Why Is Bipolar Disorder So Misunderstood?

When I say the word “bipolar,” what comes to your mind?

Some of you may imagine someone like Robin Williams whose intense energy and rapid brilliance were a mainstay of his public persona. His suicide sparked a major discussion about bipolar disorder, even though there were other factors involved in his death.

Others may think of someone like Winston Churchill, a much darker, more depressive character, who called his swings into depression “the black dog” and channeled what many believe was hypomania into long endless hours of work throughout the day and night. There are many other celebrities that might come to mind for you — Carrie Fisher, Mariah Carey, and Demi Lovato to name a few who’ve revealed their illnesses.

Perhaps you have some closer-to-home experiences; you may love someone whose moods vary from quite euphoric and highly energized to dark despondency. They may be huge denial of these swings, but many seek treatment and get help. Like all mental illnesses, bipolar disorder can range from mild mood swings to severe, and medications or lifestyle choices that offer stability can lose their effectiveness.

Perhaps you yourself struggle to navigate the uncertainty of not knowing whether your “good mood” is really mania beginning to creep back into existence. You may find yourself exhausted as your moods change within hours or days from being the life of the party to an overwhelming need to isolate yourself.

It’s a tough disorder to manage.

The many faces of bipolar disorder…

Peter was a highly achieving, well-respected college professor who came in because he hadn’t slept in four days, a pattern that he was beginning to recognize had been a part of his life for years. Marjorie, a twenty-something architectural student, was having a hard time reining in thoughts that raced a mile a minute, but she couldn’t find the energy to take a shower. Stan, an elementary school principal, at work by 5:00 in the morning, was there for everyone and anyone who wanted some of his time. Yet he’d had secret thoughts of hurting himself and was fighting the urge to drive off the highway.

All had some form of bipolar disorder. Could you tell from these facts alone? No. Sometimes the diagnosis is clear. Sometimes, not so clear.

If you’ve been diagnosed, you might have been relieved by the hearing the word “bipolar” because it’s given you a structure to understand and a plan to move forward. You may also be afraid of what others will think, as there seems to be more stigma surrounding bipolar disorder than depression or other mental illnesses. In fact, calling yourself or someone “bipolar’ has mistakenly been used as a way of mocking yourself or others for being emotional or moody… Or deciding someone is unpleasant.  Bipolar illness is far more than that.

Is It Hard to Diagnose?

A psychiatrist I saw many years ago was convinced I had bipolar disorder because my natural energy was so high. He put me on Lithium, a mood stabilizing medication, which I stayed on for three days. I’ve not had three days quite like those again —  overmedicated and completely misdiagnosed.

It was clear either Lithium wasn’t the drug for me, or I didn’t have bipolar disorder. Both statements turned out to be accurate. He’d completely missed the boat. I was anxious, not depressed. My mind had never raced uncontrollably, I’d always been a great sleeper.  Bipolar disorder wasn’t my issue — seeing a lousy psychiatrist was.

In his defense, bipolar disorder, especially what’s called Bipolar II disorder (an abbreviated form of bipolar disorder, with mood swings not as severe as Bipolar I), can be tough to diagnose.

Learning to manage bipolar disorder… 

If you’ve been diagnosed with bipolar disorder, you know that you can be productive and creative if you channel your energies carefully, and that your sadder moods will not last forever. Stan said at one point, “The most important thing for me to do is wait if I have a new idea, a strong emotional reaction or impulse. Wait and see if I feel the same way tomorrow. If I do, fine. If I don’t, I haven’t created a problem for myself.” You learn to look for triggers that might dislodge your schedule and thus your stability- things like going on a trip where your sleep cycle will be disturbed, or going through an anniversary of a death or loss — anything that will upset what, for you, can be a fragile balance between okay and not okay — stable or unstable.

Knowledge is powerful. You can offer compassion and empathy for someone with bipolar disorder. You can learn what they’re dealing with on a daily basis.

And if you have bipolar disorder, you can offer that same compassion to yourself.

 

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Originally published on June 2, 2018; updated and republished on October 30, 2021.