When I was first told that I might have bipolar disorder, the best way I can describe the resulting events is the KÃ¼bler-Ross model, more commonly referred to as the “Five Stages of Grief,” denial, anger, bargaining, depression, and acceptance.
The denial part is something that preceded even my diagnosis; indeed, it’s something I unknowingly struggled with for years. In May of 2010, the Science Museum of London conducted a study on lying. They interviewed 3,000 Britons 18 and up, men and women, and charted the results. Besides finding that men tend to lie more and women tend to lie more efficiently, they also found that in both men and women, one of the most prevalent lies told was a seemingly harmless, “Nothing’s wrong, I’m fine.”
I spent years in denial. I claimed the label of bipolar, took my medication and maintained the theory that I was cured. I briefly attended therapy, browsed the internet until I had a vague understanding of my illness, and moved on.
In other words, I was telling myself and others, “Nothing’s wrong, I’m fine.”
Getting past the denial was due less to my own initiative and more because of circumstance. Whether depression or mania, for me the consequences were steep: broken promises, missed work, bankruptcy, and a shattered reputation. It’s still something I struggle with when I’m at my worst, but I’ve been attempting to become more conscientious of when I’m being unrealistic.
The anger involved is more apparent, following the typical questions people in crisis observe. Questions like, “Why me?” for instance. “Why of all people should I have this illness? Why should I be struggling with this when others breeze through life not knowing or accepting that others are not like them? The people who don’t want to accept that others have struggles deeper than what they can comprehend. Why not them?”
The anger is selfish, I know. The old adage that there are always others worse off than you comes to mind. But it was all pervading during the initial diagnosis, when things were irrevocably all about “me.” Especially for people who experience debilitating depression, it becomes a matter of life or death when this anger takes hold. Suicide is a very real danger when anger turns inward and becomes depression.
Overcoming the anger took selflessness and acceptance of who I am and the struggles I’ll face. It wasn’t about giving up; it was about the wholehearted belief that while I didn’t ask for this, there’s nothing I can do to change it. Manage it, yes, absolutely. Change it? No.
Bargaining isn’t as obvious, but it’s just as insidious. When dealing with bipolar specifically, bargaining can take many forms. For one, bargaining over dangerous behaviours while manic can often sound like, “If I just do it this once, it’ll still be okay.” The “it” can be overzealous spending, dangerous sexual situations, taking on too much work, or just about anything. Some of it is harmless, but when it becomes a habit, the harmlessness fades and turns into damage.
Bargaining can also take on another form, which is attempting to bargain with my illness. Believing that if I can just accomplish one or two things, that I’ll be cured. That if I can just be consistent with medication, if I can just keep going to therapy, if I can just manage to avoid another depression spell, that everything will be normal. It is as though I am promising my illness that I’ll do certain things, under the impression that then it will leave me alone and never recur. Naturally, that doesn’t always happen: recurring episodes are normal for people who have bipolar
“Recovery” is a word I hear quite often. I have a friend who insists that the term “mental illness” should only be used in conjunction with someone who is not managing their illness well. Those who do manage their illness are “in recovery.” I always found this strange because it places an undue burden on those who are mentally ill to be perfect at managing their illness. It implies that bipolar disorder is not something that will take vigilance, and that the symptoms will disappear.
There’s one thing that’s been apparent to me as I’ve cycled between depression, mania, and being stable. There is no “cure” for bipolar disorder.
The obvious result of coming to this conclusion is part of the initial problem to begin with – depression. This is one of the easiest to identify, but because one of the symptoms of bipolar is depression already, it becomes diluted among all of the other reasons, both chemical and mental, that cause depression.
Depression isn’t just feeling sad. I can’t express this enough. The depression experienced by those with clinical depression, bipolar disorder, and other mental illnesses is not simply feeling down. Whether it’s caused by something external, such as a death in the family, or something biological, such as bipolar disorder, depression is a debilitating illness that can affect even the seemingly most well-adjusted individual.
What is different about depression for me is that depression based on grief feeds on the beliefs that I’m somehow broken, and that I’ll be unable to accomplish what I want to because of my illness. This can feed into an already developed depression, but it is also a feeling all its own.
Some people will tell me that despite my illness, I should feel like I can still accomplish anything I want as long as I put my mind to it. These people are either extremely lucky, or don’t understand depression and other mental illnesses. If I’m very clever, and if the stars align in the right way, I may find a way around my illness to achieve what I want to achieve. But in many cases, mental illness will hinder what people can do.
This is the hardest part of the grief cycle. It’s hard not to get stuck in this rut, and I think all of us do to some extent throughout our lives. It’s a harsh reality to face: but if you’re able to, acceptance is the next step.
Part of this acceptance is not getting caught up with what I can’t accomplish, and focusing on what I can. Lack of sleep can be a big trigger for me, which means no all-nighters. For someone with tight deadlines, this can be a problem. The alternative is to find work that I can space out over a longer period of time. This may seem like a no-brainer, but in some cases, such as freelance work, not taking on shorter deadlines may mean a completely different career.
Mental illness can also influence day-to-day tasks. To better explain this, let’s look at the Spoon Theory, a well-respected concept originally describing energy levels related to chronic illness that can also be a way to explain what it’s like to have a chronic mental illness.
In the Spoon Theory, Christine Miserandino explains that most people start the day with many, if not infinite spoons: spoons being a metaphor for energy. When you have a chronic illness, you start with much fewer spoons. Everything you do during the day takes a spoon, and at some point there’s the real possibility of running out. This means that when you have a chronic illness, you have to carefully manage the day to make sure you keep enough spoons to finish what you start.
Chronic mental illnesses can work the same way. When under a depression, my spoons are limited. It may take a spoon to shower, to call somebody, to eat, and several to manage going to work. This affects not only what I can accomplish daily, but weekly, monthly, yearly and within my lifetime.
This is what takes acceptance and what causes grief. And that is the crux of it. I make different choices knowing I have a mental illness than I would if I didn’t. Some people can go through life letting themselves handle the consequences, and thinking about their actions later. People with mental illness don’t have that freedom. Not thinking through a situation, keeping in mind the fact that a depression or mania can hit at any time, can cause unwanted consequences.
I’m not all the way to acceptance. It comes and goes depending on my state of mind and the situation. When I’m doing well, I recognize I cannot change that I have bipolar disorder. There is one thing I can change, though. As said by Albert Einstein, “The world as we have created it is a process of our thinking. It cannot be changed without changing our thinking.”
I can’t change my mental illness and I can’t change the hurdles I’ll encounter as a result. What I can change is how I think about them, and action is the counterpart to the way that we think.