It took over a year into therapy before I finally sought medication. My therapist had been recommending it for just as long. I was likely clinically depressed, he said, and there was no shame in seeking further help. For most of that year, I ignored him. Medication was an admission that there was something that I couldn’t control. Medication meant that years of resisting dependency on alcohol and drugs to deal with the unbearable sadness would be for naught- that isn’t a fair comparison, but I couldn’t help but consider it as similar to my father’s alcoholism or my brother’s drug use. Besides, could I really be depressed when there were days, sometimes weeks, where I felt so high and elated and powerful that the sadness was a distant memory, even if I did inevitably crash?
A few months ago, I finally made the call to a psychiatrist to get formally diagnosed with clinical depression. It wasn’t that I was in a particularly horrible place and it wasn’t that my therapist finally wore me down. Quite the opposite: I had a wonderful internship, a beautiful apartment with people whom I love living with, and a part-time job that paid me well and kept me fed. It was in those ideal conditions that the depression became pronounced, and it was because my position was so stable that I was able to bring up medication on my own. I went into my psychiatric appointment nervous but sure: I was clinically depressed and medication would help. At the end of the appointment, my confidence in those truths was shaken. What I suffer from isn’t clinical depression, it’s Bipolar II.
Bipolar carries with it a slew of connotations, most negative. When most individuals think of bipolar disorder, they may think of severe Bipolar I. The type of Bipolar that causes mania and psychosis and, sometimes, hallucinations. They may think of violent mood swings, of abusive parents, or of dysfunction. But bipolar disorder is a spectrum, and it doesn’t mean that an individual is violent or abusive. Really, it’s just a label to describe a handful of symptoms, the most notable of those symptoms including episodes of mania and depression. Mania is an elevated state that goes beyond the highs of average excitement. People are who are experiencing mania may not sleep for days, they may feel so powerful that they make reckless decisions, they may talk so fast it’s difficult to keep up, and they may be irritable. In severe bipolar, mania may mean hallucinations. But that mania will eventually crash in depression, during which an individual may feel hopeless and self-loathing, fatigued, sluggish. To be diagnosed with bipolar, you need to have experienced at least one manic episode and at least one depressive.
In Bipolar II, which is what I have, individuals experience a less extreme version of mania called hypomania. Hypomanic individuals face less severe manic symptoms, including but not limited to sleeplessness, elevated self-esteem, distractibility, irritability, etc. Even though the highs are less severe, the lows in Bipolar II are more pronounced. There is also Cyclothymia, which is a milder bipolar disorder, characterized by hypomania and mild depression. Even within each type of bipolar disorder, there is a spectrum of severity, and not everyone with bipolar experience the same levels of mania, hypomania, and depression, and symptoms vary.
When I was first diagnosed, it was a difficult label to accept. “Bipolar” was such a weighted word, and applying a name to symptoms that I had recognized as just aspects of my personality for years felt like I had lost control of my identity. But I’m not any different than I was before the diagnosis. My hypomania didn’t create my ambition, nor did it fabricate my passions. My depression doesn’t define me, and the sadness and guilt that plagues me is no fault of my own. The only thing that it means is that my neurotransmitters are wired a little differently.
Bipolar disorder isn’t this unspeakable Big Bad. It’s a collection of symptoms, symptoms that exist on a wide spectrum from mild to severe. The more we speak about mental illness, the more we can strip mental illness of its stigma and its power to create fear and uncertainty. There is no shame in speaking up, nor is there shame in seeking help.
Famous individuals with bipolar: Halsey, Mary Lambert, Max Bemis, Carrie Fisher, Catherine Zeta-Jones, Vincent Van Gogh, Virginia Woolf