Originally published on SELF.com on December 1st, 2017 by Tessa Miller
A lot of people only know bipolar disorder as it’s shown on TV or in movies. You know the trope: One minute characters are catatonically depressed, and the next they’re so manic they think they can fly off a building. They can’t hold down a steady job, and their relationships with friends and family are destructive at best. They’re hypersexual and prone to fits of rage. Essentially, they’re portrayed as completely out of control. And most of the time, these are the only facets of their character; bipolar, and little else, defines them. But for real people living with bipolar disorder, their lives may or may not resemble those stereotypes.
Bipolar disorder, according to the National Institute of Mental Health (NIMH), is a brain disorder characterized by shifts in mood, energy, and activity levels. Typically these mood shifts range from highs (manic or hypomanic episodes) to lows (depressive episodes). There are several types of bipolar disorder, each differentiated based on the pattern of mood and energy shifts:
- Bipolar I disorder: Manic episodes last at least seven days or are severe enough to warrant immediate hospital care. Depressive episodes usually occur, too, and last at least two weeks. Mixed episodes are also possible.
- Bipolar II disorder: A pattern of depressive episodes and hypomanic manic episodes (which are less severe than manic episodes), without ever having a full manic episode.
- Cyclothymic disorder: Multiple episodes of manic and depressive symptoms lasting for at least two years, though not meeting the diagnostic criteria of hypomanic or depressive episodes.
- Bipolar disorder “other specified” or “unspecified”: Symptoms don’t fit into the other types, but include significant shifts in mood and energy levels.
You can be diagnosed with bipolar at any age, but most people are diagnosed in their teens or twenties, and you’re at a higher risk if you have a family history of bipolar. Traumatic events, like the death of someone close to you, and drug or alcohol use can also trigger the first episode.
Manic episodes, according to the NIMH, have several telltale signs including: feeling euphoric, having more energy than usual, insomnia, speaking fast about several things at once, jumbled thoughts, feeling irritable, and doing risky things you usually wouldn’t (like spending a lot of money or having unsafe sex). During manic episodes, you might also experience psychosis or hallucinations. Depressive episodes, on the other hand, include signs like: feeling hopeless, having little energy, sleeping too much or too little, eating too much or too little, forgetfulness, and thoughts of death and/or suicide.
But bipolar is treatable with medications including mood stabilizers, antipsychotics, and antidepressants, as well as psychotherapy, and people with the disorder can absolutely lead fulfilling, successful, happy lives. We talked to seven of them.
1. Julianne, 25: “My emotions were so uncontrollably heightened that I wanted to die.”
“At first, having bipolar wasn’t life-threateningly terrible. I was hypomanic throughout middle school, recklessly using my sexuality to manipulate my guy friends and lacking the empathy to realize that I was hurting them. But I excelled in school, volunteered with multiple organizations, babysat, and played in the school band. I wasn’t [necessarily] ‘acting out.’
By freshman year [of high school], I drank heavily and did every drug I could get my hands on. But as long as I was acing my honors classes, I didn’t care. But during the beginning of sophomore year, when I tried [to study] or read something, my mind would cycle through every terrible detail of my life. Without being able to [focus], my academic life was shattered. Every night I’d scream into my pillow, shaking and crying. My emotions were so uncontrollably heightened that I wanted to die. I kept telling myself it would get better, but this continued for months.
I also started taking scissors to my thighs and I would imagine cutting the fat off, even though I was also starving myself. I would feel such overwhelming mental pain that I would cut and scratch my skin to try to somehow numb it. I also experienced psychosis and paranoia: there were snakes on the walls and people following me. I wouldn’t sleep for days in a row. A month before I turned 16, I was diagnosed with bipolar I at an outpatient mental health facility for children and teenagers.
Now, I’m a genuinely happy adult with fantastic friends, a life partner, a home, and a career I’m proud of. I’ve been clean of drugs of alcohol for about eight years. But I still don’t tell people about my past unless they’re a close friend. The media often portrays people who are mentally ill as one-dimensional, low-life characters. But their lives have been shattered in different ways and they’re just trying to survive. You shouldn’t write them off for making choices you don’t understand.”
2. Emma, 25: “It drives me crazy, this attitude that mania is a gift that justifies the pain of depression.”
I was diagnosed with bipolar II at 14, after being misdiagnosed with ADHD for about six years. My pediatrician referred me to a psychiatrist after she suspected that my ADHD was a misdiagnosis. Now, my depression is easier to handle than it has ever been, partially because [more people publicly talk about it], so it’s easier to find communal support for it. Mania is still hard because the effects are harder to deal with after the fact, like [financial problems from overspending], or hurtful things I say or do to people I care about.
I’m terrified of having children, which is also something I really want to do. I would have to be off my medication at least during pregnancy, if not longer if I breast feed. Beyond actually having a child, raising a child is scary. I would hate for my bipolar to affect my relationship with them negatively. I’m always on the hunt for positive narratives about bipolar parents raising children with healthy relationships, but they can be hard to find. But I think I have a lot of natural empathy for how other people move around in the world because my movements, at times, have been so illogical. I find myself being able to accept the symptoms of my friends with [mental illness] at face value and I try to support them as much as possible without judgment.
I feel like the thing Hollywood gets the most wrong about living with bipolar disorder is that mania is a super power or gift. I’m thinking about artists that created while manic, or Carrie [Claire Danes’s character] on Homeland cracking the case because of wild leaps in logic while manic. The idea that the world deserves the results of mania more than those with bipolar disorder deserve safety in their own minds is really [upsetting]. It drives me crazy, this attitude that mania is a gift that justifies the pain of depression. I think it is hard for people to understand that my manias are my most destructive times, both in terms of how it affects my life and my relationships.
3. Danielle, 29: “The suicidal thoughts that come when I’m down are really tough.”
“Before I was diagnosed by my former psychiatrist, I experienced intense mood swings and, retrospectively, extreme overreactions to everyday situations. I would swing from deeply insecure to super confident, and I had thoughts of suicide and worthlessness coupled with bouts of creativity.
My symptoms now aren’t much different really, but I’m older now so I know how to recognize when I’m having a swing and can attempt to not give into it. I still experience insanely low lows that last for a couple weeks at a time. The suicidal thoughts that come when I’m down are really tough. Even though I can recognize them as temporary because of my experience with bipolar, it doesn’t change that those thoughts are deeply unsettling. For me, the highs are much more infrequent.
I used to turn to my loved ones for support, but I don’t want to burden anyone. My dog is always a quiet supporter, and journaling and meditation have been extremely helpful. Right now health insurance is unaffordable for me, so I’m without a therapist.
Still, I sometimes think that I’ve been given a gift. Bipolar kind of forces you to deal with your emotions head on. Shoving them down isn’t an option.”
4. Sabrina, 34: “I literally racked up thousands of dollars in debt due to my uncontrollable urge to spend.”
“I have bipolar NOS, which means ‘not otherwise specified.’ I don’t have bipolar I or II; my symptoms include aspects of both. Before I was diagnosed by a psychiatric nurse practitioner (and later confirmed by a general practitioner), I experienced a long depressive state, while at the same time having prolonged bouts of creativity where it felt like I had access to every emotion ever. I also exhibited more than a decade of insomnia and uncontrollable spending. I literally racked up thousands of dollars in debt due to my uncontrollable urge to spend. I also alienated friends and family as I navigated depressive states.
Now, my mood is regulated by medication, but it does a better job at curbing the highs than the lows. I still fight low-to-moderate level depression most of the time. But I feel like I can engage properly with the people around me, I have a better handle on my emotions, and I’m [better at my job]. When my meds are wrong I can bounce around between good days and bad days of varying degrees. There’s no real ‘normal’ when I’m un-medicated.
I live alone and have for a decade and a half. Most of my close friends are people that I talk to over the computer or phone (and I do very regularly). I do have a couple of ‘real life’ friends but they don’t live in the area so I mostly talk to them on the phone, too. My family is scattered around the country so I only see them occasionally, but I’m very close to my mother and we speak daily. She helps me keep tabs on how I sound and how that might relate to how I’m feeling. I’m also very close to my coworkers.
I want people to know that bipolar isn’t as ‘big’ as it appears on TV. Manic episodes don’t necessarily mean hopping around the house or harassing people or going ‘crazy.’ And depression associated with bipolar doesn’t necessarily manifest as sadness. For many people, myself included, it’s an unrelenting and insidious apathy.”
5. Anna, 23: “Mixed episodes scare me the most. That’s where I feel like I completely lose myself.”
“My psychiatrist diagnosed me with bipolar II when I was 19. Even with medication and the coping skills I’ve learned, I still have mood cycles that are a bit irregular, but they aren’t constant highs or lows. I actually have periods of time where I feel ‘regular’ which is great! But in the last five years, I’ve had periods of depression and some prolonged periods of hypomania. I also tend to experience mixed episodes where I’m both severely depressed but with a lot of energy and restlessness. I keep track of my moods so I’m able to address if I’m slipping into a depression or coming into a hypomanic period.
Mixed episodes scare me the most. That’s where I feel like I completely lose myself. It’s not just that I’m depressed and think that I’m worthless, but I have the energy to do something about it. In mixed episodes I’ve put myself in dangerous situations or excessively used substances. I’ve ruined relationships because I didn’t think I was deserving of love. Being hypomanic tends to make me less hungry, but in times of mixed episodes I restrict my food intake as a means of self-harm. It’s not exactly an eating disorder, but it’s definitely disordered eating.
At the same time, being bipolar is one of my favorite aspects of myself. I am creative and enthusiastic. I am passionate and ambitious. I have art all over my house that I’ve created during hypomanic periods. As a graduate student, I can (and want to) write page after page of papers. I can fill up a journal with thoughts and ideas. I’ve learned to utilize my symptoms for the better. I’m not broken. Yes, I [have to] manage severe symptoms, but the amazing things I’ve experienced from being bipolar are things I actually want to keep.”
6. Eryn, 42: “I wouldn’t get out of bed, I wouldn’t shower, I wouldn’t eat.”
“I was diagnosed with bipolar II by a psychiatrist when I was about 30. Before I was diagnosed, my [manic] states were becoming very high, and my lows were becoming very low. In a manic phase, I would clean non-stop and talk incessantly, always plotting the next grand scheme for my life. Of course I never followed through with any of these plans. I would also become reckless with my behavior. Before I was married, I would sleep around a lot during manic periods and I ended up in some very compromising situations with one-night stands. I was lucky I was never hurt. I drank a lot to bring myself back down, which eventually it would, but then I’d be depressed for weeks. I wouldn’t get out of bed, I wouldn’t shower, I wouldn’t eat. Since I started medication, my symptoms have become manageable and mostly unnoticeable.
I have a loving husband and a three-year-old son. My mother has been my backbone through it all; when I first got on medication she stayed with me for a few weeks to make sure I was stable. Starting a new medication can be difficult at first and she was very much there for me during that time.
The depression is what scares me the most about bipolar. The low is so low that you just don’t want to wake up anymore regardless of how great your life [might actually be]. I’m also afraid that my son will end up having bipolar. But I want people to know that though it can be a difficult disorder, most of us can lead perfectly ‘normal’ lives.”
7. Hannah, 28: “I’m freaked out by the thought that I’ll never have a full grasp on stability and normalcy.”
“I was diagnosed with what’s called bipolar II rapid cycling with mixed states, when I was 26. I’ve always been someone who has what I’d call ‘an unusually wide emotional range,’ and my family and friends have described me as ‘extreme,’ but the first time something felt truly offwas with a sudden overwhelming wave of depression. I felt completely hollow. It persisted for a few weeks and then suddenly lifted, like it was never even there. Then not long after, I started feeling riled up in a way that’s still hard to describe. Everything felt faster: My heart rate increased, I couldn’t keep up with my thoughts, and I couldn’t sit still or sleep. I went five days sleeping just one or two hours a night, yet I didn’t feel tired.
I had all these ideas about what I wanted to do and I’d just go for it, like starting projects by spending hundreds of dollars on stuff I never touch now, giving myself tattoos, and shaving my head. Then one day, I could sleep and my heart calmed down. That didn’t last long. I had my first mixed state a few months later. Those are nightmarish. I had so much energy, but it was angry energy. I was on edge about everything, destructive, aggressive, and angry. My suicidal thoughts were real and actionable. These different states repeated with feelings of normalcy in between.
It took a year to get somewhere close to stable with medication and therapy. In that time, I lost my boyfriend of a decade and my best friend, both of whom said it was just ‘too much for them to deal with.’ Now I’m on multiple meds and a lot more stable. When I get really stressed or big changes occur (or sometimes just out of nowhere), I start cycling again. My symptoms are less intense now, but the depression can still be temporarily debilitating, and I tend to do and say stupid and inappropriate things when I slip into hypomania.
I’m freaked out by the thought that I’ll never have a full grasp on stability and normalcy. I’m terrified by the idea that I depend so heavily on psychiatric meds to achieve what stability I have, and that if something happens that changes my access or my reaction to these drugs, I’ll go off the rails again.
Now, I’m working on my Ph.D., I maintain stable employment, I live independently, and take good care of myself. My family is wonderful, and I have a phenomenal group of friends and a super supportive boyfriend. He struggles with depression and is very understanding when I get a little shaky. All of my best supporters have had some mental health struggles, and I think that surrounds me with a group of people who are extraordinarily empathetic and patient.”
Tell me below how bipolar disorder has affected you and your life.