There is a an episode of Crazy Ex-Girlfriend where the main character, Rebecca Bunch, finally receives a medical diagnosis for her mental health issues. From the beginning of the show, she assumed her issues were anxiety, depression, and OCD, but after a psychotic episode, a doctor tells her he has an official diagnosis for her. At first, Rebecca is relieved about this and is even looking forward to finally knowing what her issues are. Since this is a ridiculous show involving choreographed musical numbers, Rebecca sings a power anthem about how finally finding the right diagnosis will change everything. A few days later, she finds out she is being diagnosed with Borderline Personality Disorder. After a quick Google search of the characteristics, she demands that her doctor give her a new diagnosis. In that moment, Rebecca would rather live without proper treatment in order to avoid an undesirable label.
As I’ve started to write about my experience with bipolar disorder, I have heard from so many people who thanked me for sharing, but who also expressed that they struggled with their own diagnoses –not so much with managing the symptoms, but with accepting the reality that they have bipolar disorder. These are people who, like me, have struggled with their own misunderstandings of the condition and above all, with other people’s perceptions of it.
When I was first diagnosed, I was very uncomfortable with the label “bipolar.” It sounded extreme, and it both frightened and embarrassed me. But then I spent time learning about what it actually is and how my experience fits inside the spectrum of the disorder, and I started to feel immense relief. I’m sure this sounds like an oxymoron to some people, but I had a moment where a light went on and I thought, “I’m not crazy, I’m just bipolar.”
I thought it might be helpful for me to share some of the things I used to believe that made it hard for me to accept the reality of my diagnosis.
Misconcpetion #1: People with Bipolar Disorder are Erratic and Dangerous
First off, let me just begin by saying that any statement beginning with “People with bipolar disorder are x, y, or z” is probably wrong. That’s sort of like saying, “All pregnant women will have morning sickness.” Yes, there are things about pregnancy that make morning sickness more likely, but there are women who never experience it, women who are sick once, women who are sick for a few weeks, and women who are sick constantly their entire pregnancy. Whatever scale the symptoms are on does not change the fact that they are all pregnant.
In the media, we often see the extremes of BD–people or characters who are at the highest heights of mania or the lowest depths of depression. These extremes do exist, and they are heartbreaking, but they are not the definitive experience of BD. And it’s not common for people to reach these extreme states if they are receiving proper medical care.
It’s also worth noting that an official diagnosis of Bipolar Disorder is characterized by having consistent depressive periods and at least one manic (Type 1) or hypomanic* (Type 2) episode in their lifetime. ONE. Of course, lots of people have more than one. But I’m just saying, to assume that someone with BD is constantly having or on the verge of having erratic and irrational episodes is just not true.
Misconception #2: Being Bipolar Means Having Rapid Mood Swings
“My teacher is like totally chill one day and then yelling at us the next. She is so bipolar,” I overheard a 7th grader saying to her friend. People toss around the term like it’s the punchline of a joke. Sometimes I like to joke about it too, because sometimes it’s healthier not to take ourselves too seriously, but also, this perpetuates the idea that bipolar really means “Someone with wild mood swings.”
If having mood swings were the metric of what makes someone bipolar, about half of the world’s population would be bipolar approximately once a month. Have you ever started the day in a bad mood and then had something totally turn your day around? Or been in a great mood and had something bring you down? That’s a pretty normal experience. Emotions fluctuate and some people are more sensitive than others.
Bipolar Disorder does not mean having constant mood swings all day every day. It means having longer term cycles of depression, stasis, and (at least once) mania or hypomania. In many cases, those cycles come only once or twice a year.
There IS something known as rapid-cycling BD, but rapid cycling refers to having four or more cycles in a year. That is still not the same thing as having a flip of the switch mood swing or a Dr. Jekyll and Mr. Hyde personality.
In other words, sometimes, a girl is just hangry, OK? Give her some cheese. (If she is me).
Misconception #3: Bipolar People Can’t Live Normal Lives. They End Up Homeless or Dying Young and Tragically
There are two parts to this one – first, the idea that people with BD can’t live normal lives. In fact, most people with BD experience (sometimes long) periods of normality in between periods of depression and mania/hypomania.
People who experience BD with severe depression (especially if untreated) may have difficulty holding down a job because they can’t keep a regular schedule. People who experience BD with extreme mania that causes them to have delusions or make other reckless decisions (especially if untreated) may put themselves in risky situations. And yes, people who leave their BD untreated or who choose not to seek help will probably not live a healthy life.
But, BD is not a hopeless diagnosis. There are so many treatment options, both with medication and without. Some incredibly successful people are/were bipolar (Carrie Fisher, Catherine Zeta-Jones, and, for better or worse, Ernest Hemingway to name a few). In fact, I would argue that people with BD are some of the most passionate, creative, and empathetic people on the planet. Those same emotions that can overwhelm and cripple us also give us a rich and complex emotional and creative life.
When I was first diagnosed, my biggest fear was that someone would find out and think I was unfit to do my job, which involved a huge amount of responsibility of a group of teenagers. I did not want anyone to hear the word “bipolar” and make assumptions about me or my work based on that one word rather than on my character and my proven track record. I think this is a common concern for people with bipolar disorder, and that’s why I think it’s so important to educate people about what it really is.
Misconception #4: If Someone I Knew Was Bipolar, I Would Be Able to Tell
Nearly everyone I know who is aware of my condition has the initial reaction, “But you seem so (normal/competent/together/calm/happy/successful, etc.)!”
I just like smiling. Smiling’s my favorite. This face right here – this is me at the tail end of one of the most severe depressive episodes of my life.
Newsflash. The way people look on the outside and the way they feel on the inside do not always match up.
I have spent months at a time somehow getting up, putting on my makeup, pulling myself together, and doing my job with a smile on my face. And the minute I got home, I would put on my sweatpants and spend the rest of the day on my couch or in my bed barely speaking because it was SO BONE-NUMBINGLY EXHAUSTING to make it through the day. I never wanted to wear a mask, I just had responsibilities and I had to keep functioning.
Of course, I understand that there are people with BD who genuinely cannot do that. I get it. There have been at least two points in the last few years where I thought, “I’m about to break.” I honestly don’t know how I got out of bed, and to anyone else who has felt that way or worse, I believe you are doing the very best you can. But a lot of us are very high-functioning and great at over-compensating for how we feel inside.
Not only are the symptoms we experience internal and therefore not noticeable unless you are really close to us every day, but it’s also something people are afraid to talk about. At least, I know I was. Sometimes the people who suffer the most are the ones who nobody notices are suffering.
I know this has been long, but I would like to leave you with a few last thoughts. If someone you know and love confides in you that they have bipolar disorder:
- Ask them, “What is that like for you?” Remember that it can be different for everyone.
- If you are concerned about them taking care of themselves, ask them what they are doing to manage it.
- Educate yourself.
- Other than providing them with any support they may ask for, treat them the same way you did before you knew.
*Hypomania is a less extreme form of mania that usually lasts for a few days rather than weeks and is characterized by being happy/euphoric, full of energy, being very talkative, racing thoughts, feeling full of ideas and plans, and often an increase in impulse spending or in sexual desire. It does not include delusions, paranoia, or hallucinations that can come with Mania