Person who sticks out from the crowd,

You know when you feel sure other people are talking about you? You notice them whispering, or looking at you, or studiously not looking at you, and you think, what are they saying about me?

Psychologists call those feelings “ideas of reference.” Ideas of reference are often associated with paranoia. However, if you ask people with clinical depression or people with bipolar disorder, you will find many of them have them as well.

I know I have. It’s hard not to. You already feel that you’re not really “normal” (whatever that means) and you’re afraid that it shows. If people can see you’re not like everyone else, they’re bound to be talking about it. Never mind your difference is a mental one; you’re sure everyone can tell just by looking at you that you’re “crazy.”

In actual fact, the people you think are talking about you usually aren’t — until you go over to them and defensively berate them or accuse them of doing so. Then you can be sure they will be talking about you after you leave.

Except most people in everyday life do not spend their time discussing how odd the people around them are. The average person is too involved in his or her own daily life to give more than a passing glance to a stranger. The people you see whispering behind their hands are most likely developing their own secrets or gossiping about someone you don’t even know.

Even if the people are talking about you, ask yourself — so what? Do their opinions really matter? I know you want to say yes, they do. But in the larger scheme of things, they don’t. Your life will not change in the slightest if they are saying they don’t like your haircut or that they heard you bite your nails. Malicious gossip and social bullying are separate matters. But again, you don’t really know these people are saying anything that’s actually harmful.

Perhaps you feel it’s more significant if the people you think are talking about you are family members, coworkers or friends. They may really be talking about you. The point is, even if they are, you have no idea what they’re saying. Most of the time they speak in low tones so as not to upset you, never realizing that upsets you more. Tell yourself they could be planning a surprise party or talking about Aunt Edna’s affair with a younger man. Remember not everything is about you.

Ideas of reference may be a factor in imposter syndrome – the feeling that you are not really successful, competent or talented, but are just faking it and that everyone around you can tell. Or perhaps your ideas of reference are like intrusive thoughts — sudden, distressing notions that pop into your head, seemingly without cause or warning. These can be anything at all, from, “I wonder if my passport has expired,” to “Who would miss me if I died?” to “Those people are talking about me.”

What can you do if you have ideas of reference? Resist the urge to ask if the people are really talking about you. Ignore them if you can. (This is not the same as the bad old non-advice about ignoring bullies. You know when a bully targets you. With ideas of reference, you never really know if your fears are true.) Since you didn’t actually hear what the people said, you can realistically assume they were talking about someone or something else entirely. Imagine that one is telling the other that her slip is showing. (Do people still wear slips? I know they don’t wear pantyhose anymore.)

If you feel you must react, use a minimal response such as the good ol’ side-eye, which is sufficiently ambiguous that the person (who may also have ideas of reference) can assume it’s directed at someone else. Another suggestion I’ve heard is to work with your therapist on issues of self-esteem and self-concept, or to try cognitive behavioral therapy. Some medications may help, too. Still, if you feel you can manage it, I think the best idea is to tell yourself, “So what?” and move on.

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Thinkstock photo via Grandfailure

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To myself for when I miss my mania,

You’re bipolar. I know it’s been hard to admit to yourself until now but after an official diagnosis, there’s finally a word to describe the chaos you’ve been going through for years.

After a terrifying bout of what you now know was mania, you’ve finally realized there’s something wrong. Now you’ve slipped into depression and you’re missing that euphoric high. You miss the days when you had all the energy in the world, as you lay in bed unable to get up the energy to do anything. I’m here to tell you that your mind is playing tricks on you and not everything was as great as it seems.

You can romanticize being a free spirit all you want, but deep down you know better. Even though you tell tales of your spontaneous world travels to others, you know that feeling like you’re on top of the world — that everything is beautiful and thinking, “How could you ever be sad?” — one moment, only to be crying on the floor of a hostel the next isn’t healthy.

You can romanticize dramatic relationships all you want, but deep down you know better. You think you had torrid love affairs, the stuff of poems. However, you know sleeping with random men you just met because you were feeling every emotion too deeply for words isn’t healthy. Your poor judgment, combined with your erratic, seemingly “quirky” behavior, may have been attractive to some. However, it also led to a series of self-destructive behaviors that caused you to lose a good friend and have to pay for an abortion. That’s anything but healthy.

You can romanticize not needing sleep all you want, but deep down you know better. You thought you were the cool party girl, but recklessly spending over $1,500 in less than a week on drugs and alcohol is anything but cool. Plus, during these all-nighters, you couldn’t stop your thoughts from racing and had only anxiety-inducing panic attacks to greet you in the morning. You might’ve thought you were being productive and creative like the “crazy artist” trope you identify with, but in reality, all you had were “amazing” ideas combined with a mind so scattered you were unable to accomplish anything. That wasn’t creativity.

These feelings of euphoria may seem amazing at the time, but you know they have devastating effects on your wallet, on your body, on your overall mental state. It’s like you’re borrowing happiness from your future self. Being manic means the crippling depression is just around the corner. Stability may seem boring and routine may get stale, but it’s what you need more than anything right now.

Going into a manic state isn’t the way to get over your depression. I know taking medication and going to therapy seem like lost causes, but they can only help you. Happiness may seem like an impossibility right now but being manic won’t fix that. You don’t miss your mania; you miss feeling alive. One day this fog will lift and you’ll feel alive once more — this time, without leaving a path of destruction in your wake.

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Thinkstock photo via tatyana_tomsickova.


I paint self-portraits when I am battling my mental illness. Some are realistic, like on my good days. Most of the portraits depict aspects of my illness. I recently went through my portraits and found pictures of the stages of my mental illness. So here is my version of bipolar disorder, generalized anxiety disorder (GAD), dissociation and psychotic episodes.

Brokenness

I have painted many faces like this one — all lines and abstract shapes, some in color, some black and white. I paint these faces when I feel only emotion and am unable to speak. I feel broken and hurt. Sometimes it’s not safe to speak or show my self. I paint these faces to show the pain I feel inside.

Brokenness portrait

Depression

I don’t often paint while depressed. I feel weak and have so little energy. Creativity doesn’t flow. But in this painting, I am rising from a long battle with depression and anxiety. My mental illness is behind me and in front of me. But I still stand and look ahead to the future.

fighting through depression portrait

This is another painting created as I was coming out of depression. I felt lost. Everything was the same shade. I wanted to feel something. I used sand in the paint to give it a gritty texture. The paint felt real and powerful as I laid it on the canvas with thick strokes. I was lost in the background, but I was still there. I kept my voice.

rising from depression portrait

Anxiety

My anxiety was thick within me. I was angry. I wanted to carve into the canvas, to destroy it in order to express the overwhelming anxiety and frustration I felt. I painted in red. I was angry with how the painting ended, but it felt real and complete somehow, so I left it and moved on to another canvas.

anxiety anger portrait

Mania

When I am manic I have a million ideas at the same time and my mind is spinning frantically as the emotions chase after. I created this collage in a frantic, feverish state of mind, dancing around my apartment and flipping between anger and euphoria. Finally, after eight hours, it was finished and I collapsed with exhaustion.

bipolar mania portrait
This painting followed the other. I became even more frenzied. I painted thickly on the canvas, mixing the paint with gritty sand, not patient enough to blend colors. The colors weren’t right and I kept getting angrier, but I couldn’t stop. I painted a dark face and then covered it with parts of comic books. The strong intensity of the comic heroines felt right. They felt powerful and intense, like my manic self. I kept switching between loving and hating the collage, wanting to destroy it and then frame it. I kept pacing around the room. Finally I decided it was done. It had been hours of art-making with no breaks for food or rest. I was exhausted and finally rested, trying to get something to eat.

mania 2 portrait

Inner demons

I feel something self-destructive inside of me. I feel forces inside me that want to destroy me. When I look at them too closely I get frightened. I painted this while feeling intense anger and anxiety. I didn’t like looking at this face. So I quickly painted over it.

anger portrait

The face I wear

I painted this blank, safe face on top of the last face, to hide the inner turmoil I felt. I can make my face blank and be peaceful and no one will know my inner struggles. This face is safe, but she feels empty since she is hiding so much inside.

mask portrait

My two selves

This depicts my inner and outer self. My outer self on the right, is polite and refined. She is nice and knows what to do to get along in life. My inner self has tumult and chaos, the raging storms of bipolar disorder, the emotions and anxiety, all of the swirling thoughts that fill my head. Yet the inner self feels very alive and interesting. The outer self is kind of boring.

face divided

Psychotic episodes

Sometimes I hear voices. Some are good and some bad. This painting/collage shows me distressed by all the voices I hear, looking to the sky for some peace.

psychotic episode

Flashback

Sometimes things trigger memories and I become a former self. Suddenly I am 14 again or 20 or eight. I see myself in the small box of the memory. Like the self depicted here. She doesn’t look much like me but that’s OK.

flashback portrait
Dissociation

Sometimes when I am under a lot of stress, I disappear into the sky. I lose myself somewhere. Several times I have woken up in a city with no memory of the drive there. Sometimes I feel as if I leave my body and I am floating in the sky, watching myself below. Sometimes my life doesn’t seem real. It’s freeing but terrifying at the same time. Thankfully I always come back home in the end. This painting shows me dissolving into the sky.  But I’m not lost.

dissociation portrait
When I am under extreme stress, my mind splits into parts. Suddenly I am two selves or three or five. Sometimes I speak from other selves. Under extreme stress, my mind splits and doesn’t work right. I painted this during a time when I felt very split into different selves. I looked at myself in the mirror and didn’t recognize myself. I thought painting a self-portrait would help me come back to myself. But when I drew the face it didn’t look like me. I painted over the face. I recognized myself in the blank face. I was happy to see this blank face, it was me in that moment and I felt like I knew myself again.

faceless portrait

Confident

I don’t have red hair in real life. Red doesn’t work on me. But to me red is the color of confidence. I painted this after I had finally conquered some mental battles. I saw beauty in myself again and was hopeful. I was starting to like myself again. The colors in the background represent the complications of my life with mental illness. I am strong enough to stand in front of them and have my own voice.

confident portrait

Love

My husband is a photographer and he took this photo of me. When I look at it I remember how loved I am. All the paintings show my brokenness due to my mental illness, but I look at this photo and I see beauty in myself and the love of my husband. I believe everything will work out in the end.

love photo

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All photos via contributor.


America is going through a major crisis right now. The political and social climate couldn’t be more tense. And yet for me, it feels as though I’m living in a bubble. I can see and hear everything that’s going on in the real world and witness the events unfold, but I can’t get involved and put in work as I would like. I’m watching from a distance, unable to connect with anyone or anything.

I want to be on the front lines, making my voice heard and speaking up for justice. Instead I’m confined to my home, relegated to social media as my only means of resistance. My mental and physical health are just not up to par these days. I’ve been pretty sick for a while now, actually. I always hear having bipolar disorder makes you less able to handle stressful situations and at the same time stress exacerbates the symptoms of the disorder. It’s a trap I long to escape.

In my mind, I know this storm will pass and I will feel up to joining marches and attending rallies. But deep down I can’t help but feel a sense of shame and regret my illness is taking so much out of me. Some days I’m able to put my best foot forward and be grateful for the outlets I do have. And at other times, I give in to the feelings of hopelessness and helplessness. All in all, I know the best thing I can do is accept myself for where I am and what I’m able to do at the moment. And look forward to the days when I will feel whole again.

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Photo via contributor. 


On Tuesday, Passion Pit’s Michael Angelakos went live on Facebook to share his experience getting a lesser-known noninvasive mental health procedure, transcranial magnetic stimulation (TMS), as a way of treating bipolar disorder.

“The whole point is like, everyone says, ‘Oh, I don’t want to show people what I do, I don’t want to talk about therapy.’ If we don’t talk about it, it’s quite literally why no one understands what we’re talking about,” Angelakos said in his video. “So, I don’t have anything to hide. I think this is an amazing treatment.”

TMS is currently considered an off-label treatment for bipolar disorder. The procedure, which uses magnetic fields to simulate nerve cells, is approved for treating major depressive disorder and treatment-resistant depression. Because TMS is not yet approved for bipolar disorder, and therefore not covered by insurance, it can be expensive, Angelakos, who said he used to get electroconvulsive therapy, explained.

The video, titled “This is what getting help looks like,” is almost an hour long, and features Angelakos and his doctor, “Bobby,” answering questions and providing information about TMS. All of this takes place while Angelakos undergoes treatment.

“I’m manic right now, I’ve not slept in three days,” Angelakos shared. “I’m tired, but not at all. I talk a lot. Ideas are kind of just going, going, going, going, and I need to calm down. Sometimes I take lithium, I would prefer to do this. This helps calm me down.”

This is not the first time Angelakos has opened up about living with bipolar disorder. In 2012, he told Pitchfork he was diagnosed with bipolar disorder when he was 18.

Angelakos also used the video to talk about mental health stigma and answer questions from fans about his experience living with bipolar disorder. Since posting the video, many have thanked the artist for sharing his story and shedding light on a less common treatment option.

“Thanks for being open about this. It’s super helpful to have famous musicians show that mental disorders are common and manageable and bring that message to the rest of the population,” one commenter wrote.

“It’s so amazing to hear someone else verbalize and express what I feel on a daily basis. It really means a lot, because it feels like I’m not going through this alone,” another shared.

Update:  It appears the live video has been taken down, and Angelakos posted the following update.

You can watch Angelakos’ full video below.


I learned a valuable lesson in retrospect. Looking back on my initial diagnosis and hospitalization with bipolar, I guess I was in no condition to make a sound determination on my own treatment. To be honest, I didn’t realize there was a problem.

I was serving in the U.S. Marine Corps and had just recently gotten married. My first child was born, I had changed jobs and there were a plethora of other life changes happening simultaneously. After a few weeks of some odd symptoms, I headed to sickbay one morning. The thing that triggered my move to action was my memory. I had always prided myself on it and it had started slipping, mainly, facial recognition. Friends of mine I had served with for quite some time would approach me and I kind of knew them, but simply couldn’t place them. Additionally, my sleep was a wreck, mostly non-existent — and there were the taco salads. Yes, taco salads. It’s the only thing I would eat or had any appetite for eating. Anything else just seemed to turn my stomach when I considered them.

So here I was at sick call. I laid out my perceived issues in the same manner I just did here. That’s when the doctor shifted his attention to my left arm.

“How’d you get those cuts?” the doctor asked.

“Oh those? I sit in the window at night and look over downtown Washington D.C. and cut myself with an X-Acto blade. It helps to ground me. The pain sort of takes away the numbness,” I responded without a second thought that this behavior was anything except normal.

It was at this point that the doctor rose and asked me to take a walk with him down the hall. He led me through a set of double doors that locked from the inside. He told me to take a seat in what appeared to be a makeshift lounge. I waited. When he returned, there were two others with him. They sat down and asked what number they could reach my wife. I was a bit confused at this turn of event and running rampant through my mind were a hundred different scenarios, the most prevalent, that I was in trouble for destruction of government property because of the cuts to my arm. Was I headed to the brig or worse? The one thing that was not in that typhoon of scenarios however, was that I was mentally ill and about to be hospitalized because of this condition I had never heard of prior to this visit.

I did my three weeks in the rapid treatment unit. That was the unit I was in. It was for people who were not yet suicidal or a harm to the public, but there were some behavioral markers that indicated that I just may be. During those three weeks, I learned about occupational and recreational therapy and took whatever meds they handed me without knowing what they were. In group, we talked about this thing called bipolar disorder and how I was categorized as rapid-cycling.

I was no longer numb. I was scared and just wanted to go home. The day of my release, I was happy to get out and eat with regular metal utensils again. Unfortunately, of all the things I learned, I wasn’t proactive in pressing for ongoing treatment and medication. I assumed, at the time, I was “cured.”

Twenty-five years would pass for me before I had a total relapse, although is there such a thing? Basically I spent those years oblivious to the new behaviors I had developed. The hyper-sexuality, the risky behavior, the manic and depressive episodes, the anxiety, fear and anger. Because I assumed I was cured, I shrugged them off to being moody and overly ambitious with possibly an overactive sex drive. Wow, I was more lost than when I first sought help for a taco salad problem.

After getting myself back in to treatment, real treatment, a little over two years ago, I started to sift through those years, realizing the damage I had caused. From disposable relationships, to behavior I am not very proud of, an additional memory surfaced.

About 18 months prior to that visit that landed me in the hospital, I sat in a bar one night with a friend. We rolled lit cigarettes in between our forearms until they snuffed out. I still remember that pain. If you’ve ever done this, the ember doesn’t die right away. Of course the following morning, I headed to sickbay as my arm was a charred, weepy mess.

This doctor asked no questions, if he did, I don’t recall the lie I told. Following a clean-up of my arm, I was sent back to the barracks with a week supply of iodine swaps, gauze pads and bandages. That was that.

Why that incident surfaced was that who knows how very different my life may have been if I would have been diagnosed and treated a year and a half earlier. The memory of my hospitalization taught me I am the one that has to be proactive in my treatment and not to just accept what is or isn’t being offered to me.

It’s a bit painful and shameful to share some of this as I was a Marine, served with distinction and even promoted meritoriously to Sergeant. However, this disorder has a way of bringing even the most prideful and squeaky clean people to their knees, and I for one am responsible for these wrinkles in my character.

I hope that through this public sharing and acceptance, the importance of seeking out and maintaining the best possible mental health care and treatment reaches at least one person.

If you or someone you know needs help, visit our suicide prevention resources page.

If you struggle with self-harm and you need support right now, call the crisis hotline at 1-800-273-8255 or text “START” to 741-741. For a list of ways to cope with self-harm urges, click here.

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Thinkstock photo via jhack

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