As Nick grows older, his symptoms grow worse, and he becomes more and more depressed, even when times are "good." This is also common with the disease. Nick's brain did not see things the way others do, and he was like a confused child in many ways. Lithium helped the disease, which is also common, but it constantly has to be controlled, and so Nick endured highs and lows as the medication altered. He simply could not contend with the lows. The book very accurately portrays the life of a manic-depressive. It is clear to see how difficult it was for Nick, in the middle of it. It is also an accurate depiction of the progression of the disease, and how it affects everyone, from friends to family, and how difficult a disease it is to successfully treat. Steel clearly indicates how difficult it is to live with this illness, and nearly shouts out how she did not understand the severity of the illness, and how deadly it can be. She writes in the Prologue, "And alongside them [the mentally ill] are the people who know and love them" (Steel, 1998, p. xix). Her decision to write the book shows how difficult it was to see a loved one suffer from mental illness, and how difficult it was to be him, trapped in his own body. It is quite clear throughout the book that Nick was a difficult child, and I doubt I would have had the infinite patience Steel seemed to have with him. He "acted out" before the term was popular, but his behavior was often so outrageous, that it was clear something more was wrong that simply "growing up." It is hard to imagine how it felt to be inside the body and mind of this disease,...

He could not understand his demons when he was young, and it seems like his life was painful and full of anger from the time he was a baby, and he could never understand why. That is sad and frightening at the same time. Steel notes, "Nicky's world revolved mostly around himself, and by sixth grade, he had become singularly self-involved, and appeared to have no particular interest in other people's needs or problems" (Steel, 1998, p. 50). This indicates his own self-involvement with his condition, and his lack of understanding at what was happening. It is a sad thing for a child to bear without help.
I do think reading this book has given me additional insight into what it is like to suffer from mental illness, and what the family suffers. However, I do not think it will change how I will care for clients with mental illness, because I have always been aware these clients needed understanding and hope, as well as physical and mental care, and I have always hoped to give them that, as well as care and nurturing. The book did make me feel just how bleak and hopeless life seemed to Nick, and getting inside his head in his journal entries was enlightening and terrifying at the same time. It made me wonder how many other people are suffering the same torture without being diagnosed, and made me hope they get help, and move on to better lives. I hope I can treat my clients with manic-depressive order with understanding and awareness after reading this.