Judging Those With/Without Well-Controlled Bipolar Disorder
Even amongst people with bipolar disorder, the disorder is highly contested. People argue about what it’s “really” like to have bipolar disorder. What mania is like. What depression is like. And perhaps most hotly debated of all is what the appropriate treatment of the symptoms is – antipsychotics, mood stabilizers, antidepressants, psychotherapies, alternative treatments and so on. People argue about virtually everything.
And one of the reasons why this is the case is because the experience of bipolar disorder is so vastly different. Some people experience manic psychosis, others do not. Some people experience delusional depression, others do not. Some people experience suicidality, others do not. And so on. Severity varies as do symptoms.
And I would argue that much of this disagreement stems from the two basic types of bipolar disorder: well-controlled and not well-controlled bipolar disorder.
Well-Controlled Bipolar Disorder
Well-controlled bipolar disorder is what we all aim for. It’s bipolar disorder that is effectively treated and has minimal remaining symptoms. People with well-controlled bipolar disorder live one of those “normal” lives people are always talking about. They hold down jobs, they have families, they have friends and they have their health. It’s a great place to be.
Not Well-Controlled Bipolar Disorder
Unfortunately, many people do not have well-controlled bipolar disorder. This group of people is often being treated, the treatment just isn’t entirely successful. Often in this group the bipolar is semi-controlled. So, in spite of everyone’s best efforts, there are still many symptoms. People without well-controlled bipolar disorder may have a hard time maintaining relationships and employment.
And what I see is one group of people judging the other group. Often, it’s the people with well-controlled bipolar disorder judging people who aren’t that lucky. Often people for whom treatment has been successful assume that there is something “wrong” with those for whom treatment has not been successful. Often if a treatment has worked, people assume that if it hasn’t worked for some, it’s their fault.
Similarly, those who are not experiencing successful bipolar treatment may judge those who have as “not really having bipolar.” Some assume that constant pain and suffering is the only “real” version of bipolar disorder there is.
Bipolar Experiences are Different
And this is because one person’s reality is so strong, so overwhelming, requires so much work, is so well-lived, that they assume it is the only real reality there is.
This, of course, is false. There are almost as many versions of bipolar as there are people. When I write about bipolar I can honestly say I’m an expert, but I can’t honestly say I’ve lived all the versions that exist – far from it. I only intimately know my kind of bipolar disorder, and that isn’t necessarily someone else’s kind. And that’s okay. We both still have bipolar disorder, we just have very different experiences of what that’s like.
So what we need to do is be inclusive rather than exclusive. We need to embrace those who have been successfully treated and those who haven’t been. We all need to admit that we are part of the same community. One is not “better” and one is not “worse.” They are just different. And white you’re well-controlled or not, you really should realize that it is luck that separates you from others. And that’s nothing to judge people over.
Tracy, N. (2013, August 12). Judging Those With/Without Well-Controlled Bipolar Disorder, HealthyPlace. Retrieved on 2022, August 9 from https://www.healthyplace.com/blogs/breakingbipolar/2013/08/judging-those-withwithout-well-controlled-bipolar-disorder
Author: Natasha Tracy
I am not bipolar, but I have a daughter who is. And I agree, all people with bipolar disorder are not the same. Even when taking medication faithfully, they are still judged.
My daughter has been suffering with depression since she was eighteen years old. She was on so much medication that she could not function, she could not go to class all she did was sleep. Her speech was always slurred; it was ridiculous. the amount of medication she was on.
Fast forward, to today, she has been in treatment, because like most people with bipolar disorder she used drugs to maintain mania or depression. Mostly, she suffers from bipolar depression. She has been on medication that has caused her to have seizures, and other side effects such as slurred speech, loss of balance, slow movement..you get the point. She has loss many jobs that she is very good at, just because she was judged on her affect. Though, she was the best at what she does, and her disorder does not effect her performance, people think she is on something. She struggles to tell people she is bipolar. Just today after one day, just one day of starting a new job; which was a jump start to her dream job, they called her and said she was not a good fit. The trainer pulled her aside and said to her, "I notice you speech is slurred are you ok?" I should preface that she was also sick yesterday and they could tell she was not feeling well. She explained that she was not feeling well. They were able to see that and told her to get rest and come back in the morning on her A game.
Well, we were taking her to work, when the owner called and told her she was not a good fit. Can you believe that? she was their for only two days. She finished all her online training with high marks and started her practicum yesterday. Now tell me, how can one judge someone so quick in just on day of training? I mean really? So how do you think she feels right now? She is tired of people commenting about her affect when she is simply just taking her medication, but performance is great; she gets 5 star ratings from her clients. It is the co-workers, not the clients that are judging her.
So my daughter says to me she is tired of living with this, she is tired of people judging her, she does not know how much she can take? What do you think that can lead too? My worse nightmare as a mother: my daughter taking her on life. Which she has attempted twice now.
Frankly I am sick and tired of the Psychiatrists who prescribe the types of medication with tremendous side effects, some which can make her disease worse.
No I am fed up, someone need to start looking at CBD's in medical marijuana to treat this disorder, just like they are doing for veterans who come back from war with PTSD. Frankly, the more research on this subject, the more I am convinced that the pharmaceutical companies, the FDA and doctors are tearing this country apart.
I am not ruling out the opioid crisis as well. Greed and lack of empathy for any group suffering from addiction wanted or unwanted, mental illness are all subjected to medications that are destroying the brain.
So with that said, yes there are as many variations of bipolar disorder and good for those who can function. But, guess what? You may function well now. But, if you read some accounts of those who did function and all of a sudden 7 years later had another manic attack they are perplexed. Why, because this disease is so bad, even the medication at some point will stop working.
So speak the truth about this disease. Stop dehumanizing it, it is real, just like cancer and diabetes to name a few. Sometimes, one can control or even reverse the symptoms, but just like many illnesses, it can come back with a vengeance.
So what is the answer? Because right now, I feel no one really knows. I have even sent her to have TMS therapy. Which by the way helped her not feel depressed anymore, this therapy does not require drugs. It is a revolutionary new treatment. It worked on her depression. She stopped feeling hopeless, but the Psychiatrist kept her on all her medication anyway, and here we are. Her affect still the same.
She has said to me the funny thing about all this judging, is that when she used drugs such as cocaine,, no one thought anything was wrong with her, no one judged her on her affect. Isn't that something? So what do you think she will continue to turn to as well.? though she does not want too.
Her side effects are so bad, she has had seizures, runny nose, slurred speech, and incontinence. She has literally peed on herself in public because she had been unable to control her bladder. The doctor ruled nothing wrong with her bladder, it is the side effects of her medication.
So again, there must be a better way, because what modern medicine is doing, is not helping at all it is destroying lives.
So speak the truth about this disease. And if you are going to advocate, then their should be an organization that will work with other organizations to help people suffering from what you term "uncontrolled bipolar disorder," to gain meaningful employment. And by the way at some point all those suffering from bipolar disorder that are deemed "in control" don't get it twisted, they are only in control because of their medication. Research indicates, even they will have attacks that they are unable to control while on their medication. So no, no one is truly in control, if they were, they would not need medication to aid them.
Hi,I was diagnosed as Bipolar in 2015. Since then until now I'm doing great! I take my medicine everyday,I go for a walk everyday,read or watch positive articles or shows . Also made new friends and embraced few hobbies. Probably I'll start working soon. I believe in myself for who I'm.
I can remember when my bipolar was well-controlled. Then it turned for the worst. I see others with bipolar disorder doing well, are in college, have their doctoral degrees and I wonder what is wrong with me. If I get out the bed in most days, that was a major victory. I am longing for a return to those golden years, but with Jesus, I keep moving the best I can.
A couple of thoughts. The first I want to share with you is that I think everything you wrote is spot on and in fact, an excellent summary of what everyone else has already contributed, including Natasha's article. Beautifully done, in my opinion, on that regard.
My other thought is that I disagree with you in your opening sentence. Here's why. First, the rest of your post carries on to contradict that sentence. Everything else you wrote thereafter WAS indeed, a general statement about bipolar disorder.
Secondly, it's impossible not to make general statements (about any condition, and other things too). Making general statements is the only way we can talk about things (or specific statements, whatever).
i think it's pretty clear from your posting that your objection is not to the general statements themselves, but the use of the general statements as always being true and as applied to distinct individuals. I mean this kind of goes to stereotypes, right? I've always said stereotypes exist for a reason--they're true IN A CERTAIN REGARD. The problem occurs when people take that overarching statement and say it always true for everybody in that class (ie bipolar, or whatever) no matter what. That's why stereotypes carry a bad rap; that's why we have stigma; that's why so many atrocities have been committed; that's why ASSUME-ing makes an . . .
Anyways, I really enjoyed your post, just not your first sentence ;)
I think it's inappropriate to make general statements about bipolar disorder because it can be so different for different people.
"Controlling" bipolar requires understanding of the condition - both from the treating doctors/specialists and the individuals. Bipolar can be unmanaged due to diagnosis (eg many people live with it and are undiagnosed, or diagnosed years later). It can take a lot of time/trial and error to get the diagnosis and the medications/treatment right. This is something to aim for.
People with bipolar are often judged because of their condition and that's unfair. They need to be judged on who they are as a person. There are jerks with bipolar and jerks without bipolar. Not all bipolars are difficult people - I know some very 'normal' and lovely people with the condition. The condition is not the issue. Then there are people who use bipolar as an excuse for their behaviour - while it can explain some behaviours, it certainly is not an excuse.
I have bipolar and I try to be the best person I can be and do what I can to manage my condition as much as I can. I was diagnosed only a few months ago, so I'm still trying to understand and learning to manage my condition. I make mistakes along the way and I often 'failed' to manage my condition. But what else can I do? I listened to my doctors/specialists, trialled meds which didn't work, working on psychological therapy. It's all trial and error at the moment.
Basically, I want to be judged on who I am as a person, not my condition.
Categories vs stigma. These are two different things. The relationship is this: stigma occurs when false (negative) meanings are attached to a category. For example: You've got bipolar, that means you smell funny.
or when appropriate category labels are over-extended (expanded) to include false information. For example: Bipolars are always difficult to deal with (rather than occasionally difficult during some severe episodes)
Quite true - never said anything contrary to that. Categories do exist to classify things and is inherent in communication, but as Joel said, it isn't always the best way to understand another. And it does depend on how you use it. Unfortunately, sometimes it is used in a way that describes others in an incredibly narrow-minded - and yes, judgemental - ways. Like people who hand out a dozen psych labels without really understanding what said application(s) really means.
Categories aren't necessarily only a tool used to judge, although they certainly can be used that way. Choosing to remain "categorialess" is simply putting yourself in another category to judge those others.
Don't kid yourselves: all humans categorize and sort information. It's what we do with it that counts.
@Diane. Wanting someone to guide you out of destructive situations is fair. However, there are right ways to go about it, and ways that are definitely WRONG. Sometimes doing nothing at all is better than the wrong way.
@Joel. Well said. I agree - it is impossible to know what another's actual experience is unless you ask, and they tell you. Some people do need categories, which they use to judge others.
For me, the most important thing is to mind my process. I also hold this important in a group setting. What disturbs me is not where people are on their journey, but whether or not the environment is disrupted. So I don't like sorting people into compliant/noncompliant, controlled/semi-controlled/uncontrolled. It means very little to me and I only use the language lightly to communicate to others who can't seem to be able to live without them. But this language is a poor substitute for understanding what goes on in any individual or community of people with this illness or any other.
Avoid judging others? Well, some people love categories. I like seeing how things flow.
You hit the nail on the head; that's pretty much exactly my point.
Shawn, you completely missed my point, I think anyways, from what you wrote. Accountability has everything to do with the way we live our lives, regardless of the hand we're dealt.
But to get to my redirection, I wasn't suggesting in any way that people with less-well-controlled bipolar are always unaccountable. Or that's even necessarily ever the case. How well-controlled our illness is is something over which we have only a very small portion of control. Sure, I'd like to say it's more, but the fact is, it's not. So none of us is always anything.
I'm glad to hear that you're still fighting and doing the best you can, despite the illness' determination to the contrary. That's really the only control we have, and sometimes even that can be questionable. So keep it up and don't lose that fighting spirit. As I'm sure you know, it'll get you through the darkest days, the most crazed days, and all the other days in between. Simply by being honest with yourself, your family, with where you're at, and by doing what you can each day, you are accountable. So according to my little diagramming above, you'd fall under #3. I don't even know where I fall, because I don't know how well my illness is controlled yet. I'm hopeful this is not the best that it gets, but I'm grateful that it's not as bad as it was.
Well worth a retweet
I am one of your “not so well controlled” people. I have been diagnosed as Bipolar II, rapid cycling. I have a hard time staying employed and am constantly damaging my relationships with my wife, kids and friends. I have done many stupid things in my life, including attempting suicide, primarily when manic. When depressed, I just curl up in a ball and hope the world goes away.
Yes, I have sought treatment. Yes, I work constantly at being “normal,” whatever that means. But, it’s just not taking. I am heavily medicated and that means I am constantly suffering the side effects of those medications.
Those who know I am bipolar treat me with kid gloves because they believe I will “pop” at any moment. I believe they think they can catch it, so they keep their distance when I need help the most.
I appreciate your blog post. I feel judged by the world, especially by those who are also bipolar. As I read the comments posted here, I can feel the judgment and condemnation. Accountability? Honestly!
I wish everyone could read and internalize your comments.
I think accountability has nothing to do with one's diagnosis. Some people are jerks. And no treatment takes away jerkiness.
What do you think it has to do with Diane?
The only thing I really have to add to this posting and responses is an observation I made in reading. Commentators very quickly brought up the point of behaviors and attitudes people with bipolar often exhibit, though this was not something directly addressed in Natasha's posting.
I do think it is key. We often engage in harmful behaviors, particularly when manic,though not only then. Especially when we're ill, we impose a difficult burden on our loved ones, and sometimes it seems as though we don't care. All of this can be part of the illness and not something we have control over, or sometimes even any. So this can be the case of somebody who has bipolar that is not well-controlled.
What does this person's accountability look like though? Do they say, "oh it's just bipolar", which even though true, doesn't preclude one from the responsibility to mitigate those effects as much as possible. The sooner a person with bipolar can began to recognize those signs and pull themselves back (or implement some strategies to hinder the destructive behavior) the better. Because believe it or not, that will actually help to treat the disorder better. What we tell ourselves does matter.
So there can be:
1. well-controlled bipolar with high accountability (those would be the most pleasant probably to be around, and highest functioning I'd imagine.)
2. well-controlled bipolar with low accountability (I think these people would just come across as jerks and not particularly grateful for anything,)
3. Not well-controlled bipolar with high accountability (this group probably suffers the most, and though perhaps often unpleasant to be around, it's at least tolerable because it's obvious they're trying.)
4. Not well-controlled bipolar with low accountability (and this would be the group that needs the most help, but they're also the most difficult to help because they often don't want it.)
p.s. Natasha, did you find my other little note/question for you?
I agree we are all very different and there are so many variables as to why one person's bipolar may not be under control. I agree we cannot judge especially since we cannot know the whole story.However I would hope that someone would care enough to try to guide me out of destructive behaviors that made my illness worse. Also I don't think it has to do with luck.
No, the untreated mentally ill types do not tend to be pleasant to be around, unfortunately for them. If someone has made a sincere effort at getting treatment but practically everything fails and/or has minimal effect, they'll generally have my sympathies, even if I am unable to tolerate much more than small doses of their company. The ones who deliberately eschew and avoid treatment simply because their complaints of *minor* side effects tend not to have my sympathy at all. I struggle with my feelings about people who's disorders aren't as well controlled because of my own guilts around my own mental disorders, though, however "normal" and well-functioning I CAN be around others...
I think bad behavior goes both ways. Sure, while manic, I may have done some pretty weird stuff, and probably really hurtful, but to be quite frank, some of the "other parties" in my life were really quite terrible themselves. Borderline criminal, in fact.
If I offended, I get the anger, and I do believe that they have the right to be angry. But to violate my privacy and do some pretty unsavory stuff behind my back? At some point, it simply makes sense that you cannot right a wrong by committing a wrong. It WILL just escalates things, as it did in my case, and it really did exacerbate things.
There is a difference between wanting peaceful negotiations and grovelling - which I am not willing to do and wouldn't expect it from the other party. And while it is true that you shouldn't use bipolar as an excuse, for some people, it really is TRUE that they did not have control at that time, or even knew what was really happening. Like in my case, I was on antidepressants, which triggered a manic episode, and to this day, I feel some of the people around me will never let me forget it, and in fact, will constanly throw it in my face. Some of these people have known me for years, and quite frankly, I am HURT that they would discount a pretty significant number of good years - at least five years - and just judge me from one unfortunate incident. I don't see the logic in that at all.
Just a perspective from the other side. Not everyone is lucky enough to have understanding folks around you, and some people's experience was just plain bad.
I have no problem with people who are mess... I have few friends who slip there from time to time.
I don't think it's people *suffering* that increase the stigma. It's the type of people who does something and adds "I can't control it, I am bipolar"/"bipolar made me do it" when often it's things you could do with little effort. I am not talking about one slip up... but don't do it over and over again. Bipolar is not excuse to be abusive, but I see people use it as such. And if you hurt someone as result of your bipolar actions..more than "I am bipolar" needs to be said and done. Refusal to take any kind of responsibility is what creates stigma of bipolar people as "stay away from them" kind.
Before I learned to control my illness, I had stigma painted all over me. Now I am 'high functioning', I can escape some of the stigma. People say with barely hidden relief "oh, I wouldn't have known you were bipolar" or "you seem quite normal"
Although it's an awful thing to say, some of the stigma arises from the terrible nature of the disease itself. People just can't handle it. They are afraid of it. I can't say I blame people for being afraid, when I am afraid of this illness myself.
But at the end of the day we're all human beings and need to be treated with compassion.
I'm thinking of writing to some of those people who struggled in my early days and left me - employers, friends and so forth. I want them to know that while I was angry, I forgive them; and while I can't apologise for something that wasn't their fault, I acknowledge that my illness caused them difficulties. I want them to know that I am trying, everyday, to better manage my illness, and that I hope they will also have compassion for other people with mental illness that they come into contact with, that there's nothing to be scared of.