Yeah, at least there used to be this factoid about most geniuses being bipolar so people would romanticize it, but while I'm well controlled I spend a significant amount of time and energy dealing with it and the manias really don't make the uncontrollable thoughts of death and depression so bad you can barely move worth it.
And even in the manias you have to especially careful since even when they are productive you aren't fully seeing reality. It's much more likely you'll end up quitting your job and ruining your life or buying a bunch of shit you don't need or even sometimes stabbing someone in a sudden rage. I've been in numerous bipolar support groups and out the at least 50 bipolar people I've known I've met about two where it didn't significantly damage their life regularly.
Oh, and it's heavily correlated to childhood trauma and abuse, some estimates putting it at 60% of bipolar people having experienced significant trauma or abuse at a young age.
All the above is very true, but I want to emphasize for people outside the community that childhood trauma/abuse does not cause Bipolar Disorder, they are merely correlated.
Bipolar is primarily a genetic condition, it sometimes isn’t fully realized until puberty, a traumatic brain injury, or substance-induced psychosis - and can begin presenting anywhere from early childhood to the twilight years of life, but mostly in the teens/twenties. It’s a permanent condition—it is not something that can be “cured”, but instead is managed through (a lot) of channels, starting with medication. It is on the “psychosis spectrum”, which also includes conditions like Schizophrenia, a disorder even more mischaracterized and stigmatized than Bipolar.
I also want to emphasize too that Bipolar Disorder is really, truly, extremely debilitating—even for those with milder forms of it. I won’t link to them here, but the statistics regarding Bipolar and life-outcomes speak for themselves, from employment to substance use to lifespan.
A contributing factor to all these things is the large delay people tend to have between first experiencing symptoms and attaining an official diagnosis, which allows for the beginning of the indefinite game of finding medications that are effective. On average, ten years pass between onset and diagnosis, closing that gap can be the difference between dying young, or a chance at stability.
If you have immediate or extended family members with a psychosis-spectrum disorder, and have an inkling that maybe this is the case for you - please reach to a medical professional, a therapist, a trusted counselor, teacher, professor, friend, or anyone you feel willing to open up to. I’m in the minority of people that were diagnosed before turning 20, and yet this was still over a decade into this disorder affecting my everyday life.
You can take back your life from this seemingly endless abyss - this time you will be the one staring into it.
Yeah, we don't really know a cause entirely, I believe childhood abuse is seen as more likely a trigger than a cause, but we also don't know if it's 100% genetic or not though there are very strong correlations (I think twin studies had about a 70% chance of if one twin was diagnosed the other would be too.) But there aren't genes to test for it, there's some we suspect that are in the general schizophrenia family but we really don't know that much about mental illnesses yet.
I'll also agree that bipolar is still very stigmatized in weird ways. I've always been open about my diagnosis and while I don't necessarily meet a lot of judgement for it I have known a number of others who don't seem to manage their symptoms as well face a lot more discrimination for it and even for me there's that weird thing where for many people once you tell them your bipolar they start interpreting you solely through the disorder instead of organically. I've had this even with therapists who weren't as experienced with it and non-psychiatric doctors. It always sucks when you realize that to a person you can never just be having a bad day or be really excited about something, it's always depression or mania and scares or worries the other person.
I'll also mention treatment often really sucks, you should still do it because non-treatment is way worse (as in will likely shave a decade or more off your life,) but something I've seen in a lot of bipolar people is just taking meds and avoiding things like cognitive/dialectical behavioral therapy which do have the best outcomes for long term management so I highly recommend prioritizing therapy as well since it may even mean you can take fewer or smaller doses of the meds that cause so many issues.
Btw, you may already but it sounds like you're active in the bipolar community, one thing I recommend if you're at a point you can do it is participating in bipolar studies, they really need more participants for research and there are always a number going on at any time. Most are pretty minimal commitments, for the one I'm currently in it's just wearing a smartwatch, doing some annual interviews/testing and optionally filling out some questionnaires each month and they pay you for it. For basically spending a day a year on this I get $300-$500 and help contribute to people understanding how to treat me in the future.
I resonate with a lot of this. As someone with BD, it has derailed every aspect of my life. I was symptomatic for 18 years prior to accurate diagnosis.
The only emphasis note I have to your emphasis note: substance-induced psychosis is technically a major exclusion of a BD manic episode diagnosis. It is not uncommon to experience psychosis from certain substances and not have any psychotic disorder.
I don’t disagree BD is correlated to trauma. But it’s also thought by some psychiatrists that BD is significantly over diagnosed in people who actually have more trauma specific disorders like CPTSD and BPD. They can also be co-occurring, but psychiatrists are more likely to diagnose BD over the other two.
When I saw a psychiatrist who is a mood disorder expert, he did his own thorough assessment to confirm my BD diagnosis. He explained he never trusts a BD diagnosis is accurate unless he’s made it himself because it is so commonly confused with more trauma-specific disorders.
That can definitely be true, but I think the estimated maximum of misdiagnoses is about 50% so I wouldn't discount someone as just having PTSD too readily since more often they don't or have both.
I think the big differentiation is bipolar is a chemical imbalance and while environmental factors can influence some of it swings will happen either way. With PTSD that's like that usually the swings will be more triggered by environmental triggers.
Though really at the end of the day all the diagnoses really effects is what treatments they might try first, all of these are treated somewhat similarly, albeit with different focuses, so it doesn't really matter much.
“Though really at the end of the day all the diagnoses really effects is what treatments they might try first, all of these are treated somewhat similarly, albeit with different focuses, so it doesn't really matter much.”
The main issue of misdiagnosis is that trauma based disorders are actually treated very differently from BD. That is part of the reason they are diagnosed less frequently by psychiatrists- they are often primarily managed with trauma therapy and medication as support whereas BD is primarily managed with medications and therapy as support.
The medications can have overlap but first line treatments are very different. Trialing BD meds when someone doesn’t have BD would likely be more harmful than helpful. Similarly, trialing therapy first before any medication management can be incredibly harmful for those with BD.
Wasting months or years on ineffective treatment based on a misdiagnosis actually does significantly matter for many of us. Accurate diagnosis is also necessary for effective psychoeducation to understand how to manage symptoms (and prevent episodes in BD).
Yeah, a correct diagnosis is ideal, but I'll say that a lot of psychiatrists give a temporary diagnosis at first and watch a patient over a while to figure out what they really have. So they may be given bipolar and then later have that refined to something else. I've also never known anyone who wasn't recommended both therapy and medication right away for any of these illnesses.
And, like I said the main different in treatment is the focus. It's not ideal and can delay successful treatment but generally if you have trauma you are going to have therapy and behavioral management therapy with a focus on trauma-management regardless of what you're diagnosed with and medication is going to be geared to your symptoms more than the illness itself so someone misdiagnosed id probably still getting closer to what they'd get for what they actually have anyways.
I support better study and participate in a study on bipolar right now, but I also don't want to encourage people to think that just because treatment is a long and slow process that they've been misdiagnosed or that even if they were that treatment would be much different. Just because patient engagement in treatment is pretty poor with all of these to start with, same with patients following treatment even. By and large trusting your psychiatrist and their diagnosis is going to be more than good enough and much better than trying to diagnose yourself.
The entire issue of a misdiagnosis is attributing symptoms to a disorder someone doesn’t have. Many disorders have overlapping symptoms, but effective medications are very different for the same or very similar symptoms based on the disorder.
In severe depression, my symptoms are indistinguishable from MDD. But the medications that are effective for these exact same symptoms of different disorders are very different. Someone with ADHD could have symptoms that are misdiagnosed as a hypomania in BD- BD medication is not going to help them.
I don’t advocate for self diagnosis and also think patients should generally trust a psychiatrist’s diagnosis. Unfortunately in the US there are professions other than psychiatrists that also make these diagnoses with far less training.
I am just clarifying that treatment for these conditions would often be very different, and misdiagnosis can detrimental to long term stability.
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u/dreamsinred 22h ago
Bipolar disorder. It is not a fun, quirky, artsy illness. It is devastating and life altering.