Oddly enough, one of the symptoms of both unipolar depression and all phases of bipolar disorder is the idea we aren’t sick.
In depressed phase, it is associated with lowered self-esteem. Together with all other negative thoughts comes the idea that we are just lazy, and we’re just pretending, and we don’t have depression at all. (This is greatly aided by having relatives or friends who provide us with helpful phrases along the lines of “why don’t you just pull yourself by the bootstraps” and “you know, you could just try not to be depressed”.) And so we find ourselves on the floor, curled into fetal position, thinking we’re just imagining all this and in fact don’t have any reason to feel bad, so why don’t we get up and do something. Then we don’t get up and we don’t do something, because depression won’t let us move.
In hypomanic phase it’s very easy to decide we don’t have a disorder of any sort. After all, hypomania feels great, and our decision making process is impaired. So we quickly decide we are cured, or we were never sick in the first place. Many people stop taking their medication at this point — after all, why bother taking meds when you’re not sick? If you are one of those people, you know that what follows is either dark pit of depression or florid mania that gets you institutionalised, not to mention withdrawal symptoms from many meds.
Obviously, mania is similar. On the forum I often use I saw a few posters who came to declare they have been cured by all sorts of supplements from Omega-3 to exercising 7 times a week. They were certain they were stable and happy. Unfortunately the things they wrote, and particularly the way they wrote them, suggested otherwise. When we’re manic, we aren’t the best judges of our condition (understatement) but thanks to delusions of grandeur we believe nobody else knows what is going on, and that we are doing just fabulous. Until we get hospitalised or arrested, that is.
Unfortunately the actual stable state is no different. We’re productive. We sleep well. We can focus long enough to read a book, write an essay, produce a website design. Life is good. Why bother taking 10 pills a day when everything is clearly fine? A few months of stability can convince about anyone that our bipolar diagnosis was a mistake. We have no mood swings, we don’t get irritable, hypersexuality is a distant memory. Why not just go on living happily ever after and skip the meds that make us fat and turn our memory into Swiss cheese? And then, of course, we find out the hard way that it was the medication that made us stable…
The problem with illness living in our head is not only that people outside can’t see it. It’s also that we ourselves can’t see it, and so it’s easy to decide we don’t actually have it. Nothing’s bleeding, nothing’s broken, there are no plaster casts or bruises. And the message we too often get from society is that mental illness doesn’t exist, and we are just suffering from lazyitis. It might be helpful to remember the times before we got diagnosed and medicated and what led to us finding ourselves in a psychiatrist’s office.
The best thing you can do when you have a feeling you are not sick and don’t need medication — or that you are just lazy and have no reasons to be — is speak to your psychiatrist and/or significant other. Sometimes it is other people who can judge our condition best. Our memory lies to us, which is why I recommend mood charting. When you keep a regularly updated mood chart, you can see it black on white, in your own handwriting: you are not lazy and you are not recovered. You are not faking it (and if you are, consider applying to the Academy as you deserve an Oscar). You might be in remission thanks to the meds you are taking (and if so, congratulations!) but bipolar, as of now, is not something you can recover from and stop having it. The good news about bipolar: everything passes. The bad news about bipolar: everything passes.
Photo: “Pills 3” by e-Magine Art (CC 2.0)