can't even function in the comfort of my own home.

   Thankfully,  I have an amazing support team, made up of my family, a handful of sincere friends, and my psychiatrist, who honestly believe that if I persist to push myself, I will continue with my slow but steady improvement.  My psychiatrist has faith in me and has not "written me off" ever to return to work.  He says I am a very strong person.

   On an end note, having a support team that has continual faith in my progress, has made be believe more in myself.  Yes, for now I will have to accept that I'm on Long Term Disability, but I will constantly shoot for the day when I CAN return to the workforce!
​
   Thank you Mr. Walt Disney; the kick in the teeth may be the BEST thing for me!

**Note:  Please don't inquire about which medications I was on as I've been on about 25 over the past 6 years and don't recall side effects (or no benefit) I had with each.

   A few months prior to my onset of Bipolar Disorder, I was initially treated for depression due to being constantly antagonized (not an understatement) by an individual (eventually they were the one that pushed me over the edge).

   The medication my General Practitioner had put me on for the depression was not improving my depressive state and I continued to sink lower and lower until my breaking point.  I just cope with the abuse any longer.

   During my days in the psychiatric unit, they put me on my first "med cocktail" (a combination of more than one medication) that being an anti-depressant, an anti-psychotic, and a mood stabilizer.  The first 2 years were a nightmare of adding, removing, upping doses, lowering doses, within that "cocktail", to try and put me on an even keel.

   I honestly detested taking my medications but I did know that it was the best for my mental wellness.

   Within a 1 year period, I gained 84lbs.   I went from 98lbs to 182lbs!  Almost doubled my weight!  I had not only lost all my flexibility, muscle tone, and stamina, but also my self-esteem.

   I was eventually informed that one of the meds I was on (don't ask me which one!) didn't trigger the little switch in my bipolar brain that told me when I was full! I had an insatiable appetite!

   I decided it was time to put my life back in my own hands, straighten up my back bone, give myself the kick-in-the-arse, stop whining, and do something about it.

   I first set my S.M.A.R.T.  weight loss goals (I use this method for most things).  Then all I did was change my "eat-every-thing-in-sight" lifestyle to a healthy one!  Haha! Not one diet pill, fad, or gimmick.  I ate 5 small nutritious meals a day and when I did get the urge to snack I ate 0 calorie fruits and veggies.  Oh...and A LOT of water...with lemon slices.  One the 1st anniversary of my change in lifestyle I lost 40lbs.  By my 2nd anniversary I lost 22lbs bringing me to a comfy 120lbs.  Now that my metabolic rate is back up I do have some freedom to enjoy those forbidden tasty treats that I do love.

***Possible trigger***

   Back to the search.  I will be blatantly honest here.  I'm not truly happy.  In fact I haven't had a day of sincere happiness since my onset.  I wear my mask everyday and it is wearing me out.  It sucks.  Two months ago, I broke down crying to my psychiatrist that I wanted peace.  I hated how I was feeling and I was tired of fighting but promised him that under no circumstances was I going to self harm or end my life.  At that moment, I cracked, I was helpless, I was so very tired.  Okay Laura, let's look back on what you haven't tried.  He prescribed me a new med.  All was hunkydory when one month into it I became very physically ill.  Apparently it was hyponatremia , a drastic drop in the level of sodium in my blood which caused my blood pressure and pulse to plummet in half over a 2 day period.  At the next appointment we tried another new medication. Again, all was fine, until week 3 when I woke up with a full body rash! I have no luck whatsoever.  Now, I'm on ANOTHER one and 2 weeks and so far so go.  I don't feel any change but no reaction.  Let the trials & tribulaltions of "In Search of My Med Cocktail" continue.  I will reblog if and when we become successful.

   I apologize for the length of this post, but I thought it was important to show how tedious it is to get an accurate diagnosis.

   Well I wish I could tell you it was an easy process...but it wasn't. It was long, and at times, a very grueling one.

   Fortunate for  me, because of my short stint in the psychiatric unit, I was immediately assigned a psychiatrist, one that I instantaneously connected with, I've had him, and only him, for a little over 6 years, and our family absolutely adores him.  He is an old school pen, paper, and files kinda guy, he counsels me for one hour a month, and isn't the typical pill pusher  type of psychiatrist.

   Initially, the process started with a lengthy questionnaire, that I had to fill out, and he tabulated the results.  Based on what the ER on-duty psychiatrist had documented and his results, based on his interview with me and my husband, as well as the questionnaire, his initial  diagnosis  was Bipolar Disorder II, Rapid Cycling, Mixed State.

   He then scheduled me for blood workup, a CT scan, and EEG, to rule out tumors, and to a neurologist, to rule out out MS or any other neurological disorders.  I passed with flying colours.  Was that a good thing or a bad thing?!

   At my next visit, a week later, he interviewed my parents, as he wanted feedback on what I was like as a child, in elementary school, and in high-school.  He wanted to see if there were any early warning signs or symptoms, as late onset at the age of 41 isn't the typical.  The typical age of onset is before the age of 25. (Source NAMI.org)  Yes, I had a very "normal" (sorry again) life, I was always cheerful, had a great long-lasting circle of friends, and did well at school.

   He also interviewed my two girls to find out what kind of mother I was. HaHa! They said I deserved the mother-of-the-year award as I was so loving, I took great care of them, I never raised my voice, I did crafts with them about every other day, I read books to them nightly, I always included them while I was cooking or baking (Mommy's Little Helpers!).  I taught them manners, how to respect their elders, and I taught them the importance of being involved in their community.

   So basically, until the "event" that triggered my Bipolar Disorder, I was fine in all aspects of my life.

​   Now the torture begins!  My psychiatrist referred me to a specialist at CMHA (Canadian Mental Health Association, in Toronto, Ontario).  I had 2 sessions, each lasting 4 hours, of interviews, question and answer period, mind games etc. After each session my brain felt like it was about to burst!  I was a little deflated as the specialist confirmed the initial diagnosis of Bipolar II Rapid Cycling Mixed State (this I will discuss in a later post on how this feels for me).

   Lastly, my psychiatrist referred me to Baycrest Heath Sciences, also in Toronto, Ontario, which typically serves the older population who have dementia, Alzheimer's,  and cognitive disorders.  Yes, I was only 42 at the time, and a long ways away for being considered part of the "older population", I was referred to Baycrest Health Sciences as they are one of the leading centres in brain health.  Similarly, as with those who have dementia or Alzheimer's, I have cognitive issues, that being in my "frontal lobe" (the front part of your brain) which affects my "executive functioning" (difficulties with planning, verbal fluency (grasping for words), inability to multitask, difficulty processing, storing, and retrieving information, loss of interest in activities and trouble planning for the future). Note: At this point my IQ had actually dropped, since then though, due to my new learned brain exercises, it has gone up. 

   Now with that large serving of information, I had learned a lot about my physical brain, how it works, and where my deficits lay.  The specialist relieved me, that I was not headed into early ages of dementia or Alzheimer's, but my cognitive  impairments were clearly caused by my Bipolar Disorder.

   So, the bottom-line is, being confirmed by psychiatrist and two highly trained specialists, that I have Bipolar II Rapid Cycling Mixed State.

   It was a long and tedious process, but was important to me to get a proper diagnosis.

   I will now leave you,  as that was a lot of information to process!  I will address more on this in upcoming posts.

   To be blatantly honest, I don't remember the next 5 days.

   Once upon a time, the was a "normal"(my apologies on using that word) Laura.  It was one month after my 41st birthday.  I apparently was alert, zero signs of anything concerning or abnormal. I got dressed in my uniform, drove to work, and chatted with some of the staff.  I then took some of my co-workers to an industrial building, when suddenly I stopped walking, I was unresponsive, somewhat like a catatonic state.  Someone brought me home (to this day I don't know who it was).  

   I then perked up and insisted on going to Canadian Tire (local hardware store), wearing a skimpy black dress.  When my husband and I were touring through the store, I thought that I must have a 200lb concrete bird bath and started dragging it down the aisle.  Hubby put that back.  I immediate discovered a $2000 BBQ that we HAD to have, which I started wheeling down another aisle, even though we had a perfectly good one at home!  Let's just say hubby got me out of there quick before I actually purchased something outrageous.

   Remember, I STILL don't have any recollection of anything!  I apparently was very happy when we returned from the store and BBQd steaks, on our perfectly good BBQ.  I even sauteed mushrooms and onions, baked some potatoes, and whipped up a Caesar salad for the family.

   After dinner, hubby noticed that I was starting to crash; slurring my words, walking very slow and staggering, so he told me to sit down in a chair, that he had put out for me in the sun, while he worked on his car.

   I guess at some point, I went into the house and made 5 superficial cuts on my left forearm.  I went to the adjoining door to the garage telling him, "Hun, I've been a bad girl".  His response was calm with an "Oh Geez".

   He then realized that something seriously wrong with me and immediately drove me to the ER.  After being examined by the on duty psychiatrist, who gave me an initial diagnosis of Bipolar Disorder with psychotic features, I was convinced to voluntarily admit myself into the psychiatric unit for observation and initial treatment, I was not placed under the "72 hour watch". (Note: I STILL have no recollection of these events!

   After 3 days of being on the "lock down" side of the unit, I finally awoke from my state and was alert.  The nurse came in, with a big smile (one of the two nice nurses there, in my opinion).  She asked me where I was, I looked around and replied, "a hospital".  I provided her with my name and date of birth.  It was only when she asked me what day it was, that I realized that I had lost a few days!

  They then transferred me to "other side" of the psychiatric unit, assigned me my room, with another female, and was encouraged to mingle and participate in the group sessions.  I volunteered to stay an additional 5 days to ensure the med therapy, the had given me, was working.

   I hate to say this, I wanted to get out of there so much sooner and so did my husband as it wasn't the most healing environment.  I realize the staff had their rules, but it was run literally like a jail (maybe worse).  If I was exhausted by the end of the day and asked politely if I could take my night meds a half hour earlier, they would just point at the clock, give you a dirty look, and state, "medications are distributed for another half an hour", and slide the plexi glass window shut.  All the lights were shut down at a specific time; bedrooms, halls, most of the common areas, except the nursing offices.  If I got up in the middle of the night, as I wasn't quite tired, I would quietly grab my book, and walk to the common area, that did have a light on, and sit and open my book and read.  The two nice staff, would come up to me smiling, and quietly ask, "you can't sleep?" and I would tell them I would only read for a little while, as reading made me sleepy, and I would return to my room shortly, which I always did.  The rest of them however, would scold me like a child and send me back to my room like I was being punished!

   The hospital, as a whole, is very lovely; comfy chairs, warmly painted walls, lovely art work on the walls, and nice new magazines.  However, the "psych ward" was a totally different experience; mismatched furniture, old torn magazines, it's not a warm and nurturing environment; it's cold with it's atmosphere and staff (minus the two nice ones).

   That was my "one and only" psychotic episode that has ever occurred, due to a life altering event (the trigger), since my diagnoses in 2010.  I stay med compliant, to the letter, and use every one of my learned coping strategies so I will NEVER have to go there again!  After a total of 10 days (5 being unaware, 5 being aware), I was discharged to go home.

   I do however, stop in several times a year, to drop off new magazines that I have read because I know they will be appreciated by the residence. 

   So, if you have some fairly not abused magazines or puzzle books you aren't using, please don't throw them out, and consider donating them to your local psychiatric unit!

When you first met Laura, what was she like?

When I first met Laura, I saw a blonde bomb-shell.  Some of the guys at her workplace said to check her out.  
The first time I worked with her, I was volunteering, showing a bunch of Brownies, that Laura was doing a presentation with, how a Fire Fighter puts on his/her gear.
Laura was extremely happy, extremely energetic (I'm not exaggerating with the extremely), big blue eyes, bright smile, and raring to go.

Laura's Bipolar Disorder didn't manifest itself until after you were living together.  Why did you still marry her?

Even though she was diagnosed with Bipolar Disorder and her behaviours were different, Laura knew she needed therapy, and we assumed things would get better.

We sat down, and we said we would be committed to do everything possible to regain her mental health.  I told her not to allow the Bipolar Disorder to consume her but to turn it into a success. 

**Note:  I find this question offensive as would you ask the same question if I had cancer or was in a vehicle collision and was paralyzed?

How has Bipolar Disorder affected your friendships, personal lives, and professional lives?

In the beginning, I had to take off a significant number of days due to Laura's deep depressive cycle and to attend the numerous specialist appointments.  My previous employer wasn't understanding nor tolerant with my absences.  I have since changed employers who is very understanding and accommodating.

Our friends, that were close to us (therefore the important ones), all were completely understanding of Laura's Bipolar Disorder and it did not affect those relationships.  We have two close friends that when they come over, they will just look at Laura and say, "you're not having a good day", make every effort to engage in conversations with her, and try to brighten her day.

How do you feel society treats people that have Bipolar Disorder or other Mental Illnesses?

I hate to say it, but society/Joe Public, even people working in the mental health care system, treat those with Mental Illnesses as 2nd rate citizens and have no regard for their true feelings (which is why so few come forth or hide behind the mask).  When Joe Public is around someone with a Mental Illness, they literally turn the other cheek, talk behind their back, and spread vicious rumours.

What do you think are Laura's greatest strengths?

When the dark cloud covers her, and there is nothing we can do to help her, she keeps saying, "It is what it is, tomorrow is a new day".

Also, no matter how low, sad, and numb she may be feeling, she wears her happy mask, as not to create any extra stress or worry for her family, especially her 2 girls.  When she takes it off however, you can visually see the amount of effort it takes her to stay strong for her family.

In your opinion, what have been the major contributing factors to Laura's constant improvement?

#1  Consistent access to a good psychiatrist who cares.  In fact it's paramount.
#2  A wonderful family support team.
#3  Constant commitment to continuing education on the disorder that she has.  It's safe to say that through self-study, in my opinion, Laura is resident expert on Bipolar Disorder.  Under Laura's psychiatrist recommendations, she has tried just about every available therapy and she is completely honest and open about the results, and she continues to use every coping strategy, that she researches and learns, and moves progressively forward.

What advice can you give to someone who's significant other has Bipolar Disorder?

#1 piece of advice for someone who's significant other has been diagnosed with a Mental Illness is to understand that this diagnosis was not caused by them, it is not their fault, and no matter how much you think that you understand what they are going through, you don't have a fucking clue.  There will be times when they aren't "there" or not themselves.  You just have to be there to ride it out.  There's really nothing you can say or do that will help them get through the episode .

I could elaborate greatly on this question alone and think that this should be discussed in another post of its own.

Listen, if the person, who is diagnosed with a Mental Illness, doesn't take their treatment seriously when they aren't in an episode, it's not fair as a partner to have to try to support them when they are in an episode.  It won't end well.