Crazy. Lunatic. Psycho. It’s embarrassing to admit these are words we use to humiliate and marginalize people living with bipolar disorder. These are the words that saddle them with shame, time and again. After every manic episode, they hang their heads as the realization (or recounting) of their “descent into madness” rushes in. And the general American lexicon and attitude does nothing to protect or bolster their self-concept.
Bipolar disorder, in its most notorious form, causes people to have vacillating mood states that consist of depressive and manic episodes. In a depression, a person has low mood, loss of interest in things, and usually changes in the way they sleep, eat and concentrate. They may also experience guilt, fatigue and suicidal thinking. In mania, people have an upward shift in their energy level. With it, they may have a euphoric, elevated mood, or may have severe irritability. Episodes are characterized by impulsivity, increased activity, racing thoughts with speech to match, sleeplessness and agitation. To read more about bipolar disorder, visit my article here.
Of the two phases, it's the mania that causes the embarrassment. And that’s understandable. How do you face yourself after you’ve suddenly disappeared to have an affair with someone 30 years your junior, leaving your kids and spouse crushed and humiliated? Or what if you’ve sent out over a thousand aggressive emails to people at the local news station, warning them that electrical chips are in their heads. Stalking behaviors, disrobing in public, spending to the point of bankruptcy, shredding strangers to bits with profanity and vicious speech, erratic behavior in front of one’s children. Mania is not just a fun, high-energy, creative time. Mania can truly be destructive.
While the symptomatology is good to know, the most important thing to remember about the different phases of bipolar is that mania, depression, and other manifestations of the illness are not evidence of flaws in character. They are manifestations of a brain in incredible flux.
We often say people with bipolar disorder don’t take medications because of the side effects. There’s truth to that. But I think sometimes the rejection of medicine is rejection of the entire diagnosis. It’s a way for someone to say, “I am NOT crazy!” It’s a protest needed in a culture that hasn’t yet evolved to understanding all the iterations of its people.
In my office, there are three factors that I repeatedly hear as stigma-sustaining ideas and behavior. Could the world be rid of the stigma that alienates our mothers, fathers, brothers, sisters and friends living with bipolar disorder? I think so. Some communities and groups have already started to champion the cause. Whether you are someone living with bipolar disorder, a family member or friend, here’s 3 ways you can help:
1. Abandon Labeling Language
First, let’s stop calling people “bipolar”. A person is not bipolar, they have or live with bipolar disorder. Identifying someone by the name of a disease they have makes no sense and usually is applied only to mental health disorders. The exception to that is when we call people diabetics, epileptics or asthmatics – and even that’s not the same. The “-ic” ending makes the word mean, “one who suffers from…”
But you’d never say, “Oh you know how he is, he’s cancer” or “I can’t deal with her, she’s heart attack.” It sounds silly, right? So, let’s make an agreement today. If we’re speaking of someone who lives with any mental or physical disorder, we will say they have or live with the disease, not that that’s what they are.
If you are someone living with bipolar disorder, please don’t perpetuate stigma by self-deprecating speech. Whether it’s your desire or not, as someone impacted by the diagnosis you are an ambassador for how it’s perceived in the world. In my office, my patients joke around at times about their illnesses, because they know I understand – and the humor helps them to cope. But if you’re dealing with an uninformed audience, try to avoid use of words that ridicule you or the disorder.
We should all avoid demeaning jokes that turn folks into caricatures. And those who do not have this diagnosis would be wise to abandon the judgmental bliss that fools you into thinking you're “better” than people with bipolar disorder because you’re “sane.” Words like “psycho” should be dropped, too.
2. Break the Bias
So, why do we call people “bipolar” in the first place? It's because of bias. It’s because of discrimination against those with “invisible” brain disorders. When brain function changes and causes someone to be moody, rude or erratic, people mistake the disruption as a personality flare or character deficit and meet them with judgment and criticism.
When brain function changes and people have a physical manifestation, like with a stroke, seizure or dementia, people are empathetic and compassionate. Seeing is believing when it comes to medical disorders for most people, and it’s just not fair.
Psychiatric disorders are the only group of illnesses that are equated with a person’s overall being and worth. We have come to believe we are our brains.
Please don’t fall prey to this misconception. Just because bipolar disorder’s impact on the brain is not visible to the naked eye does not negate the fact that there’s a chemical and physical change happening. People aren’t making it up or seeking attention. For the most part, bipolar disorder is not fun – and I’ve never met anyone interested in faking it.
Let’s give the same respect and care to neuropsychiatric brain disorders as we do to all other medical issues.
3. Admit You’re Afraid
I think people are afraid of mental illness. We’re all afraid we’ll get it, or it will happen to our children, or that we have it and it will destroy our lives. Bipolar disorder, because it’s symptoms can be prominent and loud, so to speak, is one of the most feared illnesses known to man. It truly doesn’t need to be, but it is.
To cope with the fear, the community shuns the disease and in large degree all those impacted by it. We shroud it in stigma. Stigma, which literally means “marks of disgrace,” is just a tool we use to separate the “healthy” from the “unhealthy” and soothe our fear of catching something. We emotionally and verbally stigmatize (or mark) people with bipolar disorder by essentially saying, “You with the mental problem – you stay far away from me.” We treat them like they are “bad luck” personified. In reality, we're afraid of what bipolar disorder means about human frailties.
See, people who are living through an experience as disorienting as bipolar disorder have a lot to teach humanity. They show us that it is the inherent value of the human spirit that matters, not the strength of the body, the approval of others, or the ability to control life's circumstances. When they chose to push through the disease state day after day, episode after episode, they are demonstrating immense faith and strength.
If you are living with bipolar disorder, please don’t discard your self-esteem. Don’t shrink instead of pursuing your dreams. Never settle for mistreatment in relationships because you think your illness makes you unworthy of more. Don’t let denial push away help that can lift you out of the storm.
And please, don't be ashamed. You are our teachers, you are valuable, and you are needed here.