An Open Letter to People Who Reject Their Bipolar Diagnosis
Years ago, Adam completed suicide because there’s something important he didn’t know, something I hope you’ll understand by the end of this letter.
Adam had a hard life early on, mostly due to his father’s Bipolar Disorder. His dad struggled most of his life, going on and off meds, spending time unstable, in and out of jail, and in the bottle. The man was cruel and abusive to his family when he was unstable. When Adam turned 18, he enlisted in the military to get away from that situation.
Adam was absolutely determined to be nothing like his old man. He was a loving husband and attentive father. He didn’t drink or touch drugs. He was hard-working, and trying to build a career in IT once he got out of the service in his mid 20s. But then something odd happened. He started to get paranoid, wasn’t sleeping, and started drinking for no apparent reason.
Then one day, his wife had to call 911 because of his erratic behavior. Adam was involuntarily committed until he crashed out of his first manic cycle, and he was diagnosed with Type 1 Bipolar Disorder. Now, when I was diagnosed with Bipolar Disorder, I felt hope for the first time in my life. I felt that my life could be better than a dumpster fire.
But Adam? Adam didn’t. Adam didn’t see a treatable medical condition. All he saw was a life sentence to become like his dad. He believed he only had two choices. Either become his father, or die before that could happen.
After he was released, he immediately quit taking the medication he was prescribed and refused his diagnosis. He refused to entertain the idea that he might have Bipolar Disorder because he was not his father, and he never would be. He had made every effort to distance himself from his old man the moment he gained independence.
But, unfortunately, mental illness doesn’t care about what we want or what we believe.
Adam took his life not long after in a moment of clarity, because he thought he was turning into his father. But it didn’t have to be that way. I don’t know if what I’m going to tell you would have saved Adam, but maybe it would have given him a different choice.
Simply put, you are only you, no one else.
Mental illness doesn’t look the same from person to person - even with the same diagnosis. For example, I present what they call “atypical Bipolar Disorder.” What makes it atypical? Well, I rarely experience the euphoria, or the bright parts of the disorder. Instead, it’s just mostly anger, paranoia, hostility, and depression.
But atypical doesn’t mean rare. There are a lot of people who experience it just like I do. People just don’t talk about it as much because of the guilt and shame. I mean, who really wants to talk about the times they terrified or terrorized the people around them because of their unwellness?
The difference matters because no two people are the same.
Adam looked at his father, looked at what his mental illness did to him, and assumed he would turn out like his dad. But that isn’t how that works. It’s hard to know what trauma or bad decisions were guiding his father’s life. Plus, his old man grew up in the 60s and 70s, and stigma was awful. Maybe his dad would have a better life had he felt comfortable enough to acknowledge his struggles.
Adam was already making better choices from the start, by graduating high school and going straight into the military to build a life for himself. Adam was choosing to break that traumatic cycle because he wanted better for himself.
A lot of people reject their diagnosis out of fear. The problem is you mostly see the worst cases. The people who are struggling are far more visible than those doing well. If you turn to the internet without that context you can wind up scaring yourself. The people who are doing well are out living their life, not sitting around and talking about how good they’re doing.
But what if you don’t believe you have Bipolar Disorder? You read the DSM, you watch videos, read what other people have to say about it, and you don’t relate to any of it. Many folks in Adam’s situation are diagnosed, look at someone like his dad, and think, “Well, I don’t act like that! I can’t possibly have it because I don’t act like they do!”
That’s a common, but wrong conclusion. The diagnosis may be the same, but the way the symptoms present can be very different from person to person.
For example, my hypomania is dark, and it’s a much different experience than the brightness of euphoria. I couldn’t relate to the bright experiences at all really, or with the people who see their mental illness as a gift. All I have to look forward to is paranoia, anger, not sleeping, and poor impulse control.
When I was first diagnosed, I came so close to convincing myself I did not have Bipolar Disorder because of it. My first therapist recommended a book to me, but all of the examples of escalation in it I couldn’t relate to because it was written with euphoric mania in mind. It didn’t talk about depression or depressive cycles. It didn’t talk about atypical Bipolar Disorder.
I had to learn a lot more before I could finally see it, and that took months.
If you find yourself in that position, let me give you a couple of suggestions.
The first is don’t set out to understand mental illness. That’s a mistake that a lot of people make. Instead, when you’re reading, watching videos, or in therapy, do it with the intention of understanding how your mental illness affects you, specifically. A general knowledge is not what we mentally ill people need. A better goal is aiming to become an expert on yourself.
The way I look at myself and life is like a giant jigsaw puzzle. Every time I listen to someone, read a book, or otherwise gain more information I’m gathering puzzle pieces. I stop and look at those pieces, and then I have to figure out where they go in my puzzle. Often, I find that those pieces don’t go to my puzzle. My puzzle is completely different from Adam’s, his dad’s, or yours.
Other people can provide perspective and insight, but you will have to figure out your puzzle for yourself. No one can do it for you because only you know what’s in the shadows of your mind that you keep hidden away from the rest of the world.
Adam’s mistake cost him everything. Unfortunately, that happens a lot in the world of mental health. It most likely will catch up to you sooner or later if you actually do have a mental illness. There is a high chance you’re going to experience some form of instability again in the future.
Unfortunately, too many folks have to learn the hard way, and some don’t survive the lesson. They keep trying to live their life, right up until it resurfaces again. Then, the mental illness devastates them - suicide attempts, infidelity, bankruptcy, or worse.
The hard truth? Some people just don’t survive the fall to rock bottom. Or even worse, they find out that rock bottom doesn’t exist. It’s just a convenient storytelling device to signify when someone felt like they lost everything. But hey, once you’ve been around the block once or twice, you realize that no matter the situation, it can always get worse.
Personally, I was undiagnosed for like 16 years, but it was only when I experienced psychosis that I finally realized something was seriously wrong with my brain. My mental illness tried to persuade me to project all of my anger and hopelessness outward, to make other people feel as fucking awful as I did. I reached the point where I felt like I no longer had a choice, similar to Adam.
I used to think of it as my rock bottom, but it wasn’t. It would have been much worse if I hadn’t grounded back into reality when I did and had the opportunity to act on those thoughts.
But diagnosis? That was the first time I could ever remember feeling hope, relief, that maybe my life could be something different. Diagnosis was the first real step to understanding my puzzle, as it is for you.
You cannot look at any other person and think, “That’s what I’m going to turn into.” because that’s not how it works. You’re not doomed to become anyone other than yourself. And if you want to maximize your chances of avoiding that kind of road, acceptance is the second step in preventing that devastating fallout.
The earlier the intervention, the earlier the treatment, the better chance you have for a positive outcome.
Bipolar Disorder is a severe mental illness, and it will most likely get worse without treatment. May not be today, may not even be a decade from now, but the chance that you won’t experience future instability is slim.
I’m 46 years old, and I’ve been living with Bipolar Disorder for like 33, maybe 34 years now. My life isn’t perfect, I have my own problems, but my mental state is the best it’s ever been. The only reason for that is I got help from mental health professionals who understood how to treat this disorder.
And when that book I read almost convinced me that I didn’t have Bipolar Disorder, I stopped and asked my clinical social worker why I was diagnosed the way I was. I asked him, “What did you see in me that I’m not understanding? Because I can’t relate to that book at all.” That helped my counselor reframe my experiences, better understand myself, get the right treatment, and find ways of making things work.
I’m not special. I didn’t do anything that anyone else can’t do. I get that we don’t always have access to appropriate resources, but if you do, make the most of it. Your life doesn’t need to become a tragedy. You don’t deserve that. No one does.
Adam thought he only had two choices. He didn’t. And if you’re thinking the same thing - you don’t either.
If any of this feels uncomfortably familiar, let me tell you what I would do. I would go back to the professional that diagnosed me and ask, “Why did you diagnose me with this mental illness? Can you help me understand what you’re seeing?”
That’ll get you moving in the right direction, and it’ll help identify a misdiagnosis if there has been one. It forces your professionals to think about your diagnosis, what they know about you, and how to fully contextualize what they’re seeing. That gives them another opportunity to determine whether or not their diagnosis is accurate.
If you’re someone who has been diagnosed, and you refuse your diagnosis, understand that you are sabotaging yourself. It takes some people decades to accept their truth, usually only after they are left standing in the ashes of their life when their mental unwellness burns it all to the ground.
It doesn’t have to be that way, though. It didn’t have to be that way for Adam, his father, or anyone else.
Did you enjoy my writing? Well, this is an episode of my podcast Bluntly Bipolar! Clicky the button if you’d like to listen to me instead!
I am not a mental health professional. I have no training or certifications of any kind. None of my material should be viewed as medical advice. It is not a substitute for treatment with certified mental health professionals. All I am is a mental patient with a microphone who is decent with words. Nothing more.