I once wrote an article on high-functioning bipolar disorder. High-functioning bipolar disorder is bipolar disorder where the person can still function in the major areas of his or her life. So people with high-functioning bipolar disorder hold down jobs, pay their rent, have food in the fridge, shower, and maintain social relationships.
Many people with bipolar disorder do all those things. The thing is, many people don’t. And the tendency is to compare a person who functions highly to one who may not be able to work or pay bills or shower. When this comparison is made, it is assumed that the high-functioning person must not be that sick when compared to others. This leads to doctors not taking the illness seriously of the higher-functioning person. And this is too bad because it can lead to people with high-functioning bipolar disorder get suboptimal treatment.
So how do you get your doctor to take your bipolar seriously if you’re high-functioning?
High-Functioning Bipolar Disorder is Still Serious
I think it’s important to remember that maintaining a job and paying a mortgage is not a prophylactic against the serious nature of bipolar disorder. People with social ties who shower die just as dead as everyone else. And just because a person functions well in some respects doesn’t mean that other parts of his life are not falling apart. It also doesn’t mean that they aren’t in severe amounts of pain.
Getting Your Bipolar Taken Seriously
Remember, bipolar is an invisible illness so the key to getting your bipolar taken seriously is to communicate about it effectively in an open and honest way. This is much harder than it sounds. People, by and large, don’t want to talk about their pain; they don’t want to talk about their suffering. This is normal. But you have to because your doctor cannot know how much pain you’re in unless you tell him.
You must say things like:
- My depression is really severe. On a scale of 1 to 10, my depression is an 8.
- I’m feeling suicidal.
- I feel like I might hurt myself.
- I feel out of control and overwhelmed.
- My thoughts are moving so quickly I can’t keep up with them.
- I’m starting to think things that I know aren’t true.
- My behavior is really unusual for me – I couldn’t stop myself from gambling away 100s of dollars even though I can’t afford it.
- I couldn’t work two days last week.
And so on. These are things you probably don’t want to say. These are things you probably don’t want to admit to. But you have to. They indicate the severity of your illness. And it’s this severity that will make your doctor take you seriously.
And if your doctor still isn’t responding? Then simply say this, “I need help now. I can’t live like this.” It’s very simple and it’s the truth. You wouldn’t be there and you wouldn’t be making yourself so vulnerable if you didn’t really need the help and it’s okay to say that.
It’s Important to Take Bipolar Seriously
You’re right to want your bipolar disorder to be taken seriously. Ideally, that should happen without your concerted effort but the truth is, if you present well, you’re likely to be treated like you are more well than you really are. You have to use your own skills to overcome this. You have to make your doctor understand what you’re really experiencing. This is hard work. But it’s worth it because it’s the way you’re going to get the help you need to really function as well as you appear to.
Im greatful you have put this,i have known im my own mind for just short of 2years my brain doesnt function properly,i mean who knows more about my own brain than me?i know when its normal and i know when its not,so i finally plucked up the courage today to visit my gp,but when i left i felt totally deflated.she was more interested in my dept and my past(which is not whats troubleing me) and sent me away to ring some help line and come back in a few weeks…i feel totally misunderstood.probably due to me being young she thought i dont know what im on about,i just dont know what to do next,i feel helpless and crazy.
Just wanted to thank you for this post.
I once had a so called mental health worker aggressively question me about my diagnosis (basically made it very clear that he did not believe me). I had said I was struggling and not functioning. He rapid fire asked me if I was working, did I have a home, was I in a relationship. When I answered in the affirmative he actually said – “Then how are you not functioning?”
I explained that I was utterly miserable and exhausted at all times, that most of my friendships had fallen by the wayside, that my job was in danger because of my erratic behaviour / inadequate grooming, that I was in financial difficulty due to poor decisions made during hypomania.
He again insisted that I “Was functioning though,” and had the nerve to suggest my diagnosis (made by a senior psychiatrist) was wrong. I don’t even know if he had looked at my medical records – he had no idea that I had been on various medications for a decade. No idea of my detailed history of prior counselling / therapy.
To this day I don’t understand why I was even referred to him. The whole consultation was pointless and insulting, and has made me doubt myself and my problems for years. I made a complaint but have no idea if any action was taken.
I’m a 15 year old girl and I really think I’m bipolar. I haven’t told anyone. I’m afraid no one will believe me because I play sports, have a job, am on high honor roll, and have a lot of friends. But sometimes I just can’t do anything. I’m so unmotivated I just stay home from school. I fell like I’m drowning in my thoughts and no matter how hard I try I just can’t stay above the water. I feel alone even when I’m surrounded by people. I just don’t know what to do
Hi G, unfortunately I can relate. My symptoms started around your age, everything I did looked great on paper even though something was definitely wrong. I can’t say what’s best in your situation, but I can say that I wish I’d put my finger on what was wrong way earlier and talked to my mom (or anyone who could help). If you feel as if you need treatment, asking to go to a doctor because you haven’t been feeling like yourself can be a really good first step. I hope that’s helpful!
Well I was going to post my story, but after typing it I realized I just feel like I’m whining or attention seeking. Which I’m not. But that’s when it hit me that being a high functioning bipolar person makes me feel this way. Like I’m not worth someones time, not even on the internet. Because that is what my family, doctors, and society has made me feel like. Like because I can grin and bare it I should just keep doing it and my feelings or pain doesn’t matter because there is someone else way worse than me.
Well, I’m posting this anyway because even if I think I’m not worthy maybe being proactive will help change my mind. Or maybe someone else will read it and realize that’s what they have been feeling. (I’m bad at recognizing my emotions) Or maybe I just need to tell anyone, that I feel this way. I don’t know.
Keep strong everybody! God knows no one else is going to be strong for us, so we have to keep going.
Your comment is exactly to the T, how Ive been feeling latley. 20 Years of bipolar and I function pretty well on the outside. But I have begun to hold stuff in because I felt exactly what you described and it is literally eating me up inside.
I so totally agree both with this article and you! I feel as if I’m seen as “not as sick” as others just because I am “high functioning”. The things that go through my head every millisecond, though… I don’t think I should be given less treatment attention because I have a job and can fake it really well. After work, I can barely make a decent meal (I eat a lot of sandwiches), and I can seldom clean, walk dogs or do anything that would be considered recreation. I don’t consider that high functioning. Yes, even the doctors stigmatize us. I am going to review this blog before I see my new PDoc (whenever that may be).
I was high-functioning with Bipolar I. Sometimes for 3-4 years and then a decline. Finally when I turned 39, it all went haywire. Now I am treatment-resistant except for Lithium. It helps with the Mania but almost nothing helps with the depressions or mixed states. I was in an executive position with a large corporation, made great money and highly educated in my last good 4 years. But now, I am hanging on to everyday. I had 10 rounds of ECT and over 10 hospitalizations. It has been very hard and I feel so afraid I will never be what I was again. It seems like staying unmedicated for so long was a very bad thing.
SHANICE!
you should go to a different doctor. I have had Bipolar Disorder 1 with Ultradian rapid cycling for 20 years, or at least treated that long. I do not have episodes of Mania (High as you called it) that last for days or weeks usually, because my episodes cycle throughout the day. I can be manic when. I wake then depressed by the early afternoon, the. Manic again by 4pm. I tried pretty much every RX out there. …..the key is to tale a MOOD STABILIZER such as Lithium, Depakote (Valproic acid), or ugh I cannot remember then newest one I tried Imitrex, maybe. You should NEVER take an unopposed antidepressant because that can make your symptoms much worse! Over the years, Ive found that taking Depakote ER 500mg (long lasting) pills at night and Klonopin a couple times a day is all I need. Though I may be trying something more this next week, possibly One more Klonopin a day as I’ve had alot of panic and anxiety, amd OCD symptoms that have been troubling in. The last few months. I tried Lithium first as many Doctors do give it first but I allergic to it and cannot. I cannot take anti depressants because they make me Manic.
I hope this has been informative and you get the help you need. Remember, as much as they would like to help amd thunk they know what they are doing, regular doctors are NOT qualified to diagnose you, they can however, send you to a proper physciatrist. good luck! Jenn
I think I am being followed. How do you know if Social Security is investigating your case. I am on SSD. And my phone is beeping.
Hi, I am English, and have read many of the posts above. My comment is really that anybody who is, or who thinks they are, bipolar, should be given lithium chloride. If it makes you feel and function better, then you are highly likely to be bipolar since this benefits 70% of individuals with bipolar in this country. Be prepared for the side effects, though, a loss of cognitive function (varies from person to person), high likelihood of interference with thyroid function, weight gain, hair , acne and so on. If you can function without this kind of self inflicted side effects then maybe bipolar isn’t affecting you to the extent that it needs to be to make you feel that you have to take it. This isn’t the same as saying the symptoms you are experiencing aren’t serious. However, you are hearing voices and you know they are not real; you are obviously not going to be taking instruction from the voices so you are not in danger, 4% of the population hear voices and do not regard them as unusual. To be seeking medical attention for symptoms that do not cause distress may well be seen by the medical profession as attention seeking; the medical profession in UK is not dependent on finance directly from patients and so is more independently minded, the latter behaviour of attention seeking from psychiatrists is likely to get you a diagnosis from a psychiatrist but it won’t be bipolar and you’d find getting rid of the diagnosis difficult. My comment is BE CAREFUL WHAT YOU WISH FOR.
Bipolar 1 and bipolar 2 are both damaging illnesses which affect individuals in different ways. Bipolar 1 by the nature of the definition is a severely psychotic illness, and bipolar 2 tends to be more deeply depressive in nature. A patients level of intellect will not enable him to rise above the illness and function at a high level because he is a superior human being, a person of high intellect will not seek this diagnosis if he is high functioning; a person will end up getting this diagnosis because his/her life is in the gutter where they are not functioning and the medical profession will invest considerable resources in that individual to help them reach a level of functioning compatible with todays society. To attention seek to label yourself as bipolar when you are high functioning means you have a psychiatric illness but it is not bipolar.
I know I have bipolar, I have been taking anti-depressants for the last 6 months, I have never worked for more than 12 months as I can’t hold a job down. I have episodes where I physically can’t stop talking and I say things that I wouldn’t normally say and think why have I just said that. I suffer from anxiety too. My mother has bi polar quite serious, I’m 22 and it seems like the high episodes are starting to get worse. My doctor said I can’t possibly have bi polar because your highs arnt lasting long periods of time (weeks, months) they just last a day or so. Don’t know what to do, just changed my anti depresents and sent me on my way. Lost my job because I had a high and said inmaproriate things, I don’t know what to do, my relationship is at breaking point because of my mood swings, I know I’ve got something wrong with me but I don’t know what to do.
I also have lupus, Sjögren’s syndrome, hyper mobility and fibromyalgia so live with chronic pain conditions too, but I still work from home and run a family with 5 children.
Hi there, I loved your article, I had no idea there was a high functioning bipolar. I’m in the uk and I wrote my doctor a letter explaining things. I know I have bipolar, my brother is diagnosed with it. He offered me a councillor that I have to wait 6 months for and amatriptaline, he didn’t give me a prescription though. So I came to search how to get a doctor to listen to what I think is wrong with me. I’m about to give up and carry on living in this hell cutting myself for relief. Yes I told him I cut and showed him my scars. Now it’s just a case of battling on like always. Ride the highs n trudge through the lows.
I have been on Anti depressents (worrying dislexic) on and off for 13 years!!!
Once I was told by a theripist that I looked like a classic bipola type 2, she the. Sent me to a pdoc to get assessed and after two visits (maybe 1 I can’t remember) he said your not bipola, you just need to come and see me every week for a couple of years! WHAT!!!!??? Need I say $$$$$$$$$$!! In his pocket and me left to struggle on as I didn’t go back to see him and my threpist finished with me.
Thank you for your article.
From outside I am seen as a successful individual with high class educational background… witty, good looking, charming…blah blah even though very few wiser people suspect my mental health as I am sometimes completely absent from social settings.
From inside I endure a lot of pain; with a little disappointment I fall into serious depression and amidst that deep misery I suddenly feel really happy with little amount of hope coming from environment!! I fluctuate between these two peaks quite often insofar as I sometimes think “how relieving it can be if I died”.
In reality I push unbelievably hard to maintain the image people have of me. To produce high quality documents for work I may stay awake two consecutive nights (needless to say that sometimes I can’t work even for 10 minutes during day time cause of concentration issues)
When I first walked into my psychologist office due to severe sadness and the fact that I just had started to skip work, the way I behaved (and unconsciously manipulated her) she even didn’t think I was clinically depressed!! After 3 sessions I finally confessed I was in huge pain and it was only then that she sent me to my future psychiatrist. The Pdoc said I had mild major depression and prescribed me antidepressants however he didn’t find me a patinet with serious condition and assumed I would be fine with the medications only (considering my so called high functioning state). I was lucky that after some 4-5 months of taking antidepressants my therapist suspected my diagnosis and eventually I was diagnosed with bipolar Type II being prescribed medications accordingly (I am not going to bore you with how I finally became medication compliant).
Now, how have I been taken seriously by my doctors? 1) Being 100% honest with my therapist and telling her in details what I have done and have felt recently have so far allowed her to spot my unusual feelings and behavior no matter how subtle. 2) Regular visits to my Pdoc and passing my therapist’s concerns to him has made him to be quite serious when it comes to me.
If you don’t have a therapist, try to give the Pdoc details of your recent behavior and state. Don’t be shy! I mean I know some people who think they shouldn’t bore their doctors with details. After all they are being paid for that, aren’t they? If they are not patient enough to listen to your details carefully sack them and find new ones who are attentive enough to spot your changes and needs.
Although I should mention that in the part of the world that I come from, Pdocs are less conservative in the dosage and number of medications they prescribe for bipolar patients.
The last couple of times I have seen my psychiatrist, I was very blunt and honest about how rotten I feel most of the time. I’m high functioning. I work. I pay bills. I am a mother. But most days when I open my eyes after the alarm goes off, my first thought is how happy I will be when I get to go back to sleep that night. That is the highlight of my day is knowing I can sleep later and forget everything. I told him that. That I can’t concentrate at work or function on the weekends. He asked if I was dating anyone and then told me most of my problems would be fixed if I started exercising and lost weight. I guess it’s time to find another doctor because he obviously thinks I’m making this shit up.
Hi Amy,
I’m really sorry to hear that your doctor treated you that way. I had one that was convinced that if I had a boyfriend I would feel better too. Sounds like it’s time for a second opinion that isn’t based in the 1950s.
– Natasha Tracy
Yes it’s disappointing when you are finally getting the courage or seeking help to face what may be a serious situation, and then to be discounted in the midst of it, is so discouraging. So sorry to hear this.
When I was younger and very sensitive I went to see a psychiatrist about the on going panic attacks I was having. After I finished expressing the depth of my severe anxiety I was having I looked at the Psychiatrist and realize he fell asleep! I then felt abandoned, which was one of my core problems. Of course I never went back..
Thank you so much for this article. And all of your articles. I had a period of depression earlier this year, and went on 5-HTP to treat it, and it induced a pretty intense mixed episode. I started working with my therapist to understand mood disorders, and have made an appointment for a psychiatric evaluation. I’ve been struggling with both the prospect of not being able to communicate what I’m going through (I’ve gotten really good at keeping it hidden), and also not understanding it fully myself. I’m scared of being told that I’m fine because I’m highly functioning, when I know I’m not, and I know that things feel scary and out of control right now. I tried to talk to my family about it today, and they were adamant about explaining my symptoms away—like we all have mood swings, and I’m just exceptional and driven, etc. How many times in my life have I explained it away to myself in the same way? Ha. I know where they are coming from, and it is a lot to understand and face. But I appreciate this article so much, just knowing that I’m not the only one who’s struggled with seeking help, and knowing that it’s important and imperative for me to do so—and to be honest with myself and others about the gravity of the situation. Thank you!
I am high functioning bipolar. Over the past 6 months or so dealing with an extremly painful and serios back problem. I am back on bedrest after my last round of conventional treatment. I was coping well, thanks in big partsto a therapist i trusted so much, and great staff and pysicatrist. Adjusted meds when needed to help depression, also adjusted therapy to get me through day to day instead of long term goals. I have a new therapist now. I was very manic when i went last. He didnt quite know what to do, he wanted to continue the Abandoned Heart therapy. Which would be fine if i was still stable. The depression is taking over. Im trying to fight it,but i have been for a while now. Between that, the pain, and everyday life problems, im loosing my grip.
You were right. Because the drs look at me as high functioning, it has to get this bad for them to listen. New therapist isnt helping. Kinda the last thing i needed. I have to speak directly about how bad im getting. And it makes me feel embarassed, and angry at myself! Why cant i get it together! I know how irrational those thoughts are. Another sign im not well. I know being so hurt physically and scared about future isnt helping. Too much timeto dwell is making it worse. Trying to atleast keep my mind busy when i can is best i can do.
Its the weekend, place is closed. Cant even drive myself somewhere. Im not in complete crisis, but i feel it coming.Just have to do what i can until monday. Your blog helps so much. Needed this reminder esp today. So that mondayi can communicate properly that i need help! Also, i feel too embaressed to admit to family and friends the severity. They get used to me being high functioning. Then dont understand when im not. Thankful to have somewhere to talk about it. Feel less alone, and get great facts and suggestions! I hope this was not writtten to badly! Cant wait until monday!
Wish drs could be reached on weekends!
Honestly, much of these problems you describe of doctors not responding is a general, overall reluctance on their part to commit to too many programs because of fear of litigation. Yep, we can blame those that are quick to sue in order to get something for nothing. I’m serious. It’s rampant in our society. It’s in our schools, it’s in every aspect of our culture [now]. And it’s mostly the leeches of our society; those that live on welfare, bilking the system, taking advantage of government hand-outs for how many kids they have per their social status. These people are takers, not givers. And so, those of us that are NOT so inclined, miss out on the freedoms doctors once could employ on behalf of the many–the few truly fu** things up. I also think this problem has gone on for so long, it’s begun to form the mindset of young(er) doctors and other healthcare professionals into believing they are being most prudent by withholding. Strange, since the pharmaceutical and insurance companies that govern much of how doctors operate peddle drugs, drugs, drugs, you would think they wouldn’t have so much reticence…but then…there’s that fear of litigation. Such a screwed up, vicious cycle.
Thank you for this! Especially thank you for those phrases. I am weird, I think, in that I function highly in some ways and not in others. Yes, I’ve graduated from school, but I’m having a hard time applying for jobs. Yes, I take care of my home and my son, but I have a hard time showering or brushing my teeth. I just don’t get it.
Great post about a very important concern. I have unipolar depression and OCD, and I’ve been considered “high functioning” since I was diagnosed in my 20s. I’m grateful to be able to work, pay bills, etc., but that doesn’t negate the fact that I have times of terrible pain. With some docs I’ve had to be very clear, very explicit to communicate that pain to them. It’s hard–I like being seen as capable. But I don’t like leaving the doctor’s office with no help and going home and facing the pain again.
I am considered “high functioning” and many many times, I am barely functioning… however; on appearance – I’m just slower today or just “nervous and anxious” appearing.
My family members have even said to me, here recently, that they do not “see” me as mentally ill and in need of their assistance and/or help at times because I am NOT like “other” mentally ill folks and/or family members.
A new psychiatrist, that I just met this past week : I told her of the things I see and sounds I hear and voices that talk to me, from time to time and how most of the time I know that they are not actually real BUT there are times, when I cannot tell the difference for a while and times when I absolutely do not trust my own thoughts.
She said that they were not hallucinations nor psychotic, but she had no IDEA what they were and no idea how to note them… kept saying that as long as I knew they weren’t real, then there was no issue with them.
WTF?
They are often disturbing and at times, when highly symptomatic, I’m not entirely certain that they AREN’T real… yet, according to her “no issue with them” and she had no idea what they were but declared them not psychotic hallucinations.
I ended up telling her what to prescribe me (Lithium) because she just couldn’t decide what to give me… and then diagnosed me with Bipolar I Mixed.
I have also had the discriminatory experience with a few Neurologists because they have deemed my Partial-Complex Seizures as “pseudo” with NO medical diagnostic test that PROVES them as “pseudo”… because I have a long psych history… go in with a pain to the primary, it’s depression manifesting itself… have issues with leg cramps, it’s depression manifesting itself
this is one reason I no longer GO to any MD… unless it is really really frightening… like the newest psychiatrist this week due to be highly suicidal
I just made it through a mixed episode without missing a day of work (very fortunately I had a previously scheduled vacation week during this period). My psychiatrist made the comment that at least this episode was just an inconvenience, it wasn’t too disruptive. I suppose he is comparing it to my last depression, which required a leave of absence and hospitalization. But it didn’t feel like just an inconvenience, and if the med adjustments hadn’t worked so quickly I would have been in really big trouble. People seem to assume that just you can drag yourself to work and do your job well enough to not get fired you are doing pretty well. Even if it is the only thing you do, because that is all you have left in you after the depression, etc. I wish is were true.
Mr. Pruitt is absolutely right when it comes to having the right psychiatrist. I’ve been seeing a private doctor concerning my BPD for several months now, and he’s helped me more in those few months than any psychiatrist in any C.M.H.A., has in the last few years. He takes medicare and I’ve had no financial problems with any visits ! That says a lot about mental health agencies, as we know that the psychiatrists are the big money makers. While working at Gateway/Detroit East, I heard several horror stories, and assisted clients in writing up doctors if the client felt it necessary. One of the worst had to do with a psychiatrist who told a client mentioning that she was feeling suicidal, and the doctor told her to go ahead and do it ! I have been telling everyone I’ve run into, to check their insurance and whether it would cover any visits with a psychiatrist outside of a C.M.H.A. These agencies aren’t going to promote such actions, so getting what you may need in order to take care of yourself DOES concern who you are talking to !
Interesting post. Those with OCD often also “present well” and might even downplay their symptoms to their doctors. If everyone is going to get the help they deserve, honesty about how you are feeling is paramount. Of course there are always doctors out there who make up their minds without really listening to you, but that’s a whole ‘nother post, I’m sure!
Hi, I had an unusual problem recently. My previous Psychiatrist, who was very well educated in current trends in Neurology/Psychiatry recognized that I had Complex-PTSD along with my Bipolar, also with great help from my Therapist. While I’d always been considered a High-functioning Person with Bipolar, I still can’t seem to hold a job very long because of the C-PTSD.
C-PTSD differs from PTSD in that, instead of being a single occurrence of life-threatening trauma, C-PTSD is like a series of less severe Trauma distributed over a long period of time. It’s a little controversial, since the DMV-II has yet to accept is as a new classification of a disorder, instead is relates it to a combination of Personality Disorder and Dissociative Disorder and PTSD.
Well, my new Doctor had a little bit of qualms with this. He didn’t seem to believe in C-PTSD, instead just saying “we all have problems, even if someone elses are worse than others.” I didn’t think about it at first, but later I was really offended.
Thankfully, the diagnosis that’s really “keeping-me-down,” is able to be treated with therapy primarily, but I still called the office this morning of my Mental Health Clinic and asked to be referred to another doctor. They have a great system, I just think this Doctor isn’t the right fit for me.
If the situation calls for it, and if you have the means, I would suggest doing this in cases where you and your Psychiatrist don’t see eye to eye, especially if it’s going to affect your ultimate care. Many places with multiple doctors will just ask you to ask for a referral to another Doctor, it’s that simple.
Again, this ought not be one’s first thought. My wife would probably call it “breaking-in” a doctor if one has the ability to work with them to see eye-to-eye or come to a mutual disagreement that doesn’t ultimately affect your end care.
Thanks for this blog. Wanted to say thanks for the hypo-mania description in a long ago post. It helped me see the difference between mania and hyper-vigilance.
Be Well!
I consider myself high functioning. Had a doctor I loved but moved out of state. Saw the new psychatrist and told her I was currently on nothing but an occasional Ativan for anxiety or klonopin for sleep. She looked at my chart (prior inpatient and outpatient for mania, rapid cycling BP1) and having only “known” me 15 minutes started telling me how non high functioning I am! That if I didn’t go onto a mood stabilizer right now I’d be back in the hospital or arrested. I tried to explain that with major lifestyle changes and meds for anxiety and sleep I’ve done well the past year. She wouldn’t listen and wouldn’t give me any kind of sleep medication. Guess this way when I get manic and psychotic from lack of sleep she can tell me “I told you so”. Grrr Wish she would listen to me, not look at a chart and make broad assumptions.
YES. THIS.
I have been told repeatedly by health professionals that I COULD NOT have ADHD or bipolar because I’m too functional. I have been denied treatment that I desperately needed because I don’t appear “sick enough.” It didn’t matter that I said that I couldn’t sleep, that I couldn’t work for months at a time, or that I was thinking about self-injury for the first time in 15 years. I had to complain of intolerable anxiety for 4 months (actually, more like 6 years) before I was offered an anxiolytic – a non-benzo – and when that didn’t work, I wasn’t offered any other options. That particular doctor treated me like a junkie even though I stopped self-medicating with alcohol just as soon as mood stabilizers made that possible. Switching doctors made a big difference – I now see someone at a much smaller practice where they actually listen to and respect their patients, instead of just being a pill farm. I use my PRN benzos very sparingly and am therefore able to work on days when I would otherwise lose the entire day to irritability or anxiety.
Stringy hair and body odor is NOT how my illness manifests. Judging my mental condition by the appropriateness apparel and hygiene, rather than what I say or the massive amount of consistent, reliable tracking that I do, is just insulting. Just because I’m smart doesn’t mean I can think my way out of mental illness. Because gosh, don’t you think I would have if I could have?
I had a difficult time getting a diagnosis because of this. The first doctor that I was stuck with twice (TWICE) told me that I had a nervous disposition, but no real problems. I pushed the issue, and lo and behold, BPD (erm… no). His boss was much happier to take my reams of data and work with me (to include a fucking uppy-downy wiggling mood line across SEVENTEEN YEARS), and now I’ve got two good psychiatrists on my side.
I was bemused, however, when I saw the locum at my surgery a few months ago. I had a minor question, and he cheerfully noted my bipolar. He congratulated me on being so upbeat and ‘well’ and told me to keep it up. Yeah world, just because I’m really freaking skilled at dragging myself by the sunshiny shorthairs doesn’t mean I’m okay. Having said that, I’m more okay right now than usual, ha ha.
I assume you are talking about primary care doctors?! I come to any new doctor with a long, well-documented mental health history so I do not have the problems you’re describing; I have the opposite problems. I have found it to be difficult to be taken seriously about any health complaints by my primary care doctors BECAUSE I have bipolar disorder. They take it rather too seriously! For example, any physical pains I’m having that are not specific are assumed to be part of depression (any by the time I complain about them, they are so chronic they cause depression in themselves). Things like thyroid deficiency are not explored because all symptoms are ascribed to bipolar disorder. I am very fortunate to have insurance that does not require referrals, so I simply make an appt. with whatever specialist my research or people’s suggestions indicates may be able to help me. Thank you for this article; I have not thought before about the difficulties of people with high-functioning bipolar disorder.
Getting one’s doctor to take one’s BPD seriously can be tough and frustrating. Pain/suffering is such a subjective thing; often doctor’s are too conservative–playing it “safe” as it were–in approaching how to treat or manage pain and suffering. This is no surprise, really, given our litigious society; doctors [understandably] are leery of the potential for a lawsuit. I guess, in large degree, one’s success in open-minded, receptive cooperation from that person’s doctor will have to do with whether he or she knows the doctor well and has a long-established relationship. My thinking is–if your insurance allows the leeway–CHANGE doctors is yours isn’t at least OPEN to honestly trying to provide effective action for your suffering. I’m an adult and I don’t need my doctor treating me like a child or teenager, you know? Allow me to take responsibility for myself. Hell, I’ll sign a waiver, if you’d like! Or doc can provide brochures beforehand! Just don’t try to deny me some exploration of approaches that COULD be effective for ME! Everyone is different. Not all “possible side effects” even apply to everyone!