We asked our twitter followers to submit questions about bipolar for our panel of women with the condition. This the second part of a two-part post in which we blog the answers, the first part is here. The panel consisted of Zedkat (@stfumisogynists), Mel (@wondermare), Athena (@AthenaGenevieve), and Jane (@jelizap). Please note that these answers are based on personal experience only and should not be taken in lieu of medical advice.
[Content note: discusses suicidal ideation and attempts. Briefly mentions childhood sexual abuse.]
Do you think you are treated differently as a woman with bipolar?
Athena: Yes. From research I have done there is a disparity between the genders. Doctors look for the ‘male’ symptoms of the disease and often dismiss women as more emotional. I have experienced this first hand. While hysteria is not considered a real disease anymore, society largely still treats women as emotional and hysterical and doesn’t take into account that illness in women is just as legitimate as it is in men. While men and women may experience and exhibit signs differently, in my opinion likely due to cultural constructions of gender rather than actual biological differences, that does not affect the presence or severity of an illness. Unfortunately sexism infiltrates all aspects of civilization, including medicine. I’d recommend getting a second, third, fourth opinion if you feel you’re being misdiagnosed based on your gender.
Zedkat: Well for the whole of my adult life I’ve had bipolar so I don’t really have much to compare it to, but I think sometimes the symptoms of bipolar – particularly in the up swings – can deviate from expected norms about how women are supposed to behave – I become louder and more sexually outgoing, for example.
Jane: I can really only compare the treatment I got as a woman labelled bipolar vs a women labelled depressed; I think the bipolar label makes people a lot more nervous.
Mel: If you’re a woman, and you’re presenting to your GP with mental health issues, I think it’s very hard to be taken seriously. It certainly was until recently. How the changes to the primary care system will affect that, who knows?
Do people assume you shouldn’t have children?
Jane: I haven’t really run into this, I think because my diagnosis post-dated my children’s arrival.
Zedkat: Yes, people do unfortunately, which hurts a lot.
Mel: No-one’s ever said that to me. But then most people know I’ve never felt the maternal urge and am quite passionately child-free. I know Natasha Tracy who writes the Bipolar Burble blog has talked about how her fear of passing on the gene outweighs any maternal instinct.
Athena: No, and I think it is cruel and offensive to tell someone with mental illness that they should consider remaining childless. With proper medical help and dedication to maintenance there is no reason why someone with mental illness can’t be a good parent. While there is always the chance of passing on the disorder to your child, that does not mean the child is not worth having. Knowing the risk, my partner and I still intend to have children and know that we will have to be prepared for raising a child with mental illness. But I do not view this as insurmountable. I believe I will make an excellent parent and can help my children find stability like I have too.
Do you worry about passing the condition along to any children you have?
Mel: I’m 43 and still don’t feel grown up enough to have children, so let’s say I’m not worried about that! Although Dr Robert Winston has gone on record as saying it’s not a hereditary disorder. I’d never get tired of slapping that man. Everyone I know with bipolar disorder has a relative with a similar condition.
Zedkat: Yes, I worry about this a lot.
Athena: Yes and no. I know it is a possibility, but I also know it won’t necessarily ruin their lives. I in part attribute my creative and distinct way of thinking (that helps me to excel academically) to have this unique and sometimes difficult brain chemistry I have. I hope they only get the good, not the bad, but if they do inherit the disorder I’ll be there to help them.
Jane: It was something I definitely considered even with the less accurate diagnosis, but was not the major reason in the end that I ended up only having children that are not my biological children.
Do you think your experience of bipolar is different from men’s, particularly in terms of social norms and stereotypes?
Zedkat: Yes, I think sometimes the way I behave when I’m having an episode deviates from societal norms and stereotypes of how women are supposed to behave, which can be difficult.
Athena: Like I mentioned before, there is still this pervasive and deadly idea that women are hysterical, that we are too emotional and somehow less than human because of it. There is definitely more discrimination and dismissal of women with mental illness. I have one male relative with undiagnosed bipolar disorder (when it’s in the family genes you can tell pretty easily when a relative has it) and we are estranged so I don’t know what his experiences with it are. I have not met any other men with bipolar disorder so I can’t speak to how it might be different from a male perspective.
Jane: Hysterical is not a word that applies to men much, and yet the behaviour it describes can match a hypomanic state of the less-fun variety really well. I think that my symptoms are written off quickly as “typical woman moodiness” where in men they are remarked upon and cause people to either be afraid of the guy or more insistent that he needs treatment.
Mel: I only know two bipolar men in real life. One has spent a lot of his life under section, but is now in his fifties and been pretty euthymic for a number of years, he’s stopped taking his meds. We shall see if it lasts. The other one is ignoring his diagnosis and doing as he pleases but his life is pretty chaotic.
Perhaps it took a lot longer for me to get diagnosed because more women will go to their GP to talk about their mental health than men will. And I think, as a result of that, we’re not always taken seriously.
In terms of social norms and stereotypes, I suppose men have always had the romantic, artistic Van Gogh thing, and women with bipolar are given the psycho, bunny boiler label.
Can you think of any good media depictions of bipolar?
Athena: Nope. The media mostly gets mental illness wrong. The American version of Shameless isn’t the worst I have ever seen, and tries to show more nuances. But I wouldn’t say they exactly get it right either. People with bipolar disorder are still the other in the media, not a part of the regular cast or regular society.
Mel: There’s been a lot of classically awful depictions of madness, but very few good ones. I always got a lot of comfort from King Lear, although obviously his condition was never named as anything other than madness. I enjoyed Clare Danes’ performance in Homeland, it was less reductive than most media depictions of mental illness.
Bipolar has become the hipster mental illness, and I really do hate almost everything written in the newspapers about it, mostly because they usually employ some middle class white male academic to tell us how we’re feeling. I’m so happy that Twitter exists – I’ve discovered wonderful bipolar blogs like Purple Persuasion and Bipolar Burble. It’s outrageous to me that print media is not giving these writers all the commissions. It would be nice to have one of us write about it. Preferably not Stephen Fry.
Two recent works of fiction struck a chord with me – Cage’s Bend by Carter Coleman is the story of a bipolar man as told by his brother, and Lux by Maria Flook has a bipolar woman as its main protagonist, but it’s not dwelt on. She is what she is, and I loved the simplicity of that.
Oh, and very recently Charlotte who writes the Purple Persuasion blog told me about Marbles by Ellen Forney – a wonderful graphic look at an artist’s diagnosis. I read it in an afternoon, and still keep it by my bed as I get great comfort from it. And it’s fucking funny, too.
Zedkat: I quite like Carrie’s character in Homeland. I thought they did a good job with it. My boyfriend says she reminds him of me, so I suppose that’s a good indicator! Also the book Marbles is AMAZING – would really recommend it to anyone interested in bipolar.
Do you feel agitated depression/dysphoric manias are underrepresented in the media?
Zedkat: Yes, I really think they are. I think there’s a perception that bipolar is about being ‘happy’ and ‘sad’, which is really a complete misunderstanding of the condition. I don’t think the way the media reports bipolar really helps with this perception.
Mel: Yes. Homeland got very close, but the perceived notion of bipolar is the swinging between two extremes. In fact, the most damaging, dangerous states are the mixed ones – a fizzing anxiety that means you can think AND act on those impulses to self-harm. And I keep mentioning Charlotte’s blog, Purple Persuasion, but she wrote a very moving piece about her experience of mixed moods. If I was clever I’d do one of those link things…Fementalists? You’re young, can you do one of those? [Ed – here you go: purple persuasion]
Jane: Given that I can’t actually think of any, outside maybe some snippets of horror films where it is conflated with psychosis, yes.
Athena: Yes. We’re either portrayed as monsters or just totally invisible. The vast majority of people I have met with bipolar disorder lead normal lives. I’d like to see the star of a series have bipolar disorder, but not have it be the focus of their whole life.
Any tips for family members of people with bipolar?
Mel: Trust them to tell you when they’re in need. If they’re being an utter cock, which I have to admit I can be, forgive them. If their behaviour hurts you, tell them, and, if necessary, keep the crisis line number handy. If you think they’re at risk of harming themselves, call it.
Athena: Acceptance. Accept it immediately, offer support and understanding, and then help them move forward and be successful. You can’t force them to get help or be healthy, but you can do your best to show that you care, you’re not judging, and you just want them to be happy.
Zedkat: Be kind. I know it’s not an easy condition for loved ones to live with and you really want to help, but try to imagine you were in my position and how much you would resent someone trying to micro-manage your life. On the other hand, if you can try and keep the lines of communication open because chances are sooner or later they’re probably going to want to talk to you about what’s going on. When they do, treat them with compassion and understanding, even if you are shocked or surprised or even disapproving of their behaviour. If you love them, love them for the people they are – bipolar and all – and don’t keep wishing they were different. Chances are they wish they were different too. Bipolar isn’t a great deal of fun quite a lot of the time and we’re not doing it on purpose, our brains just work a little differently.
Any tips for newly diagnosed people?
Jane: It takes time to figure out the balancing act; keeping track of how you are feeling over the long term is very useful.
Athena: Also acceptance. I experienced denial off and on, which made it more difficult for me to handle episodes, and made me reluctant to seek help. Continue with proper treatment (therapy and medication), structure your life for stability and happiness, and accept that there will always be issues but you can always overcome.
Zedkat: Your life isn’t over, it just might be a bit different from what you had planned. Plus, ultimately, very few people’s lives go exactly according to plan, you just have maybe a better idea of the ways in which it might deviate. Don’t beat yourself up, you didn’t cause this and you’re not making it up. Find people who share your diagnosis because though your specific experiences may differ it can mean the world to find some solidarity from others who’re in the same boat. I’ve been blessed to get to know some really amazing people who share the condition through twitter who are now genuinely friends. We look out for each other. Come and join us, we’re a nice bunch!
Mel: Everyone’s experience of bipolar is different. There’s a lot of help and solidarity online, specifically on Twitter. I would also warn you that if you need help from the Acute Mental Health Team, be prepared to wait a long time and to have to keep asking. I’ve been discharged, by mistake, twice. Having a mood journal works for some people, though I abandoned mine months ago and tweet instead. But notes about your mood are good for the psychiatrist, and can help if your p-doc happens to be a stuck up fool, like mine is. Oh, and always remember that most psychiatrists are people who wanted a medical degree but couldn’t be arsed to do seven years training. Question them. They are there for you, believe it or not.
What do you do if your family refuses to accept your diagnosis?
Zedkat: You have 2 options really, either fight them on it or accept their lack of acceptance. I had a problem where my best friend (who is more like my sister) refused to accept for a long time and it was unbelievably hurtful. Eventually though things came to a head and we stopped speaking because I felt she just wasn’t prepared to support me. Eventually she came around and now accepts the diagnosis and we can have proper conversations about it and have actually got even closer. If they really won’t accept it and are making your life miserable though, maybe it’s time to consider who you want in your life, tough as that might sound.
Mel: Ah, I think I may have submitted this question, on account of the fact that I’ve only recently told my parents about my diagnosis, and my mother’s first response was to tell me I just got sad sometimes and I was going through an early menopause. She understands now. Bless. So I guess my advice is be patient, because at some point, if they’re not utter bastards, they’ll see for themselves. And if they are utter bastards, stay away from them.
Athena: I’m grateful that was not my experience. I would recommend keeping your distance and building a support network of accepting friends. Maybe try group therapy and meet other people with the same issues. For me it is important to keep negativity out of my life, even if that means having my family at a distance (I am estranged from many members for reasons other than my own bipolar disorder). It’s not easy, but you have to put yourself and your health first. Suggest they educate themselves about the disorder, and then take space until they are ready to listen.
What do you do if your doctor/counsellor refuses to ‘label’ you?
Athena: Bipolar disorder is difficult to diagnose because it is a disorder that exists on a spectrum of severity and symptoms. One of my best friends has bipolar disorder and it is very different to her than what it is to me. Get to know your symptoms, research the illness, and if you’re sure that you have bipolar disorder stand your ground. I fought for years with doctors over my diagnosis. I saw over 20 doctors in about 10 years about it. It’s worth fighting for, which means you have to be patient. Doctors are human, and have their own perspective and bias. Keep looking until you find someone who listens.
Jane: If they give me treatment that works, I don’t care about the label. But in my case, until they found the right label, they didn’t try the path that led to right treatment.
Zedkat: Change doctor if you can. There’s no point in putting up with substandard care if you’re in trouble. I know it can be really hard to self-advocate so maybe, if you can, take someone you trust with you who can explain from an outsiders perspective what’s been going on – unfortunately doctors still seem more prepared to believe ‘sane’ people over those seeking help.
Any advice on explaining bipolar to people? What about explaining it to kids?
Jane: With my kids, we’ve talked a bit about how it feels when they get stressed out from being overstimulated as an analogy to the height -> crash phase of hypomania (sometimes complete with tantrum and nap phases.) And that depression is like being stuck in sadness for a long time when simple cheer-ups like dessert or cuddling a stuffed animal aren’t enough to get less sad.
Mel: Well I still don’t feel like a proper bipolar, even though, looking back through my answers, I’m surprised it took me so long to accept my diagnosis. Most people have a skewed understanding of it, and it is a fluid thing. Give them an example of what you’re like at your most high, most low, and most mixed. I think most young people would find it easy to understand, given that they’re so much the stars of their own dramas.
Zedkat: I try to explain it a bit like epilepsy in that the electricity in my brain fires wrong and affects the emotional/energy part of my brain so I either get surges of energy or low points in energy. It’s probably not a perfect analogy, but it does seem to help people understand, especially that depression isn’t about being ‘sad’ per se, but more about having NO energy or will to do anything. I’ve never tried to explain it to kids but maybe they’d get a hyper/tired analogy?
Athena: I usually don’t explain unless they ask. I put it out there the same way I would telling someone I have asthma, and then I discuss it with them if they ask or if the clearly do not understand what I am going through. I try to be honest about my symptoms and whatever it is I am going through. I don’t know how else to do it besides just dive right in. People are either accepting and willing to listen even if they don’t understand, or they are judgmental and not the kind of people you want in your life.
I don’t have kids yet so I am not sure. Once I do have children I plan to be honest and open with them the way I try (key word) to be with everyone else.
If you could get rid of your mental illness, would you?
Mel: I hate my mixed states, I hate the nothing of depression, I hate the come down, I hate the anxiety, but hypomania, happy hypomania can be awesome. That said, it’s not worth the cleaning up afterwards. So yes; have it, take it, kill it with fire. I would LOVE to know what it’s like to be a normal.
Zedkat: Tough question. Maybe? I would like to be rid of the awful depression and everything that goes along with it. But ultimately I think it’s part of what makes me me and I’m not sure I’d want to start tinkering with my brain like that. I guess I’m trying to learn to accept myself, dodgy brain and all. But honestly, you could take the depression, I’d be glad to see the back of it.
Athena: I don’t know. For all the down sides, I feel like there are a lot of upsides I experience as well. I am very artistic and creative. There’s no way to say this without sounding like I am bragging, but I have a unique way of thinking and processing things (thoughts, my environment, my emotions) which make me very intelligent. I experience emotions deeply and passionately, which in turn makes me very empathetic and compassionate. I can’t say 100% for sure that being bipolar is the source of this, but I have a feeling it is a part of this. I like the whole package, I like who I am. Even if it’s not always easy, I don’t want to be anybody else and I wouldn’t want to change anything about myself that would compromise my identity.
Jane: Yes. I used to think the hypomania was good for my art, and then I realized that even if I made a lot of things while I was up, that they weren’t very good. Clarity and stability are a much better place to work from for me.