Anxiety Disorders
Bipolar-esque features: Paranoia, panic, restlessness, obsessions, fear, worry, insomnia, depression, strange behaviors, self-medicating with alcohol/drugs.
Condition: Primary Insomnia
Bipolar-esque features: Inability to sleep with seemingly no cause; can lead to hallucinations, agitation, depression, suicidality, self-medicating with drugs/alcohol.
Condition: Chronic pain
Bipolar-esque features: Depression, suicidality, insomnia, anxiety, self-medicating with drugs/alcohol.
Condition: Seasonal Affective Disorder
Bipolar-esque features: Marked changes in mood and energy levels, insomnia, anxiety, hypersensitivity.
Condition: Spiritual Experience
Bipolar-esque features: Intense energy, feeling like God or talking to God, seeing lights and colors, “grandiosity,” desire to talk to strangers or make big gestures. Other times: depression, suicidality, guilt, agitation, dissociation. (People on meditation retreats experience this stuff all the time.)
“OH MY GOD, I THINK I HAVE ALL OF THESE! I'M AN ASPIEBIPOEPIANXIOUSPAINSOMNIAC—AND I'M ALLERGIC TO KIWIS, CAT HAIR, AND RAIN!”
OK, OK, easy, Tiger. You might be an AspieBipoEpiAnxiousPainSomniac . . . or you might just be a human being who's working with a particularly challenging mind and body, the same way your cousin Angie is a human being who's been working on an unusually challenging muscle car for the past six years (she got it running ages ago, but now she's obsessed with getting it to make a particularly . . . muscular . . . kind of roar when it drifts around corners . . .).
On the other hand, AspieBipoEpiAnxiousWhatever might not be that far off the mark. With the rise of genetic testing, scientists are finding possible links between conditions like bipolar, autism, and schizophrenia—hinting that they might not be as separate and distinct as we've assumed. Other researchers have found a strong connection between bipolar disorder and chronic pain, bipolar and anxiety, bipolar and trauma, bipolar and Kundalini syndrome (it's a thing!). . . the list goes on. So where does one condition end and the next one begin? It's hard, if not impossible, to pinpoint. That's why it's important to take steps that improve your whole life, not just “bipolar”—because “bipolar” is almost never the whole story.
3. FAMILY HISTORY
It's taken as a given that your uncle Bernie is off his rocker, but has anyone else in your family been diagnosed with a mental illness? Have any of your relatives been hospitalized for depression, mania, or psychosis? Anyone receiving counseling or taking meds for a psychiatric disorder? Or does anyone have a condition that can look similar to bipolar, such as Aspergers, temporal lobe epilepsy, schizophrenia, or straight-up depression? Bipolar appears to have a strong genetic component, and bipolar in the family can predict bipolar in you. Don't be afraid to contact family members and relatives to get as complete a picture as possible. Maybe your mom/uncle/grandpa has a condition you didn't even know about.
4. PSYCHIATRIC HISTORY
Did you get diagnosed with unipolar depression three months ago, and now you have so much energy you can't sleep? Have you ever been diagnosed with another psychiatric disorder? The doctor will want to rule out unipolar depression, schizophrenia, and other possible psychiatric causes for your symptoms. The doctor might ask you to draw a “mood chart” of the past twelve months or several years. This might seem obvious, but if you've been through a recent trauma such as rape, a violent relationship, or even a scary car accident, you should definitely speak up. Trauma can shake you up in a way that resembles mental illness. And if you have both a mental illness and trauma, there's no reason you should address only one of the two and ignore the other.
“BIPOLAR” IS A WORD FOR A PATTERN
You didn't get diagnosed with bipolar because you're ugly or because the doctor doesn't like you. Let's face it—he's uglier, and his personality needs improving. You got diagnosed bipolar because your symptoms more or less fall into a common, distinct pattern, observed in millions of people. We're currently calling that pattern “bipolar” and treating it with pharmaceuticals and talk therapy. In the past, the same pattern has been called by a different name (hello, “hysteria”) and treated by different means (like lots of cold showers). In the future, it will undoubtedly be called something else entirely and treated with mind melding and cosmic nanoprobes. In other cultures, what we call “bipolar” has other names and other symptoms and explanations entirely.
No matter what the psychiatric community wants to call it, you're still you—whether you have bipolar, hysteria, a wandering womb, or just plain sand madness. Everybody else changes their mind about what to call it, so there's no reason why you can't too. Don't think “bipolar” is an accurate description of your experience? How about Chronic Sleep Taxationitis or Acute Porn Star Overidentification Syndrome? No matter what you call it, no matter how you think about it, no matter how you treat it, you're a person—not a collection of symptoms or an entry in the DSM-V (the hefty diagnostic manual produced by the American Psychiatric Association that you've probably seen lurking under your psychiatrist's desk). Nothing can change that. Don't dwell on whether or not “bipolar” is the perfect way of describing your condition; actually, dwell as much as you'd like, but do consider whether the solutions available for bipolar are helpful for you.
And in the year 2037, when they yank “bipolar” from the DSM-XXIV and replace it with “Intergalactic Hypersensitivity Disorder,” you can go through the whole ride all over again (“Intergalactic Hypersensitivity Disorder—it explains everything about me, man . . . now pass the nanoprobes!”)
Life is long, and your understanding of yourself (not to mention your family, your culture, and your weird roommate Sun Man) can and should evolve over time. It's OK to go through many stages with your thoughts and feelings about bipolar disorder. Who knows—in the course of your wanderings, you might just hit on something useful or wise.
WHY DO I HAVE BIPOLAR?
WHY DID I GET BIPOLAR?
This is a really, really great question, and you'll get a lot of different answers depending on who you ask:
Psychiatrist: “You have bipolar because you have bipolar genes and your brain chemistry is out of whack.”
Anti-psychiatrist: “The whole ‘brain chemistry’ thing has no proven scientific basis, and it's mostly a play by the pharmaceutical industry and the American Psychiatric Association to get more and more people on meds.”
Sociologist: “You were diagnosed with bipolar because you come from a certain socioeconomic class and a certain culture, you live in a certain society at a certain time, and the beliefs of your society cause people like you to be labeled ‘bipolar.’”
Therapist: “You had a traumatic childhood, as did your parents and grandparents, and it was easier for society to label you as ‘mentally ill’ than to take responsibility and address the root causes of your ongoing distress.”
Ecopsychologist: “We have poisoned the earth, deleted meaningful social roles, and broken down tribal and family structures. Of course you're freaking out. And of course they're going to blame it on your ‘brain chemistry.’”
Scientist: “No really, it's totally genes and brain chemistry. We've studied the hell out of this shit. Don't listen to those hippies.”
As you can see, there are a lot of different opinions about what constitutes ‘bipolar disorder’ and what causes ‘it’ to manifest in a given person. And you can find intelligent,