Peace of Mind

John McManamy Health Guide
  • My shareposts over the last few weeks have centered on two related themes: “Illness vs Personality” and “Gift vs Curse.” The heart and soul of these posts involve your comments. Judging from your replies, if a magic pill were to come on the market tomorrow that would make your bipolar go away forever, the vast majority of you would take it in a heartbeat, no question about it.

    I think it’s fair to say that most of you do not view bipolar as a gift. Or, even if you do see some upside, it is definitely not worth the very considerable pain and hardship it has caused you and those close to you. In addition, rather than being a part of your personality, you view your illness as an interloper that has robbed you of your life and made off with the true you.

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    But a surprising number of you accept that that there are gifts that come with the curse, and that your illness is so integrated into your personality that it makes sense to reach some sort of acceptance. Even those who disagree offer highly nuanced insights.

    Last week
    , I pointed out that the psychiatric rough guide to teasing out illness from personality is “functionality”. A natural “life of the party” type, for instance, might not raise eyebrows dancing on tables. This is her “normal” behavior. She fits right in. When morning dawns, she is likely to emerge from a bed she shares with her loved one, text message some friends, and get ready for work.

    A more bookish type engaging in the same behavior, by contrast, is probably spinning out of control. She may go out alone or with a group of strangers into the night, run through her credit cards, engage in random sex, and not show up for work the next morning.

    Now reverse the situation. This time the life of the party is reading a book at home. So is  the bookish type. The critical difference is that while the life of the party may be sliding into the type of depression that means no getting out of bed the next morning, the bookish type is all set for an hour in gym before work.

    Key red flag words in the DSM include behaviors that are “observable by others” and “out of character.” This sets the scene for a comment by Tabby:

    To be considered "highly functioning" while living with Bipolar often times masks the fact that while one may appear fully functioning, thriving, coping... one is actually, in truth, struggling and living in intense emotional pain.

    One considering each moment whether to make it to the next or take oneself out, all while working and coping and maintaining that functionality.

    Or, having the overwhelming panic, roaring, racing, and pressure building... the sounds and sights... the churning of thoughts that won't settle to allow precious sleep... all while working, paying bills, raising families, and maintaining that facade of "normalcy".

    My guess is nearly all of us has been through what Tabby so forcefully describes. We excel at wearing the mask. We fool our friends, our loved ones, our colleagues, our doctors, even. Deep down inside, however, we are the crying clown, our souls in torment, our psyches in a thousand pieces.

  • You’re going to laugh at this, but I have ventured out into public trying to maintain that “facade of normalcy" in the face of thudding depression, only to be mistaken for acting hypomanic. Boy, we really do know how to wear the mask.

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    Year in, year out, it goes on. But one day there is a reckoning. Things fall apart. The mask flies off. Next thing, people are talking about you. Next thing, someone is dialing 911 ...

    So, obviously, there is another key component to functionality. Something more than just being able to hold your own around other people and at work, and I think this is what Tabby was driving at. That something is peace of mind, the ability to feel comfortable within ourselves, inside our own skins.


    This translates into a feeling of ease, whether in the middle of a crowded room or alone in our own thoughts. We are flowing with the current, with the wind at our back. We are not struggling, battling demons, overcompensating, and otherwise consuming huge amounts of psychic energy just to be standing still.

    Life offers no guarantees, but peace of mind does hold out the prospect of a very rewarding and productive life. Many of us are able to function, but only barely so. Peace of mind, not pieces of mind. Your comments, please ...

Published On: December 25, 2009