In 2012 cartoonist Ellen Forney published a graphic memoir about accepting her diagnosis with bipolar disorder, a mental illness in which one experiences extreme mood swings, ranging from manic highs to depressive lows. Now Forney has returned with a sequel, Rock Steady: Brilliant Advice from My Bipolar Life, a personal guide offering practical advice on coping with the illness, that will be published by Fantagraphics Books this month.

In Forney’s earlier book, Marbles: Mania, Depression, Michelangelo, and Me (Gotham Books), she told a personal story about her diagnosis with lessons from her life. In her new companion self-help guide, she offers very specific advice as well as a variety of therapeutic tools for mood disorder management and maintenance in graphic form.

Rock Steady is being released at a time when works of graphic medicine—nonfiction comics narratives focused on illness and recovery—have shown increasing popularity and acceptance by medical professionals as well as consumers. PW spoke with Forney about her new book, what she’s learned since the publication of Marbles, and the ways that mental illness is perceived and understood in our culture.

Why did you choose to create this kind of book as a follow up to Marbles?

A lot of people told me that [the memoir] was really helpful, not just my personal story, but the tools [for coping with mood disorders]. There was a lot of stuff that didn’t fit into Marbles and there is certainly a lot that I have learned since then. I love research, so I figured if people were using Marbles like a manual, that I could do a better manual. There was a lot of research on my part in Rock Steady, and I was also working with a psychiatrist as a consultant all the way through it.

What would a sequel to Marbles be? Ideally, how to maintain stability, which doesn’t have much of a story arch, you know? I think that’s why a lot of memoirs about bipolar disorder are about stabilizing and not necessarily about staying stable. The kind of maintenance guides that are out there are mostly by doctors and therapists, and I thought that the voice of someone who’s in it, who is experiencing those things too, could have an important angle.

Rock Steady is not a memoir, but a self-help guide. What was it like to work in that format?

One of the things [about Rock Steady] was feeling like the book was not complete. There were a lot of things that I brought up that I decided not to get into a whole lot of detail. For example with the SMEDMERTS support system [Sleep, Meds, Eat, Doctor, Mindfulness, Exercise, Routine, Tools, Support], I got into Sleep, a lot. There’s a whole chapter on insomnia. But Eat, which is the third, there is so much out there about eating well. I mostly wanted to say that what you put in your body is going to affect your mood and that is one consideration that you might keep in mind when you’re thinking about your diet.

Can you highlight something you learned from making your books that was helpful for your own self-care?

When I did Marbles, it took so much effort and so much emotional work that when I was done I felt like whatever I do next is not going to be a memoir. It’s going to be in the third person, and it’s not going to have to do with mental health. So I brought up another couple of topics, and nothing really struck me to do a book. In the interim, I got so much feedback from people who found Marbles helpful that it made me feel really purposeful. It took a few years for me to be able to come back and say, “I really like doing material about mental health and I feel like I have more to offer.” What I needed was a break from it and, in the interim, I feel like I became a mental health advocate or activist. I’m really excited about and comfortable with that role.

What is the biggest misconception about mood disorders such as bipolar disorder and why does it have a stigma?

So far as mood disorders go, bipolar is hard to treat. One of the biggest aspects of the stigma of having it is this feeling that people who have some sort of mental disorder are violent and unpredictable and can never get better. I think that it’s easier for most people to imagine what depression is like. They can kind of tap into the low energy, and feeling isolated, and it’s a bit more understandable. Mania is harder to describe and harder to imagine what that would be like. Maybe it’s hard for people to understand the difference.

Your also discuss the erroneous connection of violence with mental illness

Right now [what you hear in the news is that] mental illness is related to violence. They’re not correlated! It’s really hard to argue that point because obviously people who are doing really violent, mass killings are not thinking well or are not emotionally well. They’re not stable. But it’s just not correlated with mental illness. The proportion [of people committing violent acts] that have mental illness is small. And if you look at the population of people who have some sort of mental illness, very few are violent, and they are most likely to be violent against themselves.

What can we learn from your book about dealing with someone who is suffering from mental illness?

One thing we hear all the time is “you are not alone.” I personally prefer to say, “you have company” because you have a thing, not that you lack a thing. As the author and being a bipolar person myself, I am giving you company. But also that it’s hard [to deal with this illness].

We see so many articles about what you “should” do. You should get enough sleep. You should do this and here’s a list of ten things that make it better. We can know all these things, but it’s hard to incorporate [all of it into your life] and remember everything. I think [those of us suffering from mental illness] can feel guilty, like we are not doing what we “should” be doing. We can feel bad about ourselves, like we’re failing, when really we need to know that it’s hard, that we have a lot of company, and that all we can do is the best we can do.