Friday, October 9, 2009

Rerun - Is Bipolar Cool?


Here's a piece I did in January that warrants a second look:

Something major has happened in the ten years since I've been diagnosed with bipolar. Back then, it was an illness you concealed. It was a shame you hid. Friends, family, and colleagues had a way of only seeing the diagnosis, and what they chose to see was not good.

To disclose your diagnosis was to risk everything: friends, relationships, livelihood.

Then something started to change. Over time, bipolar morphed into something that could be "cool" to have. Mind you, those struggling mightily with their illness saw nothing cool about it. Neither did their suffering families. But the flip side was the stigma was diminishing, and this had to be good news.

Part of the trend had to do with the recent recognition of bipolar II and various forms of "soft" bipolar. In other words, bipolar wasn't an all-or-nothing disease. You could be a "little bit" bipolar. And a little bit was cool. Even the way-out-there bipolars could make a claim to cool.

Van Gogh, Hemingway, Woolf - how cool was that? Okay, they all killed themselves. But maybe if they were alive today - the thinking goes - that wouldn't have happened.

Over the years, I have urged individuals to embrace their entire illness - the good as well as the bad. If we simply viewed ourselves as patients who suffered, I kept saying, we would always wind up stuck well short of recovery.

Last night, I went to Facebook and searched under "bipolar." If the word appeared anywhere on a profile page that a member created, Facebook would find it for me.

My results revealed "more than 500" finds. I suspect many thousands. There were a great many examples to choose from, but let's go with three:

First, there were those whose lives seemed part of a weird Andy Warhol movie. These weren't exactly people you would be seeking out as Facebook friends. Then again, their bipolar credentials carried an air of exclusivity, as if to challenge the world. In the past, these people would have been shamed for failing to meet the standards of society. Now, there was an air of pride and defiance. They weren't about to please you. You had to please them. Too bad if you weren't good enough.

Then there were young hotties who advertised themselves as a bit on the wild side. Most of them, I suspect, had never seen a psychiatrist. But they proudly proclaimed themselves as "semi-bipolar" or "must be bipolar." Forget for the time being the dangers of romanticizing one of the worst illnesses on the planet. Instead, focus on the fact that these young women - part of a new generation - view bipolar as something positive, as a credential they can use (and misuse) to make new friends.

Finally, there were those I like to call bipolar role models. The image that stuck with me is that of a very attractive woman in her thirties or forties. She is in a smart pants suit, in stylish heels, posing in front of her Cadillac Escalade. I'm bipolar, is the underlying message, and not only am I making it in your world, I'm really kicking ass.

These are just some of the new faces of bipolar. They are a reflection of a changing world, a world that they (we) are changing. It is the face of a new bipolar cool.

A new generation - the Facebook Generation - is out there, in your face. They are not hiding in the closet. For good or bad, they are wearing their bipolar as if it were something to be embraced and envied rather than an entity to be feared and despised.

The rest of society is likely to embrace this change, as well, but possibly at the expense of being indifferent to our pain.

In the meantime, we are looking at tons of upside. Here's hoping ...

20 comments:

Yanni Malliaris said...

cool bipolar article...if only we could treat the more severe expressions of it so well to the point that we make it cool for all...if only...

Loretta said...

Great article, John. Searching Facebook was a very interesting idea. Five years ago, I was mostly in the closet re: my bipolar II. Since then I came out to my employer and colleagues, and many other people as well. I'm a social worker in the mental health field, and I believe we need a critical mass of voices saying "me too", to spread information and education and stomp stigma.

John McManamy said...

Hi, Loretta. You are exceptionally brave. From what I gather, the mental health field is the worst breeding ground for stigma. I have heard no end of horror stories. I suspect this has to do with the professional persona that creates a separation between "them" and "us." With a simple disclosure, a competent professional suddenly becomes one of "them." I personally have encountered the worst stigma from the mental health field.

Anyway, I very much applaud what you are doing, and please tell us more about it.

John McManamy said...

Hi, Yanni. In my own case, sleep made all the difference in the world. Monica Basco brings this up loud and clear in her Bipolar Workbook. As she points out, it's not the creative or even crazy ideas that get you in trouble - it tends to be the staying up all night working on them that sets you up for disaster. Then there is all hell to pay.

The key is recognizing when this starts to happen and taking appropriate action (or nonaction) such as making sure you get to bed at your normal time.

It's amazing how introducing a bit of discipline into our lives frees us up to spread our wings and fly.

My life is by no means perfect, but it sure beats my life before I started to get smart.

Lucy Talikwa said...

Interesting topic. On the everyday level, I am self-conscious and a little embarrassed about the whole Bipolar Is Cool thing.

I used to never mention I am Bipolar II. (What a shame! Avert your eyes now!) But now that I am not ashamed of the "mental illness" part, I’m ashamed of seeming pretentious. I find myself hesitating – or hurriedly – telling someone I’m Bipolar II, about how it affects my art and life, etc, because it seems like such a fashionista diagnosis. I even find myself saying to non-psych docs, “Yes, I’m really, for sure Bipolar II,” just so they won’t think I’m making it up, that I'm some old lady who’s faking it to look cool! Yeah. Right. Me look cool. As if they can’t tell by the meds on the chart.

As you say, all the cool-ness seems to be indifferent to the pain that comes with the situation. I find myself glossing over the pain in my self-definition. It’s one thing to tell someone you’re Bipolar, it's another thing to get into the dark-side details. (Unless you’re a bit manic, I suppose…)

John McManamy said...

Hi, Lucy. Many thanks for pointing out how extremely difficult this whole topic is. On one hand I've suffered terribly on account of bipolar and I identify with others who have suffered. A year ago, I lost a good friend to this illness.

On the other, I learned that if I over-identified with the suffering and sorrow, I would never have a life worth living. At some point, I figured out that if I could blame bipolar for just about everything bad in my life, then it was my obligation to give it credit for the good things in my life as well.

About four or five years ago, I made a conscious decision that I wasn't going to stiffle some of my emotional excesses. That if I appeared over-exuberant or over-reactive in public then so be it.

Paradoxically, by being myself I appeared more normal. I'm more upbeat and personable than I used to come across as, which is a good advertisement for my illness.

At the same time, I am very careful to rein in my impatience and anger in group situations and in public. I never want to have to apologize for my illness or have people attribute normal negative reactions to my illness. It's something of a white lie I am forced to live with, but it is the reality of the world we live in.

Ironically, I (and a lot of other bipolars) can better control my emotions in public than most so-called "normal" people.

So here I am, trying live my life by projecting a positive attitude, even when horribly depressed, trying to show by example that bipolars not only fit in but are kinda cool to be around.

To me, it's a better way of living life than feeling sorry for myself or by being bad company, but I'm still not comfortable with it. There are no easy answers. We all need to grapple with these issues, so I'm extremely interested in what others have to say.

Many thanks for bringing this up.

Anonymous said...

Dear John,
I read this post in January, when it first appeared and I was still crawling over coals and recovering from a life threatening reaction to Lamictal. I was horrified to think that anyone would think recovering from suicidal depression, or it's menacing cousins, manic mood swings would be cool.

It's October now, and I have had some good months on a fairly low dose of Lithium. I am back to working full time in the health industry, skilled nursing care. No one at work except my boss, who is also a very trusted friend knows my diagnosis, and I would be loath for anyone there to know. I hear negative, careless comments daily about residents who take psyche meds, even from pretty caring professionals. No one I know thinks Bipolar is cool or even quite frankly, managable. I didn't either, which made accepting this diagnosis very very difficult.

John McManamy said...

Hey, Anonymous. I certainly didn't think bipolar was cool when I was struggling with it, and even though I'm doing much better now I know I have a Sword of Damocles hanging over my head, which definitely is not cool.

A few days ago, I came across a review of my book, Living Well with Depression and Bipolar Disorder, on the blog, Revolt and Resignation. This is part of what the reviewer said:

"Unlike so many books and sites, he doesn’t pull any punches. He makes it clear that mood disorders are brutal, and that it will take plenty of hard work and all of your ingenuity to avoid suicide and live a decent life. While most books candy-coat the diagnosis, merely saying that you have a “broken brain” that can be made right with meds, McManamy argues that existing meds are at best crude tools, and that for most people, a diagnosis is the beginning of a long — perhaps lifelong — carousel of medications and side effects both trivial and crippling. The first section, then, on diagnosis, is a downer, and it’s a bit of a struggle to get from there to more hopeful sections on recovery."

So, I'm definitely not in the "bipolar is cool" camp. But I am a strong believer that we should not be fatalistic. That as long as we're breathing there is hope. And that once we have a handle on our illness that we can make use of the gifts that come with it - the creativity, productivity, sociability - to lead full and productive and even enviable lives.

Of course, we have to fight all the naysayers you mentioned. If they keep telling us that our illness is not manageable then we start to believe their bullshit. On one hand, mental health professionals sugar-coat the diagnosis and give us the impression a few pills will fix everything. On the other, they let it be known we're never going to be well. There's no middle ground with them.

So - an unflinching look at brutal reality, but also a clear view to where we can be. Is bipolar cool? No. Can I, with bipolar, be cool? Yes, most definitely.

Elizabeth said...

How are we to believe the professionals in the "helping" communities that we can lead normal happy lives when they themselves stigmatize the disease? It is a rare bit of luck to find a social worker or therapist, let alone a pscychiatrist, who understands bipolar from personal experience.

When I was in treatment after my first high, psychotic mania--brought to me by an SSRI--and had slipped into a deep depression, both situational (I'd really done a number on all aspects of my life) and clinical, a social worker was trying to tell me that I just had to adjust my attitude, my perspective. With all her training and professionalism, she was basically telling me to look on the sunny side. Basically, there was no sunny side. Yes, I was still breathing, but hardly grateful for the fact. Rather, I was spending my time contemplating ways to stop all that breathing.

I asked the social worker if she had ever been clinically depressed. She said no. I asked her if anyone on staff had ever been. No again.

The one thing that would have helped me most would have been someone with a real understanding of my state of mind, who had survived it and got past it to a full and happy life. One would hope that the helping communities would understand this and welcome the mentally ill community to work with them, just as alcohol and drug rehabs do. Does anyone out there know of any such programs?

As for whether being bipolar is cool, I've known some pretty cool bipolars. Many are dead. Young people use the term in many ways. They may think it means crazy as in wild and crazy. They may mean to suggest that they're hypersexual.

John McManamy said...

Hi, Elizabeth. The one organization I know that welcomes peers (and trains them) is Recovery Innovations, based in Phoenix. They know the value of having someone there who has been through the same thing you have. They have peers involved from crisis through to vocational and recovery classes.

Clinicians, of course, are resistant to this. They view peers as "competition," and, of course, we are "them."

What also affects clinician attitudes is they see us at our worst. For the most part, their training has been in hospitals where we are typically in a state of crisis and where they typically hurry us out the door in a bad (and often overmedicated) state. Very rarely do they see us well.

As for the "cool" bipolars you and I have known, I'm haunted by my friend who threw himself in front of a train a year ago.

Lori~ said...

When I was diagnosed, I was relieved! Not that I wanted to be!!! Just that it was time to finally have some answers and maybe get on the right med's. I had been on a string of anti-depressants, anti-anxiety (xanax and the like), pain killers for back pain which I got addicted to (another story) and many years of ups and down...as it goes.

I had read Unquiet Mind 2 years prior and talked to a "Psych", who assured me I was not bi-polar. But I had a way of saying things that kept clear of something I did not want to hear...And then ANOTHER crash.

Is it a cool disorder? No and HELL NO! Am I cool and the better person for having gone through it and survived it so far? OH YEAH!!

There is no one on God's green earth that I would be ashamed to tell that I am bi-polar, that sometimes I suffer so damn much I beg to die. But I have been there so many times that I just wait out the storm. I would never act upon "me being better off dead", for this life IS not all about me! I have felt the effects of losing a brother to this awful illness in a bizarre car accident while he was manic. These things we as a family never understood until I was diagnosed, you see KNOWLEDGE IS necessity. Losing a loved one hurts.

Stand up if you have a mental illness, never be ashamed, it is not your fault. It IS your responsibility to be educated and in turn educate those around you!

John McManamy said...

Hey, Lori. I read about your brother on your blog - thank you for keeping his memory alive. I also read your piece about your son Tan, who is a living affirmation of all that is right in this world.

Thank you for standing up and being counted.

To readers: Lori's blog, Wildflowers and Weeds:
http://wildflowersandweeds.blogspot.com/

To Lori: A weed is simply a misunderstood wildflower. :)

Lori~ said...

Thank you for the shout John!

...and from one "Weed" to another...

keep digging for your words are inspiration and it gives all of us with any kind of mental illness, hope.

John McManamy said...

Many thanks, Lori. Proud to be a weed. :)

bipolarized said...

John,
As you say in "About Me," writing about it can help in recovery. I started a blog back in April and wondered if it was a good thing to do. Not because of any shame about it, but because some things are just better left unsaid. But ultimately I felt that any dialogue about it can only help to remove the stigma that it once had. I don't know that it's "cool" to be bipolar, but I am certainly astounded, as you were, by the number of people out there who claim to have the disorder. As long as the conversation is productive and thoughtful I'm all for it. Thanks for sharing, Marco
http://bipolarized.wordpress.com

Life on the Edge said...

Great post! I've been wondering how so many people ended up being diagnosed with Bipolar Disorder, too and while I am sure some people actually have it, it has become somewhat "cooler" than when I was diagnosed years ago.

That said, here's a link to yet another Bipolar Blog. www.manicdepressivetalk.com

Elle said...

I'm so glad you posted this. I literally typed in Google "is it cool to be bipolar" because it seems so many people talk about it with out ever being diagnosed or really experiencing depression, mania, rapid cycling or mixed states.
I just started talking about my bipolar diagnosis (I've been diagnosed for years but afraid to speak about it to everyone except my husband) by writing about it and having a family, it's hard but it's working out for me.
I'm bipolar II with Ultra Radian Cycling. It simply sucks, but thanks to medication, too many to count, I feel good.
I applaud anyone with bipolar who talks about it.
I hope you have more good days then bad,
cheers, Elle.

SparklyPrincess said...

thank you oh so much for writing this article. i was diagnosed with bipolar 2 in june, and i've been trying getting my head round the 'bipolars cool' thing, especially when my boyfriend came home fuming the other day afted one of his employees kept getting excited because she thought she was bipolar. He couldnt understand why anyone would want it, but i've heard stories of psychiatrist's client's going in asking for a bipolar diagnosis, and ending up with a borderline personality disorder, at whhch point they no longer want anythhng to do with MH services. Also, im so glad someone in the working in the mental health field has finally been braves enought to be open about their disorder. i, myself am a mental healtn nursing student and thought my diagnosis was the end of training for me, especially with no support from peers in my group. however, on my last placement on a rehab unit i met a nurse with the same diagnosis who was the most amazing nurse i've eved seen. she gave me the confidence to keep going with my training and i gave her the confidence to be honest about her illness by showing its ok to be open. its great to know stigma may be going.

Cee said...

This is a subject that makes me feel a lot of things: hurt, shame, anger, frustration. A month and a half ago my diagnosis (of 42 years) was changed from unipolar depression to bipolar NOS. I am glad to have what I hope is the correct diagnosis of what I have been suffering all these years so I can get the correct help. I feel I am definitely in the middle of the spectrum you have been talking about. The thing that hurts is that because the spectrum is not well known, I feel like people think I am part of this so-called over-diagnosis of bipolar. If you don't have extreme manic symptoms, so they figure, it must be because you are trying to be "cool" or the pdocs/drug companies are trying to push meds. It is hard enough to come to terms with the bipolar diagnosis without feeling that now you can't even trust it is real (last session my therapist said I was in denial, I certainly hope he was kidding). I always knew I wasn't the typical depressed person. When I came across the term "atypical depression" I said, "finally, something that sounds like me". I had my first depression at 17 and it has recurred on and off since then. My mother died when I was 4 1/2 so it was through relatives that I heard she was very "moody". I just found out recently that my 30 yr old son has bipolar II. He said, "Mom, I've had this since I was a kid". We never could figure out what was wrong with him back then. At the time, the doctors said ADHD. I have felt suicidal many times and have suffered from SAD and what I think was probably post partum depression after my son was born. It is hard to remember any episodes of hypomania through my early years. It was always depression I seemed to be struggling with. Back then, I didn't even know hypomania existed so how could I know if I had it? Now that I know more, I can see that in the past 2-3 years, at least, I did have times I felt "too happy" and "too irritable". Over the years I have been on Sinequan, Prozac, Celexa and Wellbutrin. Sinequan didn't do anything. The others helped somewhat, but never enough or they stopped working. I've been through psychotherapy too. You can't tell me with all that history that there isn't something wrong. Because my symptoms cycle almost daily now (from years of antidepressants?), I was put into the NOS grab bag. I can't help what I experience: too many symptoms for "real" depression and not enough symptoms for "real" bipolar. The last thing I am doing is trying to be "cool". Thanks, John, for a place where I am just accepted as "real".

Cee said...

This is a subject that makes me feel a lot of things: hurt, shame, anger, frustration. A month and a half ago my diagnosis (of 42 years) was changed from unipolar depression to bipolar NOS. I am glad to have what I hope is the correct diagnosis of what I have been suffering all these years so I can get the correct help. I feel I am definitely in the middle of the spectrum you have been talking about. The thing that hurts is that because the spectrum is not well known, I feel like people think I am part of this so-called over-diagnosis of bipolar. If you don't have extreme manic symptoms, so they figure, it must be because you are trying to be "cool" or the pdocs/drug companies are trying to push meds. It is hard enough to come to terms with the bipolar diagnosis without feeling that now you can't even trust it is real (last session my therapist said I was in denial, I certainly hope he was kidding). I always knew I wasn't the typical depressed person. When I came across the term "atypical depression" I said, "finally, something that sounds like me". I had my first depression at 17 and it has recurred on and off since then. My mother died when I was 4 1/2 so it was through relatives that I heard she was very "moody". I just found out recently that my 30 yr old son has bipolar II. He said, "Mom, I've had this since I was a kid". We never could figure out what was wrong with him back then. At the time, the doctors said ADHD. I have felt suicidal many times and have suffered from SAD and what I think was probably post partum depression after my son was born. It is hard to remember any episodes of hypomania through my early years. It was always depression I seemed to be struggling with. Back then, I didn't even know hypomania existed so how could I know if I had it? Now that I know more, I can see that in the past 2-3 years, at least, I did have times I felt "too happy" and "too irritable". Over the years I have been on Sinequan, Prozac, Celexa and Wellbutrin. Sinequan didn't do anything. The others helped somewhat, but never enough or they stopped working. I've been through psychotherapy too. You can't tell me with all that history that there isn't something wrong. Because my symptoms cycle almost daily now (from years of antidepressants?), I was put into the NOS grab bag. I can't help what I experience: too many symptoms for "real" depression and not enough symptoms for "real" bipolar. The last thing I am doing is trying to be "cool". Thanks, John, for a place where I am just accepted as "real".