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ON BEING BIPOLAR

AT AGE EIGHTEEN, I WAS DIAGNOSED BIPOLAR II. Less than a decade later, sometime in my mid-to-late twenties, I participated in a study that sought to glean insights from “high-functioning” bipolar people—presumably to figure out why we were high-functioning, and if we had anything to share that could help others become high-functioning, too.

The study took place in a little room in a low-slung building that seemed like it was built in the seventies. (This feels true of many of the buildings where psychological studies take place.) A grad student, maybe a bit younger than me, administered the study. She was cleaner-cut, normal-seeming, slim. We could have had a friend or two in common; we could have ended up on the same coed dodgeball team. At the beginning of the interview, she consulted with an older man before we entered the room. And then she proceeded to ask me questions about my diagnosis and mental health history. When she got to the part of the survey about hallucinations, she seemed apologetic, ready to skip it—bipolar people can but don’t always experience hallucinations and/or psychosis, and it’s less common with bipolar II than bipolar I.

“Oh,” I said, “we will need to go through those.” After I answered: yes, I’d experienced visual hallucinations while ill, and yes, I’d experienced auditory hallucinations while ill, she excused herself and went to consult, a second time, with the older psychologist. When she came back, I could tell that I had gone from being one type of person, in her perception, to another type of person. The wrong type of person. The type of person we place in a separate category in order to quarantine whatever it is that makes them abnormal and a bit frightening. (I’m using the word “abnormal” here colloquially—but also because abnormal psychology is the branch that studies mental disorders, of which I have several.)

During the period of time when I was hallucinating, I was also living in circumstances that the woman who was interviewing me probably would have found appalling. In the winter, my then-partner and I wore toques and hoodies to bed because it was too cold not to. At the very end of my bachelor’s degree, which coincided with the peak of one of his drinking binges, I woke up to write my final exam and had to step over him, as he was passed out on the floor and surrounded by broken glass, to get to the coffee maker. I was taking lithium. I saw birds in the corners of our rooms—one owl, in particular, recurred. I heard a low, echoing voice. I knew these were hallucinations, and I lived with them just I like I lived with my boyfriend’s alcoholism and the broken glass on the floor. Many years later, now that I am stable and my life is stable, I can sometimes still be picked out by normal people, ones who can sense that I’ve experienced periods of poverty and illness. Other times, I can pass for the type of person who has never experienced these things—and then, if they come up, they come as a shock. I’m not sure what’s better or worse.

WHEN THE MEDIA TALKS ABOUT MENTAL ILLNESS, the conversation is usually framed around reducing stigma—#LetsTalk about mental health—and around the costs to employers, as half a million workers are out sick with mental health issues weekly, translating into a $50 billion hit to the economy. Focusing on stigma cleanly removes the personal economic costs of mental illness from the conversation; focusing on costs to employers frames the illness in terms of productivity, what one owes one’s employer.

For sixty percent of people diagnosed bipolar, what one owes one’s employer is a moot point, because sixty percent of people diagnosed bipolar are unemployed. Stephen Fry’s 2006 documentary, The Secret Life of the Manic Depressive, is mostly filtered through his personal experience as he seeks to get to the root of the causes and effects of his bipolar disorder—and as he struggles to decide if he’ll take medication for it. But he also speaks to other people, including a doctor who works half time, a young woman who can’t work at all, and celebrities for whom work is presented as less of an economic problem and more of a creative expression or outlet. Fry works. Fry works almost compulsively, almost as if he is a shark who will die if he ever stops moving. I might do this, too, even if I weren’t currently the main earner for my very moderately middle-class household, which includes my partner and my toddler and my tabby cat (and an uncountable number of what I at first thought were wolf spiders but are actually “giant house spiders”). I live with a feeling of constant stress that began in childhood, stress that if I don’t work at or near max capacity, I will lose the roof over my head. In childhood, I had no control, no way of stemming the tide of calls from collection agencies, calls from the bank. The first thing I did when I made real money of my own was not to save for a Game Boy or new comic books; it was to buy the food I wanted to eat.

When I spun out at eighteen, I was between my first and second years of university, and had come home to Hamilton instead of staying in Guelph. My parents had split up in my first semester after the daylighting of an affair between my mom and my best friend’s father, and the composition of my family and my best friend’s family had shifted into a temporary, liminal space—as if we had been suspended before we could move forward. My mother and my best friend’s father were renting a small house by the highway in Winona, just south of Hamilton, on Lake Ontario. My dad and my brother were still in our childhood home, where I went; that house was a stone’s throw from my best friend’s house, and that summer we all, except for the two in Winona, had regular barbecues in our backyard. Through a buddy of hers from the bar, my mother got me a job at a Hamilton Parks & Rec location near her house. Ten-hour days at the beginning of the season progressing to twelve-hour days later on. Mowing lawns, clearing firepits, picking up garbage, directing parking traffic during events. I had a second part-time job at the video rental store I’d worked at near the end of high school, so I was working anywhere from ten to sixteen hours a day when I went off the rails.

While everyone around me—my dad, my brother, my best friend, her family—seemed to have been slowly processing the affair and its aftermath, I felt like I’d returned from the freedom of university life to the direct, unrelenting pressures of life with my mother. Whatever progress I’d made at school evaporated; my mother wanted me to stay over at her place after work to avoid the drive home, and if I relented, she’d get progressively drunker as she complained about how shitty my dad was. We’d never talked about the affair, which had started when I was living at home and working at my best friend’s father’s store, and which I’d attempted to confront my mother about in high school. We’d never talked about her drinking. I was angry and resentful, but my anger was a chiminea to my mother’s forest fire. One night, when I yelled at her that I couldn’t take it anymore, she yelled back. I’ve blanked out what, exactly, she said, but I remember later thinking that it was as if she’d used the years she’d been my parent solely to hone the sharpest and most painful insults. I also remember later cautioning myself, based on what she’d said, that I couldn’t trust her, that I’d have to give up thinking of her as a mother, my mother. I ran out of her house and down the lane, the sound of highway traffic audible beyond the noise barrier. I heard my mother’s door open; I heard her car start. I looked around. I could jump into a drainage ditch or sprint to the end of the road and hide behind a concrete barrier. I went for the barrier. I could hear my mom driving around, which terrified me because she was drunk. I called my dad, who came and picked me up. I never stayed at my mother’s house in Winona again.

I tried to maintain the pace of my life for a few weeks after that. The confluence of my jobs already meant that I wasn’t always getting as much sleep as I needed. I started sleeping even less. I went to a party in the west end of Hamilton, got drunk, and had no way to get home. The buses had stopped running. Instead of taking a cab, I made an overnight elevenkilometre trek home along the rail trail that connects Hamilton and Dundas, arriving just as the sun was coming up and my dad was leaving for work. I got into a fender-bender on the highway driving home one day, and then I got into another accident while picking up my co-worker; the other car’s hubcap went rolling across the road, like in the movies, all noise suspended except for the sound of metal spinning and then falling on concrete like a top. I drank and smoked and cheated on my boyfriend with someone I’d had a crush on in high school; I promised that boy the world. On the phone with my boyfriend, I felt as though I’d promised away too many worlds. I could no longer keep anything together. When I realized that my mother was not a mother like other people had, I began to cycle between grief and self-recrimination, wondering why I was not lovable, wondering why my own mother could not love me. I couldn’t think straight. I thought maybe it would calm my nerves to take a shot of my father’s whisky. I had already taken an Ativan, which I’d been prescribed for one of my anxiety disorders. I took a shot, and then another shot, and then everything I was holding tight began to unravel. I emptied the bottle of whisky and took the rest of the pills. My boyfriend, the one who’d later become an alcoholic himself, called 911 and an ambulance arrived at my house just as my dad and brother did, too.

I wasn’t kept overnight at the hospital. The nurse, whom I’d irritated by neglecting to stop keening about what a fuck-up I was, handed me a pamphlet for Alcoholics Anonymous as I was shuffled out of the hospital the very night I’d arrived. I never went back to the Parks & Rec job but couldn’t quit working outright—I’d signed a lease on a place in Guelph and needed to make rent. Very shortly after my nadir, I got a part-time job at a grocery store as a checkout clerk.

When I think about mental illness, I think first about Virginia Woolf placing her hand into a pocket of rocks. I think about movies or shows I’ve seen where depression is depicted as a series of long, slow-moving days, stuck in one’s home, maybe breaking the monotony by heading to the corner store in a bathrobe in search of cigarettes and ice cream. (When I think about mania, I think about rich young men taking cocaine and driving fast and apparently covetably ugly small cars.) Only after a few beats do I think about myself—my life oriented around working through illness, an economic crisis never far off. Perhaps this anxiety is protective; perhaps I’ve never been so badly off, maybe all those mornings I’ve shoved my legs off the side of the bed to propel my body out of it wouldn’t have been possible if I were more ill, truly ill. Depictions of serious mental illness seem to exist without a middle—celebrities whose lows are captured by paparazzi, men with shopping carts under bridges. But the truth is most of our breakdowns are private, and if we talk about them at all, we talk about them after we’ve stabilized. If you’re not stable, people talk about you, for you, instead.

BIPOLAR DISORDER HAS BEEN ROMANTICIZED IN POP CULTURE. It’s presented as better, perhaps more inherently interesting, than depression, which we see as a disease that renders already waifish young women thinner and sadder, or middle-aged men more bloated, full of beer and ice cream. Like schizophrenia, bipolar disorder is generally embodied onscreen by men—though it affects women at more or less the same rate.

Bipolar disorder is depicted as a font of creativity, fun, and terrible choices. Virginia Woolf, van Gogh, Stephen Fry, Carrie Fisher, Charlie Sheen, Britney Spears, Chris Brown, Catherine Zeta-Jones, Lou Reed, Kim Novak, Edvard Munch, Marilyn Monroe. If you’re famous and bipolar, your name will grace googleable lists, many devoid of any kind of context. You can be known for succeeding despite your diagnosis, or you can be known for the train wreck you make of your life and career. The only way you can stake a claim to your own story is to tell it yourself, like Fry did.

The problem with sharing your personal story—or the story of being bipolar filtered through your experience—is that people who don’t share your diagnosis may essentialize the disorder, placing your experience at the pinnacle of their pyramid of understanding of what it means, in general, to be bipolar. And the further problem is that it’s easiest to package your illness in the way that it is already culturally understood—and maybe the cultural understanding even begins to shape your understanding of yourself.

The end result is that the story of being bipolar—an illness with ups and downs, which offers a narrative more easily than illnesses without—is one where, often, the manic protagonist must wrestle his euphoria to the ground for the sake of his sanity. When you are manic, the understanding is that you enjoy your mania. It’s only the mess, afterwards, that provokes reflection and a tidy combination of SSRIs and mood stabilizers.

This has not been my experience of mania. Or maybe it has, and I like it less. The broad truth about suicidality and bipolar disorder is that people with it are about thirty times more likely than the general public, and twice as likely as people with unipolar depression, to kill themselves. The broad truth about me is that I never want to die, and that if I did kill myself, it would happen accidentally, while I was hypomanic.

Adjacent to the list I can recite of famous people with bipolar disorder is another list, a list of non-famous people, friends and acquaintances. I won’t list them—their stories are not mine to tell. Two of them died by overdose, one accidentally and one not as accidentally. Both were people who maybe found it easier to care deeply about others than themselves. When I’m up late at night, wanting to sleep but pushing sleep off because I am afraid of death, one or the other will come floating to the top of my mind, and I will think, Shit. Because I don’t want either of them to be dead. And I don’t want to die, either. Not ever, and definitely not accidentally. The night that I was briefly hospitalized—the night that was a culmination of terrible days and weeks, the night that led to my diagnosis—is a blur with pinpricks of clarity. But I remember very acutely the feeling that led me to down, by shots, and then all at once, an entire bottle of whisky as well as what remained of my Ativan prescription—like I had, sometime earlier, swallowed firecrackers and would give anything, do anything, to put them out.

I don’t associate mania with creativity, or fun, or clarity; I associate it with an abundance of energy that seems like it needs no fuel but that will end up using me for its fuel. When it comes, now, I prepare for it as if I live on a cottage by the ocean and a storm is about to blow through. I don’t think that my experience of bipolar disorder should be read as bipolar’s new urtext, but I do wonder why I feel such a chasm between the way that the illness is so often depicted and my experience of it. I wonder if there is something about me that is lacking, essentially unfun, as dull and bland as baby cereal. Or if, when I am asked to help explain why I am “high-functioning” and other people are not, the answer is fear. Fear of poverty and fear of dying. Can fear keep you safe? Or will fear kill me early, just in a different way?

ESMÉ WEIJUN WANG WRITES VERY MOVINGLY about being one of the good sick. Her doctors are initially reluctant to switch her diagnosis from bipolar disorder to schizoaffective disorder, bipolar type, because schizoaffective disorder “has a gloomier prognosis and stigma than bipolar disorder does.” During an earlier hospitalization, Wang had noticed that there was even a hierarchy on the ward: the two women at the bottom of the hierarchy were the women who were very clearly, to the other patients, schizophrenic. Wang, who had not yet experienced psychosis, treated schizophrenic Pauline “like a contagion.” Perhaps, she writes, she sensed the possibility of psychosis “thrumming in [herself] even then.”

There are many benefits that one gets, being the good sick. And there are compromises one makes to remain the good sick. And then there is the fear of becoming the contagion.

I’ve been asked several times why I chose not to come out as nonbinary to my OB/GYN and the other medical professionals I interacted with when I was pregnant. There is the simple answer, which is that I didn’t feel comfortable doing so, and the more complex answer: I knew that the hormones that would come along with pregnancy and birth, and the not-sleeping that would come along with having a newborn, had the potential to throw me into a manic crisis. (“Women with bipolar disorder are at a very high risk for having a much more severe episode of illness in relationship to childbirth, often with psychotic symptoms like hallucinations or delusions,” researcher Ian Jones says in the Stephen Fry doc. “And really these episodes can be some of the most severe episodes of illness that we see in psychiatric practice.”) I didn’t have alternatives for what, other than “mother,” I could call myself, and I didn’t know if I could find trans-affirming care; on the flip side, I had a very strong urge to be as candid as possible about being bipolar so that I could be streamed into emergency mental health care if it became necessary. While being candid, though, I also wanted to appear as stable, as normal, as possible. I needed to begin as one of the good sick so that if I became, over the course of my pregnancy or after birth, one of the bad sick, I would have the best chance of accessing the kind of care that might save me. To be the good sick, it helps to be articulate, to make the right kind of eye contact, to check off as many privileges as you can. I did not know if I could afford to be both non-binary and bipolar. So I compromised.

WHEN YOU ARE THE BAD SICK, you become a cautionary tale. My great-aunt is a cautionary tale. She was first bipolar, and then got dementia, and then, most recently, cancer. I don’t know my great-aunt except through photos; she was the youngest of three sisters and very outgoing in her youth, but by the time I was growing up she didn’t like to leave her apartment. I learned she had cancer when my cousin posted about it on Facebook. My cousin wrote first that she was upset to have unexpectedly learned of her aunt’s illness, and then, two days later, that “every disease is mental first,” and “everything is mind over matter,” and “[e]verything is about vibration.” I wondered at what stage my cousin thought that my great-aunt should have vibrated herself out of illness. I thought a series of angrier things.

If you lined up my cousin and me, my dad, my grandmother, my great-aunt, you would clearly see we were all related. Variations on a theme. If my cousin can assign vibrational blame to my great-aunt’s illnesses, maybe that helps her to not see herself in them. When my great-aunt was diagnosed with dementia, a disease my great-grandmother had as well, I thought, Well, my bipolar disorder isn’t as bad as hers. I thought, I do the crossword. I did not build my rationalizations a spiritual structure and I did not invite them to stay, but I thought them and I felt them.

Like my initial desire to distance myself from my great-aunt’s illnesses, I don’t feel proud of the compromises I’ve made to try to be, and to appear to be, one of the good sick. But I’m sure if I was faced with the same choices at the same points in my life, I’d make the same decisions over again. I do worry about the way that illnesses like bipolar disorder are rendered visible, via personal narrative and through productivity statistics. I worry that we understand illness and wellness as something that we hold and foster as individuals, and that this masks the extent to which social conditions like racism, sexism, homophobia, overwork, classism, and eviscerated social safety nets trigger and exacerbate them. This is the dark side of gleaning what we can from the narratives of the good sick in order to give better “tools” to the bad sick, to make them “higher-functioning”—is the idea to improve a person’s quality of life, or to render them a better worker? It’s also why I tap out, each year, of participating in campaigns like Bell’s #LetsTalk: they place the onus on the unwell to share their stories for nickels and dimes while raising brand recognition. Understandably, people share what is safe for them to share; I doubt Bell will chip in on my mortgage if I no longer appear quite as employable because I regularly saw an imaginary owl for a steady period in my early twenties. The result is a sanitized portrayal of illness that does little to shorten psychiatric wait times for people, like me, who rely on provincial health care to seek mental health treatment.

Sometimes, I dream about how wealthy I would need to be to take a break from feeling the fear that propels me to remain stable. I don’t dream about not being bipolar, because I don’t know where my self ends and where the illness begins, and if there is even really a difference. I don’t even know what I would dream to render the divisions between good sick and bad sick unnecessary, to make it so that we all get to remain people, without reducing some of us to possibility models—or, worse, sacrificing us to quarantine and cautionary tale.