This week is National Mental Illness Awareness Week, and because I have bipolar disorder, I want to take a minute to talk about what it’s like to have a severe mental illness, and what you can do to help.
I have Type II ultra-rapid-cycling bipolar disorder, which is one of the more severe forms of bipolar disorder. Without medication, I suffer major mood swings, anything from hypomania to severe depression. I get visions of being tortured (a knife thrust between the two bones of my forearm, being flayed alive, pins thrust into my eyes), mental pain like having my skin rubbed raw with sandpaper, and an inarticulate sense of being in great danger, of something hunting me. I get suicidal: I get impulses to smash the car into the concrete supports of an underpass, to jump off an overpass, to hang myself from a tree I happen to see. Not always, and not all the time, but it’s a constant worry, a constant concern about keeping myself stable and symptom free. It’s a delicate balancing act, reducing stress, avoiding anything that could trigger a bipolar episode. In many cases that has meant breaking up with boyfriends when stressed (because people stress me out), hiding in my room, and avoiding anyone who doesn’t feel extremely safe. It also meant, for many years, understanding and accepting that I would live a short life with an unpleasant end, when the pain grew too much to handle.
What I want to say is that this is different from being irrational, and different from being insane. It is possible to be perfectly sane (in the sense that you can behave, process information, and think logically) and still suffer from a severe mental illness. Even at my worst times, I was aware that there was a disconnect between my feelings and how I would “normally” feel in the same situation, and could reasonably compensate, at least enough to “pass” as normal.
So that is the first thing I want to say: people with severe mental illnesses can look and behave perfectly normally. (You probably know a couple of them yourself.) They are, in fact, people like yourself, except with a few additional challenges that make life significantly harder.
The second thing I want to say is that, as medical professionals will tell you, you should take it seriously when someone talks to you about depression, or looks or acts suicidal. There’s a very good chance that they have been “covering up” their feelings for quite some time – especially if things appear suddenly – and are near the end of their rope. Don’t panic (that doesn’t help anyone), but do find out whether they’re feeling suicidal, and how long they’ve been feeling that way. You might suggest consulting a doctor. It wouldn’t hurt to mention that depression is a physical (biochemical) disorder, not a personal weakness. Don’t be afraid to call the police if you think they are really about to commit suicide.
(A side note: just because you’re suicidal does not mean you want to die. I have gone through many periods of having impulses – even nearly continuous ones – to suicide, without wanting to die. I have also reached a point where, after an extended period of severe mental pain, I came very close to choosing to die – not because of the suicidal impulses, but because no one in their right mind would want to continue living under those conditions. That was not depressive thinking but a perfectly rational decision. It’s been almost ten years since that desperate time, but I still feel the same way: I would rather die than go through that much pain again, and I mean that quite literally.)
The third thing I want to say is that mental illness is not forever. If you have a mental illness, there’s a very good chance that it can be treated. Even if you have a genetically based mental illness – and I do – modern medicine can help control it, letting you live a normal life despite your genetic predispositions. I’ll be taking bipolar medications for the rest of my life, but they’ve allowed me to be symptom-free the last eight years (since I was diagnosed and the right combination of medications found), and I now expect to live a normal lifespan. This is so much more than I had expected, especially right after being diagnosed with a lifelong disorder!
And the last thing I want to say is that people with mental illnesses are real people. The reason why I am public about my bipolar disorder is that I feel, very strongly, that unless some of us are willing to stand up and tell our stories, the stigma against people with mental illnesses will continue. We are people, just like everyone else. We have our ups and downs, good days and bad days, virtues and faults. The only difference is that, in addition to the rest of life’s challenges, we have biochemical disorders to deal with.
I wrote an essay on living with bipolar disorder this time last year, in response to a social worker who asked me to tell my story, in hopes that it might help one of his clients. I urge you to read it, and perhaps share it with someone else you know who is struggling with a mental illness, who needs to know that mental illness is not forever. It’s at http://www.tienchiu.com/2009/10/living-with-bipolar-disorder/ .
Cheers, and a peaceful Mental Illness Awareness Week to you!