Mar 19, 2021 | OPINION | By Lorea Zabaleta | Photo courtesy of Lorea Zabaleta
Content warning: This article discusses mental health/illness, suicide, and substance abuse.
When I got diagnosed with bipolar disorder part-way through my third block at Colorado College, I felt like I was handed a death sentence. And in a way, I was, if a delayed one.
By virtue of something I had no control over, my life expectancy was reduced by up to 10 years. Additionally, as many as one out of five people with bipolar disorder commit suicide each year, and four of five bipolar people contemplate suicide at least once in their lives, compared to one of 12 in the general population.
As I left the psychologist’s office that day, shocked and distraught, I called a loved one. I was then told that “maybe this wasn’t something I wanted to advertise.” So here I am, over a year later, advertising it for World Bipolar Day, which will be occurring on March 30. In preparation for this day, I want to get some things out there.
Let’s start with some more fun facts!
Bipolar disorder, formerly known as manic depression to some, is a mental illness that causes “dramatic shifts in a person’s mood, energy, and ability to think clearly.” It is estimated that bipolar disorder occurs in roughly 2.8% of the U.S. population. Of that, approximately 83% have “severe” cases. Additionally, bipolar is connected to genetics and often runs in families.
There are four main types of bipolar: bipolar I, bipolar II, cyclothymia, and unspecified bipolar. All four forms of bipolar include a different combination of mania (extreme highs) and depression (extreme lows). Some people also experience “mixed episodes,” in which they may experience aspects of depression and mania simultaneously.
While bipolar cannot (yet, I hope) be cured, it can be treated in a variety of ways. Psychotherapy and medicating are common. To complicate things further, two of three bipolar patients have a comorbid mental illness, such as an anxiety disorder or substance abuse disorder.
Because bipolar is a part of a person’s genetic makeup, it is important to acknowledge that certain medications are unsuitable for individuals with bipolar — such as steroids like prednisone or traditional antidepressant medications like selective serotonin reuptake inhibitors (SSRIS). Unlike someone with depression without a genetic predisposition to mania, someone with bipolar could unknowingly be put on these meds and be sent into a bout of mania that could endanger them or place them in a hospital.
Anecdotally, I know several people whose doctors did not perform due diligence and screen them for bipolar before prescribing one of the above medications, and the results were catastrophic.
That brings us to the issue of bipolar diagnosis. One site suggests that bipolar individuals face up to 10 years of coping with symptoms before a diagnosis and that half of people with bipolar are receiving no treatment in any given year.
It is also widely acknowledged by mental health professionals that people are more likely to seek treatment during or for their depressive episodes, which can lead to misdiagnosis for a depressive illness. If not screened for mania, this can be a serious issue, as mentioned above.
Now opinions, because this is an op-ed…
Okay, so. That probably read like a research paper and I apologize. Now we switch roles. That was the hard part for you and now’s the hard part for me — writing about my own experience instead of reporting on facts.
I got diagnosed pretty early on in my college experience, after a genuinely terrible first few months. And I’m grateful for it — not ashamed, even though sometimes I think I should be. After all, being told not to advertise a part of myself immediately after discovering it was not super encouraging. Neither was, later that day when I confided in a close friend, being told that I “don’t seem bipolar.”
A good, supportive start.
Another negative, beside the debilitating mental illness itself, is that sometimes when I tell someone, I feel like I’m putting a relationship at risk. One extreme example was a friend who ignored me for weeks on end whenever I confided I was feeling either (hypo)manic or depressed.
The stigma around bipolar is perhaps less severe and obvious than surrounding disorders like schizophrenia, which is often demonized in media and society as a whole. However, it’s certainly not treated like anxiety or unipolar depressive disorders, which have been normalized far more than I ever would have expected, in recent years. Bipolar, rather than being normalized, is both romanticized and demonized.
Let’s look at some myths and see why they’re bad…
On the one hand, we have the romanticized and minimized traits, such as the idea that mania is fun or that bipolar lends itself to creativity and shouldn’t be treated. The concept of the “tortured genius” is particularly common to bipolar.
On the other hand, there is the misconception that because of the disorder a person is a bad partner, parent, or inherently violent and dangerous. Additionally, because bipolar can sometimes lead to the maladaptive coping strategy of using drugs and alcohol, there can be an idea that bipolar people are often or always drug addicts or alcoholics.
These are all harmful in various ways — even the “positive” connotations. A person happy and alive is better than an a glorified artistic, pained by years of suffering, no matter how beautiful their art. Discouraging someone from seeking treatment is wrong, especially when treatment has come so far.
I’m not going to explain why generalizing millions of people who share a trait over which they have no control is bad, because that should be self-evident, but I will say that bipolar people are two and a half times as likely to be victims of violence and abuse than to perpetuate it.
As to the stereotype surrounding bipolar individuals and substance abuse issues, that is often rooted in lack of appropriate and effective treatment for the person. Not to mention, overuse of drugs and alcohol can exacerbate bipolar symptoms such as psychosis and suicidal ideations. So, instead of stereotyping and perpetuating negative perceptions, it’s probably better to have empathy and want people to get the treatment they both need and deserve.
You may be asking yourself, what do you want me to do about all that? Great, I’m glad you asked. Here are some suggestions.
- Take “manic” and “bipolar” out of your vocabulary unless referring to the state of mania or the disorder itself. It’s not just that using these words flippantly and incorrectly could potentially upset someone around you, it’s that the incorrect usagetrivializes and muddles the definitions, making it more difficult for people to actually communicate their symptoms.
- Bipolar people should, in fact, seek treatment. It won’t take away their sparkle, but they will probably live longer.
- When it comes to the individuals in your life, the most important thing is to listen to them. I could list “do nots” all day from the truly absurd things people have told me, but it really comes down to being okay with not fully understanding bipolar, initially, and being willing to learn.
Lastly, bipolar has been found throughout human history. It’s not a new thing. Recorded cases of bipolar date all the way to Ancient Greece. In the early 20th century, it was known as “manic depressive insanity.” This was later changed to “manic-depression” and then eventually classified as bipolar disorder and grouped with mood disorders. People have been living, surviving and even thriving with it for quite some time. That’s something to remember.
In addition to its long-standing history, bipolar has been noted in many public figures, including some celebrities who have spoken openly about their experience or have made their diagnosis public, such as Carrie Fischer, David Harbour, Richard Dreyfuss, Kurt Cobain, Amy Whinehouse, Patrick Kennedy, and Frank Sinatra.
Perhaps you’ve noticed a theme of tragic lives or struggles with these figures. And I mean, yes, bipolar isn’t fun, but those examples aren’t supposed to be bleak. They’re reminders that bipolar people live among everyone else and can love and be loved. And perhaps most importantly, diagnosis and treatments for the disorder are vastly improved compared to what they were in the 20th century and likely improved even since the article I linked was written (my therapist seems to think so).
Bottom line: on this upcoming World Bipolar Day (March 30, in case you forgot), maybe keep those figures and me in your thoughts — and keep your preconceived notions out of them. I also accept yerba mates and gift cards.
Resources and Hotlines:
firstname.lastname@example.org or on Instagram @loreazabaleta. I’m not a mental health professional but if you want a non-judgmental ear, don’t be afraid to reach out.