Recently, someone I know to be an otherwise compassionate and intelligent person made a comment that seemed to be minimising the seriousness of Bipolar II. The comment itself is not really important, and it’s possible that I read the tone wrong (although I did not mishear the content). The way it was made reminded me of a friend I once had who dismissed bipolar as a “casual illness.”  It wasn’t that the comment was made in an unkind way; it struck me as uninformed.  This surprised me, because it was not said by someone I would expect to be uninformed, and not said by someone I have known to be dismissive; yet the comment was both.

Essentially, the person suggested that Bipolar II is not a “serious” illness and doesn’t cause “severe vulnerability”, as compared with other illnesses which are much harder to “recover” from (my thoughts on “recovery” are available here and I believe, and have seen, that people can and do experience recovery from and within all sorts of illnesses, even those deemed most severe).  I hear this kind of thing a lot: “just” depression, “just” [insert any number of illnesses].  But in my experience, “just” depression, “just” Bipolar II, are things that can actually kill.  As in, quite literally, cause death.

What I wanted to say/ should have said/ didn’t say to this person, is that I don’t have the luxury of taking bipolar lightly. On more than one occasion, I have almost lost my life because of it.  On more than one occasion I have lost friends, jobs, opportunities, because of it.  I will probably be taking medication for the rest of my life.  I will always be sensitive to the changes in my mood, the way a sailor learns to be sensitive to the wind.  I cannot afford to take any period of wellness for granted, and  I can’t afford to be flippant about it.  If you can, then count yourself lucky, and educate yourself on the topic before you say something.  (The person, by the way, did acknowledge that there were things that s/he didn’t know about bipolar/ depression.  Which is absolutely fine, most people are not walking medical encyclopedias.  But if you don’t know something, it is probably better to do a superficial google browse before dismissing as casual the illness of a person you know has that illness, in front of that person).

I know where I’m fortunate, by the way.  I know that (especially at the moment, not being consumed by any particular mood) I am lucky, and I have zero interest in playing a game of comparisons.  I am also aware that some people are impacted much more severely by bipolar (I or II) than I am (currently).  My point isn’t that my particular mental state, at this particular time, is better or worse than that of anyone else.  My point is that it isn’t the name of the illness that should shape your perception of it.  “Personality disorder” or “bipolar” or “schizophrenia” or “PTSD” are all different conditions.  The severity of each varies from person to person- not necessarily from diagnosis to diagnosis.  No two people, with the same diagnosis, will be impacted in the same way by it.  People can and do have periods- even long periods- of stability within the trajectory of their illnesses of any kind.  Some illnesses have higher “recovery rates” than others, some have lower “relapse rates”, the likelihood of recurrence varies.  But you should never put the word “just” before anything.  It disrespects the experiences of the person with the problem.  It makes you look like you don’t really care.

Bipolar II

The sub-category Bipolar II was created in 1994, by a man named Allen Frances.  Imagine that- my diagnosis is younger than me.

There are many criticisms of the DSM and one of them is that, in its various incarnations, it has created a “false epidemic” of mental illness.  By adding new disorders and subcategories it has, it is argued, medicalised many of the normal emotions of everyday life.

Sometimes I feel as though bipolar II is belittled, both in terms of the minimalisation of its severity and in terms of some people thinking it isn’t an illness at all, not in its own right.  In turn, when I am depressed, that makes me feel guilty. So, my diagnosis isn’t even a thing.  So, why take medication? Isn’t it normal to soar and fall?  Isn’t that what life is?  What if, after all, I am drawing resources away from the people who really need it?

But I am brought out of this by the very depression that leaves me guilty in the first place.  Because it isn’t normal.  It isn’t normal to feel suicidal and it isn’t normal to have your thoughts race at fifty kilometres an hour, or to sleep four hours in two days for two weeks running.  I am not a little off-kilter, not “just” suffering from the stresses of the modern world.  When I am ill, I am ill.

I have to admit scepticism at the ever-expanding catalogue of mental illnesses and at the number of people diagnosed (a study showed that children born towards the end of a school year are many times more likely to be diagnosed with ADHD, because nobody had taken into account their relative immaturity).  But as a sub-category myself, who am I to judge?  If a person can put their finger on a diagnosis- even one whose creation seems arbitrary- and find it fits them perfectly, then they should probably try the recommended treatment for that disorder.  I guess.

One thing I do know is that my medication works for me.  Call it a placebo effect if you like.  Call it whatever.  But as they say, if it ain’t broke don’t fix it.  Psychiatry may well be broken but I’m not, and in part that is due to my treatments.

Perhaps I should stop reading up on placebo and the failure of psychiatry.  Perhaps it is making me unduly paranoid about diagnoses and treatments.  I’m a curious person, though, and I like to read up on those things which affect me.

One thing I will say, is that I would never scoff at another person’s mental distress.  I have slipped through cracks into misery and it is not a pleasant place to be.  Bipolar II may be younger than me, but that doesn’t mean it doesn’t exist. 

30 Days: Day 5

Do you believe nature (biology/physiology), nurture(environment), a mix, or something else has an impact on mental health?

I believe that to some degree, my mental health problems were inborn.  Even as a child, I displayed symptoms which later developed and came to play a significant role in my day-to-day life.  For example, from the age of 9 I was convinced that I was being watched by invisible cameras.  As I grew older, the belief grew with me.  Partially due to the “cameras” I was hospitalised at 14.

The early development of symptoms lead me to understand my bipolar disorder as, in a sense, inevitable.  Something was always going to happen.  I remember being told in hospital at 14, that if my self-harm and mood were not trauma related, they were a “warning sign”.  I believe that now.

In terms of nurture, there was nothing significant in my family life that would account for my mental health problems.  I do recognise, however, that some events outside my home life may have triggered something that was already there.

I think that the fact that chemical treatment has proved the most effective in improving my life, proves that a chemical imbalance of some sort has affected my mental health.  I would never come off the meds in exchange for “talking therapies” for example, because I do not feel that these would be adequate on their own for treating bipolar disorder.