As a mental health advocate, functional medicine practitioner, and someone who was diagnosed with bipolar disorder at 18, there is a frequently used phrase about bipolar that makes me crazy.
When someone says, “he is bipolar” or “she is bipolar” or “she’s acting bipolar,” I’ll likely get pretty defensive pretty fast. Bipolar disorder is NOT a personality trait.
Mental health awareness is important, but current awareness and discourse sometimes comes at the expense of the over-identification of our personality with symptoms of an illness.
You don’t say “she IS diabetes” or “she IS depression” or “she IS rheumatoid arthritis.” For some reason, bipolar disorder is the only diagnosis and physical illness that becomes an identity statement and personality trait.
A lot of people who use that phrasing don’t understand that for most people with bipolar disorder, they’re not having constant mood swings. They may have one or two mood episodes a year. For example, in the past, I tended to get depressed in the late fall and winter and then I would head into hypomania/mania in the spring/summer. Some of that was triggered by trauma, diet, poor lifestyle choices, and substances. Even the wrong medication caused psychosis and hallucinations in me. (Yes, prescribed medication made my symptoms worse, which isn’t discussed enough.)
Bipolar disorder is a mood disorder rooted in many physiological issues that causes fluctuating episodes of mania or hypomania (which is milder than mania) and depression. Episodes can last several days to weeks, and between episodes there may be seasons of stability. Mania and depression are broken down by the following symptoms below.
Symptoms of mania (an episode includes 3 or more):
- Abnormally upbeat, jumpy or wired
- Increased activity, energy or agitation
- Exaggerated sense of well-being and self-confidence (euphoria)
- Decreased need for sleep
- Unusual talkativeness
- Racing thoughts
- Distractibility
- Poor decision-making — for example, going on buying sprees, taking sexual risks or making foolish investments
Symptoms of depression (an episode includes 5 or more):
- Depressed mood, such as feeling sad, empty, hopeless or tearful (in children and teens, depressed mood can appear as irritability)
- Marked loss of interest or feeling no pleasure in all — or almost all — activities
- Significant weight loss when not dieting, weight gain, or decrease or increase in appetite
- Either insomnia or sleeping too much
- Either restlessness or slowed behavior
- Fatigue or loss of energy
- Feelings of worthlessness or excessive or inappropriate guilt
- Decreased ability to think or concentrate, or indecisiveness
- Thinking about, planning or attempting suicide
Because I have been mentally stable for a very long time, my mood symptoms are minimal. Sometimes I feel low motivation in the winter, but so do a lot of people. I get a nice boost of energy in the spring, but so do a lot of people when the sun comes out regularly. That’s what is tricky about a diagnosis based upon symptoms for a short period of time. If you look back at the list of descriptors for mania or depression, anyone can feel at least one on any given day.
Unfortunately, someone can receive a life-altering diagnosis of bipolar disorder even when they had one manic episode that was substance-induced by something like SSRIs or even THC in marijuana (which happens more frequently than is discussed). This then leads to a lot of shame and confusion, often begging the question, “Do I need to take medication forever if this only happened once?”
I don’t have the answer to that. What I do know is that by being consistent with my sleep routine, managing stress and trauma triggers, exercising regularly, eating a whole food-based diet (mostly a Paleo style), and taking nutritional supplements that restore my body what was depleted by poor immune health, trauma, and medication, I feel more stable than ever before. (Even in perimenopause, as my hormones are all over the place. That’s no small feat.)
My current symptoms, if I have any, do not hinder my function or interaction with other people. In fact, I’ve been married for over 15 years and my husband has said he doesn’t know what bipolar symptoms would look like for me. I’m just me—sometimes I have a lot of energy, sometimes I get overwhelmed and don’t.
I used to have symptoms of a mental illness. I no longer have these symptoms. Just because someone met a checklist of diagnostic criteria for a period of time doesn’t mean that person will always experience those symptoms. There are so many tools to support healing.
You are not your illness. You are not your label.
That’s why I share what I share, and that’s what I hope to express in my upcoming book, out this fall. I’ll be sharing more about that soon! Stay tuned!
