Mental Health: the under-represented bipolar disorder

Written by Jessi Quinn Alperin

Illustrated by Katie Rhian

According to the National Institute of Mental Health (NIMH), approximately 4.4% of adults in the United States have bipolar disorder. 

This statistic doesn’t really make a distinction between bipolar I and bipolar II which are distinctly different diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), that are distinguished based on the severity at which mania occurs. However, if you talk to individuals with bipolar, the way these diagnoses are given out is pretty arbitrary and almost never discussed between patient and provider.

It took me over three years since my first manic episode to get a diagnosis from a psychiatrist.

It’s hard to put down in words what bipolar disorder is like for everyone because it is so complex and not very well understood. The different moods that come with bipolar can present in totally different ways. According to NIMH:

“Bipolar disorder is characterized by dramatic shifts in mood, energy, and activity levels that affect a person’s ability to carry out day-to-day tasks. These shifts in mood and energy levels are more severe than the normal ups and downs that are experienced by everyone.”

This is probably the most comprehensive explanation of the disorder that exists. But really, bipolar is one of those “you have to see it to believe it” kind of things. It can also include impairments in memory (I struggle to remember things from different mood phases than the one I’m currently in), dramatic shifts in sexual and risk-taking activity and changes in appetite.

I could argue that I’ve lived with bipolar disorder my whole life. As young as 11 years old I can remember having bouts of hysterical crying, skewed thinking, suicidal ideation and engaging in self-harm. Even younger than that, around six years old and up, I can remember having auditory hallucinations and depersonalizing, which is when you disconnect from your body and sense of reality.

It wasn’t until I moved to college that true mania hit the fan. I hooked up with guys I didn’t know even though I didn’t like men, I constantly stayed up or past 3am completely wired, my skin felt like there was a swarm of bees underneath it, and I tore through money like it was my job to make my parents broke.

I knew I had bipolar as soon as I broke through the mania and had a mental breakdown in a high school’s showing of The Drowsy Chaperone. I walked into the production feeling high, giddy, and honestly a little horny. But something happened after the curtain closed for intermission and my mood drastically shifted, throwing me into anger and then heaving sobs before “Bride’s Lament” could begin. This comedy is the furthest thing from sad, and this experience left me knowing that something was undeniably wrong and that I needed help.

In recent years there’s been a huge flux of articles, essays, books, mental health programs all geared toward people with depression and anxiety. They all wear the disguise of “wellness” and general “mental health” but focus solely on “feeling good”. Mania already makes me feel good. What it doesn’t do is make me feel satisfied.

Face masks and meditation can’t really give you a come-down from the mania when your mind is a bullet train and there’s -$8.50 in your bank account. But the thing about mania is that it always leaves you feeling unsatisfied. The best treatment for manic-depressive (or bipolar) disorder is consistent medication. It’s better than any therapy and more effective than any at-home remedies. In reality, bipolar disorder is a volatile imbalance in brain chemistry and it requires long-term care to take care of.

We’ve done some work. Your mom probably won’t tell you your depression is “all in your head” anymore and your corporate job probably wouldn’t be angry if you took a mental health day. But there’s still no understanding in the media about what bipolar disorder is.

It’s hard not to sound clinical when talking about bipolar, especially when I’ve been medicated so long that the true highs and lows aren’t really there anymore; they’re much more muted now. But more important than being acutely aware of the bipolar experience is being sure bipolar disorder is part of the mental health conversation.

Many people with bipolar disorder are unable to be as “productive” in a capitalist system as those with major depressive disorder and are at a risk of attempting suicide that is anywhere from 5-25% higher than those with clinical depression. Much like how we can’t treat these disorders in the same way (for example, most people with bipolar disorder cannot take SSRIs because they will make them manic), we shouldn’t be talking about or acting like all disorders present in the same way depression and anxiety do.

We have come a long way but as a society, we’ve only begun to scratch the surface when it comes to understanding the many mental health disorders that people live with.

The Author

Jessi is a poet, a YouTuber and a photographer. Currently, they are a Springboard Social Justice Fellow for Oberlin Hillel. On the side of this, they review queer books, speak out about mental health and have attended protests on international issues such as gun law in the US.

Edited by Stephanie Kleanthous