There really is no other way to begin this post than…
Hello, my name is Pat. I have bipolar disorder.
I am not alone in this: an estimated one to five per cent of people in the United States are bipolar, an estimated 10 million people. The disorder affects men and women equally. I am Bipolar Type II, which means that, as far as I or anyone else can tell, I have not had episodes of full-blown mania, instead suffering from the lower level hypomania. According to the psychologist who leads my Dialectical Therapy Group who is an expert in BPD, the disorder is increasingly seen to exist on a spectrum. It’s all labeling, anyway.
I have not written about my mental illness before, although some of you either know me well enough that I have spoken to you about it, or you guessed by hints I dropped in previous posts about mental illness. Some of those posts were not exactly subtle, and I am sure anyone reading them would wonder about my own mental status.
Why disclose this now? After all, aren’t I worried that a future employer might find this post and hold it against me?
The reason is simple enough: it is going to be in the public domain soon, anyway. I have written a chapter for a book titled Motherhood, Mental Illness, and Hope: Stories of Recovery, edited by N. Benders-Hadi and M. Barber, Springer-Verlag, 2014. The book is a compilation of professional articles interspersed with stories of women who have lived with mental illness and dealt with the challenges that it poses. My chapter is called, rather prosaically, “Being a Mother Saved My Life.” (It did, too, but that is a story for another time.) Even though I have a really common name, I expect that any employer Googling me would find the book, so there really is not any reason to keep it secret here.
I have to confess, part of this is vanity: I wanted to be able to crow about being published again, and it seemed a little silly to say “I’ve written a chapter for a book, but I’m not going to tell you what it’s about or what book it’s in.”. Even though I volunteered for this gig (and wasn’t paid), the fact that at least some number of people out there are going to read what I wrote makes me happy. I am also pleased that the editors praised my writing, indeed that they accepted my writing to begin with. When I was told about this project by the Resident Shrink (who had received notice of it through professional mailing lists), the editors were going to either interview women or have them submit their stories in written form. The editor told me that they were happy that my contribution needed only very minimal editing. When I got it back, there were only a few corrections to grammar, and one change where I misidentified the criteria for bipolar II as opposed to bipolar I. Go me!
I also would like to include it on my resume, because it does mean something to write well enough to be published. I would like to use it as a writing sample if I need to (I happen to think it is one of my better pieces of writing), but that might spook people.
I actually have written a much longer piece – about twenty pages, whereas the book chapter is six – about my experiences generally as a mentally ill person. I would love to publish it somewhere, but I am not sure where: it is too short to be a book, and too long to be an article. I might serialize it here. (Be forwarned! : ) ) If anyone is interested in reading it, for whatever reason, shoot me an email (or comment below) and I’ll send you the PDF. (I don’t think I can send the book chapter to anyone, but I’ll certainly tell you when it comes out.)
I have disclosed difficult issues before, and I suppose in some sense I might appear to be a emotional exhibitionist. But as I said in this post, sometimes we tell our stories so that others in a similar predicament might know that they are not alone, and to change hearts and minds of those who would fear or condemn us.
There are a lot of people who feel uncomfortable around mentally ill people. Why tell us, they say. It’s private. I understand privacy: I do not talk about my sex life, since it really is not anyone’s business and, truth be told, I find people talking about their sex lives to be boring. Sex is fun; talking about sex is uninteresting. I really don’t want to bore people.
But the discomfort people feel around people coming out as being mentally ill strikes me as different in quality. The statements I have heard around that are very similar to those I used to hear about sexual orientation.
The reason for disclosing mental illness is the same for disclosing that one is gay: standing up to stigma. It is freeing to announce to the world: yes, I have bipolar disorder. My condition is not a moral failing. My disorder is not an intrinsic personality flaw. I am not my disease. I refuse to be put in a box any more. I refuse to be silenced anymore. I refuse to allow your disapproval to be my problem ANY LONGER.
[Cut for length — rather long and rambling.]
The fact that there is stigma seems odd in this day and age. So many celebrities have come out, surely there is no reason to think that being bipolar is anything that society frowns upon? Why, it’s almost trendy. Carrie Fisher, Patty Duke, Catherine Zeta-Jones, and the one who has done the best job of discussing his disorder, Stephen Frye. It’s not like I am schizophrenic, after all. Those people are really dangerous. (I’m not serious. They’re not – they’re pretty much like other people except they have to take meds to control their condition. The organization Time To Change has put together several ads combating stigma against the mentally ill. This is my favorite. )
And yet, there it is: I hear the stigma when a friend tries to talk me out of my diagnosis. (“Are you sure they have it right? You’ve been through a lot in your life, it would be enough to depress anyone, maybe they misdiagnosed you. You should get a second opinion.”) I hear it when people decide to tell me their “bipolar horror stories,” as many people do. You know, the stories about the cousin who refused to take their meds and would attempt suicide at regular intervals, the boss whose bipolar ex-wife called up his employer to assert (untruthfully) that the man was an abusive alcoholic, the former friend who would get very drunk and phone at random hours to ask for reassurance that they were not a waste of oxygen. I have heard all these stories. I have never had someone say, “I have this friend who is bipolar, and you would never know it.” In some cases (not all) these are just awful people, who would be awful people even if they were not mentally ill. Being bipolar does not automatically make you act horribly towards others; it also is not a free pass for bad behavior.
A few years ago, when California passed its laws requiring mental illness to be treated on par with other medical conditions, a good friend and I were discussing what conditions were covered. “Oh, yes, those are the ‘scare-your-neighbors’ diagnoses,” she commented. She was not trying to be cruel, but her comment underscored what the general attitude towards the mentally ill is even here in relatively enlightened California.
The media does not help, either: whenever someone shoots up a school, or a shopping mall, or a theater, one of the first questions asked is, “what mental illness does he have?” There are some serial killers who do have an established history of mental illness: the man who shot up Virginia Tech, for example. James Holmes, the Aurora, Colorado, theater shooter, claimed after the fact to be bipolar.
The report of on the Connecticut shooting came out recently. Reading it, it is clear that Adam Lanza, the shooter, was very troubled. He had a diagnosis of Asperger’s Syndrome, and seemed to have problems beyond that. What worries me is that similarly troubled people will automatically be viewed with suspicion and mistrust, even though what they really need is help.
Society worries about the mentally ill when they go on a rampage; not so much the rest of the time. The result is that there is an impression than the mentally ill are more prone to violence than others, when the mentally ill are more likely to be victims of violence than perpetrators. (One of my reasons for loving the show Criminal Minds is that on several occasions, when dealing with suspects who were mentally ill, they mention this fact.)
If you go to social meeting sites such as OK Cupid (which I do from time to time, not seeking romantic partners but potential friends) you will sometimes see “no one with a personal or family history of mental illness need apply.” I have yet to see “no cancer survivors” or “no people with diabetes.” The only groups more frowned upon than the mentally ill are smokers or drug users.
It is not that people are unkind, necessarily. Or at least, they don’t think of themselves as unkind. One man stated that he had a lot of compassion for the mentally ill, but he did not want people like that in his life. As far as I am concerned, that’s not compassion, that’s hypocrisy.
People often see you as your disease. When you are depressed they hesitate to tell you good things because it might make you feel bad about your life. They are hesitant to tell you bad things because it might make you feel more depressed. The love you, or claim to, but they keep you at arm’s length. Relationships not based on mutuality are not friendships, they’re charity.
As I mentioned earlier, popular culture depictions of mental illness can be quite frustrating. Silver Linings Playbook was lauded by critics as being a honest look at the travails of a bipolar man coming to grips with the real world. He gets better in a remarkably short time with the love of a good (but equally troubled) young woman, and learning how to dance. He conquered his demons so easily. I started to mention the movie to my therapist, and she rolled her eyes, and talked about how awful it was.
One artistic work which captures a lot of the frustrations of a woman with poorly controlled bipolar disorder is the musical Next To Normal. Although her case was extreme, and was hell on her family, especially her daughter, elements of her travail spoke to things I have experienced. The songs capture some of the frustrations of trying to find the right set of medicines (“My Psychopharmacologist and I”) or what it is that you give up when you go on meds (“I Miss the Mountains”) or simply the terrifying feeling that you are going under (“You Don’t Know”). Some of the lyrics capture the highs of mania “I miss the mountain, I miss my life.” Other lyrics capture the depth of depression: “Do you wake up in the morning and need help to lift your head? Do you read obituaries and feel jealous of the dead?.”
I saw Next to Normal with the Resident Shrink. She tends to be very critical of representations of her profession in popular media, usually on the grounds that in most cases, the portrayal is inaccurate. (She froths at the mouth at discussions of Silver Linings Playbook, and just don’t get her started on Good Will Hunting.) She sat through the play wincing. When I asked her afterwards what they got wrong, and she said “Nothing. That’s the problem.” One of the themes of the musical is how the psychiatric profession can only do so much, and it really is an inexact science that involves a lot of trial and error.
I spent several weeks after seeing Next to Normal in mourning. It was not a depression: depression is different from simple sadness. I was mourning the life I could have had, and the ways that my disorder had damaged me, and more importantly, my family. Had I not been ill, life would have been so much easier. I lost a lot of years of productivity to the disease.
I was not diagnosed until I was forty-two. I had probably been bipolar since I was a teenager (most people show onset of symptoms early on). I did not evince full bipolar pathology until after I had children. It took another twelve years (from the birth of my first son) until I was diagnosed. Prior to that time, I was diagnosed as being a major depressive, and treated accordingly. I never thought I had mania or hypomania because the popular description of them makes includes feeling of expansiveness or grandiosity. At that point in time, I had never experienced that.
Early on, my hypomania manifested as a hair-trigger temper, lashing out with no warning, and a feeling that my brain was a spring curled so tight that it was in danger of flying apart. Because I was a stay-at-home mother, my kids suffered the most. I was a stay-at-home mother in part because I was ill, but also because I had an autistic son. If you are in a manic episode, the social landscape is filled with land mines for other people, and sadly my middle son tripped them with some regularity.
Before I was diagnosed as bipolar, the drugs I was being given weren’t working, mainly because they were for a condition I did not have. Finally, a psychiatric resident asked me about irritability and anger, and given my history with post-partum psychosis, diagnosed bipolar disorder. They changed my treatment, which has helped, although I am still subject to relapse.
I have since talked with each of my sons about how my bipolar disorder affected them. They were some of the most emotionally devastating conversations I have ever had. But in the end, my sons still love me enough to talk about the way my illness hurt them. They are remarkable people, and I love them dearly. Had I not had them (and the rest of my family) to worry about, I would have killed myself years ago.
I often wonder when to tell people. I usually don’t tell them until I have known them a long time, with a couple of exceptions. The one time I told someone very early on, the result was painful. “I’m bipolar, and if you are going to run from that, run now, before I befriend you.” They didn’t run, at least not until things got bad for me. Then they disappeared. I can sort of understand that it can be difficult to watch friends go through pain, but abandoning them is cruel. It is much kinder to go away before they get attached to you. I wonder if my friend who seems to be only interested in knowing me when I am healthy would feel the same way about someone with cancer: you know, people who have frequent remissions, who have to go back to the hospital because the tumor has come back, or have to undergo surgery after surgery.
Earlier this year, one of my coworkers disclosed to us that he was bipolar. I thought it a courageous and honest move, and I told him so at the time (in private, since I was not ready to disclose my condition to anyone). He was just like the rest of us, and did a good job. He has now moved on to do something else, and I sincerely wish him the best of luck. He was a good guy and a hard worker, and I have no doubt that he will do well.
I work to control my disorder, and to lessen the impact that it has on others. I have signed contracts that I will keep myself safe, that I won’t try to kill myself, that I will take my meds regularly. I love my family, and my friends, so I try not do anything that will scar them.
One of the tricky parts to being bipolar is that the world rewards hypomania. The ability to stay up for days helped me get through school. My speed at data entry made me the second most valuable field operations clerk in my Census office, even as the push to do faster and faster work wound me up tighter than a spring so I could hardly sleep at night. When you are hypomanic, you can work harder, for longer, possibly more creatively. (There have been studies that show a link between bipolar disorder and creativity. Maybe that’s so, I don’t know that it has helped me any. )
The world loves you when you are hypomanic; not so much when you eventually crash.
I am still subject to mood episodes, much more depression than hypomania. The depression can be almost indescribably awful. The hypomania can be troublesome enough – I am not always careful about what I say to people, for example. Most people I know with bipolar, though, are more stable. Their treatments seem to be working better than mine are. Or maybe they are better at hiding it.
I hope that none of you think worse of me because of me saying all this. Part of the dangers of being mentally ill is that you lose people who simply cannot cope. It feels good, though, to know that I won’t have to censor myself. It feels good to know that the next time I write advocacy posts around the issues of mental illness, I can write in the first person. Before, I would write of “people I know,” as though all those issues were divorced from my life except in a purely academic sense.
I can be myself. It is well worth the costs.