What Having 'High-Functioning Bipolar Disorder' Means for Me (and What It Doesn't)


I was asked to come in for an unscheduled or emergency session. The walk to the doc’s office took 10 extra minutes thanks to the drowsiness of my Seroquel increase. I sat across from him as always and began to explain to him the symptoms I have been experiencing. The doc explains that my psychosis is mainly in the form of hallucinations. He asks me if I have distorted thoughts or ideas, if I have been having delusions of grandeur or if I feel that people are talking about me behind my back. There are those moments when I’m paranoid others are talking about me or discussing my weight, but most of what has been happening has been hallucinations.

The doc sits and watches me for a moment and says, “You seem quite well to me.” I ask him what he means. “Most people with your symptoms are very obviously ill, but not you. You have a very good hold of your bipolar disorder, don’t you? I wouldn’t have picked you to have any of these symptoms unless you told me,” he says.

I think about it for a moment and start to think, “Does he not believe me?!” I explain to him how I don’t feel I have the capacity to let go completely: I have a job, a husband, a life. I need to keep it together. I tell the doc how I’ve learned over the years to present myself well to avoid people noticing there’s anything wrong. This has proven to be very important for my work life.

The doc tells me I don’t need to go to the hospital as yet, but he points out that if I were to go to the emergency department of a public hospital, they would most likely not take me in based on the fact that I look like I’m perfectly in control. I would have to get the nurses to call him so he can explain how unwell I am. It would be best for me to go into a private psychiatric hospital. “It would be much easier if you were in hospital though, because then we can increase your dose enough to get you better,” he says. We have to go slow with the increase of Seroquel and lithium because I’m still working. I need to still be able to work.

I have what some might call “high-functioning bipolar disorder.” It does not mean I don’t struggle. It does not mean my bipolar disorder doesn’t affect my life, and it certainly doesn’t mean my bipolar disorder is not serious. I’m only really high-functioning during the day, to get me through work. I put on a facade. Even when I am manic or hypomanic, I have to pretend I can focus and get work done. I am always acting “normal” and in control. It is incredibly tiring and taxing on me. I don’t like to go out anymore; I don’t like parties. Socializing takes a lot out of me, because I need to seem like I am OK. If I stop acting, if I let go even just a little bit, then I will fall down the rabbit hole so fast I won’t be able to get out.

It’s not always easy being high-functioning. Sometimes I get overlooked because I am not visibly struggling. Sometimes I feel like people don’t take my disorder as seriously. I act like I am OK to keep going. Acting like I am OK keeps my rational side active. My rational side keeps me in touch with reality and away from a world of hallucinations and delusions.

Image via Thinkstock.

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