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It’s impossible to have any sort of relationship with someone who has bipolar disorder. One minute they’re up; the next minute they’re down. They’re volatile. They are easily triggered, dangerous, and dependent on drugs. Or so it might seem.
Being bipolar, you’re subject to a lot of assumptions. Those are only some. When you’re euthymic, just feeling kind of normal, other people only see someone like them. When you’re depressed, people get annoyed because you stop doing things, go inside of yourself, and don’t just bounce back. When you’re manic, people get scared of you, and when you’re hypomanic you could very well be everyone’s best friend. Don’t even get me started on mixed states.
All of these roles piled so closely together leave neurotypical people feeling uneasy and confused. How do you treat someone like this? What is true and what is a stereotype? What should you expect? While these questions can’t possibly be answered across the board, there are some things bipolar people want you to know.
1. We Are Not All Addicts
It’s no secret; Bipolar disorder comes along with a pretty hardcore chance to become addicted to something. According to research (1), the chance is higher for bipolar people than for people with a lot of other types of disorders. Whether it’s gambling, alcohol, sex, drugs, or more, being bipolar and being an addict will not surprise anyone.
However, it is pretty important to know that just because a person is bipolar does not automatically make them an addict. When a bipolar person picks up a beer, don’t flinch. They might just be cracking open a cold one with some friends. When they light a joint (in legal states and countries, obviously), don’t worry. Once in a while it can be nice to see sounds and paint like Van Gogh. And when they tell you about their latest Tinder conquest, don’t shake your head. Human sexuality is too taboo, and if you’re really worried make them a nice condom-related gift bag.
People who are bipolar can enjoy things and not become addicted. And, like everyone else, addiction occurs when the use becomes dangerous to the person, other people, and begins to control behavior. If your bipolar friend is drinking beer because they are depressed, keep an eye on them. If they’re having reckless sex with anyone and everyone despite dangers to their health, worry. If weed becomes a crutch they can’t function without, ask the right questions. But don’t be overcritical of bipolar people just because there’s a chance, they might hurt themselves. They are probably already very aware.
2. We Are Trustworthy
If you’ve ever had more than a passing relationship with a bipolar person, you probably know that consistency isn’t always their strong point. They start things they don’t finish. They say things they forget. They forget the most important thing on the shopping list. They don’t call you when they said they would. They say they’ll come over and pull out at the last second. They lie. They tell you they didn’t do anything this weekend when you know that they were out all Friday night. They pretend they don’t know something when you know they do. They tell you they’re okay when they’re really not.
The question on your mind might be, why? Sometimes this kind of behavior can be incomprehensible. Why not just tell the truth? Why not just say no instead of making plans and not following through? Why get someone excited just to back out?
There are a lot of reasons. It isn’t that bipolar people aren’t trustworthy, because a bipolar person is just as trustworthy as anyone else. It depends on the person. Certain qualities displayed by bipolar people more noticeably than other parts of society, like lack of follow through and white lies, may be largely due to the fact that mood episodes are unpredictable. A seasoned bipolar person may be able to tell when things are going downhill, or when up is getting a bit too high, but when those things will happen is at the mercy of the brain alone.
If a good person who is bipolar tells you they will do something, they probably want to. If they pull out, maybe something changed that they aren’t comfortable telling you about. Sometimes things go downhill and all of their effort is going towards keeping themselves safe, and the best way to do that is alone. If they lie in a way that isn’t like the person you know, something could have gone uphill and tipped over the edge. So you saw them out clubbing, and for anyone else that might just be a full out lie. For someone with bipolar disorder, mania induces all sorts of behaviors that are outside of the norm, extreme, dangerous, and not always things to be proud of.
But what can you do? If the person trusts you enough to let you know their diagnosis, you should know they trust you fully. Give them that space to handle their illness, and don’t try to control it for them. Tell them how you feel, your boundaries, and how you need to communicate. You are just as important as they are. Chances are, this honesty will make them feel more comfortable being honest with you in turn. Judgement is terrifying, so let them know that trust goes both ways.
3. Being Bipolar Does Not Mean Things Are Always Black and White
One of the biggest misconceptions about bipolar disorder is that the person will always be extremely happy and outgoing, or very depressed and suicidal. While these are all emotions that bipolar people may feel, there is a lot more. Remember, this is a brain abnormality. Illnesses and disorders all have one thing in common; the person living at the core. Under any emotions the person is displaying or feeling, remember they are alive inside.
Bipolar disorder comes in a spectrum. Apart from the two “main” bipolar types, there are several subtypes. Bipolar 1 and Bipolar 2 are the main types, which are essentially the same to varying extremes. Then there’s Cyclothymic disorder which is basically the same as bipolar disorder but in shorter bursts. Bipolar may be rapid cycling, which means that people experience more ups or downs in a year than standard bipolar. And each of these diagnoses comes with varying mixtures and extremes. In my article The 6 Faces of Bipolar Disorder, I go into greater detail on each of these phases. The important thing to remember is that although the word bipolar means having two opposite extremes, there is a lot that goes on between these extremes that is equally important to the life of the person inside.
4. We Don’t Process Other People's Emotions The Same
This is something I had always wondered about but didn’t know. My mother was constantly annoyed at how often I would ask her “are you okay” even when she was just fine. In fact, I would ask people this question to the point that they were no longer okay and instead had just become annoyed with me. I genuinely could not tell. I went, and still go through life deeply trying to analyze the emotions of people around me. I constantly assume that people are angry with me or upset with me or keeping something from me. I suppose the best word to describe it is paranoid.
After years of experiencing this I became so frustrated that I asked myself the question: do people with bipolar perceive emotions the same as a person with no known mental illnesses? The answer surprised me.
Several academic studies have looked into this exact problem.
One of the studies compared two types of bipolar, those with psychotic symptoms and those without, against neurotypical participants and those with schizophrenia (2). It was almost comforting to find out that the study found some similarity to the emotional perception ability of bipolar people and schizophrenic people. Perception was impaired when presented with visual stimuli, auditory stimuli, and when both stimuli were combined. Interestingly, while all emotions were perceived with impairment compared to neurotypical participants, perception of anger was the same for bipolar patients with psychotic symptoms and schizophrenic patients. Looks like it might be time to suggest this to my psychiatrist!
Other interesting studies I read include one that found a deficit in both bipolar and depressed patients (3) in emotional perception, and one that finds marked differences in the ability to accurately perceive emotion between bipolar patients who are employed vs those who are unable to work (4). Of course, where there are studies to prove it there are also studies to disprove it. I can only speak from experience that I have always experienced a deficit in ability to perceive emotions, and that it has affected many, many areas of my life.
5. Love, Understanding, and Acceptance Are Worth More Than Anything
It has been an extremely long road to diagnosis. When I was 13, I had an attachment disorder. When I was 14, I had depression and anxiety. When I was 21, I had depression “bad enough” to need medication. And, finally, when I was 26, I was diagnosed with bipolar disorder. It took professionals that long to diagnose what I had always had because the stereotypical knowledge is that bipolar symptoms emerge in your mid-20s. In retrospect, and reports from my mother, I have always displayed the symptoms. Throughout this entire journey the one thing that has kept me going more than anything else is the people who love me.
As many times as I’ve held a knife to my arm, and the many times I have failed to stop myself, my little sister is what kept me from going into dangerous territory. She is the one who made me make sure to be healed by the time I saw her because I didn’t want to be the one to expose her to that kind of sadness and worry. Out of all of the nights I have felt like tomorrow wasn’t worth seeing, breaking my mother's heart is what made me sleep it off. Every time the bottle is in my hand and the open road calls me to play, my cat is the one who calls me home. And through every mistake I’ve made, every upset and every joy, every drug and every scar, every tear and every passionate idea, my partner is there to hold my hand. All of these people accept me for who I am, help me learn what I need, and stand by me for the entire range of emotions. They are soft, they are caring, they never tell me I’m too much to handle. They see when I am trying and let me know that they know. They support me when I’m down and ground me when I’m up, and never make me feel like I could be doing more because they know I’m already giving it my all. They are always there when I need to talk, and treat me like a human when they know I feel like a monster. They educate themselves, take care of themselves, and listen to me because I know what I feel like and what I need better than any scientist ever will. Love, understanding, and acceptance have meant more to me and kept me safer and more secure than any other aspect of my care and treatment. Although I can’t speak for everyone, I can venture a guess that the thing bipolar people want you to know more than anything is that you really do make a difference. We are solely responsible for who we are and what we do, and the science can be daunting, but open arms and a caring heart can make us want to take care of ourselves. What seems small to you might mean the world to us.
1) Salloum, I. M., & Brown, E. S. (2017). Management of comorbid bipolar disorder and substance use disorders. The American Journal Of Drug And Alcohol Abuse, 43(4), 366-376.
2) Thaler, N. S., Strauss, G. P., Sutton, G. P., Vertinski, M., Ringdahl, E. N., Snyder, J. S., & Allen, D. N. (2013). Emotion perception abnormalities across sensory modalities in bipolar disorder with psychotic features and schizophrenia. Schizophrenia Research, 147(2-3), 287-292.
3) Kohler, C. G., Hoffman, L. J., Eastman, L. B., Healey, K., & Moberg, P. J. (2011). Facial emotion perception in depression and bipolar disorder: A quantitative review. Psychiatry Research, 188(3), 303-309.
4) Ryan, K. A., Vederman, A. C., Kamali, M., Marshall, D., Weldon, A. L., McInnis, M. G., & Langenecker, S. A. (2013). Emotion perception and executive functioning predict work status in euthymic bipolar disorder. Psychiatry Research, 210(2), 472-478.