From time to time, even I, mental health writer and speaker, have forgotten that bipolar disorder is a physical illness. Well, I don’t forget, exactly, but I have acted like it wasn’t physical with my actions in my own life. But how could I act like mental illness (which I even call brain disorders) isn’t physical? Why would I ever forget that bipolar disorder is a physical illness?
Bipolar Disorder Wants You to Believe It’s “All in Your Head”
I think part of the reason that people forget that bipolar disorder is a physical illness is because of the bipolar disorder itself. Bipolar disorder is a big liar and it wants you to think that it’s your fault and that it’s all in your head. And even if our conscious, wise and knowledgeable minds know differently, bipolar’s voice can be awfully convincing now and then.
People Want You to Think Bipolar Isn’t a Physical Illness
And then there are all the other people who want you to think that bipolar disorder isn’t a physical illness. There are all the scientologists, all the antipsychiatrists and all the uneducated, just to name a few. These people have a vested interest in making you believe that bipolar isn’t physical. These people have a vested interest in making you believe that bipolar can be cured with vitamins or pseudo-therapy or religion. Sometimes these people are driven by money. Sometimes these people are driven by ignorance. Sometimes these people are simply driven by dramatic dogma. Whatever it is, these people will tell you, and even convince some, that bipolar disorder is not a physical illness.
How Could I Forget that Bipolar Disorder Is a Physical Illness?
For my part, as I said, I never forgot, really, but I acted, in my own life, like I didn’t understand the physical basis for bipolar disorder. I beat myself up for having bipolar. I begged a deity I didn’t believe in to fix my bipolar. I felt guilty for having bipolar. I felt like a lesser person because of having bipolar. I didn’t think I wasn’t good enough to be around others because of bipolar. All of these things suggested that bipolar disorder was somehow my fault and unlike all other physical illnesses – but, of course, it isn’t. Bipolar disorder is a brain disorder – physical – and my actions should betray that fact.
But, like I said, bipolar is a big liar and I am not immune to its effects. Just because I know otherwise, it doesn’t mean that other forces can’t convince me, for moments, that I’m a horrible, bad, no good, awful, weak, messed up person to exhibit the signs of this illness and not be able to “pick myself up by my bootstraps” and just get on with life.
It’s Natural to Have Moments Where Bipolar Disorder Doesn’t Seem Physical
In other words, I think it’s natural to forget that bipolar is a physical illness and act like you don’t believe it’s a brain disorder. I really do think that’s a natural thing considering the forces thrust upon us.
That said, I think it’s important to fight back against this. When we see ourselves doing something that suggests bipolar disorder isn’t physical – like beating ourselves up about bipolar – then we need to confront those feelings with logic and knowledge and remind ourselves that the brain can be sick, just like any other organ, and we just are unlucky enough to have that happen to us.
Perhaps you can read a bit here to help you remember. Or maybe there’s a book that helps you. Or maybe writing helps you. Or maybe doing art helps you. I don’t know. What I do know is that standing up to this idea is important because not believing that bipolar is a physical illness hurts us – and we already hurt enough already.
Header image by A Health Blog.
Inset image by Live Life Happy.
People have many misconceptions regarding mental illnesses. This is just one of them.
There does seem to be a recent increase in research studies which are identifying what they call “biomarkers” for different mental illnesses, including Bipolar. Some of these are brain scan differences (for example when presented with a series of images meant to elicit an emotional reaction), some are protein differences, and others.
And I do mean recent, as in even this month. Just go to Google News and enter “bipolar biomarkers” to read more about what the Mayo Clinic, Yale, UT Southwestern Medical Center, and others have been doing in this area.
Although it’s still early stages, at least these do offer the hope of a providing a more clear diagnostic protocol which is not dependent on an individual therapist’s or psychiatrist’s opinion (even if it is an expert opinion based on interviews with the patient and family members.) This would be a big step forward, and then hopefully could lead to better understanding of the origins of these disorders and when and how treatment options might be possible.
The big question of course is when (not “if” in my opinion) the advancements in this research could lead to more objective, and more widespread and clear diagnoses for more people. And of course whether this could all lead to some effective treatments, or even prevention in some cases.
Even if there was just a more clear and reliable and objective method of diagnosis, that could help lessen the stigma, increase the availability of insurance/medical coverage, and also help more individuals who have Bipolar or other mental illnesses be more open to accepting the possibility that they are ill and that they do suffer from something that is in fact a physical ailment (one which happens to affect the brain, emotions, etc.), leading to more people getting treated and enjoying the benefits of that treatment.
One can hope. I’m glad the researchers are hoping along these same lines. :)
Hi Bob, thank you for posting that info about the recent studies re: biomarkers/proteins as markers for BP and psychosis. I’ve been to the (not so) merry land of manic psychosis, and it’s been difficult living with an illness that’s treated with so much doubt on one hand and contempt on the other.
I’ve been pessimistic for a long time about whether much effort goes into R & D of definitive diagnostic testing for BP and Schizophrenia. I just read the studies you mentioned and they give me some hope. When compared with the sample size of the studies the NIH does, these studies have considerably larger populations. Even 300 ppl. for the Mayo Clinic is a significant number – 700-800 ppl. for the UT Southwestern study is astronomical. The studies I’ve read that the NIH puts out only have between 23 and 135 participants – they always conclude with…more studies of larger populations are needed. The studies you mentioned also conclude that, however, they at least started with more sizable populations. There’s hope the next studies can duplicate the data with a much larger population in the near future.
When I had breast cancer and needed to make a lumpectomy vs. mastectomy decision, I got to peruse long term studies of > 10,000 women. It infuriates me to see NIH studies on BP disorder with 23 participants – it’s like a bad joke. My brain is far more valuable to me than my breasts, yet so few dollars have been spent on MI studies by comparison.
Thank you again for posting that info – imagine it could come down to a blood test someday for an early and/or accurate diagnosis for bipolar. Those studies are a great starting point and a long time coming.
Of course it’s “all in our heads” – that’s where our brain is housed. I don’t think BP d/o will ever be given it’s due until it’s renamed something with the word “neurological” in its title. Then the illness will get the respect it deserves as the actual neurological pathology it is. Until then, we have to endure changes in our most significant organ (the human brain) alone – untrusted, trivialized, disposable people. I’m envious of my friends with Epilepsy and MS, for they have socially acceptable disorders – no one questions their accuracy, their worth or their validity.
Meanwhile, my amygdala (the emotional center of the brain) shrinks in size during an acute episode, while my hippocampus (the memory center) doubles in size. My pre-frontal cortex is shrinking and WMHs (white matter hyperintensities) consisting of myelin are taking up residence in the lateral ventricles of my brain where they don’t belong. This leaves me at a higher risk for dementia, but no…it’s not a real illness! Yeah, right…and unicorns are flying over my home as I write this.
Ever since the advent of PET scans, FLAIR imaging and fMRIs a decade+ ago, the NIH has pursued studies which illustrate this empirical evidence – they still don’t know whether it’s the chicken or the egg. That’s because the sample study population is always so small; they always conclude the same thing…we need more studies. From a diagnoses and treatment perspective, it doesn’t matter if it’s the chicken or egg – the brain pathology is there to be seen during acute phases of this illness.
I don’t know when it will change and medicine will start to seriously diagnose BP with empirical data – I’m 62 and it won’t be in my lifetime. My son with BP is 34 – I hope some progress will be made in his lifetime but I’m doubtful of even that.
I often wonder if our government is worried about the increased volume of disability cases when doctors can start diagnosing with empirical data…when people are diagnosed correctly and swiftly – not after a decade of a badly damaged life as is the current diagnostic average time frame.
Well, I’ve had my say – I’m fed up with having a second class neurological illness I must hide – tired of pretending I’m okay in front my friends with their socially acceptable brain disorders that no one diminishes them or berates them for.
When is the medical community going to give BP disorder the effort, time, money and credence it deserves?
Smart comments. Nice one. And, I might add, we will and are seeing more progress made in the field of mental illness all the time, and will continue to, for yours and your son’s futures.
i had an MRI in 2008 that showed an imbalance/aysmmetrical of my hippocampi and with symptoms I was having (seizure in nature), Neurologists diagnosed me with Partial Complex Seizure disorder. That was until they found out my very long and lengthy psych history and most, not all, of the med trials I had been through for the psychiatric.
Suddenly, the same Neurologists who diagnosed me with seizures based on an MRI with and without contrast/Flair imaging… suddenly started mumbling “psychosomatic non-epileptic” and encouraged me, quite adamantly, to go see a psychiatrist.
See, I was told that the medications they prescribe for seizures would be hazardous, even possibly life-threatening, if I actually DIDN”T have seizures. So, they didn’t want to prescribe me any anti-epileptics.
Most anti-epileptics are prescribed infinitely to those with psychiatric illnesses and disorders. So, i laughed at the Neurologists and they wanted to know why I was laughing? THis was serious, they said.
I explained that apparently they didn’t believe Psychiatric illnesses nor disorders were actually biologically based, aka “real” but that psychiatrists had been prescribing numerous anti-epileptics for years and would continue to do so.
The neurologists quieted, but refused to prescribe me any anti-epileptics until I had been seen thoroughly by a Psychiatrist (which, i was being seen by one at that time and told them he didn’t feel they psychosomatic and had urged me to see them for neurological) and insisted that I undergo a 1-2 week hospitalization while they hooked me up to electrodes and filmed me the entire time – in hopes of “catching one” or distressing me until I “had one.” They hadn’t argued the need for a potentially costly and lengthy hospitalization until I argued as to whether they psychosomatic or “real”.
Since that time… I still have seizures. I’ve been to 2 additional Neurologists; one even a Epileptiologist.
The random generalized Neurologist (her words) first diagnosed seizures, put me on Lamictal and then got my psych history and med history, suddenly and quite explicitly she told me “I don’t know what is wrong with you. You have a mood disorder, right? Likely Bipolar related and we will no longer see you, you need a Psychiatrist.”
Went to the Epileptiologist… told him straight out about the psych history and med trials… he diagnosed me with Seizures and started me on Keppra. I had a blistery itching rash… he got the long psych history and even longer med history and on the 2nd appointment “We are not sure what exactly these are and I don’t feel comfortable with prescribing any further meds because the meds we prescribe are potentially hazardous and possibly life threatening if you do not actually have a seizure disorder or biological disorder.”
I again… chucked and again, this one wanted to know what was so funny? I told him what I told the first group in 2008. He, like them, grew quiet.
No.. sug, the neurological world is not as friendly and accepting.
I have to hide my seizures from my employment, so as to 1) be employed and 2) not suddenly be up for layoff when they let go or downsize folks. I am not on any medication for the seizures because my PCP and my Epilepsy Specialist do not want to continue to prescribe possibly hazardous medications but want a 1-2 week inpatient hospitalization with electrodes and strangers videoing me and sitting with me round the clock to watch me… of which, I can’t afford.
I mention seizures to psychiatrists now… they want inpatient records of diagnostic testing and then wonder why I am not medicated? I have to go through the history again.
I have diagnosed mild cognitive impairment from a neuropsychiatrist… my memory is getting more and more shotty as I grow older and I have to write everything down or I lose everything in my short-term memory. I have the hypersensitivities white matter spots… was told it was part of aging.
Just 2 weeks ago I had a really bad seizure, fell down a short flight of stairs within my home and face planted upon my hardwood flooring. I was taken to the ER… broken nose, gash requiring 7 stitches and a concussion. The ER doc asked what happened? I told.. “seizure”… wanted to know what med? Told “none”… wanted to know why? Told…
“I’ll just put down that you fainted and have a broken nose and laceration.”
No sug… neurological disorders are not really accepted or diagnosed when you also come with a package of psychiatric…
The psychs want me to see neurologists and neurologists want me to see psychs and I can’t be free and tell anyone outside of the “medical clinical” world… or face issues with employment.
Unbelievable. Sorry for your suffering.
Hi Tabby,
What a nightmare you’ve been through with Neurologists and PDocs all diminishing you for the horrible misfortune of having epilepsy co-mormid with BP d/o. You’ve been consistently invalidated by some very callous practitioners.
My friend with epilepsy (for over 30 years) is on Keppra – she is carefully monitored and treated with much respect and sympathy in the medical community. She doesn’t have any psych diagnoses, therefore she’s considered entirely credible. She lives a full life and has been considered disabled since the onset – no one questions that either, unlike with serious MI when ppl. treat you like there’s really nothing wrong with you, or it’s not a big deal. You know, the “suck it up” school of thought and treatment. If you’re disabled by BP d/o some folks treat you like you’re a scammer – as if anyone would choose to live like this instead of a “normal” lifestyle. As if we would choose to go into battle every day.
Yes, Natasha is correct – it’s not only a real physical illness, but is made so much worse by the ignorance and stigma, especially from those in the medical field. It’s so discouraging and I wonder how you can keep yourself stable after so many verbal assaults about your medical illnesses from those in the field – just disgusting.
Maybe some day things will improve – but change seems really slow in coming, and I’m aging too. I hold out some hope for sufferers in their 20s and 30s that they may live to receive proper treatment for this brain malady.
So sorry to hear of that wicked fall – hope your nose and laceration are healing up okay. Mostly hope you can somehow keep your spirits up after all you’ve endured – I wish you peace.
Under mental health legislation worldwide, people with mental illnesses have no rights so no one has to take us seriously at all. But this will change – we’ve already made it out of institutions and we will gain ‘normal rights’ as time goes on. I am middle-aged but i’m sure it will happen in my lifetime.
Thank you for your encouraging words, Lilsa. I’m probably too pessimistic after a 27 year battle – sometimes it feels like we’ve gone backwards in so many ways. Yet there does seem to be more hope with advanced testing techniques for eventual diagnostic tools, and to prove bipolar is a real and physical illness. I’m getting older, but I’ll hold out some hope for ppl. your age and my 34 year old son that people will gain more understanding and compassion towards those with MI.
Be the change you want to see in the world. I am no longer ashamed of my mental illness. I am not ashamed of my unemployed status (that has been forced on me anyway and I do volunteer work). Find a way through (and my prayers are with you). Love will heal anything and God is great. I have been through a lot of horror but am nearly mental illness-free now. I have had virtually no symptoms since I as about 35 (some years ago). Process what you have been through and leave the past to God. Nurture and spoil yourself as much as you can. And there is always hope, no matter what. And fight for your rights. Best wishes always from me.
I’m 71 now, and as long as I can remember I felt like I didn’t fit in, anywhere. Being first generation American didn’t help. There was a lot of abuse physical, mental and sexual. I felt I did something wrong to deserve this treatment, so I withdrew into my own world of isolation. At age 13 I found alcohol to be my medication for several years. Making many poor decisions plugging my way thru colleges hoping to become a nurse. Most of my jobs were in the medical field. Finally at age 46 I finished becoming a RN, BSN. Icould not break thru the click of floor nurses at the hospital I worked at. So after 16 years I left that hospital and went into mental health nursing thinking; now I can share myself. I was so wrong. . After more meds than I can count, two hospitalizations and research programs . I got a diagnosis of being Bi-Polar. What I don’t understand is why I couldn’t talk about my own illness with professionals I worked with because they would not trust or understand me ?
I really like this article! I can somewhat use it to reach out to family and friends. Thank you!
I am reminded daily of the physical correlation to Bipolar. My neck, shoulder and accompaning tension headaches, especially evident when in fullblown anxiety, are the markers I am too often aware of. Thanks for your spot on article. Maybe I will remember to treat myself better.
J too have tight shoulder, tense neck, and unreal back pain.
To the author: dear, people hold our illnesses against us so it is impossible not to self-stigmatise. If you self-stigmatise then, by definition, you are looking down on yourself for having the condition. If you see the condition as a bad reflection on yourself then you are going to blame yourself for having it. Most health conditions attract compassion, NOT stigma. It has taken me about 20 years to realise that I should have been getting compassion instead of stigma for all these years for my diagnosis. Give yourself a break. Eventually, mental illness will attract compassion, not stigma – hopefully it won’t be too long before this happens. Best wishes to you – your website is dynamic and ‘happening’.
I would add that in addition to being a brain disorder, the illness is systemic–brain/body. I often feel extreme pain in my neck, shoulders, and upper back, which I attribute to managing the tension of often unmanageable emotions and mood swings.
A truly positive approach, Natasha, to understand bipolar disorder’s root cause. Perhaps we need to put our own coping skills to work by developing a strong attitude in overcoming negative feelings and emotions with positive interaction. Be a full and active participant in our own treatment. Learn everything we can about bipolar disorder. Become an expert on the illness. Study up on the symptoms, so we can recognize them in ourselves, and research all your available treatment options. The more informed we are, the better prepared we’ll be to deal with symptoms and make good choices for ourselves.
Yeah, I know. It would be nice if I could just see my pc for this, which has a small copay, than to have the much higher specialist copay for no reason.
When people tell me I don’t have bipolar disease, I get so hurt and confused. There is a stigma. I look and act “normal” so there is know way I am sick. It’s so defeating.
Hi Ann,
Well, like I said, some other people are invested in making you believe that you’re not really sick, but you know better and you have to fight those ideas with what you really know because, in all honesty, there will always be those people out there and we all have to face them together.
– Natasha Tracy