Sue, I really liked what you said about "creating" something vs giving up something. I am an RN, a former non-smoking zealot, and did not ever think I would be a smoker in my wildest dreams. My bipolar symptoms began seriously interfering with my life around age 35. One night, working those nightshifts we bipolar night owls love so much, I just out of the blue asked a co-worker for a cigarrete with my coffee.
I was in love with nicotine from the beginning, but I kept it "social". As I grew sicker with the episodes I smoked more, but still episodically. I even went without most of 2002 without any when I took up running, chanelling my manic energy into other activities. Some were just as self-destructive as smoking, like manic sexual activity, not sleeping or eating, and spending out of control.
By 2004 I was fighting deeper, more frequent episodes. I was craving alcohol and cigarettes. I gave up running. I was irritable and lost focus as work. March 6, 2005 I had a terrible, suicidal breakdown on the job.
THIS was when my bipolar was formally diagnosed.
Fast-forward four years: I live a tightrope of being in control of this disease. I had to give up my job for Social Security (but I feel this is not permanent). And I notice I SMOKE WITH MY MOODS. It is a barometer of which way I'm going. Few cravings on stable days. But when the mood shifts up or down, I can't get enough, it seems.
I am the family outcast. Once when irritable about asking to "give up just one more thing", (when I felt like I had given up so much already), I simply told them "I guess I have a death wish. I don't know any other explanation."
Sorry for the long-winded speech. I think you're on to something. Thanks for listening.
We are studying smoking in bipolar disorder in hopes that this will lead to better treatments. Our offices in central NJ (part of UMDNJ) offer opportunities for smokers to participate in research - we have opportunities both for smokers who want to try to quit and those who do not want to quit. Most services are free and smokers are financially compensated for participating. I also developed a 2 day training program for psychiatrists to learn about how better to treat the smokers they are seeing for care of a mental illness.
Information can be found on our website.
http://rwjms.umdnj.edu/addiction/
I'm glad that this issue is getting more attention and recognition than in the past. Smoking has been the cause of early death and disease in too many mental health consumers.
I can't tell you how grateful I am for your comments on mental illness and nicotine addiction. My doctor prescribed Chantix, and I took it for three months. One of the side effects is depression. I am already suffering from depression/anxiety, and I sank into a depressive state beyond anything I've known for over ten years. Not a day goes by that I don't worry about my self destructive habit. If only there was a treatment center where we could attend daily group meetings, professional support, and fun (distracting) activities to help people create constructive and positive changes. I'd save up my money and go anywhere to receive this kind of treatment. Thanks again for all that you had to say. It relieved a lot of guilt, and helped me to feel more understood and hopeful. -Katie
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How much do you know about bipolar disorder? 
You hit the nail on the head when you said quitting was like walking right into familiar symptoms. I was able to quit many years ago, but it was the single most difficult thing I've ever done. For me it was manic-like symptoms during withdrawal. When my bipolar son can't smoke it's mania symptoms for him also. If a person can prepare for those symptoms, like we prepare for inevitable mood swings it might make the withdrawal easier.
Thanks for making us think.