Are there signs before diagnosis?
I was diagnosed with manic depression (as it was then known) relatively late, at thirty-one, after several years of depression and the requisite manic psychosis. I sometimes look back to see if there is an archaeology to it: those times at school I was sent out of class to walk round the building to calm down because I was laughing too much; my friend’s grandad, nicknaming me Giggler; in my teens decorating the frame of my bike with stripes of brightly coloured handlebar tape or the way I physically bounced with excitement when my first love was coming to town – personality, youthful exuberance or madness in the making – who knows?
Then there’s the hereditary element and unconfirmed but likely case of bipolar in my grandad. I have picked up somewhere, but can’t find the reference, that predisposition to bipolar is 70% genetic 30% environmental – tell me if I’m wrong, please.
What does stigma look like?
None of the characteristics I describe above seem that particular to me and yet now I wear the mentally ill badge, I know that some people (mostly those that don’t know me well) give me a wide berth or interpret what I say through a mad lens. In my last psychosis when I was ejected from Trafalgar Square by security guards for nothing more than being barefoot on a wet and cold day, onlookers clearly thought I was raving, even though what I was actually saying did make sense, albeit in a private, parallel universe. I have been the same myself, moving seats on the bus if someone was muttering away, however harmlessly. Then there are those who think my condition is because, “You think too much” – is that even possible?
I have been extremely fortunate in that I have had a working life with employers and particularly managers who have been sympathetic and supportive. But I have also worked alongside some who are completely unaware of their own bias – the seemingly educated woman, who smirked when talking to me, her supervisor, about locked wards in a hospital, the same one where I had been an inpatient. For me, it’s a still a judgement call when is the right time and what’s the best way to “educate” people who don’t know. Do you collude with the myths, or try to bust them?
We need more stories like this
I did statistics at school and often think about the normal curve and distribution of populations – if I have remembered correctly, that in any population the bulk sit in the middle of the bell curve with outliers at the extremes. In hospital I’ve had conversations with others about what normal really means – even with the same diagnosis (mental health or other), we are each different.
By contrast, the other day I was struck by a TikTok clip doing the rounds, of comedian Trevor Noah, responding to an audience member – he talks so sympathetically of supporting people when they are unwell, not rounding on them (1:01 into the clip). He’s not doing it to virtue signal or big himself up, but because he knows about this. His grandfather had bipolar disorder and from what he says his family wrapped themselves around grandad to protect him when he got ill. We need more stories like this, about trying to understand, protect and support not fear and judgement.
Language, awareness and stigma
I think awareness campaigns are good as far as they go, but can reflect the palatable media-friendly “I was ill, I am better” narrative over some of the realities of lived experience – the unseen terror of the person experiencing extreme suspicious thoughts or the external normality of masked yet severe depression. I recently offered some friendly feedback to a gardening website about their use of language to describe a very striking spiky flower – “bonkers” and “crazier” – a micro aggression (is that too strong?) that demonstrates a lack of awareness with an irony as (and I mentioned this to them) gardening is a therapy for many with mental illness, including me.
In the latter part of my working life (admittedly when my reputation was established and the risks were lower) I have made it my business to advocate for people with mental illness in professional networks online and having lived thirty years with bipolar am more confident about doing so. I think that many young people I know are more mental health literate than I was at their age. An optimist by nature, I believe this is a good sign.
Further reading
- Media guidelines: talking about mental health – Mind (charity) website