Written by IB
TW: mentions of suicide
I knew I had Bipolar Disorder the second I opened up the Diagnostic and Statistical Manual of Mental Disorders, or the DSM-5 as we clinical social workers call it. I remember the day I read it: it was my first day at my supportive housing field placement for my Master’s in Social Work at NYU, and I had just sat down at my desk with 7 binders we called “charts.” Charts had all the information pertaining to the medical history of our clients that one could possibly think of: their birthday, their intake form for when they were admitted to the supportive housing agency, a copy of all psychological evaluations done by doctors, a list of their diagnosis (sometimes there were multiple), and their address and phone number among other things.
My first client, I’ll call her Sandra, was a 40 year old Black female who suffered from Bipolar I and PTSD. Her treatment plan included medication management, community engagement, and vocational training. On my first day, my job was to identify her symptoms so that when I did my first home visit with her, I would be able to compare her current symptoms (if any) to those listed in her chart. All I knew about Bipolar disorder was the association with low-lows and high-highs, which was not very descriptive at all, so I asked my coworker for a copy of the DSM-5 to get more familiar with the illnesses my clients suffered with. I flipped to the section “Mood Disorders” and found Bipolar listed as the first illness. The definition told me there were extreme sides of a person’s mood. The high was called “manic,” or “hypomanic” episodes, and the lows were called “depressive” episodes. As I read through the symptoms I began to panic. My thought process was a mixture of deep denial and the sinking feeling I always get in anticipation when I watch a scary movie and know that something messed up is about to happen.
Mania includes:
Delusions and hallucinations (in severe cases)
This sounds serious. I don’t have this at all. I am fine. Everything is fine.
Feeling unusually “high” and optimistic
This is also fine. This is just my personality. I like to look on the bright side of things, especially now when the colors of the sky are so pretty and vibrant and the world has so many endless possibilities for me and my friends. I am a sparkly blessing to everyone and can enrich their lives with optimism and beauty.
Intense irritability
Maybe I am irritable. But I live in a constant state of irritability and that is normal. I was also irritated at the bouncer at the bar last weekend and I got thrown out for mouthing off to him. What a prick. That was obviously a him problem and not a me problem. Although my friends did coin the term “She Hulk” to refer to my anger lately… probably just a coincidence.
Unrealistic, grandiose beliefs about one’s abilities or powers
This is ridiculous. This cannot be me. I consider myself to be very humble about my achievements, and I genuinely felt I was qualified for the 24 scholarships that I applied to at 3AM yesterday morning. Why can’t I reach for the stars?? Why should I let perceived barriers in my life stop me from achieving my goals?? I am the most deserving of the things I apply for and no one can stop me.
Sleeping very little, but feeling extremely energetic
This is one symptom I probably cannot ignore. I’ve been getting approximately 3-4 hours of solid sleep in the evening but that’s okay, because I use the hours between 3-7am to work on important things like browsing amazon for unicycles, listening to inspirational Oprah podcasts, and color coding my entire Global Public Health binder according to the countries we were studying. When I am satisfied with my productivity for the morning, I go for a run at around 7am because I decided a few days ago that I would like to train for a half marathon. If I’m so productive on this little sleep why would I be concerned about that? This is the life of a grad student, and personally I think it is better not to ask questions about the things that help us thrive in this impossibly difficult time.
Talking so rapidly that others can’t keep up
I do not understand this. I already am a fast talker so I feel this does not relate to me. Although I did have to repeat my starbucks order 5 times because the cashier was incompetent and it clearly was not a problem of my annunciation. Again, not a me problem. I told them they needed to use their listening ears before storming out of the establishment a little too quickly and crashing into a stranger and spilling my coffee all over myself.
Racing thoughts; jumping quickly from one idea to the next
Hmm. As productive as I am, I’ve been finding it extremely difficult to read my assignments for school. I was also frustrated with the fact that my 15 page paper for Social Work ended up being 42 pages long, and the professors refused to accept it. This was a truly inspired masterpiece???!! Don’t they know an inspired masterpiece when they see one??? I don’t understand this.
Impaired judgment and impulsiveness
Oh no. Was agreeing to buy seven Pit-Bull Bulldog puppies from Westchester County not a good idea?! I am questioning that now. I am also now questioning a number of quirky amazon purchases that I was very confident in until about 2 minutes ago. Hopefully that man selling me the dogs can give me my money back… nah I think it’s fine?! Those puppies will greatly improve my quality of life in my two bedroom apartment on the Upper West Side.
Acting recklessly without thinking about the consequences
Okay so. I definitely have been shoplifting A LOT lately but I always thought it was kind of funny??? Like let’s see how many useless things I can get away with taking. Like this pen, or this candy, or this button that says “love myself” on it. Shoplifting is fine if the item does not cost a lot of money. Right? This is fine. Everything is fine.
So this was pretty spot-on to the things I’ve been experiencing lately. What was shocking (and a little disheartening) was the fact that I thought I was simply embracing life and loving the productivity I was maintaining. However, I couldn’t ignore the flip-side to all the fun: The Darkness. I knew that I had been experiencing pretty intense depressions over the summers following the death of my Mother, but I thought that was always just grief. The depressive symptoms were pretty straightforward: feeling hopeless, sad, or empty, irritability, inability to experience pleasure, fatigue or loss of energy, physical and mental sluggishness, appetite or weight changes, concentration and memory problems, feelings of worthlessness or guilt, and thoughts of death or suicide. I came to know these symptoms well because I have lived with them for such a long time. They became part of my normal existence and it was hard trying to express that to anyone. When depression hits, I feel like a pathetic Sad Sack who is glued to the bed and the thought of doing the tiniest task is too painful to bear sometimes. I feel Pathetic, Burdensome, and an all-around Drag of A Time. But it is who I am, and I have learned to accept that I feel this way sometimes.
I remember taking a picture of the page in the DSM-5 and sending it to my best friend, who was also getting her MSW, saying “Fuck, dude. I think I have Bipolar.” She immediately responded saying “It does make sense, but I’m sorry you had to find out through a book LOL.” It was true. I had given myself a psych eval and I knew that I had to be seen by a legitimate doctor. But who has time for that? I had classes to finish.
As one might imagine, my manic symptoms were completely destructive to my academic and social life. I was convinced my roommate was a dark angel demon sent from the depths of Hell to sabotage my life, so I decided to move apartments. I had to take incompletes for my social work classes because my professors would not accept unedited 42 page papers. I got into fights at bars with strangers and had altercations with people on the street. I was combative to my new therapist/psychiatrist who I believed was the equivalent of an Asian Cruella DeVille. Before I knew it, I had plummeted into the deepest darkest depression I had ever experienced. I was sluggish. I felt worthless. I had persistent suicidal ideations throughout the day. It was torture getting out of bed in the morning even after getting 12-14 hours of sleep.
The darkness felt impenetrable, oppressive, and paralyzing. I’ll spare the graphic details but after flunking out of my MSW program, missing important family engagements, losing my essentially full ride scholarship for NYU’s dual Mater’s Degree in Social Work and Public Health, missing my best friend’s wedding, and a botched suicide attempt, I decided that I needed to completely change my priorities in order to address my mental health. It was one of the hardest decisions I had ever made, but by far, one of the most important.
Flash forward a few months, a move back home, some serious support, a new job, and a new therapist and psychiatrist, I finally felt like I was back on my feet. I was starting to understand what caring for myself really meant, and just how much hard work it entailed. I never knew what prioritizing my mental health meant until I had to stop running around like the Tasmanian Devil trying to avoid my feelings. I voluntarily admitted myself into the hospital where I felt imprisoned and miserable, but I also began to feel better than I had in years thanks to some medication changes and the care of some truly phenomenal counselors and doctors. I initially thought I had Bipolar II, but I was correctly diagnosed with Bipolar I Rapid Cycling, and with BPD, or Borderline Personality Disorder.
At the hospital I met a man who changed his name to Luke (his Biblical name) because he felt as though he transcended into the same spiritual space as God when he was manic. He also told me that he believed LSD should be used as a legitimate treatment for folks with psychotic features, and that he tried to cast a spell on Donald Trump to remove him from office. This was before he tried to saw off his own arm the last time he was hospitalized. There was a lady who bought her own tombstone before coming to the hospital, and a girl my age who had been addicted to heroin and opiates since the age of 14 and had to do her 9th detox. There was a woman who had attempted suicide 15 times as a teenager, and a man who ran away to the woods for 5 days when he was manic and was brought to the inpatient unit completely naked.
As difficult as I felt my life was, it was not until then that I realized I was not the sickest person on the planet. The perspective shift was staggering. I was humbled, grateful, and more motivated than ever to turn this disability into something I could manage and use to enhance my life in a healthy and meaningful way.
People who suffer from mental and physical disabilities are marginalized because society assumes that everyone is able-bodied and able-minded. Not all places are wheelchair accessible. Not all schools have Braille typewriters and teachers who speak in sign language. Not all jobs are welcoming and understanding of people who suffer from mental illness. For example, we need to take more sick days than the average person, and may potentially need to be out of work for 5 weeks to attend intensive treatment like I had the privilege of doing.
I did not start to become open about my journey with mental illness until I went to the hospital. I was surprised and amazed at the number of people who were reaching out to me saying that I had inspired them to seek treatment and how my words had helped destigmatize mental illness for them and their family. Although on the outside it appeared I lived a perfectly normal and functional life, the facade on social media was exhausting to keep up, and it was extremely validating to know that people appreciated and deeply respected that I was being real about my struggle with mental health.
As supportive as many friends and family have been, discrimination and prejudice are things that that anyone living with a marginalized status is forced to confront. I’ve been abandoned by my friends who can’t handle my symptoms; I’ve been told I’m selfish because my depression caused me to miss many important life events of my friends and family; I’ve lost jobs and scholarships, and failed classes because mental health was destructive at the time. I’ve been told by the people closest to me that they think I’m using my mental Illness as a crutch to excuse seemingly selfish behavior and irrational overreactions to things. The negative thoughts of being a failure, feeling like a burden, and feeling like a bad person are bad enough; to make it worse, many situations and people have validated these very real thoughts of mine. Anyone who suffers from Mental Illness can say their most “irrational” thoughts have substantiated beginnings.
Describing how Mental Illness affects my life is similar to describing how the moon affects the tide: one can’t live without the other. Sometimes the ocean rages with intensity, other times it is calm and docile. Regardless of the destruction, or beauty, or time of day of the tide, the moon remains, waxing and waning to its own schedule. I have dealt mainly with the destructive parts of my illness; learning how to access the beauty and serenity through my highs and lows is a process that requires more patience than I feel is possible most days.
Mental Illness is an invisible disease. It is easy to dismiss it, or to not understand or acknowledge its effect on you or someone close to you. The amount of suffering and confusion that I endure on a daily basis would make anyone who can’t relate just run for the hills. It’s a miracle that so many people have stood by me throughout this process and I am eternally grateful. I think it is important to acknowledge that I have more support and privilege than many others who need help. My family is accepting; I have insurance; I have access to an excellent treatment team; I have the financial ability to cover the costs of copays, medication, and hospital programs I’ve had to attend; I have the ability to take time off work if my episodes start to become destructive again. Many other people who experience barriers to attaining those things do not have the privileges to prioritize their mental health in the ways they need to.
Many people suffer silently with their demons due to the systemic strains of racism, classism, heteronormativity, and generational trauma. People self medicate by abusing drugs and alcohol because they do not have access to the treatment they need. The cycle continues. The disparity continues.
**
I have reached a point where I want my “coming out” process in sharing my journey with mental health to be one of empowerment and pride. I have a long way to go in dealing with my resentment about the fact I have to take multiple medications a day, the fact that I can’t pile on too many things at once because it will trigger a manic episode, the fact that I can’t stay out late or drink alcohol anymore, the fact that BPD is one of the most stigmatized and misunderstood diagnoses out there and many clinicians refuse to work with me because of it, and simply the fact that I have to learn how to manage this illness every day for the rest of my life when other people do not. Trust that this is some hard work; it is work that the average person who does not suffer from mental illness would never even think about. As hard as this has been, I know I would not be the person I am today without my illness. I am not Bipolar; I have bipolar. I am both She-Hulk and the Sad Sack. Sometimes having bipolar really does feel like a super power. How will I harness it? How will I control it? Will I always feel this misunderstood? Despite all the challenges, I am immensely proud of myself that I have chosen to embrace my mental illness as a pathway to becoming an empowered, more compassionate, and more resilient person.
You are not your illness, and help is available. It is never too late to start your journey in mental health. If you or anyone you know if struggling with thoughts of suicide, please visit https://suicidepreventionlifeline.org or call the Suicide Prevention Lifeline at 1-800-273-8255.
Resources:
NAMI (National Alliance of Mental Illness: https://www.nami.org
DBSA (depression bipolar support alliance): https://www.dbsalliance.org
AFSP (American foundation for Suicide Prevention) you can make donations using this link: https://afsp.donordrive.com/index.cfm?fuseaction=cms.home