When friends know you are sick, it’s natural that they should want to help. I am very pleased to say that I have never found bipolar an exception to that rule. I know, and I’m sorry, that some people do find their friends melt away after a mental health diagnosis; all I can say is that, thankfully, I have not found that to be an issue. So I thank you for being here for me, whether I know you online or in person. I thank you for listening to me over hot chocolate, for reading my tweets, for commenting on my blog, or for texting me because you’re wondering how I’m doing. I like it when you ask me how my week has been and really want to know. It’s great when you remember when I’ve had a medical appointment and ask me how it went. And I love it when you celebrate my little victories, from a good night’s sleep, to less frequent appointments with the psychiatrist.
And yet there are a few things I wish you wouldn’t ask. It’s not really about you; it’s about the questions that I hear over and over again, and which I honestly don’t know how to answer. I’ve tried, many times, to answer honestly, but they reveal where the gaps are greatest between the non-bipolar and the bipolar experience. Sometimes I get annoyed when you ask them. Understandably, you then get upset; you were just trying to help. Let me share with you what goes on for me whenever someone asks…
1) “But why?” Sometimes when my mood state has recently shifted, I don’t like to mention it to you. I know you mean well when you ask me how I am, but disclosing a switch in polarity or a move from elation to irritability sets me up to be asked why. If you have no personal experience of mental health difficulties, or tend to get clinically depressed in response to a clear trigger, I can see why you’d find it hard to understand a mood state with no obvious cause. I know that many people feel low because they have experienced a bereavement, a redundancy, a relationship breakup or other loss. Elation too can be part of the normal human experience. It’s natural to feel over the moon if you receive good news; the longed-for pregnancy, the prestigious job offer, the exciting new relationship are things that give most people an emotional buzz.
But it’s not like that for me, or for many of us with mood disorders. Sometimes I can pinpoint triggers that bear some resemblance to my mood state. But in most cases, if there’s “cause”, I’m not aware of it. That can be hard for you to accept. It doesn’t connect with your personal experience, so you think I’m not being honest. You hope that if you dig just a little deeper, I will admit to something that’s troubling or exciting me, so that you can understand why. But when there’s really nothing there, looking for reasons just makes me feel guilty. I start to feel that I should feel happy when I’m actually depressed; that’s it’s not OK for me to be anxious, because there’s no reason for it. Sometimes, a mood is just a mood, and I’d love it if you could trust me on that.
2) I hate what those drugs are doing to you. Have you thought of trying natural remedies instead? I can see why you’re asking this. Yes, they are really strong, and they do have nasty side effects.I understand that you, or someone dear to you, may have had a bad experience on psychotropic meds. I’m actually not that keen on Big Pharma myself, and worry about the over-prescription of drugs in the place of scarce talk therapies.
The thing is, sometimes anything less than drug therapy isn’t going to cut it. I used tea tree oil on my son only the other day when he had an infected toe. But if it doesn’t clear up, we’ll be getting oral antibiotics. And if for some reason (God forbid) the infection became systemic, I wouldn’t think twice about having him admitted for IV antibiotics. I’m all for treating things yourself, using self-help and possibly natural remedies, when things are mild. I don’t set out to cost the NHS who knows how much of its drug budget. But bipolar in all its forms is serious, and I’ve been in a particularly long and acute episode, even by my psychiatrist’s reckoning. I’ve been way beyond treating myself for decades now. So yes, I’ve considered taking fish oils, or St John’s wort, or cutting out sugar and alcohol. But to a certain extent, my drugs work. They’re incredibly blunt instruments; they reduce the functioning of my digestive system and make me so dopey I’m not allowed to drive. But they are making me sleep well for the first time in over two years, and they also help my mind to be less busy. And I don’t believe there is any food or complementary therapy that can do that. So thanks, but I’m not about to swap my lithium for walnuts at the moment.
3) But what does it feel like? In a way, I’m glad you ask. I’m glad you’re not like the friend who “explained” to me that people with bipolar don’t feel emotions any differently to the rest of the population (presumably this means that I am just a “poor coper”, unable to weather life’s normal ups and downs). So I’m happy that you recognise that someone only gets a bipolar diagnosis if they feel emotions much more strongly, and for longer periods, that most people. I just don’t know how to answer you. What is it should I describe? People tend to be particularly interested in elated (hypo)mania, and that’s possibly the easiest to describe. But it’s not just about depression or elation. I know the name makes it seem that way, but there’s whole lot more. I’m sure when you asked the question you didn’t want me to go onto irritable hypomania, anxious hypomania or mixed mood states, and that’s a good thing, because I really don’t want to relieve how it feels to be out on control and the mercy of negative emotions while I’m just having coffee, or at a party or tweet-up. So please don’t think I’m being rude when instead of answering, I pass you a business card and suggest you check out my blog.
4) Are you sure you’re not a bit high? Of all the dreaded questions, this is the most annoying. Remember being a kid, and your parents responding to some behaviour on your part by asking, “Are you tired?” Remember how if you said, ”No! I’m not tired!” that was taken as proof that you were? Can you call to mind just how frustrating it was to be told your feelings weren’t your feelings, that they were down to some other cause?
That’s how it can be to have bipolar. As soon as you show any sign of being happy, someone asks you, “Is that a sign you’re going high?” There are only two possible ways I can respond to this question: irritation; and irritation. Because if I am actually getting high, the last thing I want you doing is bursting my hypomanic bubble by asking me if my elation is pathological. Yeah, maybe it is, and do you know what? If I really am hypomanic, I DON’T CARE, and I don’t want to be dragged away from what I’m feeling.
If I tell you I’m feeling good and I’m genuinely not hypomanic, I’ll still feel irritated by this question. It’s incredibly dispiriting if you ask me if I’m high. I know you’re worried for me. But whenever I’m finally feeling well – not fast, not elated, not over-enthusiastic, not BRILLIANT! or FANTASTIC!, but well – I’m proud of that fact. If you question that wellness and ask if it’s symptomatic, you knock the relief and pride that I am feeling out of me. I start to wonder, why bother? Why share my delight in being stable, if delight is going to be viewed as pathological? It’s dispiriting. And it’s…irritating.
Of course, there are times when you genuinely worry for my mental health. But there are ways and ways of expressing that. I would rather hear, “You seem to be getting a lot of things done, are you feeling productive in a good way?” than, “Is all that rushing around a symptom of going high?” “I’m concerned you don’t seem to be getting much sleep, do you think that’s becoming a problem?” is better than, “Uh-oh, are you hypomanic?” Focus on the possibly worrying behaviour you’ve noticed – but try not to suggest your interpretation. I rarely have a problem with self-awareness. If I think I am going high, I will already know, and I will happily tell you. If I’m well, please don’t take the joy out of that by labelling it a “bipolar high.”
I know I sometimes seem irrational in response to these questions. I hope I’ve bridged the gap a little between my experience and yours. I’m not really that irrational. I just think like a bipolar.