Twelve Myths About Bipolar Disorder

I have to rebut these when they are said by family members, fellow patients, and random members of the public. Every one of us who lives with the condition has heard some if not all of these time and again. You might even have a few of your own to add. You may note that I don’t include “It’s all in your head” (though the issue of faking is covered below). It is all in my head! Bipolar disorder is an organic brain dysfunction and the brain resides inside my skull. So I don’t count that a myth, just a misapprehension of the truth.

Here are my twelve most common myths:

Bipolar disorder is just something psychiatrists made up so that they can get rich.

Not too long ago, a Fox Radio commentator told a caller that she had been duped by her psychiatrist. They just made it up to get your money, he told her. She begged to differ but he was having none of it. Even when he was forced by his employer to apologize, he equivocated.

There are a few things wrong with this belief. The first any person with bipolar disorder can tell you: the highs, the lows, the paranoia, the hallucinations, and the delusions are all too real. Physicians have observed the disease in patients since the time of Hippocrates. And patients have suffered, suffered mightily.

Related to this is the common refrain “Everyone has ups and down so what is the big deal with you?” Yes, but you don’t get the highs and lows that people like me get. To put it geographically: when you are happy, you are atop Cadillac Mountain in Acadia National Park (1528 feet). When I get high, I’m atop Mount Everest. When you get low, it’s the edge of the sea. When I get low, I dive to the bottom of the Marianas Trench (-6.831 miles deep). Unless you have had a drug high, you don’t know the euphoria that I have experienced. Nor do you know what it is like to feel so fatigued, so lost in a dark night of the soul that you lie in bed for weeks at a time and obsessively contemplate ending your life.

As for psychiatrists getting rich, consider this: They have to go through college and medical school. Then there is their internship. Then comes years and years of residency at dog pay. When they finally get out in the world to practice, they enter into a specialty whose billings to insurance companies are more restricted than any other. Oh, did I mention the student loans for college and medical school? Those take years to pay off. Get rich? Hardly unless they were one of the lucky few whose parents paid for their education.

Mass murderers and serial killers usually have bipolar disorder.

Even though bipolar disorder sufferers have the highest rate of violence — one in every 10 — of any of the classic disorders — I include schizophrenia and depression here — our acts of violence tend to be the direct result of feeling threatened while in episode. One thing that you learn living with someone with bipolar is that you do not get in the way of the door when they want to run out of it.

People who live with Antisocial Personality Disorder or sociopathy are the most prominent killers. They have no conscience and seldom feel guilt. Still, when one of these incidents occurs, the first condition to come off the lips of pundits and armchair experts of human behavior is bipolar disorder because they thought they heard something about it once. “So and so had a wife who screamed at the top of her lungs and hit him,” they might recall. These outbursts are nothing like the cold-blooded calculation it takes to be a mass murderer or a serial killer. You have to have the cunning of a corporate raider (an appealing profession for a sociopath) to carry out these crimes. People with bipolar disorder tend to explode and regret their outbursts afterwards.

As for that rate of violence that I cited, remember that 9 out of 10 people who live with bipolar disorder aren’t violent. That’s 90%.

Our relationships never last.

There’s a grim statistic that floats around support groups and blogs: Ninety percent of bipolar marriages fail.

Now, I thought for the longest time that I had to be some kind of outlier. I have been married for 27 years as of this writing. But then, I met several other bipolar friends who had equally long and even longer marriages. Sure, there are a few people who have gone through a divorce or two. My experience in support groups, however, was making me think that something was off here.

I tracked down the source of the statistic to a 2001 Psychology Today article. No studies on this question, no surveys were cited. 90% sounded like a good number and the writer ran with it. The author had just pulled the number out of a hat.

I don’t know how many marriages involving sufferers of bipolar marriage fail — and no one does — but I am sure that it is not 90%. I have encountered all kinds of scenarios involving marriages that include a bipolar spouse: the husband is bipolar, the wife is bipolar, the couple is gay, the couple is lesbian, the couple is straight. I even know marriages where both spouses have bipolar disorder and, after many years, they are still going strong.

What is damaging about this myth is that it convinces some people that they can never love again, that they contain a tragic spark that will incinerate their happiness every time. In my case, my wife and I struggled through 17 years of marriage when I did not take my meds. We are still here, living in the same house that we moved into back in 1999. We have loved each other not only with this disease hanging over us but also through uterine cancer. To my single readers with bipolar disorder, I say this: Take a chance on love. You can have it and thrive.

We all swing from ultra-high to ultra-low.

Bipolar is not always a condition of mania and depression. Some people never get the really good manias. Instead they get a fleeting condition called hypomania. Hypomania is like being a little high on speed — except you aren’t taking speed. You have lots of energy, you get things done. Then, you crash. And you stay crashed for weeks or months. This pattern is the hallmark of Type 2 Bipolar — where you get the depressions and very very little of the mania.

Some people go through a type of episode where you are flipping back and forth between mania and depression so quickly that sometimes you feel both moods at the same time. It is called a mixed state. Mixed states are very dangerous because not only are you thinking of suicide, but you have the energy that you lack in a deep depression to carry it out. One in four of us attempt suicide. I am one of them. I was in a mixed state when it happened. Very frightening experience. I was hospitalized for five days until they brought my anti-depressant levels down and stabilized me on lithium. My hospital psychiatrist saved my life.

We all love our highs.

My highs were mixed states and they sucked.

When I got those under control thanks to Lamictal, I did experience some euphoria, but my depression followed; and the stupid things I did or said became a subject of severe self-reproach which didn’t make me want to go back to the reputedly green and pleasant land of manic psychosis.

We are retarded.

I’ve been treated as a child by a few people who assumed that because I was bipolar, I was unable to carry on even the simplest of conversations or understand basic math. (I graduated from one of the top ten undergraduate schools in the country according to Forbes Magazine.)

Cognitive impairment is one of the features of bipolar depression. We become sluggish, experience memory loss, and make mistakes, but we don’t become stupid. Studies show, in fact, that most of us have higher than average IQs.

We are lazy.

When the brain and the body don’t want to move, they can thwart our best intentions to accomplish things. We have a real disease; among its symptoms are fatigue and a loss of desire to exercise — even to have sex. Many people will yell at us, call us names, and threaten us in attempts to motivate us into activity. You might as well yell at a person to produce more insulin with their pancreas. Believe me, I would will myself into a better mood if I could. But when my brain becomes The Demon Machine or The Beast, controlling my energy level is nigh impossible. Not even those walks that people are always urging us to take have much effect on our mood despite the folklore. Not wanting to exercise is a symptom, not a cause of our illness.

There is also reason to doubt the power of positive thinking. German researchers discovered that people who engaged in the kind of positive thinking where they imagined that they would achieve or acquire that which they coveted actually ended up getting more depressed and failed in their objectives. When you are depressed, magical thinking is a fix which like any street drug delivers a letdown on the heels of its bliss. Avoiding it is a fight that you must take to the very streets of your soul and it is hard to wage it under grim circumstances. It is actually better to acknowledge that you are in a bad way. The secret of survival is to not beat yourself up for it.

The side effects of our medications are so bad, we refuse to take them.

Our bodies react differently to different medications. There are people who take Zyprexa — Zywrexya as some of us lovingly call it — who never develop the carb cravings. Not everyone who takes Depakote loses their hair. Lithium doesn’t make all of us fat.

It is true that some people give up when they experience side effects. I know one fellow who will start a med but as soon as he feels nausea, stop taking it. Even though nausea is a side effect that is almost always temporary, he can’t bring himself to get past that stage. I know other people, on the other hand, who have stayed on Depakote despite the fact that they’ve gained a hundred pounds because the alternative — going manic and wrecking their family’s life — is worse. Most of us are quite cognizant of what the disease does to us and to the people around us. We know that studies show that episodes damage the brain and that taking the meds reverses that process. We’re not dumb: we weigh things out.

We are all geniuses.

Yes, I have seen all those lists of famous people with bipolar disorder. I don’t doubt that they are accurate for the most part. But I have known plenty of less than sharp people who have the illness and I have seen some pretty bad poetry and artwork created by people with the disease, including some of mine. We do tend to run above the norm in intelligence, but that doesn’t make us all Van Gogh or Isaac Newton or Marilyn Monroe. If we start thinking of ourselves as geniuses, it is a bad sign. The technical term is grandiosity.

We can’t be trusted with power.

Two names: Abraham Lincoln and Winston Churchill, a probable Type 2 and a probable Type 1.

If you hallucinate or are paranoid, you are schizophrenic not bipolar.

Psychosis is a symptom associated with mania in some of us. Paranoia can bind us in either mania or depression. My mood stabilizers keep my paranoid imagination at bay. Anti-psychotics treat my mild visual hallucinations. My diagnosis is unequivocally bipolar disorder.

Herbal medicine can help with bipolar.

Everyone talks about the money that “Big Pharm” makes off psychotropics. The same people don’t seem to know that the herbal medicine industry is a four billion dollar a year industry in the United States. You know what the difference is? Big Pharm has to prove that its medications work through extensive testing and clinical trials. The herbal medicine industry, up until recently, could say whatever it wanted.

Oh, there have been studies where clinicians tried to control bipolar disorder with vitamins and herbs. They failed. Sure, you can find anecdotal evidence that vitamin therapy works — a certain Canadian company has testimonials to back its claims — but testimonials aren’t tests. There is no one evaluating the patients for clinical signs or for establishing that they even had bipolar disorder in the first place.

About that Canadian company. Do you know how they got their start? Well, the founder was a pig farmer. He fed his livestock vitamins and one day he gave them a mix that made them seem happier to him. That is your clinical trial for vitamin therapy: the otherwise untested and unreproduced observations and speculations of a pig farmer.

I have a story to tell you about this woman who brought her husband into a support group. He was one of the worst cases of mania that I have ever seen outside of a psych ward. She was investigating alternative therapy because she had heard that lithium was a heavy metal. Now there is this thing called the Periodic Table of the Elements, I told her, and it lists all the elements in sequence. Now it starts with the lightest, so it goes like this: Hydrogen, Helium, Lithium…. She stopped talking to me and went to find someone who would not refute her factual errors.

Much of what people say about psychotropics and alternative medicine is based on just that kind of misinformation and ignorance.

Life is over when you are diagnosed with bipolar disorder.

47 years of my life were utterly trashed by bipolar disorder. I had psychotic breaks with reality, I suffered depressions that rubbed my face in the mud, I had endless arguments online, I thought myself a genius, I believed I was a prophet, and I terrorized my poor wife with the endless nights when I woke her up to read what I had written to flame some bastard who was probably also bipolar or a sociopath out to screw with people like me for the fun of it. Diagnosis did not ruin my life. Avoiding it did.

People with bipolar disorder hold down meaningful jobs. They write blogs, they paint, they take photos, they sing, they volunteer. When you turn off The Demon Machine, life becomes easier. Sure there is the frustrating period known as the Guinea Pig Stage when your psychiatrist keeps changing your meds until the two of you find a combination that works to quell your furies. The message I give to the newly diagnosed is that that usually passes, that you find the right cocktail in time.

Mood stabilizers do not erase your personality. I found that I had this soul inside of me that wanted to express itself but there was this evil machine that kept taking over. I read somewhere recently that being manic is like being in the back seat of a car driven by a madman. You are not in control. The disease is. Once the mood stabilizers, anti-depressants, and anti-psychotics turned off the infernal engine, my hidden soul could come out. I had to make sacrifices, to be sure: adjusting to meds is no cakewalk. You feel drowsy and fuzzy headed for the longest time. The point comes, however, when you get your mind back. You adjust your ways. You make new friends to replace the old ones who panicked and fled when you came out to them. You find new interests and get to exercise the talents you knew were there but were drowned in the noise of the bipolar factory. I often tell people that my general politics did not change; I merely became less susceptible to conspiracy theories and more concerned with the preciousness of each human being. Thank God, the man I truly am got to come out. When he did, my life began.



Joel is the founder of DBSA South Orange County. He received a degree in Anthropology from Pomona College, one of Forbes Magazine's ten top undergraduate schools. His manic adventures include traveling to former Yugoslavia during the 1992 war, believing he was the Creator of a messed up Universe, road rages, and running up $40,000 in credit card bills. He lives with his wife, dog, and cat in Trabuco Canyon, California.

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