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Understanding Mental Illness

As I mentioned, I recently took a trip east to see some family. In addition to 5-hour plane rides and meeting a long series of people I didn’t know, there was also the three hour time change to contend with. In other words, there was a lot of things that could, and did, mess with my bipolar. Now, like many people, I’m quite good at handling stressors in the moment. I can travel and meet and charm with the best of them and I can say it mostly went very well. The trouble, though, is upon return. Upon return I feel like I’ve been hit by a bloody truck and act pretty much the same way.
I’m useless in the afternoon. My functional, working hours are extremely limited. And this is thanks to my bipolar disorder. It’s like every character I type and every minute that goes by zaps just a little bit more of me until, by mid-day, there’s nothing left. This is hugely disheartening. I want to be like everyone else. In fact, I want to be like me a few years ago – me when I worked a full day – like everyone else. But the fact of the matter is, I’m not like everyone else in this regard. In this regard I’m limited. In this regard I’m disabled.
This morning, a girl from the United States (I’m in Canada) contacted me and said she had taken 40 pills in a suicide attempt and now needed help immediately. Please don’t do this. Please don’t treat the internet like it’s 9-1-1. It isn’t. It just so happened that I was checking the comments on my blog three minutes after this girl posted this comment so I caught it in time. (Help was called.) But I very much could have missed it. It could have taken me hours to get to this comment. I get many comments and emails and sometimes it takes me a long time to get around to reading them, let alone responding. I am, in no way, an emergency service. Reaching out to someone is always better than reaching out to no one, but please, if you need mental health help, know who to reach out to.
Many of us know a person who has suffered a bad bipolar outcome. Perhaps the person has lost their friends and family because of bipolar. Perhaps the person lost their job because of their bipolar moods. Perhaps the person became so unwell they ended up on the street. Perhaps the person was driven to suicide. Those are all very scary and worrying outcomes from a mental illness and, the trouble is, they’re real. I can’t take away your fear and worry by telling you that these things don’t happen because that would be a lie. These things do happen, every day. But that doesn’t mean that there aren’t things you can do to fight the fear and worry that surrounds bipolar disorder.
Mental illness isn't something that only exists in adults, the mental health of kids and teens is crucially important too. Talking to kids about mental illness early is critical.
Being sick, I think with anything, can be extremely isolating. Being sick, you’re not “like everyone else.” Be it cancer, HIV, diabetes or bipolar disorder, there is a moment when you realize that you’re different and that difference is isolating. This is a form of internal isolation. But, of course, isolation can be external every bit as much as it can be internal. And sadly, most people with bipolar disorder experience heaps of both.
Many people with bipolar disorder hold down jobs, just like everyone else. We get up, swear in traffic, survive on coffee and rant about our bosses behind their backs. But people with bipolar disorder or another mental illness have special challenges when it comes to work. We’re sick more often, we need time off for medical appointments and stress affects us more than your average person. Here are a few tips on handling work and bipolar disorder.
Even amongst people with bipolar disorder, the disorder is highly contested. People argue about what it’s “really” like to have bipolar disorder. What mania is like. What depression is like. And perhaps most hotly debated of all is what the appropriate treatment of the symptoms is – antipsychotics, mood stabilizers, antidepressants, psychotherapies, alternative treatments and so on. People argue about virtually everything. And one of the reasons why this is the case is because the experience of bipolar disorder is so vastly different. Some people experience manic psychosis, others do not. Some people experience delusional depression, others do not. Some people experience suicidality, others do not. And so on. Severity varies as do symptoms. And I would argue that much of this disagreement stems from the two basic types of bipolar disorder: well-controlled and not well-controlled bipolar disorder.
Bipolar disorder and borderline personality disorder have crossover traits and so a person with bipolar disorder can often mistakenly be diagnosed with borderline personality disorder. In fact, some feel that diagnosis with both disorders is inappropriate unless the patient’s bipolar disorder is in remission. But some people do meet the diagnostic criteria for bipolar disorder and borderline personality disorder. I would have put this number much lower than it actually is thought to be. From the research I’ve done, it appears that borderline personality disorder is comorbid to bipolar in around 40% of cases. This is particularly surprising as it was once thought that personality disorders were only comorbid to bipolar in 12% of cases or less. But what is borderline personality disorder and what does it mean if you’re diagnosed with both bipolar and borderline personality disorder?
Recently, it was announced that the very first diagnostic brain scan for a mental illness became Food and Drug Administration-approved. This test uses electroencephalography (EEG) to diagnose attention-deficit/hyperactivity disorder (ADHD). Finally, people with a mental illness (in this case ADHD) can point to a biological test and say, look – see – my disorder is biological in nature and we can test for it. It’s not terribly surprising that ADHD is the first disorder to have this type of test as we understand an ADHD brain better than we understand a brain with other disorders. Nevertheless, it won’t be the last. Scientists are actively working on diagnostic tests for depression, autism, bipolar and schizophrenia too. And while I consider this a major breakthrough in our real, tangible understanding of mental illness, there are reasons why diagnosis by brain scans matters and reasons why it doesn’t.