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