Woman measuring waistline

Bipolar disorder makes my life difficult in different ways. My mania and depression both affect my relationships, my ability to work and my life as a mother. My sometimes unstable moods also affect my self-esteem and make it difficult to see myself in a realistic way. My bipolar disorder distorts my body image in five ways, which make it seem like I never really have a healthy view of myself.

1. Mania inflates my self-esteem.

During a manic episode, I turn into someone else. I’m too talkative, easily excited and overly ambitious. When I’m manic, I’m also very confident in my appearance, which would be a great thing if the confidence were realistic. My inflated self-esteem causes me to spend too much time in front of the mirror doing my hair and makeup, makes me dress to show more skin and changes my attitude toward sexual encounters, which sometimes leads to promiscuity. I am not myself when I’m manic, and I don’t see myself in a realistic or respectful way.

2. Depression destroys my self-esteem.

Depressive episodes always come after mania, which means I go from loving myself and my appearance to essentially hating everything about myself. The depression part of my bipolar disorder completely rids me of any positive thoughts about my appearance. When I’m depressed, I look in the mirror and see a fat, ugly, worthless woman who hates her nose and thighs. Again, this view is unrealistic and is actually pretty damaging. Depression distorts my self-esteem by showing me what I think are flaws when I look in the mirror.

3. Depression causes weight loss.

When I’m in the midst of a depressive episode, I don’t eat much or eat well. Sometimes I go days without a meal and several weeks of grazing and barely eating causes me to lose weight. Not only is this physically unhealthy for me, but I praise myself for losing weight because of my depression-induced, poor self-image. Weight loss during a depressive episode is physically and mentally unhealthy. On top of the weight loss and poor self-image, when I come out of the depressive episode, I feel bad about eating normally and gaining back the weight I had lost. The weight loss caused by my depression hurts my self-esteem both when I’m depressed and when I’m not.

4. Mania closes me off to criticism.

When I’m manic and overly confident, I believe how I feel about myself is true, and ignore the concerns those close to me have about my manic behavior and change in my appearance. My friends and family may come to me with their concerns about my lack of self-respect for my body. However, I blow them off and become offended by their concerns because my mania makes me unhealthily head strong. Mania causes me to ignore constructive criticism and covers my ears when those close to me voice their concerns about my change in appearance.

5. Depression opens me up to criticism.

Depression is the complete opposite of mania in every way. Instead of causing me to ignore criticism from others, depression makes me more susceptible to all forms of criticism from other people. Any small or misdirected comment throws me into a dark pit of sadness, where I doubt myself and my appearance. When I’m depressed, I care too much about what others think of me and put my self-esteem in their hands. Even if someone simply says I look tired, my depression makes me hear it as if the person were saying I look awful. During a depressive episode, my heart is easily hurt by the criticism of others, even if it is supposed to be constructive and kind.

My bipolar disorder makes it difficult for me to have a healthy body image and makes me see myself in unrealistic ways. Only when I’m stable do I see myself as I truly am and only then do I love myself completely. In order to stay stable and to see the right version of myself in the mirror, I make sure to do what I can to combat my mood swings by taking my medication and talking openly about my unhealthy body image. I gain back my self-esteem when I’m stable. I want to keep it close to me and not let mania or depression have their negative affects on my body image.


Once in a while, I forget to tell my psychiatrist I’m low on my medication. My shrink is cautious and protective of his patients, so he rarely issues refills. I have to be mindful of this, since many of my former therapists in the past had the less responsible practice of leaving one, two, even 10 refills on the script.  While this was tons easier for me (I could go for months without seeing the shrink), it didn’t help make the psychiatrist or me accountable to our relationship and work together.

Anyway, when I do forget with my current shrink, it’s embarrassing. This last time I had to call him on a Sunday. I left a message. Then I called or stopped by the pharmacies to see if they carried the Trifluoperazine I needed. After talking in person to the pharmacist at the Target and CVS in my neighborhood, I proceeded to call the 24-hour CVS in another town for convenience’s sake. None of them had it in stock. It didn’t surprise me since the pill is quite an old medication most patrons of CVS do not use. But it did frighten me. Left me feeling uneasy. Vulnerable. It is…an anti- psychotic. Hospitals are more likely to carry it, my psychiatrist told me later, because they experience more turnover of psychotic patients than your friendly CVS.

And that’s precisely the problem. I have a block asking for Trifluoperazine in “normal,” civilian surroundings. The conversation with the pharmacist goes something like this (I’ll give you what we said and what we were really saying):

Me: Hi. I wonder if you have a certain medication in stock.

Code for: I have a mental illness and I’m still sort of ashamed of it but I need my medication.

Pharmacist: What medication? 

Code for: Just how sick are you?

Me: It’s called Trifluoperazine. 

Code for: I know, I know, it’s an anti-psychotic but I promise you if I stay on my meds I will not get psychotic or dangerous or weird.

Pharmacist: Can you spell that?

Code for: We haven’t had a request for that in years!

Me:  T-R-I-F-L-U-O-P-E-R-A-Z-I-N-E. 

Code for: See, I know what I’m talking about. I’m a healthy, normal, sane woman.

Pharmacist: Uh huh.

Code for: Ah, so you are prone to psychosis. I hope you’re OK now. I don’t want you hanging around the store.

Pharmacist: How many milligrams? 

Code for: How psychotic are you?

Me:  Oh, only one milligram. 

Code for: I promise, I hardly need the stuff.  It’s just for maintenance.  Honestly. I really don’t need it that much at all.

Pharmacist: When do you need this? 

Code for: Now we’ll find out just how psychotic you are.

Me:  I need it right away. I don’t have any more pills left. 

Code for: OK, OK you called my bluff: I am prone to psychosis. If I go several days without the drug I get shaky and unstable. And, yes, besides that, I’m irresponsible. I didn’t tell my doctor ahead of time. I’m a mess.

Pharmacist: We’ll have to order that. It will take a few days. 

Code for: You must be really bad off.  We never get requests for this drug. It’s only in the psych wards that they have a full supply.

Me: Oh. Well, do you think you could advance me a few pills until it comes in? 

Code for: I’m begging you. Yes, I have a problem. If I don’t get the meds soon, I might have another breakdown.

Pharmacist: I told you, we have to order it.  We don’t have any currently. 

Code for: Just go to a hospital.

Me: OK, thanks.

Code for: Sure, push me into a mental funk because you are too stingy to carry my medication. I know I’m not the only one! Surely other psych patients need it!  You are depriving a whole population! Tyrant.

I throw my bag over my shoulder and leave the drug store sort of empowered, with my head high, vowing to give my psychiatrist plenty of advance notice the next time my pills dwindle low in their vial.

Often times, the experience of bipolar disorder gets condensed into DSM jargon and a few brief, unemotional paragraphs in psychology textbooks. As a result, the disorder becomes a collection of somewhat inaccessible, detached medical jargon. We are so used to the phrases “mania” and “depression.” We may be able to recite a textbook definition of the two, but what do these states of mind and their equally important “in-betweens” truly feel like?

Of course, everyone’s experience with bipolar disorder is different, but in the interest of bringing greater understanding to the disorder with a humanizing touch, I’ve put together my personal bipolar disorder glossary. It is a collection of the vocabulary I formed as a teen to describe what I was feeling. This was before any medical jargon infiltrated my brain, before I knew the technical terms for what I was experiencing and before I was even diagnosed. In that sense, I feel the terms are accurate and raw.

Bruise Days: Bruise days are days when you wake up and everything suddenly feels different than it did the day before. There has been some definite, ominous shift in the way the world works. Think of the skin on your forearm. Normally, you press this skin and feel very little, certainly not pain. Now imagine you wake up one day and on your forearm is a gigantic, grotesque bruise. It’s purple and green and blue, colors not there the day before. When you press on this area, unlike the day before, you feel everything. You feel it all deeply, as if you are pressing right into the marrow of your bone.

Bruise days are like this, except in the mind. Riding the bus down the city street, it seems like colors you have never seen before have suddenly been created. This can be exciting. Life can seem like some sped-up carnival ride, a mix of excitement and over-stimulation, But it can also be devastating. On bruise days, every emotion is amplified times 10. When your co-worker does not ask you to eat lunch with her, you worry you have failed and will always fail at making social connections for the rest of your life. When you see a young construction worker walk down the street, you concoct his whole life story with excruciating detail and usually become very sad. Maybe this construction worker had an abusive dad and could be living a life much happier than the one he is now. On bruise days, even certain words or notes in a song can send you into what seems like a different dimension and a disorganized chasm of thought. A bruise day is usually a sign some sort of shift is coming. This shift can be one of two things- peeling back the film or hibernation.

Peeling Back the Film: This is the moment when everything in life comes into focus. It happens before you can even notice it’s happened. Suddenly, a film is lifted, like in those Claritin allergy commercials. Whatever thin layer of murkiness has been clouding your vision and leaving the world dull, flat and unimpressive instantaneously dissolves. Colors become brighter. People become more interesting. The edges of objects become rounded and inviting. With this new outlook on life, you feel welcome to try new things you might never dare to try before and talk to new people who might have otherwise scared you. It’s a picnic. It’s a party. It’s a good time to be alive, whenever the film is peeled back. When this happens, you are always 100 percent convinced life will stay this way forever. Like an onion, you figure there must be a few levels, a few instances of this process to truly get to the good part. This ties into false epiphanies.

(False) Epiphanies: This is one of the most devastating aspects of bipolar disorder. False epiphanies follow peeling back the film. It is when you eventually come to realize the elation, joy and beauty of the world that followed peeling back the film are not, in actuality, permanent. It is a crushing feeling: You must consider maybe the fuzziness and dullness with which you saw the world before the film was peeled back is actually the norm. Knowing this feeling of elation exists, but being unable to obtain it without devastating consequences (like inevitable hibernation) is heartbreaking.

Because with each false epiphany, there is a time when this epiphany is not false at all. There is a period of time where you believe you have truly figured things out. What this means varies from false epiphany to false epiphany, but it’s usually along the lines of having unlocked the secret formula to remain happy forever. You become entirely convinced by some great force of God, nature or your own hard work, whatever ailment has plagued your brain since childhood has been vanquished. You sing songs, write poetry and stay up all night savoring the beauty of knowing life will, for real this time, remain this good forever, because you know now all the answers.

Of course, these epiphanies are called false epiphanies for a reason. Things eventually slow. Reality eventually hits. You are forced, once more, to acknowledged you’ve been made a fool by your own self, your own brain.

Hibernation: Hibernation is often a result of recovering from the wild ride of all of the above terms. Hibernation is not wanting to face the world you thought you’d understood and conquered. It’s not wanting to admit to your latest false epiphany or to clean up any messes you made while you were sure everything you did was 100 percent right. It’s a period of time where you turn the sleep tracker on your Fitbit off because you don’t want your family and friends to know you’re sleeping 20 hours a day on the weekends. It’s when you don’t shower, when you show up 20 minutes late for work every day because you can’t drag yourself out of bed, when you eat as if you need to save up calories for some harsh Alaskan winter. You eat like this because you’re upset with yourself. You eat like this until you feel just on the verge of vomiting and fall back asleep to hopefully prevent this.

Hibernation is what you do until you can, hopefully, return to equilibrium. How long hibernation will last is always a scary unknown. It is a necessary evil, though, because often during this time, being asleep in bed is the safest possible spot to be in. Hibernation is when your mind hurts from both thinking too much and not thinking at all. It’s when you can smell your own feet and armpits and greasy hair. It’s when your spine and shoulders ache from not leaving the bed. It is a trap: You want to get up, but you can’t.

Equilibrium: Equilibrium is what it sounds like, but it’s also health. It is counseling, self-care and medication management. Obtaining and maintaining equilibrium is lots of work, which is good, because this means it is primarily in your control. Reaching equilibrium sometimes, sadly, involves either good or bad luck. So it is a blessing, and should be considered such. It is a state many take for granted, including those who struggle with mental illness, including myself. It is something that needs to be my goal every day, something to cherish and collect.

In conclusion, bipolar disorder is much more than mood swings. It is a cruel disorder, one that lulls you into a sense of false security time and time again. The key, I suppose, (if there is a key at all), is to ride the waves rather than fight and flail against them, to know cycles come and go, to take care of yourself to the best of your ability, in whatever way that may be, and to enjoy all of the good times you do have. Because the good times are, of course, the most straight-forward. They require no further explanation: contentment, happiness, joy and peace.

Last week, I wasn’t doing well at all. I cried out for help. I cried loudly and no one heard me. I was in a mixed state (both manic and depressed at the same time). This happens to me frequently with my bipolar disorder. I managed to get through that first, hellish night, but I became extremely suicidal by the next evening.

I was having nightmares about killing myself. Tragically, I have attempted suicide five times in the midst of the darkest days of my bipolar disorder, and this time I tried to overdose. My husband came in and stopped me from taking the rest of the prescription pills I was planning on finishing. My husband wanted my heart to keep on beating for many more years, he said. At the time, I hated him for it.

I was so done. So exhausted with the idea of living one more day. I just felt the dark cloud consume me as I slept for two days straight. My husband took me to the very familiar psychiatric hospital, but it was a several hour wait just to talk to the nurse. So I convinced him to take me back home. Don’t judge. If you knew how lousy our local hospital was, then you’d understand.

So, I was on suicide watch at home. I was not allowed to be alone, drive or do basically anything until I could see my doctor about some medicine adjustments. It felt like house arrest.

The next day, our 18-year-old son was discharged from his rehab program that was hours away from home. Because of my unstable condition, we asked some family members to bring him home. He had his first onset of psychosis only a few months before and was in and out of six different hospitals before being accepted into this current dual-diagnosis treatment program.

He had only been at the rehab program for about 40 days when they called and said he was ready to be released. While we were glad to be able to have our son back, I admit we were extremely nervous about what things would be like once he got home, especially since we had five other kids at home and I was still suicidal. Yeah, a little scary.

The devastating news is he was only coherent for three days. Yes, you heard me right, three days.

By the first Monday morning, my mother-in-law was getting ready to take our son to a doctor appointment. She ended up calling 9-1-1 instead because he was extremely psychotic and acting dangerously. The police and paramedics got to the scene where he was restrained, tranquilized and taken on a 5150 hold to a local crisis stabilization center, which is a short-term, out-of-home placement to stabilize or prevent a crisis situation until an actual hospital has a bed for them.

We were completely shocked. How could this have happened? This wasn’t the end. It got worse, much worse. For two days, we tried to visit our son at the crisis center, but he was so incoherent. It was devastating to hear and to not be able to see or comfort him. I was still not doing well, but I just kept telling myself I needed to hang on just long enough to be able to see my son and tell him I loved him.

The thing is, I knew how scared he must be. If you’ve never been in a psychiatric unit of a hospital, then be thankful. It can be a pretty scary place sometimes. I wanted to give him a big hug from his mommy and tell him I was fighting a raging battle in my mind as well! Finally, on the third day, we could visit with him.

Oh my word. My heart had never hurt so much in my life.

Yes, we were finally sitting there with our son, but was talking to the voices in his head, barely comprehending who we were.

All the while, I was still fighting not only for my own life, but now for my son’s. I demanded to speak with the doctors and nurses in charge and researched every medication. Finally, after four days at the crisis center, they transferred him to the psychiatric unit of another hospital about an hour away. For almost an entire day, they had not gotten his consent to let us talk to the hospital staff about his condition. He’s 18. So when we would call to check on our son, they couldn’t even confirm he was there, which, of course, means visits are off limits as well until he gives consent. Thanks HIPPA.

The next day, I ended up in the ER for six hours because I was having chest pain, vomiting, weakness and many other symptoms of a heart attack. They ran a ton of tests and EKG only showed only slight abnormalities and no heart attack. Turns out, I’m stressed.

So, all of that was one week of my life. One hellish week I would love to never repeat but opened my eyes to many things.

These are five things I learned during that week.

1. We need a support system.

A support system for me to go to when I am feeling the dark cloud consuming me. A few trusted friends who know me and who I can be honest with. Also, a support system for our family. It was not just my husband, son and I affected by all of this. As I mentioned, we have five other children at home. They need someone to check in on them, bring them meals, talk to them when they are feeling fear about the future and their family members in the hospital.

2. I am capable of way more than I ever thought possible.

I was so ready to give up and could not imagine facing one more day. Then, we experienced the unimaginable: a child with an onset of schizophrenia. My son needed me. Not only because I am his mom, but because I have lived this stuff! I know how scared he was in the hospital because I have experienced it too!

3. Those affected by mental illness are treated extremely poorly at times.

I witnessed nurses and security guards yelling at my son and even laughing at the things he was saying. I watched as other patients were treated like criminals, strapped down and locked in a room. It just broke my heart to see first-hand how completely different my son or I were treated at the psychiatric hospital compared to the ER (for my possible heart attack) in the same week. When we would encounter a nurse or doctor with some compassion, we would be so grateful because it was so out of the norm.

4. Sharing my story openly on social media helped to shed light on the fact that mental illness is very real and it affects people from all walks of life.

I was able to educate some friends and family. Before this, I had encountered many who believed mental illness is caused by a lack of faith or what many people believe is a result of substance abuse. My son had been completely sober for two months. A week and a half before, he was acting like himself, medicated and happy. And bam! He is almost 19 years old with a diagnosis of schizophrenia. I have never used drugs or alcohol in my life. I was diagnosed with bipolar disorder at age 31 and have attempted to end my life five times. It can affect anyone at any age, from any demographic, race, religion or gender. In fact, one in four people have been diagnosed with some type of mental illness. Most of the people I was sharing this with on social media had never talked about it before.

5. I am not alone.

As I opened up about my story and, later on, about caring for our son after his two-week hospital stay, I slowly started to receive comments and messages from others on social media. And guess what they were saying? Me too. They saw me as a safe person to open up to about either their own mental illness or a loved one whom they wanted to help. They wanted to share their stories too! They told me I was brave for choosing to stay alive and care for myself and my family, as hard as it is. It encouraged me greatly.

We are coming up on our almost one year anniversary of “that week” when both my son and I were in crisis at the exact same time. A lot has happened since then, some amazing and some heartbreaking. If I have learned anything this year, it’s that recovery is lifelong and there will be ups and downs. I am trying my hardest to stay connected and not give up. I am in this for the long haul!

If you or someone you know needs help, please visit the National Suicide Prevention Lifeline. You can also reach the Crisis Text Line by texting “START” to 741-741. Head here for a list of crisis centers around the world.

The Crisis Text Line is looking for volunteers! If you’re interesting in becoming a Crisis Counselor, you can learn more information here.

The doctor just left your hospital room, and left you with some information that’s hard to absorb. He said those two words and both your and your parent’s hearts dropped through your stomachs onto the cold hospital floor. Bipolar disorder. It runs through your mind over and over like a bad memory. You’re in shock, that’s understandable. Your parents aren’t speaking, and that freaks you out. But don’t worry, they’re in shock too. Don’t worry at all, it will be OK.

I know you’re scared, and I know you’re confused. The same two questions are swimming in your head, how and why. You don’t know how this happened, but now you know why. This diagnosis is the answer to so many things you’ve experienced since you were an adolescent. The mood swings, the unexplainable irritability and the risky behaviors. Now you know why. And I know that brings you a little bit of comfort. It feels good to know why, because now you can figure out how to feel better.

You feel like you’ve lost a part of yourself that has been replaced with something alien. But that’s not true. You are still you, and you are not this illness. Yes, this illness is a part of you, and has been for some time. But it’s a very small part. You are still smart, funny and charismatic, but you’re also just a little bit more sad and a little bit more happy than everyone else at times. And that’s OK. It’s OK to be a little bit different, and that’s nothing to be ashamed of. This diagnosis is nothing to be ashamed of, it’s something to accept and then in time, to embrace.

You are calm now. You know it’s treatable; manageable. You’ll be starting medication today and counseling next week. It’s important you continue with both. Both will keep you stable, and help you feel better. The coping skills you’ve learned in the hospital will, too. Just use them, and use your strength. You are stronger than you think, and you can get through this. Your new diagnosis is not the end, it is a new beginning. A new challenge, and you’re great at overcoming challenges. You will overcome this shock and this fear. You will overcome.

It’s sinking in now. You. Are. Bipolar. But you are also strong. Stick to your therapy and medication regimen, and cope in healthy ways and you will be OK. Repeat that to yourself. You will be OK. You are strong, and you are not alone, and you’ve got this. Don’t worry, don’t be scared, and remember, you’ve got this.

Dear little cousin,

When your mother told me you had been diagnosed with bipolar disorder, I cried.

I wept because I did not want anyone else in the family to walk the road I am on with my own bipolar disorder diagnosis. I wept because bipolar disorder can be more difficult to manage the younger you are when you are diagnosed. I was 23 when my symptoms surfaced. You are 14. You are too young to deal with emotional and mental concerns.

Yet, visiting you in the hospital was bittersweet. It dredged up memories of my own hospitalizations, all four of them. I was glad you were receiving treatment and on the road to recovery and wellness. Attending your eighth grade graduation, my heart swelled with pride, love and hope. I felt all of this because the last few months were not easy for you. You had more than your fair share of challenges to overcome. Thankfully, you did not have to do any of it alone.

The relationship you have developed with your therapist warms my heart. She has impacted you to your core, So much so you, too, now want to be a therapist, which would be the ultimate way of paying it forward, of passing on what was instilled into you.

I know you are only 14, but if this career goal sticks, I know you will make an excellent therapist. You have first-hand knowledge of what it means to live in mood instability and stability. You know the impact of a caring adult and professional. From what you told me about how you relate to your peers, listening and giving advice, you are already honing important skills.

Listening to you talk about your newfound career interests made me beam with pride. I, too, want to become a therapist because of my own experiences with my diagnosis. I, too, have been blessed with great, caring mental health providers and I want to pay it forward.

I hope I can also be a role model for you in how to live in recovery and instability. I’ve had nearly 10 years to learn about my bipolar disorder. I’ve learned to be reflective and proactive. If you ever need help navigating your moods, self-care or high school next year, I’m here.

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