9 Misconceptions Clinicians and Researchers Make About Bipolar Disorder

Wrong. You assume our goal is to be “normal.” It isn’t. We want to be ourselves. Normal implies unquestioning conformity to the norms of society. For many of us, “normal” would entail wearing a personality shirt (for people with no personality). As they say, normal is just a setting on the washing machine. A number of years ago, I was giving a presentation to clinicians who treat mental illnesses, including bipolar disorder. I told them, “we don’t want to be like you.” You could tell from their expressions they were stunned and didn’t understand.

Wrong. Stable, to someone with bipolar disorder, is the no-life state of limbo we find ourselves in when we emerge from a crisis. A return to wellness may involve various trade-offs between stability and the ability to function, but as a general rule, functionality is preferred and should not be sacrificed in the name of stability. We want to keep the color and vibrancy that is associated with our illness. We want to hold on to our edge.

Wrong. The highs that come with mania are often extremely frightening. Yes, we do enjoy feeling alive and productive like the rest of the human race. But in a manic episode we don’t feel in control of our brains and don’t want to purposely bring on that terror. A study published in Psychological Medicine found that clinicians identified “missing highs” and “feeling well” as the main reasons patients quit taking lithium. However, when patients are asked, that is not the reason.

Wrong. It takes an average of six years between onset and diagnosis according to a study completed in 2016, and for many people, diagnosis doesn’t come for 10 or more years after symptoms first appeared. Some of us have spent a decade or more listening to what our pain has to say. We have an intimate knowledge of our symptoms and illness that can’t be learned in med school. When we object to a doctor’s wish to overmedicate us or try something we know won’t help, it isn’t that we lack insight. We simply know our bodies and minds and are adhering to our inner wisdom.

Wrong. It is usually more helpful to address the things in our life that trigger our depression and mania, such as stress, trauma, sleep problems, challenging living conditions, and other personal issues. It would be much easier if we only needed to deal with depression and mania. The good news is that symptoms of our illness are much easier to manage once we resolve, or partially resolve, some of the contributing factors.

Wrong. Medications are one of many tools we have for managing bipolar. They are most important during a crisis. But as we move past the acute phase of an illness and learn what we need to do to get and stay well, meds move off center stage. The focus should be on proper sleep, eating right, exercising, and other ways to manage symptoms on a daily basis.

Right. But you are probably right for the wrong reasons. In theory, illness and personality are distinct. Bipolar disorder does affects one’s personality. So those with bipolar disorder are different, even when we return to “normal.” Being different, however, isn’t a psychiatric condition. It is a human condition, and a wonderful one. Without the variety and diversity of human beings and other creatures, our world would be a very boring place.

Right and wrong. Although persons with bipolar disorder experience similar symptoms and patterns of behavior, each one of us must tackle the illness with the strengths and the perspective that are unique to him or her. No two paths to recovery are identical.

Clinicians and researchers, I appreciate all that you do to help people who have bipolar disorder. I respect your training and education. Hopefully now you have a little bit more insight into how someone with bipolar disorder feels.