mental health

Misconceptions I Used to Have About Bipolar Disorder

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.

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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).

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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 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 Know

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.)!”

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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.

Some Advice

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:

  1. Ask them, “What is that like for you?” Remember that it can be different for everyone.
  2. If you are concerned about them taking care of themselves, ask them what they are doing to help themselves manage it.
  3. Educate yourself.
  4. Other than providing them with any support they may ask for, treat them the same way you did before you knew.

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*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

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Moving Abroad With Mental Illness

Many of you have (kindly) asked how my move to Hong Kong and transition to life here has affected my mental health. This past April, just over a year from when I was diagnosed with Type 2 Bipolar Disorder and a slew of other anxiety and panic disorders, I started a new combination of medications. One is an anti-depressant, and one is for severe moments of anxiety. I had reached what felt like a breaking point in my life and this was the third treatment option my doctor and I were trying.  Within just a few weeks I was stunned to realize that I felt “normal” for the first time in as long as I can remember.

Normal meant I was no longer waking up in the morning with twisted knot in the pit of my stomach before I had even opened my eyes. I no longer entered each day feeling defeated and on edge, like at any moment the tenuous rope of functionality I was holding onto could unravel. Yes, some days I still struggled with anxiety, especially when faced with something particularly triggering. But where my base level for anxiety used to never dip below a 4 on a 10-point scale, even on my most stable days, now I find that many days, my baseline is a 1 or a 2.

The best way I can describe it is that it feels like relaxing your muscles after holding them all in tension every moment of every day for years. Most days this feels like a miracle.

The past few months have objectively been extremely stressful. I think the stress of moving internationally, changing jobs, and being separated from your spouse are things that would cause anyone a decent amount of anxiety.  I don’t deny that there have still been moments where I have been overwhelmed with anxiety and fear. I have also been deeply sad about leaving behind my life in Columbia. But the thing that stands out to me is that somehow, I have managed to cope in a way I don’t think I could’ve done a year ago, or even back in March. And not only cope, but find moments of sheer joy and new excitement for this new life.

I can’t describe my gratitude for this. And at the same time, I have to acknowledge the fact that I am not “cured”. I am on a journey. I am managing so much better than I was a year ago, but it’s not as simple as just popping those two little pills each night. My mental health is a holistic battle and the reality is that it will probably be a lifelong fight.

This past Sunday we visited a church for the first time since coming to Hong Kong. We haven’t really met anyone here besides coworkers, and we are hoping to find a community. Throughout the afternoon I could feel myself getting more and more anxious. By the time we left our apartment, I felt like I was in a daze. Everything seemed a little too bright and blurry around the edges and the sounds around me were like a low buzz in my ears. Jonathan tried to talk to me about other plans for the night and for the future, and I could barely process what he was saying to me. Eventually he gave up talking to me until after the service was over.

After we sat down in the church auditorium (which looked like the church auditorium of many an evangelical church in America), all of my thoughts and all of my energy were consumed with trying to get through the service without panicking. Understand, it was a perfectly normal evangelical-style church service. There was nothing particularly objectionable about it. But for most of the service I felt simultaneously like my skin was on fire and like I was going to pass out. “You are OK. This is OK. There is nothing wrong here,” I kept chanting to myself.

After the service was over, we ducked out and went to dinner where I tried to explain to Jonathan what I’d been feeling but failed (though he was gracious as always). By the time we got home later that evening, I was utterly exhausted. Coming down off of the adrenaline that had fueled me through the afternoon was like crashing after a sugar high. My whole body ached.

Moving abroad has helped move me out of some old patterns that were not good for me. At the same time, it’s launched me into a world of unknowns, a somewhat precarious place for bipolar planner like me.

The thing about mental illness is, it’s effing scary. It’s scary to feel like you don’t have control over your own mind, or that your body has these visceral reactions you may not even understand. It’s scary to know that it’s possible for your feelings to not accurately reflect reality. The fight for wholeness and wellness forces me to choose every single day to actively work towards healing.

It’s a holistic effort. Medication is a blessing, but it is not enough. Meditation, exercise, and diet help. Nurturing life-giving relationships helps. Prayer helps. Avoiding triggering situations helps. Turning off the introspection to show love and care to the people I encounter every day helps. But the thing that helps the most is hope. Hope each morning when I wake up that today can be a good day. It can be good no matter what yesterday was like and no matter what may come tomorrow. Today I can be well.

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PS- I just wanted to give another shout out for my new travel website www.keeproamingon.com. I’m proud of the work I’m doing there and would love to have you follow me if you are interested in sharing my travel and living abroad adventures. You can follow by clicking the follow button at the very bottom of each page.

 

 

 

 

What Bipolar Actually Looks Like

Jonathan and I left Charlotte just as the sun was setting and a few storm clouds were rolling in. We’d spent a wonderful day with some dear friends and now we were driving the hour and a half back home. As we merged onto the interstate, the sky let loose and rain started pouring down. It was raining so hard, we couldn’t see more than 3 or 4 feet in front of us. Even though Jonathan was driving, my breaths started coming faster and my palms started to sweat. When the lightning strikes were followed by immediate crashes of thunder, I asked Jonathan to pull off at the next exit. As we inched our way towards the next off-ramp, a bolt of lightning ripped through the sheets of rain with simultaneous thunder so loud it rattled my teeth. Some almost animal instinct took over and suddenly I was screaming. Pure terror gripped every inch of my body and I shook so hard my teeth chattered. I was vaguely aware of Jonathan’s hand clamped down on my knee, but I couldn’t stop screaming and sobbing until we had pulled under the awning at a gas station a few minutes later.

Throughout this entire experience, I intellectually understood that we were not in significant danger, but my nervous system had kicked into override mode and there was no amount of reasoning that was going to turn it off. I wanted with everything in me to be OK, but I was most definitely not OK. All we could do was wait out the storm.

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It’s been a long time, friends.

I have wrestled with both wanting and not wanting to write this post for months. There are at least a dozen other posts I’ve wanted to write and felt that I couldn’t, because writing anything without writing this first felt dishonest. At first, I didn’t write because it took me some time to process and accept and articulate what all of this meant. And then, I didn’t write because I was afraid. I have been afraid of what you will think and how you will respond. Of the labels and the judgements you might make because of stigmas and assumptions and misunderstandings. But truthfully, my biggest fear has been of how this may impact my current job or future job prospects. I am terrified that someone will find a way to twist this honest admission of struggle into incompetence.

Over the past few weeks I’ve felt increasingly convicted that it is time to write about this, if not for myself, then maybe for one of you. I can’t be a slave to fear anymore. If writing this means that one person feels less alone, then it will be worth it.

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In March I was officially diagnosed with general anxiety disorder, panic disorder, social anxiety disorder, and bipolar depression. The anxiety and panic disorders were old news (see panic attack because of thunderstorm), but the bipolar thing threw me for a loop. I mean, bipolar people are like, legit crazy, right?

Which is why I initially fought with my psychiatrist about it.

Dr: You’ve identified periods of depression you’ve had consistently for about 10 years, and you said you recently came out of a depression. Have you ever had a manic episode?

Me: Definitely not.

Dr: Manic episodes are characterized by decreased need for sleep, racing thoughts and ideas, talking more than usual/more quickly than usual. Excessive involvement in pleasurable activities like spending sprees.

Me: I mean, yes, sometimes, maybe, for a few days or a week or whatever. After I finish being depressed. And I just feel so much better. And then I have lots of energy. And lots of ideas. But I mean, that’s only natural, right? And then I want to go shopping. But I return half of the things the next week!

Dr: Increase in goal-oriented activity?

Me: Does this sticker chart I just made for myself where I give myself stickers for things like “showering” count? (Produces sticker chart)

Dr: I’m going to say yes.

Me: Ok then.

Eventually I gave in and she explained to me that my particular bipolar disorder is a form of depression. People who suffer from depression generally fall into three categories. Category 1 are people who have a pretty normal baseline, suffer from a depressive period where they fall below the baseline, then come back to baseline. Category 2 are people who sort of exist at a consistent emotional level that is below the average baseline. And Category 3 are people who have a normal baseline and periodically dip down into depression, but sometimes instead of coming back to baseline, spike into hypomania before even-ing out. I’ll give you three guesses as to which one I am. It is also possible to experience depression and mania at the same time in a mixed episode where you feel frantic energy, like you are on speed, but also feel overwhelmingly sad. In my experience, these are the worst.

In some ways this came as a huge relief—for years I had believed that everyone else experienced the same intensity of feelings that I did, but that for some reason, I was just incapable of dealing with ordinary life, ordinary stress, and ordinary emotions the way everyone else seemed able to. The assurance that what I feel and experience is, in fact, more extreme than the average person, was somewhat comforting. To be able to say, “I’m not just bad at adulting, it’s legitimately harder for me than for some people,” was a huge relief.

In another way it brought a huge amount of shame. I was raised by strong parents, in particular a strong mother, who instilled in me the belief that willpower and discipline could cure most ailments. If I complained of cramps, she’d advise me to do crunches. If I was feeling sort of unidentifiably achy and feverish, she’d advise me to run around the block to “sweat it out.” And while she certainly acknowledges mental illness as a legitimate condition, she also believes in self-sufficiency. Her response to this situation was supportive, but something along the lines of, “You have to do what you have to do, but I believe in resilience, and someday you will too.” I couldn’t help feeling that I was lacking some critical measure of resilience that would have solved everything.

I was also ashamed of having this label fixed to me publicly. While I have written openly about anxiety, panic, and even depression, something about the specific words “bipolar disorder” felt different. Anxiety and depression are feelings that most people experience to some degree within their lifetime, even if it’s never a chronic struggle or doesn’t manifest in panic, but “bipolar” was something different. At best, it’s a punchline, and at worst, the type of condition that a Jekyll/Hyde style villain in a psychological thriller suffers from. There is a stigma associated with the word that I was not was not prepared to take on. I didn’t know how I felt about having that label, what it said about me, and how it would change the way other people viewed me.

Seven months later I can say that it has changed everything, and it is has changed nothing. A diagnosis is descriptive, not prescriptive. It is simply a name for things that have been true about me for years, how I am wired, and how my brain works. Understanding this truth about myself has given me greater self-awareness and self-compassion, but it has also challenged my own ideas about mental illness and the stigmas that go along with them.

In the deepest core of my being, I believe that courage is the antidote to fear and that bringing things into the light is the only way to live wholeheartedly. So here is some truth to combat the lies of stigma.

In case you were wondering, this is what a bipolar person actually looks like.*

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Here I am rocking pajama day for Spirit Week. Like a real adult. Responsible for molding young minds.

 

I have a meaningful job where I feel like I am impacting lives every day. I love it, and I am excellent at it.

And for the last three months I have woken up almost every day with such a incredible heaviness and sense of dread that it has been difficult to get out of bed, much less go into work.

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Serious stud.

I have been in a committed relationship with my husband for 10 years (married for 7) and I think he is the greatest human being I have ever met.

And I am often so exhausted after a day of managing my anxiety enough to fulfill all of my obligations that I can’t muster the mental or emotional energy to talk about his day or even share what happened in mine. My moods also change very rapidly, so a casual date night can turn into a SERIOUS DISCUSSION OF ALL THE PROBLEMS (INCLUDING CRYING) at the snap of a finger.

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I have wonderful friends who love me beautifully, and more than I deserve.

And I often feel worlds away from them because the reality of my every day life and what is going on in my head makes me feel like I live on a different planet than they do.

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Prague with my boo-thang

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Whitewater rafting after my brother’s wedding

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Me and my mom at a freaking ED SHEERAN CONCERT!

I love having adventures and trying new things. I think I’m a pretty fun person.

And I get a splitting headache and heart palpitations after being at large group events, like office Christmas parties or school-wide bowling. I get physically ill when traveling internationally, even though it is my favorite thing in the entire world.

I am learning to make peace with who I am.
I learning to seek help when I need it and to accept that not everything can be solved with willpower. I believe that I can learn ways to manage my mental health and for me and my loved ones to be healthier and happier, but I also accept that I may never be entirely “better.”

These October mornings, when I wake up with a pit in my stomach and a heaviness in my belly, I say to myself, “You do not have to be better. You only have to be brave. And you have been brave for so long. You are stronger than you think. You can do it again today.”

Whatever your mountain is today, please remember. You are not alone. You only have to be brave. Just for today.

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*As a disclaimer, mental illness is a very individual experience, and there are many types of bipolar disorder. My symptoms and experience of bipolar disorder are not identical to someone else’s. For example, I’ve never suffered from psychosis, though many people do. My depression is primary and is heavily influenced by my anxiety. I am not in any way claiming that my experience is the definitive for people with bipolar disorder and I have no medical or professional training in dealing with these illnesses.