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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.

Judging Others

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.

You can find Natasha Tracy on Facebook or GooglePlus or @Natasha_Tracy on Twitter or at the Bipolar Burble, her blog.

Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate and author of Lost Marbles: Insights into My Life with Depression & Bipolar.

Find Natasha Tracy on her blog, Bipolar Burble, Twitter, Google+ and Facebook.

19 thoughts on “Judging Those With/Without Well-Controlled Bipolar Disorder”

  1. Venus,
    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.

  2. 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.

  3. 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?

  4. 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.

  5. 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…

  6. 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.

  7. 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.

  8. 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.

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