I won’t recover in the dark: People with bipolar deserve to be seen

An honest investment

An episode of bipolar depression was the reason I was recently absent at BSR for a few weeks, and my ongoing recovery is the reason I’ll be away for a few more weeks.

Being honest about this is a good way to start the new year. Not because I owe anyone my medical history or even my reasons for resting, but because I see honesty as an investment in my recovery, and despite a sea of psychotherapy memes on Twitter, it’s still hard to talk about this.

Decades of misdiagnosis

That’s one reason my own diagnosis took almost two decades. Starting in my teenage years, despite many therapists, psychiatrists, antidepressants, and a hospitalization, my mood kept collapsing into exhausted despair, between brief swells of busy happiness and spates of anxiety so intense they made me physically ill.

The depression, especially, I remember even as a child. It’s like lying in a bath after the plug has been pulled, your body growing heavier as the water drains away. I sensed it like a dark blue color rolling over me, not knowing why I experienced long, gasping, solitary fits of crying and a longing to die when I was barely in my teens.

Doctors began telling me I had depression in high school after they quickly ruled out the obvious hallmarks of mania—risky actions, spates of loud, erratic behavior, hallucinations or delusions, inability to sleep. But therapy and antidepressant medications didn’t solve the problem.

Finally, an answer

A few years ago, one psychiatrist looked again, pushing me to describe not my depression but one of my periodic surges of activity. Well, yes, occasionally I get a buzzy sense of energy, waves of goodwill that feel like riding summer ocean swells beyond the breakers. It lets me take a bunch of outings or write all night. It drives me to do things like clean my whole house, reorganize all my books, or rearrange my furniture, all while binging academic lectures or dense audiobooks. I ride a rush of exciting ideas.

It’s called hypomania, and it’s typical of bipolar II, a lesser-known type of the disorder in which severe depressive episodes alternate with a mild form of mania that often goes unnoticed. It doesn’t look like the stereotype of bipolar. Left untreated, the cycles can intensify over time.

Bipolar II often gets missed in career-driven women because they channel that hypomanic energy into their work, a psychiatric evaluator told me recently. As we say on the Internet, I feel personally attacked.

Who could complain about extra energy, an unusually good mood, or a surge of useful brainstorms? Nobody, I bet—unless these alternate with longer and longer spates of depression so bad that you have to peel yourself out of bed while black thoughts bloom bigger every day, you can’t bear to answer your texts, and the fridge fills up with half-eaten meals because you keep losing your appetite as soon as you pick up your fork. Depression can flatten your life until nothing on your TV or your bookshelf or your phone feels remotely interesting. It all might as well be one giant infomercial for a life you can’t live, so you lurch back to the couch and stare into space for hours, thinking about death.

What we see and what we say

When I went to a local emergency room several weeks ago, I was quickly admitted, and spent about 10 days in the hospital’s psych ward. The stay was harrowing, but necessary.

Now I face what most portrayals of bipolar don’t show: a long, difficult, active recovery that combines medication and intensive therapy with sexy new habits like reducing screen time, getting more sleep, and taking time off work. Because with proper treatment, as my doctor recently reminded me, bipolar has a good prognosis.

But it’s often hard to see that from the inside. Like many people with all forms of bipolar, I spent years silently drowning in the tides in my brain and denying that I needed more help. And it’s no wonder, given how easily we throw words like “psycho,” “crazy,” “bipolar,” “depressed,” or “OCD” around to describe not just people who are volatile, erratic, manipulative, or controlling—but also people who are sad, anxious, mercurial, fearful, exacting, traumatized, or sensitive. How often are bigotry, mass shootings, or other violence instantly attributed to mental illness, even though people with mental illness are more likely to be the victims of violence, not the perpetrators? It’s evident every Halloween—haunted houses are full of actors playing people on psych wards.

I internalize these cruel tropes every time I worry that I should keep my mood disorder or psych hospitalizations a secret, because readers will turn away, colleagues will lose their respect for me, and potential clients won’t hire me.

What we deserve

But how can I recover in the dark, pretending that I don’t really have to take vigilant care of my own brain, and acting like it’s possible to go from the hospital right back to your office? (I tried. It’s not possible.)

When I was recently in the hospital, one of my fellow patients wanted to conceal his stay from his coworkers. He seemed nervous and ashamed about his hospitalization. I write about this because people who live with mental illness deserve to see themselves represented in realistic ways, including among professionals in the community. And people without mental illness need to see that people like me are intelligent and capable, despite our challenges.

Yes, I want to be honest with the BSR community about why I’m not at my desk right now. But more than that, I want to shout about the professional model we follow at BSR, which says health comes first and people aren’t machines. We have a flexible, reciprocal, and accessible working style that says, tell us what you need to do your job, and we will help.

I’m getting the help I need. Look how well BSR is running in the meantime. Normalize facing disability with cooperation. Normalize treatment and the work of recovery. Normalize rest.

What we all need

I said honesty about my diagnosis is an investment in my recovery, but more than that, it’s an investment in helping others with similar disabilities avoid this crisis altogether, because maybe the public conversation will make us less ashamed of our own needs.

And while we’re at it, let’s stop pretending that we don’t all have similar needs—to process emotions, to treat pain, to rest—whether or not we have a diagnosed physical or mental illness.

One of the books I took into the hospital was Sister Outsider: Essays and Speeches by Audre Lorde. I keep coming back to her 1977 paper, “The Transformation of Silence into Language and Action.”

“We can learn to work and speak when we are afraid in the same way we have learned to work and speak when we are tired,” she writes. “For we have been socialized to respect fear more than our own needs for language and definition, and while we wait in silence for that final luxury of fearlessness, the weight of that silence will kill us.”

Silence is never going to lessen stigma about mental illness or anything else. The danger is in the silence.

“For it is not difference which immobilizes us, but silence,” Lorde concludes. “And there are so many silences to be broken.” At BSR, we hope to continue breaking those silences in the coming year.