A woman wearing dark clothes and hat walks in a field of daisies.

When People Pretend to Understand Bipolar Disorder

Don’t assume anything about Bipolar Disorder.

It is much easier for me to tell people I have been diagnosed with bipolar disorder now that I have had an actual psychiatric evaluation. It has taken me years to be led in the right direction for such a diagnosis. Five years ago, I believed I suffered from PMDD (premenstrual dysphoric disorder). A few times a year, when I would become so distraught over my moods, I would schedule a doctor’s appointment. I believed my periods were causing me such psychological problems that they were the major culprit in any interpersonal relationship conflict I had with family, friends or co-workers.
In 2016, I penned an email to my family doctor:

“I am no longer taking Lexapro. I tried for 3 weeks and had some nightmares and discovered I grew a tolerance for it. I felt really hostile on it the final week. I was seemingly fine until my period this week.”

She gingerly replied:

“Unfortunately you did not follow-up at your scheduled appointment where we would typically re-evaluate symptoms of anxiety, depression, PMDD, and any side effects. Therefore none of this is actually documented.”

I had been to the same office for “mood” problems since 2012 when the doctor tried to put me on birth control pills. The “pill” was not effective in treating my mood disorder. Each time I visited the doctor, they tried to give me another antidepressant. Mostly, I was given medication in the SSRI class of antidepressants. Then, I was prescribed Wellbutrin, a medication in the NDRI class (norepinephrine-dopamine reuptake inhibitor). My doctor determined that I was “sensitive” to medications, which is why she tried me on Wellbutrin.

I was afraid to mess with the new prescription she recommended. Then, my mood would improve, I’d get a euphoric feeling. I felt creative and happy about half of my life, then I descend into depression. It was always with that period of depression that I sought help. My doctor’s office replaced the previous physician with a new doctor. I explained that I was not there for “meds” as the nurse remarked on my intake form. She reviewed my symptoms and gave me a referral to their partner clinic- the clinic that deals with mental illness, therapy and psychiatry. A wave of embarrassment and shame poured over me. The psychiatrist asked me many questions. As I spoke to her, my speech became more rapid. “Do you realize how fast you are talking?” I said I was moderately aware of how my speech changes but nobody else has ever remarked about it.

We talked about my family history, specifically, how members of my family used alcohol to mask what was possibly their own mood disorders. In the past, there was more stigma against mental illness. People kept problems hidden from others, or at least they tried. The alcoholism simply created additional problems. My grandfather was a WWII survivor (USS Indianapolis). He was quiet and held his liquor well. It was socially acceptable to throw down a few beers. He was dealing with traumatic memories that he wanted to suppress. Grandma, on the other hand, was a talker. She was also a drinker, as was my mother. As a child, I witnessed interesting discussions when they all drank together in the kitchen. My grandfather seemed to have much composure. I can’t say the say for the rest of the family.

I told the doctor about my experiences with Lexapro, and how I had very disturbing nightmares. These nightmares dealt with the macabre- death and decay. I found it very difficult to shake these dreams from my waking moments. When I quit taking the medication abruptly, I experienced unpleasant withdrawal symptoms. I prayed that I would avoid getting into trouble or jeopardizing any relationship. The other medications made me feel dull but balanced. While on the meds, I was neither happy nor sad. My face felt like a mask. Any creative inclination I had previously experienced during my “manic” episodes had all but diminished.

My psychiatrist said that my periods likely trigger my underlying condition of bipolar disorder. She told me that more than likely, my mother and grandmother had mood disorders and drank to cope with their issues. The nightmares that I experienced while taking antidepressants was common in bipolar patients.

“Your family doctor sent you here because she didn’t know what else could be wrong”, she explained. I read that in order to be diagnosed with PMDD, the doctor must rule out any mental health issues that could possibly be causing the symptoms. Although I was not thrilled with being diagnosed with any mental disorder, bipolar disorder was less-embarrassing than PMDD. PMDD is not socially-acceptable and most people misunderstand the meaning of “being bipolar.”

When I need to tell people about my disorder (so they don’t think I’m speaking rapidly because I’m strung-out on drugs), I am met with a dismissive attitude. The term “bipolar” has become synonymous with being “edgy”. The term “bipolar” is used to broadly define any rebellious, hip, or bold attitude. Mood disorders are NOT attitudes.

Bipolar disorder is defined by the American Psychological Association as “a serious mental illness in which common emotions become intensely and often unpredictably magnified. Individuals with bipolar disorder can quickly swing from extremes of happiness, energy, and clarity to sadness, fatigue, and confusion. These shifts can be so devastating that individuals may choose suicide.”-APA.org

As a society, we have all but surpassed the days of unrelenting stigmatizing of mental illness, at least for bipolar disorder. In fact, we now must contend with the ignorance associated with bipolar disorder. Much of this ignorance is due in part from people not recognizing bipolar disorder as a real medical condition.

During a manic episode, people suffering from extreme cases of this illness may indulge in risky, foolish or erratic behavior. They may spend money and put their family in debt. They may become promiscuous and wreck their marriage by having affairs. During a depressed cycle, they may experience psychotic episodes, or attempt suicide and/or self-harm. While I have not experienced those elements of bipolar disorder, I have become so depressed that I have ruminated over my own death. I am certain that such dark moods are not appealing to my family.

Bipolar disorder affects each person differently. My variety of this trendy illness doesn’t involve getting tattoos, drinking and driving, or staying up all night like a rock star. Rather, my bipolar can be managed most days, and I have been given the ability to function enough to hold down a full-time job.

Others are not able to work or even manage to get out of bed and get dressed when they are debilitated by depression. When weekends arrive, I am partially relieved because I can rest at home, or so I believe. Often, I become so manic in the afternoon that I am not able to sit down. Weekend mornings, when the kids are still asleep and my worries are quenched for a little bit of time, are the only times I can spend writing. I “binge,” write during such times, except when I am depressed, or when I am trying a new medication.

When I was in my twenties, I started to become aware that something was not right about my moods. Listening to music from Jimi Hendrix and Nirvana opened my mind to certain mental health issues (i.e., “Manic-Depression”, “Frances Farmer Will Have Her Revenge”). I was old enough to drink and I drank exceedingly to suppress or to accelerate my mood shifts. Those were some of the worst years of my life!

When people passively listen to me talk about my mood issues, they appear to be dismissive or they appear to “know it all” about manic depression/bipolar disorder. They do not care or they wish to remain blissfully ignorant. After a while, I let them stew in their ignorance or I pretend to not have a mood disorder. Such people love to use a broad lens when depicting bipolar disorder. The lens they prefer to use, however, does not liberate, it merely conveys a broad, generic perspective of the term “bipolar”.