Bipolar Today

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A few weeks ago was Mental Illness Awareness Week, which gave me a lot to think about. For the most part, I’ve considered my bipolar disorder to be something essentially private, much like if I had asthma or some other disease. As a result, it didn’t warrant any public revelation, not so much because I was ashamed of it (I’m not), but because I don’t normally discuss any of my other illnesses, so why would I discuss this one?

However, something I realized in these last few weeks is that people who are public about their bipolar disorder are actually needed. Unlike say asthma, there is a lot of what is normally called “stigma” around bipolar disorder. Because of misinformation and just plain old prejudice, being publicly bipolar can present a lot of barriers to people. While in principle we cannot be discriminated against on the basis of bipolar disorder, this happens all of the time.

Nonetheless, this need for public revelations wasn’t my only motivation. I’m not the type of person to martyr myself on the nearest available stake, no matter how worthy the cause. Living with a large secret like bipolar disorder has been harming my ability to make friendships and to work effectively. From the therapy I’ve been getting for the last six months, I’ve realized how much my secretiveness has actually been an impediment to my life, not a benefit.

So, I’ve decided to go public with my bipolar disorder today. Since one of my motivations in this blog is to not simply write about myself for its own sake, but to write about myself in so far as it can benefit other people, I thought I would write down my considerations in going public both positive and negative, and then put together a summary of why I came to my decision.

Reasons to Stay Private

For years, I’ve stayed private about my bipolar disorder, and it was not completely without reason. The following are some of my main considerations.

Discrimination

I realize that every time someone goes public with his or her bipolar disorder, it benefits everyone with bipolar disorder by removing stigma, and I’ve known that for years. I’ve never really had any doubt on that score.

However, I have responsibilities other than those to society or to other bipolar people. I have a family who depend on me financially, and if I lose opportunities for jobs or promotions because of discrimination, no matter how unjust, I am less able to fulfil that responsibility. Just because I am not “in the wrong” doesn’t mean that my responsibility diminishes any less. I don’t go walking in dark alleys at night either, justifying it on the grounds that, if I get mugged, someone else is in the wrong.

No matter how much legislation is in place, discrimination remains for people with bipolar disorder. We can’t know every decision that is influenced in other people, consciously or unconsciously, to our detriment. As a result, I worry that revealing my bipolar disorder could hurt my ability to earn a living and thereby my family.

Not Being Taken Seriously

I’m not so much worried about losing friendships. My friendships are very strong, and if I am mistaken and I do lose some friends, I will simply assume that those friendships were never very strong to begin with. My concern is more with being taken seriously.

While it is true that some of my enthusiasms are guided by my bipolar disorder, a lot of them are not. I also simply have interests and good ideas that are not simply a result of my bipolar disorder, but are simply my own.

Basically, I don’t want people thinking while I’m talking to them, “Is Daniel behaving pathologically? Is this him being manic? Is he okay?” Meanwhile, what I’m actually saying is simply being ignored. I worry that I will have an extra hurdle to go over in almost every conversation. On top of getting my ideas across, I will also have to constantly be persuading people that I am “all right.”

I Can’t Take It Back

I call this the “tattoo effect.” While getting a tattoo might seem like a very good idea, once I get one, I will have it forever. I would worry that, ten years down the line, I might not think that a particular Chinese symbol has the same meaning for me that it used to do, or I might find myself in a work environment where tattoos are especially frowned on.

The same thing applies in publicly revealing my bipolar disorder. Once it’s done, I can’t take it back. If, ten years from now, I decide that going public was a bad idea, I’m stuck. On the other hand, if I decide to stay private, I can always go public later.

Reasons to Go Public

Those are the reasons that have been holding me back. However, they are not what have shaped my decision. There are a number of other reasons why I have decided that I will go public with my bipolar disorder today.

Public Benefit

In the summer of 2010, I started to facilitate a bipolar group in Toronto. I’ve always done it under my real first name, but I’ve kept my surname private. On the group’s Meetup page, there’s a picture of me facing away from the camera (I’ll be changing that, too). So, I’ve managed to be able to help out somewhat with the mental health community while staying largely private.

One thing that I’ve realized from that group is that there is a lot that can be done in the mental health community. In Toronto, there is a lack of resources for people with bipolar disorder, and as someone who has bipolar disorder and is relatively functional, I have a lot to offer. I think that I’ve done a lot of good in facilitating that group, and I would like to do more.

However, when acting anonymously, there is only so much one can do. Sure, I can run a group, but I can’t address any governments anonymously. Most newspapers won’t publish anything that I write anonymously, so I’m restricted to blogging. I actually had a rather funny incident along these lines about a month ago. The first time I tried to post a comment on a newspaper website, my comment was rejected. What made it funny was that the article was about the stigma about bipolar disorder and why so many people hide it, and my comment was about why I wasn’t public about my bipolar disorder. The comment was rejected because they didn’t allow anonymous comments (the editor wrote me a very polite and apologetic letter in which she acknowledged the irony, but she couldn’t change the policy). Nonetheless, this brought home for me the limitations on my advocacy that would be brought about by staying private.

The other issue is that I am, in some ways, an expert in the field. While I am not a therapist, I hold a Ph.D. in philosophy, in which I wrote my dissertation on the philosophy of medicine. Specifically, I compared the ways that practical and scientific reasoning interact in both ancient and modern conceptions of medicine. However, because I am uncomfortable writing Daniel B., Ph.D, I am not able to reference that expertise, which I think is very important to any discussion of bipolar disorder. In fact, I think I may be unique in this. I have never seen anyone else who is bipolar with a doctorate in the philosophy of medicine and who applies that expertise to the subject.

Finally, there is just the benefit of being another person who isn’t afraid to say that he is bipolar. A lot of the overcoming of prejudice around mental illness is for people with bipolar disorder to be public about their illness. The more of us that do so, and the more present we are in the public eye, the more we can effect a change in public perception of the illness. Just be going public, I can contribute to this.

Not Hiding

I had a strange incident with my psychiatrist a few weeks ago. I was having a rather severely hypomanic day (it verged on mania) where my thoughts were racing incredibly quickly and I was extremely confused. I had trouble even getting to my appointment, since my anxiety kept convincing me that I was about to miss my stop and I should be getting off of the subway. My memories of the day are extremely hazy.

When I got to the psychiatrist, I was convinced that my speech was as racing as my thoughts. However, when I brought that up a couple of weeks later, my psychiatrist said that I was speaking a little fast, but that it was nothing that would have been obvious. We chatted about this for a while, and the conclusion that we both drew is that I present well. In other words, I’ve gotten very good at hiding my episodes over the years. For example, when I have racing thoughts, I just cut a lot of what I want to say rather than try to push it out, which means that my speech doesn’t race.

However, this isn’t how I’ve been perceiving things. Whenever I am having pathological moods, I am constantly afraid that people will notice (which, I assume, is how I’ve gotten so good at presenting well). However, this has two effects. First, I am often very awkward in social situations, since I don’t want to give anything away and so I simply withdraw. Second, after any social event, I go rigorously over every single thing I’ve said to ensure that I haven’t said anything revealing. This leads to a huge amount of anxiety and makes social events such a chore overall that I end up withdrawing in general.

The problem with having a big secret that we think can seriously damage our lives is that we need to live in constant fear that people will discover it. This causes massive amounts of anxiety, and I don’t really think that I can get deal with much of my anxiety so long as I am so private about my bipolar disorder.

Better Relationships

I wrote a blog post a while back about the defects of the idea of a “real me” that supposedly underlies my bipolar disorder. A large part of that post discussed the ways in which I’ve come to terms with my fluctuating moods and, more importantly, my fluctuating personality traits. I am the human being that has a succession of contradictory personality traits, and this enables me both to view my bipolar disorder as an illness while not identifying with any of them.

The problem, though, is that, regardless of my views on that front, I still interact with people on a personal level. My successful attempts to hide my bipolar disorder rest on constantly hiding what I’m thinking and feeling. Of course, I don’t do this all of the time, but I am well aware that I have constructed not a person but a persona. This has made it harder and harder to create relationships with people, because I am often withdrawn (even when I don’t appear so).

I’m not entirely sure what the effect of going public will be, but one good side is that I won’t need to be quite so reserved. I’ve often considered my reservation to be one of my greatest strengths, but one need only ask someone his or her greatest strengths to find his or her greatest vices. I hope, just as in my marriage (my wife knows), I will be able to have closer friendships with people.

Getting Cut Some Slack

I am very much afraid that I will use bipolar disorder to enable some of my worse traits and behavior. Once I have the excuse available of bipolar disorder, I don’t want to run into the situation where I will misbehave, either not do it pathologically or not try to stop myself, and then use bipolar disorder as an excuse. I was on a blog the other day in which someone asked if people had ever used bipolar disorder as an excuse for something that wasn’t really from bipolar disorder. Reflecting on the question, I realized that I had never done so, which surprised me. A lot of this is because I’m private about bipolar disorder, so I don’t have the opportunity.

However, on other occasions, bipolar disorder really is an excuse. I had a situation years ago where I lost my temper in a place that I frequent, during an especially severe hypomanic episode, and got temporarily banned. Afterwards, I went to the person in charge, and, knowing that he was sympathetic when it came to mental illness, explained the situation. I was correct. While my ban was always only temporary, it was important to me to re-establish my relationships at the place, and explaining that I was bipolar was an important part of that.

While this is a rather severe case, there are lots of other incidents where I need some slack cut. If I’m especially effusive, I might dominate a conversation and become tiresome or tell an inappropriate joke. I might run out of lecture material ten or fifteen minutes early because I’ve been speaking too quickly. In a way, it’s these minor incidents that are the problem. They don’t each warrant going public in their own right, but I believe reasonably that if people knew I was bipolar, they would likely cut me some slack.

In my current situation, I feel like I am living in an unforgiving environment. I think the moral standard for people with bipolar disorder is that they try to behave appropriately during episodes, not that they succeed. So, I feel like I’m being judged for things that aren’t my fault (even if it isn’t true; after all, how would I ask without revealing my bipolar disorder?). For a long time, I’ve simply accepted this, but it’s becoming an especially difficult burden.

Conclusion

So, let’s get to it then…

Hello, my name is Daniel Bader, and I have bipolar disorder. I am pleased to meet you.

Related posts:

1. China Mandates That Mentally Ill Be Reported To Public Security
2. Top Ten “Bipolar Today” Posts of 2011
3. “Stigma”: Reflections on Its Meaning and Use, Part I
4. Big Changes on Bipolar Today
5. “Stigma”: Reflections on Its Meaning and Use, Part II