Why the Label 'High-Functioning Bipolar' Can Be Harmful

First of all, before we go any further into my thought process about all of this, I know I’m fortunate to be considered someone with “high-functioning” bipolar disorder. I have this mental illness too, so I know I’m lucky to be able to go to school, hold down a full-time job and be in a successful relationship. However, being able to do all of that also took a lot of hard work, so calling me “high-functioning” or viewing me as less bipolar than the version of me who couldn’t stay out of the hospital is not helpful in any way. When you say this, you’re basically telling me, “You’re really good at masking your symptoms, so I don’t think you’re that sick.”

• What is Bipolar disorder?

I am that sick. And even if I wasn’t, it’s not a competition. I shouldn’t need to prove my diagnosis to anyone. Yet, to this day, being “high-functioning” means people I reveal my diagnosis to question the validity of it until I need a dramatic intervention, like needing to take a leave of absence from work or being hospitalized.

What most people I interact with don’t know is that it takes a lot out of me to act “normal” all day. In fact, some days, acting neurotypical can take everything out of me, leaving me drained with nothing left to offer. Working full-time, going to school full-time and being in a relationship is a lot to juggle — even for someone without a mental illness. And as much as I hate to admit it, there are times my mental health can’t handle it all, which causes me to get extremely overwhelmed. Sometimes, acting normal at work and hiding my symptoms is all I can handle in a day, and that means I can’t put as much effort into school as I should, or show up in my relationship in the ways I so badly want to.

Then, since I’m “high-functioning” it also means I don’t quite fit in with neurotypical people who don’t understand my condition, but I also don’t fit in with the mental health community, because oftentimes I’m viewed as not being “sick enough.” Although I know people in the mental health community intentionally exclude us, people tend to dismiss us in stable functioning because we’re viewed as “recovered,” when in reality recovery is a process that we too will always struggle with. Even therapists and doctors are guilty of labeling patients as “high-functioning,” and while it admittedly is a compliment to hear that someone with my severity of bipolar rarely functions so well in society, it can also make it really hard to vocalize when I’m symptomatic.

For example, some days I really am completely fine, thanks to being “high-functioning.” I take my meds, do my self check-ins and feel as if I have my life together. I actually do feel pretty darn “neurotypical” some days, thanks to a lot of hard work, therapy and medication. But other days, I have slips and ignore my symptoms in fear of no longer being “high-functioning,” which can lead to me having a full-blown episode that could’ve been prevented if addressed earlier, or worse, can lead to hospitalization.

My most recent example of this is actually just last month. I ignored my manic symptoms because I wanted to stay “recovered” and saw no problem with “just being extra happy” for a little while. The problem is, trying to hide my symptoms ultimately led to the mania getting worse and worse, and eventually, I had to be hospitalized due to grandiose psychosis. By the end of that episode, I had lost all touch with reality.

And who am I supposed to talk about that with? My partner is supportive, but doesn’t fully understand what having bipolar is like firsthand, and the mental health community unintentionally dismisses me in stable functioning, so when I’m struggling, it’s often a really isolating experience because I need to work through it alone.

And don’t get me wrong, I know there are websites like The Mighty that can help, but what about friends? What about people I can count on who understand my diagnosis and also aren’t strangers? Where do I find those people?

Because the nature of my illness is that it will never just go away. I will always have bipolar disorder, and I will always have slips. I’ll probably even always need the hospital every now and again. I’ve accepted that is just a part of my illness. Pretending it’s not, and instead, masking my early warning signs and symptoms behind the term “high-functioning” isn’t helpful for me. It’s actually extremely harmful.

Because I do struggle. I do have my slips. I do reach the highs and lows that the rest of the bipolar community faces.

So, my point is, please, stop isolating me for being able to function in society. Stop using the terminology “high-functioning” — and not only for people with bipolar but for any condition because the bottom line is, it’s usually harmful. Being called “high-functioning” again, and again, and again is most likely always going to become harmful eventually. I hope more people come to realize that soon.