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    Home»Mental Wellness»I Hate Hope: How to Manage Hope When You Have Treatment-Resistant Bipolar Disorder
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    I Hate Hope: How to Manage Hope When You Have Treatment-Resistant Bipolar Disorder

    William MillerBy William MillerApril 16, 2026No Comments8 Mins Read
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    I Hate Hope: How to Manage Hope When You Have Treatment-Resistant Bipolar Disorder
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    I hate hope. I really do. Whenever I feel it, I try to suppress it. And there’s a good reason for it. Hope leads to despair, and despair leads to depression and suffering. You might think I’m being negative here, but I’m not. I am being realistic and speaking from experience. If you have treatment-resistant bipolar disorder (or anything else), you know what I mean. I feel like hope is a mirage that eventually takes hold of my ears, nose and throat. I hate hope, and hope is dangerous. But it happens there again and again. So, I have tried to find ways to manage my hope so that its benefits continue without harming me.

    I hate hope, but hope is real

    Hope is a real thing, and I know you feel it. I know this because you are alive. All living things experience hope to some degree. It may be small. It may exist only in certain situations. This may take a long time. But no matter what, hope exists somewhere deep inside.

    I have come in contact with this hope and know that it keeps me alive. Sure, most of the time I won’t feel it, but if it weren’t for hope, there would be no point in being here. I believe that there may be a day in the future that is better than this present day. And that’s hope, in all its disturbing glory.

    Why hate hope?

    Most people like hope. Most people think that hope is the most important thing you can have. Most people think there is something wrong with you if you are not experiencing and supporting hope. And this is especially true when you’re dealing with an illness or a disability. Who hasn’t heard countless stories of cancer patients who “never lost hope” and beat the odds? Who hasn’t heard of the person who was told they would never walk again, but later found out they “kept their hope” and danced at their wedding? Who hasn’t heard of the coma patient who wakes up because everyone around him “hoped so”? Such stories abound, and make us realize the scarcity of being sick or disabled without hope.

    But here’s a secret no one ever tells you: Hope can kill you. I am not exaggerating. The influence of hope certainly has the power to destroy and even take away your existence.

    This is because when hope is lost, it is soul crushing. You see, many people don’t beat the odds of cancer. Many people are not able to jig after losing the ability to walk. People who doctors say won’t wake up from a coma usually don’t. And it doesn’t matter how much hope those people or those around them have. So, when a person is giving up everything on hope, even when the incredibly tall odds are against him, and then it becomes clear that he will never be able to beat those odds, it can be devastating to a fatal degree. This is especially true for those whose hopes have been repeatedly destroyed. And chronically ill patients are almost always in this group.

    If you’ve ever looked back at your 40th failed treatment, you know what I mean. That pain is indescribable.

    So yes, of course I hate hope. Hope is what leads to unimaginable suffering. And that unimaginable suffering can lead to the kind of pain that leads to suicide. There’s not much to like there.

    Can’t you feel hopeful?

    In my experience, hope exists, whether you like it or not. In fact, even if you don’t feel it, it’s floating beneath the surface. As I mentioned, I do my best to suppress that nonsense immediately, but for that to arise inside us. Duration.

    I try to go into things like new treatments without any expectations. I try not to think about what would happen if this treatment worked. I try to virtually ignore the possibility of success because I know what happens when failure rears its ugly head. And in my case, failure is the most likely outcome. Just ask any one of my many doctors.

    Recently, I underwent a round of repetitive transcranial magnetic stimulation (rTMS). This treatment had a better chance of working than any treatment I had tried in years. Things weren’t good, but at least there was a chance. And I tried really hard not to think about it. I tried to go to every painful, terrifying appointment and not bask in hope. I tried to take only one treatment at a time. Do my thing – show up, feel the pain, and get it over with. But there is little hope. Hope was in my mind anyway, even if I didn’t want it there.

    Then the most predictable thing happened: The treatment failed. I went through a whole series of treatments and got no response. And I promise you, it has absolutely crushed my being. I was more depressed than when I started because I had to deal with another failure. And no matter how much I tried to prepare for that possibility, unimaginable pain still occurred.

    Hope that nonsense is useless.

    Hope has to be managed along with your expectations

    And it could have been worse. If I had gone into that treatment, “sure” it would work, I would have been even more devastated. Anyway, I had to give up the dream of a satisfied life that I was not getting. If I had higher expectations, the situation below would have been even worse. I’ve seen it over and over again in people.

    So, if hope is so dangerous, but still insists on existing, what to do? The answer is simple: you have to manage your hope.

    This means having a very clear conversation with yourself every time you experience hope. This means being very honest and having realistic expectations about what you’re doing. I’m not saying you shouldn’t be hopeful. By SoupCon Hope is normal, and perhaps even useful. But hope can kill you by the bucketful.

    how to manage hope

    Try to base your hope on reality. If you’re chronically ill, if you’re treatment-resistant, that reality is not pretty. But although it is not beautiful, it is still protective.

    For example

    • Ask Realistic Expectations. With your doctor, focus on what is potential The best and worst case scenarios happening simultaneously. Yes, you can figure out the best case scenario and hope it’s you, as long as you understand it. probably will not.
    • Manage the expectations of people around you. Others don’t know what is likely to happen when you take treatment and they may assume it is a sure thing. Control their hopes and expectations with a realistic approach.
    • Don’t let the viewpoints of overzealous others sway you. Being around a group of people who assume you’re going to get better will put extra pressure on you in a situation you have no control over. You will also feel bad when your best does not come.
    • Don’t feel bad about not raising your hopes through the roof. Others have not been where you are. They are not you. They don’t have to deal with the effects of treatment. You do. You handle it the best way you know how. You can hate hope if you want. You don’t have to defend it.

    And finally, if your hopes are dashed and you feel wounded, even though you tried to walk forward with open eyes, don’t let yourself down. It’s very normal to feel terrible when a treatment doesn’t work. It is very human to feel bad when your hope is dashed. No problem. You need self-compassion and kindness, not self-praise.

    Don’t give up

    And now I’m going to tell you something you need to hear but don’t want to hear: Don’t give up. No matter what situation hope has taken you to, don’t give up on life. Don’t stop trying. I am not a shining example of treatment success. I’m a great example of keeping moving forward. There’s a lot you can do even without highly effective treatment. Yes, I would have liked if the treatment had been better. But even when that doesn’t happen, it’s still possible to move forward. It’s okay to pause for a moment and lick your wounds. It’s okay to feel bad. Just keep going. Believe it or not, your hope will rise again, and you will be able to try again. Ultimately.

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