The Risks of Misrepresenting Bipolar Disorder

With all the best intentions, mental health is an undeniable minefield. Its very nature is incredibly personal, and thereby varies from person to person, with each instance of mental ill-health manifesting in a unique way. Nevertheless, in an attempt to better understand these symptoms and provide appropriate support, we collect together symptoms into conditions and disorders. One such case is the way we approach bipolar disorder. Despite the fact that each bipolar person will go through their own journey with this mental illness, we naturally assume that everyone reacts the same. There are highs and lows, unpredictable behaviour and just general inconsistencies – this is just glossing over the reality of the situation. As with any mental illness, it’s so important for us to properly understand the impact it has on an individual’s life in order to create an inclusive society for all.

Most importantly, bipolar disorder isn’t a mental health condition that we really talk about very much. It’s used as a plot point in TV shows or films to cause drama, but I wager that many of us don’t talk about the true face of bipolar in the same way we do with anxiety or depression. 30th March marks Bipolar Awareness Day, where the Twitter-verse comes together under #WorldBipolarDay to share real stories and help educate about what bipolar disorder really looks like. There is also a secondary hashtag which symbolises the drive within the bipolar community to change the perceptions of just how debilitating and life-ruining bipolar disorder can be: #BipolarStrong. It’s time we stop and recognise that we’re in danger of misrepresenting people who live with bipolar disorder, recognise the inner strength they have and break down the barriers we have about discussing this variation of mental health.

What is Bipolar Disorder?

Bipolar disorder can also go by the name bipolar affective disorder, and is a mood disorder, affecting the severity of the mood changes that people experience. It used to be known as manic depression because of the common ‘mood states’ that bipolar people experience: manic/hypomanic episodes and depressive episodes. In layman’s terms, feeling high or feeling low.

Signs and Symptoms

As with any mental health condition, bipolar can appear in different ways for different people. There is the consistent notion of drastic changes in mood, but what do we know about these changes? Bipolar disorder is about the changes an individual feels in their mood, making it a very personal and changeable version of mental health. There is no textbook on what an “episode” will look like, but we do know that the illness has a series of different manifestations:

  • Manic states
  • Hypomanic states
  • Depressive states
  • Mixed states
  • Psychotic Symptoms

The following descriptions of the various episodes and symptoms are from Mind, the Mental Health Charity, to help show how bipolar may look or feel.

Manic Episodes

How you might feel 

  • happy, euphoric or a sense of well-being
  • uncontrollably excited, like you can’t get your words out fast enough
  • irritable and agitated
  • increased sexual energy
  • easily distracted, like your thoughts are racing, or you can’t concentrate
  • very confident or adventurous
  • like you are untouchable or can’t be harmed
  • like you can perform physical and mental tasks better than normal
  • like you are understand, see or hear things that other people can’t

How you might behave

  • more active than usual
  • talking a lot, speaking very quickly, or not making sense to other people
  • being very friendly
  • saying or doing things that are inappropriate and out of character
  • sleeping very little or not at all
  • being rude or aggressive
  • misusing drugs or alcohol
  • spending money excessively or in a way that is unusual for you
  • losing social inhibitions
  • taking serious risks with your safety

Hypomanic Episodes

How you might feel

  • happy, euphoric or a sense of well-being
  • very excited, like you can’t get your words out fast enough
  • irritable and agitated
  • increased sexual energy
  • easily distracted, like your thoughts are racing, or you can’t concentrate
  • confident or adventurous

How you might behave

  • more active than usual
  • talking a lot or speaking very quickly
  • being very friendly
  • sleeping very little
  • spending money excessively
  • losing social inhibitions or taking risks

Depressive Episodes

How you might feel

  • down, upset or tearful
  • tired or sluggish
  • not being interested in or finding enjoyment in things you used to
  • low self-esteem and lacking in confidence
  • guilty, worthless or hopeless
  • agitated and tense
  • suicidal

How you might behave

  • not doing things you normally enjoy
  • having trouble sleeping, or sleeping too much
  • eating too little or too much
  • misusing drugs or alcohol
  • being withdrawn or avoiding people
  • being less physically active than usual
  • self-harming, or attempting suicide

To add to the distress, not every mood will fit into one of these tidy boxes. Sometimes, those with bipolar disorder can find themselves in a “mixed state”, which is where you can experience multiple episodes (manic, hypomanic or depressive) at the same time or in quick succession. Those living with bipolar describe this state as at times, the worst to work through, as you’re unclear about how you’re really feeling. In addition, you can also experience periods of psychosis where you have delusions, such as paranoia or hallucinations (like hearing voices); although this manifestation doesn’t happen to every person with bipolar disorder.

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Who can it affect?

Realistically, bipolar could affect anyone. Scientists haven’t yet been able to determine the exact cause of the condition, but research shows that it could be due to a combination of genetic and environmental factors. You’re more likely to develop it if a close relative has the illness, which can help families plan for the possible eventualities, but there is no guarantee of diagnosis – or guarantee of no diagnosis! It can appear at any age, however most diagnoses happen between 15 and 19 years old, and rarely manifests itself after the age of 40.

A key thing to be aware of in our sector, is that some of the environmental factors that can trigger bipolar disorder is childhood abuse or trauma and experiencing the death of a loved one. These intense experiences can have effects of a depressive episode manifesting itself, therefore practitioners who work with children need to be aware of the signs that may indicate bipolar disorder.

Why do we need to get talking?

Mental health comes in all shapes and sizes, and yes while some are more prevalent than others, they all deserve equal attention and support. We need to show every single person who is fighting their own mental illness that they are loved, cared for and not alone in this battle. Currently, we don’t seem to give bipolar disorder enough time of day. We have sympathy yes, but what are we actively doing to understand it and to show those with this disorder that they have a safe place to discuss their emotions and work through manic, depressive or mixed states?

There’s such a negative stigma surrounding those who have bipolar disorder, which can be incredibly isolating, and it needs to stop. By giving bipolar disorder sufferers a platform to tell their stories and give a human and real look at what the mental health condition is actually like, we can start to break down the barriers. We need to learn about it more as a society, whether or not you have a personal connection to the illness. Only through knowledge can we truly become compassionate and considerate to the challenges people with bipolar disorder encounter every day, thereby realising how we can all support them more effectively.

Contributed by Elena Jones, One Stop Social Team. 

While you're here...

One Stop Social have a whole range of helpful guides, booklets, tools and more in our Resources Page which can help develop good practice when working with people who are dealing with mental health issues, including bipolar disorder. If you want further support as a practitioner then get in touch and see how else we can help!

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