“What’s cold, white and unstable? A Bi-Polar Bear”

This is a post about disability, but its also a post about when disability and ability collide. Often, when we talk about being unwell it’s the only part of the circumstances we find ourselves in that we focus on. For pretty much every single one of us, our disabilities come not only with the challenges they directly present, with the stigma of others, but laden with our own shames, denials and guilt. Whilst it’s simple enough now to type out this post, and to say the things I might well say from the perspective of an activist, it’s so much harder to live by the very advice you would give someone else, or to show yourself the compassion and love that you might show another. I’m going to try my best to articulate the functioning side of living with disability.

 

When I was 15 I cried all the time. I then realised that I had outstanding academic achievement one year, and then I just didn’t make the grade the next one. Not that it was anything anyone else would notice – mechanisms aren’t in place to trigger warning signs when someone drops from 1st to 2nd, but I did. My parents kind of did too, but they put it down to the usual selection of choices that face parents of teenagers; drugs, or a boyfriend, or a girlfriend, or alcohol, or all of them! It was definitely all of them! After 2 years of my mother frantically stressing about everything or everyone which ended in a massive family row about a huge vitamin tablet that my father decided was Ecstacy, I came home from a gig with mild earache, sobbed all night about it, and something finally clicked. Within the next two months, I was diagnosed as suffering from Bipolar II Disorder.

 

I’m going to break the cardinal rule and post a DSM (that’s shorthand for the Diagnostic and Statistical Manual for Mental Disorders) derived definition. Not only that, but it’s from Wikipedia. Wikipedia reckons:

 

“Bipolar II disorder is a bipolar spectrum disorder characterized by at least one hypomanic episode and at least one major depressive episode” 

That means its one of many disorders somewhat considered bipolar, and that this one moving between two poles; one which is hypomanic; 

“Hypomania in bipolar II may manifest itself in disorganized racing thoughts, irritability, anxiety, insomnia, or all of the above combined” 

It’s also a milder form of mania than other forms of bipolar, and the other which falls on the major depressive scale. 

“With this disorder, depressive episodes are more frequent and more intense than manic episodes. It is believed to be under-diagnosed because hypomanic behavior often presents as high-functioning behavior.”

 

There is a lot of debate about DSM, and psychiatry, and the place that medication versus talking therapies has in the treatment of mental illness etc etc but thats for another post at another time. I find the DSM-derived definitions useful in conversing in a language that people with no personal experience of this form of illness or anything like it might understand to try and get across what it’s like to live, on a day to day basis, dealing with Bipolar. I’m not even sure what I think about psychiatry, or labels, or definitions. There are two things I always stick to though. Firstly, although I’m still confused about categorisation and the medical discourse surrounding mental illness; when you stick a set of diagnostic sentences down, Bipolar makes most sense to me. When I read people’s personal testimonies about their experiences, it’s the same. As such, I accept that in order to have some form of discourse about how I differ significantly enough in my existence from the perceived norm to be dis-abled, it’s the best language available to me.

 

Secondly, when people talk about anti-depressants, and how we don’t need them and they’re just a piece of control from The Man and TV is dumbing down the nation and we should just throw out the Prozac, duuude, it’s mind control and yadda yadda yadda, I think about the difference escitalopram, an SSRI (selective seratonin reuptake inhibitors – a relatively new type of tablet which revolutionised the treatment of depression), has had upon my mother, who suffers from severe anxiety. I also think about the time that a course of tablets enabled me to properly get out of bed for the first time in two or three months. It’s very easy to be anti-medication and say things like that, but you have to think about the effect that hearing that type of logic has upon someone for whom SSRIs or other anti-depressants or mood stabilisers have been a life line, and how belittling that or pouring scorn upon them can add to the guilt and shame felt by people already burdened with a horrible, crippling illness. Many mental illnesses, Bipolar included, are highly genetic in their makeup – Bipolar is (almost certainly) a disorder of the brain and no amount of talking therapy or psychotherapy can miraculously alter an abnormal brain chemistry. None of them can be controlled by “thinking your way out of them”, and they are not manageable if you just “try hard enough”. If we see our bodies as a computer, then a physical illness, one which we are culturally happy to medicate and control, affects the hardware. The brain runs the software, and you would be as likely to delete a whole chunk of spyware as you would fix a broken casing. SSRIs function not just as a cure for many people, but as prevention. They are the anti-virus software of the brain, and whilst a large proportion of the population are blessed to have Macs (I do love a good analogy), some of us are virus ridden PCs and need all the help we can get…

 

I could continue to talk to you about the Mac vs PC debate, or the times I didn’t get out of bed for months on an end, or stayed awake for 70 hours solid writing a detailed analysis of time travel in Donnie Darko (I have to be honest, it stood up quite well given the circumstances), or how I had a six month existential crisis during my 2nd year of university that has left me still now with a pretty heavy death phobia and how these things can impact on my life without so much as a second’s notice and leave me completely out of my comfort zone and off base, but it’s too easy. What I really want to talk about is how insidious mental health issues are, particularly for those who are highly functioning and getting by.

 

For a lot of people reading this note, even people who know me quite well, this will be the first time they have any idea that I suffer from Bipolar. For the hefty percentage of those that do, they’ll be used to me saying things like, “Well, I used to be quite poorly but I haven’t been ill in ages”, or “You know, I manage it, it’s fine, it doesn’t affect me anymore”. These things are kind of true. I haven’t had a serious episode for a long time, and even when I did, the trigger that brought it on was completely unavoidable. By trigger, I mean the incident, or circumstance, or point at which an episode can be traced back to. By episode, I mean a period of time in which I am suffering from either an elated or depressed mood state. Bipolar is an episodic illness, in that it is not something you suffer from constantly. Sufferers can go months, weeks, years without any form of episode. The reality is though that I will always suffer from Bipolar II Disorder, even if I never undergo another episode in my entire life, if only shown and measured by the incredible structure and order by which I live my life in order to avoid ever ending up in that situation again. I do believe that Bipolar, whilst episodic, has a continual day to day impact on my life.

 

I keep slipping into writing about suffering directly from such an illness, which isn’t what I want to do. What I want to write about is guilt. Mental disorders, across the spectrum, are characterised so commonly by guilt. The guilt highlighted by my attempts to rationalise Bipolar as “something I used to suffer from”. Guilt about suffering, guilt about your loved ones, guilt for asking for extra help, guilt for not asking etc etc etc. I’ll give you an example… When I needed an extension on a recent piece of work, I felt like I was taking the piss. The work wasn’t even due yet but I knew that in comparison to my well self, because I had been feeling low, I did not have an equal opportunity to my coursemates in completing the piece of work. I could have rushed through it in 3 or 4 days and still had time to do that, but unlike coursemates who had made the choice to prioritise having fun, drinking or just plain ignoring their work, my lack of preparation was no fault of my own. I wasn’t well. I knew that in my “disability activist” headspace I would say this to someone else. Regardless, my own nagging voice was telling me that I was being a slacker, and that I should just suck it up and deal with it.

 

Whilst (crap and failing) mechanisms are at least considered for the crises felt by those at the margins of society, there isn’t even anything in place for those who are highly functioning and just slipping off the ladder, to attempt a metaphor. Whilst on my undergraduate degree, it was really difficult to get lecturers to take seriously my attempts to enter mitigating circumstances forms for high 2:1s. The logic seemed ridiculous – why would I not be happy with that grade, even if I felt that I could have done better were it not for those horrible 6 months? Luckily, my year tutor pushed and the Dean of my course, married for many years to a Bipolar sufferer, got it completely. Every time I see a new psychiatrist (which is pretty much every time I go), I spend 30 minutes being told that I’m too articulate to be ill; a 10 minute diagnosis which piles on the extra guilt despite knowing that I have been fully assessed for years on end by two senior psychs in two different health authorities who both agreed on my “label”. Sometimes, when I tell someone, they’ll say things like, “oh you don’t seem ill”. It’s these little trials and tribulations every day that stack up against you. The greatest tool to retaining this functionality in my life is order. Although it may not seem like it, everything I do is subject to strict and rationalised order. I don’t take any form of recreational drugs, I limit my drinking, I try and eat relatively healthily, and I exercise a lot. Endorphins are the body’s natural high, and if I feel my mood slipping I jump straight out on my bike and go cycling. That doesn’t mean that I can’t handle stress – I can as long as its not out of control – or disorder, I’m great with disorder! – or last minute challenges, or any of the things that can come up in a busy and complicated life. I can. It’s just that I have to feel like I am the one who is in control of myself, otherwise I lose my balance.

 

When I can’t do something, because all I want to do, nope all I *can* do is stay in bed, or because I know that I need to stay in and read, or see someone I’m really close to because going out that night could be the difference between a low mood for a day or a crashed mood for a week, I don’t say that. It’s not so easy to turn around and explain why you don’t want to see anyone, or why you’d really really love to be surrounded by all the people you love and tell them just how amazing they all are but you’ve had an idea for a research paper and you’ve been up the past two nights in a row refining it and even that gig you’ve wanted to go to for 3 months has no pull compared to that one idea you’ve not quite teased out.

 

Telling someone you’re Bipolar is like coming out. You might admit it to yourself once but every time you do it you’re admitting it again and again. I’m nowhere mature enough in my thinking on my own mental illness as I am my sexuality. It doesn’t bother me in the slightest, whereas although I know it was important that I wrote this, and that I do indeed Liberate Myself, I’m still feeling uncomfortable about clicking that Publish button.

 

I also know I haven’t gone anywhere near writing what I wanted to, and that I’ve rambling on for god knows how many words. Maybe once I’ve read it in the future I’ll refine it, but I thought it was important to just let be read what first I wrote.


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