Illness or Personality?

I answer questions as an "Expert Patient" at BipolarConnect. Two days ago, Dark Angel asked, "Why does bipolar seem like your personality?"

The question goes right to the heart of how we see ourselves, and is central to every issue we discuss here at "Knowledge is Necessity."

"Welcome to a lifelong quest for self-knowledge," I began. Okay, let's see if we can figure this out:

The experts distinguish between "state" and "trait." A state equates to an illness episode whereas a trait is part of your personality. Let's use hypomania as an example:

People tend to pair "exuberant" with "personality." Exuberant is seen as beneficial, and, most important, people see YOU as in control.

In hypomania, for the purposes of this conversation, we are talking about over-exuberance. Not only that, hypomania is often a sign that we are really about to lose control of our brain, or that we have already lost it.

I would contend that for many of us hypomania is a normal part of our personality, only in this case we're mixing bad with good. For some, it may be a rational choice to accept the bad with the good. Others understandably want no part of hypomania.

The DSM sheds some interesting light on the topic. According to the DSM, we are in hypomania when we experience "unequivocal change in functioning that is uncharacteristic ... "

In other words, we are talking about a "state" that is not a true part of our personality.

I would argue that for many of us this is not necessarily the case. Nevertheless, the DSM is making a valid point. Keep cranking up the volume, and, at a certain point, we are definitely not ourselves. We are not in control of our brains.

Think of two individuals who are "up." They are thinking alike, they are acting alike. But one is behaving rationally and in character while the other is not. Same behavior, yet a profound difference. One may be on his game, the other may need meds. On and on it goes.

Hypomania is just one example. We need to apply this ruthless self-examination to all our behaviors, as well. This includes our depressions and anxieties, as well as a range of personality quirks.

For many people, our illness is fully integrated into our personality. Others rightfully view their illness as an interloper. Well-meaning experts, including friends and family, are not hesitant to proffer advice, but, in the end, you are the only expert in knowing where you stand. But this kind of wisdom only results from responsible self-enquiry. Welcome to "Knowledge is Necessity."