The image features an androgynous person, trapped inside a pill bottle, looking at a map that says
Illustration by Jessica Krcmarik.

This might as well be part two, because quite a while back, I wrote a pretty exhaustive list of things that newly-diagnosed folks with bipolar might want to know. This might just be an ongoing series where readers have the privilege of learning from my mistakes, because I’ve made more than a few along the way. Lucky you!

While I’m writing from the perspective of someone who grapples with bipolar and generalized anxiety, I feel like much of this could be applied to other mental health struggles as well. I hope this is helpful to anyone who needs it.

Lastly, a content warning: There is some discussion about sexual assault and consent, so if that could be traumatizing for you, feel free to skip over #2.

So let’s chat! Here are some things I wish I’d known about having a mental illness:

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1. You are not a burden.

Biggest lie ever told. Not just by others but by the nasty voice in my head that likes to encourage me to do the exact opposite of what I need to do when I’m depressed. It’s the same voice that tells me I’m worthless, the same voice that tells me to stop taking my meds, the same voice that tells me to skip town… you get the idea.

It’s not really a voice that I should trust. And neither should you.

Mental illness, or any kind of struggle with mental health, does not make you a burden. If people offer their support, compassion, and love, take it. And if you’re worried that you might be asking too much of them, have a conversation about boundaries.

“I’m in a rough place right now, and I don’t want to overburden you. Can I trust you to let me know if you need space?”

Don’t push people away assuming that you know what’s best for them. Respect their autonomy and allow them to dictate the capacity in which they’ll be involved in your healing. As long as you’ve had a conversation about how to best support each other, it isn’t your place to decide for them what they can handle and what they can’t.

When I’m depressed, I have to fight every urge to self-isolate. But I know that being alone is often the worst thing for me. Let the people who want to stand by you be there for you. If they truly care for you, you’ll be anything but a burden. I promise you this.

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2. You may not be able to consent to sex while manic.

First of all: Why the fuck aren’t we talking about this? Time for me to get up on my soapbox for a minute.

I’m not sure how the law weighs in on this, because the idea of “insanity” from a legal standpoint is a complicated (and often oppressive) idea.

But I can tell you from personal experience, there may be times when your inhibitions are so low from a manic state that there is no way – I repeat, no way – that you can reasonably consent to sex with another human, no matter how riled up you both are.

As a teenager, I had unprotected sex that, when stable, I consistently refused and would never have engaged in. There are acts that I said “no” to emphatically while sane, but enthusiastically said “yes” to when I was manic or experiencing dissociation.

This is one way in which an “enthusiastic yes” model of consent fails many folks with mental illness.

It’s a painful thing for me to talk about, but it needs to be said: There may be people in this world who will knowingly take advantage of you because they are convinced that mania is fun and not at all dangerous.

Some people will argue that manic sex is just regrettable sex, or that manic sex is just acting on impulses that you’re too prude to act on otherwise.

But I call bullshit on that. More specifically, I say that this is just a larger part of rape culture and victim-blaming. If I’ve said “no” a thousand times while sane, that “no” still applies if I’m not sane, just like that “no” still applies if I’m drunk.

I know now that if I am especially manic, I cannot give consent. And now, the partners that I have know this too. I only wish I had realized this much, much sooner.

Maybe this applies to you, or maybe it doesn’t. Regardless, this is why having conversations about consent, boundaries, and the like are crucial so that everyone is on the same page and the boundaries are made explicit. Sex should be safe, sane, and consensual – always.

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3. You may be the last to notice the progress that you’ve been making.

Sometimes, when we’re in therapy or we’re trying out new medications, the progress we’re making is so incremental that we don’t notice it as it’s happening.

It can be tempting to call it quits when we aren’t seeing the magical transformation we want to be achieving. However, in my experience, sometimes I’m the last one to notice just how much progress I’m really making.

For example, when I was dealing with really intense depression, I was so focused on the sadness that I felt that I hadn’t even noticed that this new medication I was taking was helping immensely with anger and irritation.

But my parents definitely noticed. My friends noticed. And they didn’t hesitate to remind me that while I may not have noticed, things were definitely changing.

They were right. After a few more weeks on this medication, I began to notice some really significant progress.

This applies to any kind of healing work, whether it is psychiatric, therapy, self-love, or outside of the realm of Western medicine. When we’re in the midst of it, sometimes we’re actually the last to notice our own progress.

It’s counter-intuitive, but it’s a very real phenomenon.

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4. To hell with anyone who tells you that your pain isn’t important, valid, or real.

Literally. They should be consumed by a bath of fire. Cut them out of your life. Run far, far away and very fast (if you can).

If you couldn’t tell, I have really strong feelings about this. That’s because I’ve been told by people in my life, folks that I cared deeply about, that my disorder was made up, that I was “playing the victim,” or otherwise invalidating my trauma.

Instead of lending any credibility to what they’re saying, listen to me: Your suffering? It matters. Your pain? It’s real.

You need to surround yourself with people who validate your struggles – not folks who try to tell you what YOUR lived experience is, what YOUR trauma is like, what YOUR burden feels like when you have to shoulder it each and every day.

They aren’t you. They haven’t lived through it.

No one can know what it’s like to be you. But if you’re anything like me, grappling with mental illness, we both know that it can be devastatingly painful, and leave us at our wit’s end. It’s the kind of hell that is inescapable because it’s happening inside our minds.

You deserve compassion and respect, as someone who is brave enough to continue living, each and every day, with something as difficult as this.

Fuck anyone who says otherwise.

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5. You may feel like you can’t trust in yourself or in anything that’s good. But you need to rebuild that trust.

I’ve often said that living with mental illness has created a chronic condition of “waiting for the other shoe to drop.”

Sometimes, I don’t trust that the good things in my life are here to stay. Sometimes, I don’t trust myself to make big decisions (like transitioning or going to grad school) because I’m afraid that I don’t have clear judgment. I don’t trust my own happiness because I fear I might be hypomanic.

Bipolar disorder (and mental illness more generally) has left me with some serious trust issues.

After going through so many episodes of depression, and losing many of the good things I had in the process, in recovery I still find myself terrified that nothing good is permanent or safe.

No one told me that I’d have this kind of perpetual mistrust of all things good, but I kind of wish they had. I also wish I could say I’ve overcome it and impart my super awesome wisdom to you.

The best I’ve been able to do is talk about it – with people I love, with a therapist, or sometimes I just talk through it alone in my shower. Being aware of the ways that I question or mistrust the good stuff has helped me to recognize when it’s happening.

I eventually end up asking myself the same question, “Who’s going to make this decision? Me, or my fears?”

Knowing when my chronic mistrust is creeping up on me allows me to see it for what it really is: a learned condition after years of trauma. So I tread carefully, holding myself in compassion and moving forward knowing that I cannot allow fear to rule my life.

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I kind of wish that, after a diagnosis, we were given a guidebook for how to deal. Sadly, we’re usually just given a prescription and a reminder to call if there’s an emergency. Often times, we have to be our own advocates and teachers as we figure out how to manage these illnesses.

Part of why I and so many others write is because we’re trying, little by little, to create the resources that we really wish had existed for ourselves. Resources by the community and for the community are often the best ones; we have the scars and the lived experience that can be so invaluable for those of us who are in the midst of it.

I hope that showing you some of my scars can help you to heal.

As always, I am wishing you the very best. Comment with questions, more advice, or just drop in and say hello!

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A note on labels: Like many people with mental health struggles, I’ve experienced my fair share of misdiagnoses. Since writing this piece, I’ve finally been correctly diagnosed with obsessive-compulsive disorder and complex PTSD, which have been life-changing realizations for me. That said, I hope that the resources I created in the past can still be helpful. (Jan 2019)

PLEASE CONSIDER DONATING AS LITTLE AS $1 PER MONTH TO MY PATREON CAMPAIGN TO HELP FUND MORE FREE RESOURCES LIKE THESE, AND ACCESS EXCLUSIVE CONTENT WHEN YOU DO!

11 comments

  1. Your point about Hyper-sexuality is a good one. I’ve done things whilst in a Manic state that I’m ashamed of and embarrassed about now. Things I would never do whilst thinking lucidly. I’d be really interested to know (from a legal standpoint) where you would stand with the issue of consent. I’ve not given it a thought before, but now you’ve raised the subject it’s something I’m really going to explore and research.

    Liked by 2 people

    1. Let me know what you find! I am hugely curious about what the letter of the law is. I tried searching around and it seems really unclear.

      Part of the reason it’s tricky is because mania most definitely exists on a spectrum. I could be hypomanic and definitely consent. But I truly believe that there exists a point in mania where consent is simply not able to be given. How that can be enforced, especially if a partner doesn’t know said person is manic or bipolar, is when we get into murky legal territory.

      I think insanity pleas are similar — there exists a point where a break from reality makes accountability more difficult, but we also recognize that someone can be mentally ill but fully accountable for their actions.

      So basically, I think there is a point where consent cannot be given. I think I’ve reached that point before and partners have knowingly taken advantage of that. But how we define that point or measure that point is difficult to say from a legal standpoint, especially because I am a writer and not a mental health professional or policy maker.

      Liked by 2 people

  2. “If people offer their support, compassion, and love, take it. And if you’re worried that you might be asking too much of them, have a conversation about boundaries.”

    Such great advice for anyone – whether or not a mental illness is part of the relationship. I have been the one pushed away, as well as the one doing the pushing. Far better to have the conversation as you suggest.

    Liked by 2 people

  3. CW: assault
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    Thanks so much for talking about sexuality and mental illness. There have definitely been times I’ve been too triggered trauma-wise to give consent, and my partner knew this was a possibility, and we continued to have sex anyway.

    It’s so validating to hear that other people have dealt with similar things. ❤

    Liked by 1 person

  4. Thanks for your honesty about other problems I hadn’t considered during mania. It’s increased my sensitivity to other struggling with bipolar. I also thought it was good when you pointed out that sometimes we might be the last people to notice the progress we’re making. It’s not always apparent at first but is still significant and worth hoping for.

    Liked by 2 people

  5. 2. You may not be able to consent to sex while manic.
    You really hit the nail on the head with this one, Sam. It’s a sprinkled taboo wrapped in a taboo package. WHY aren’t we talking about it? Because sex and mental illness are not comfortable subjects. Because of projects of openness and honesty, such as yours, the door is slowly squeaking open to discussion, education, understanding and acceptance. But until societal norms shift drastically, I’m afraid it is going to be a long row to hoe. That said, surrounding oneself with significantly sympathetic supporters is a huge step in the right direction. As always, thank you for shedding light on this subject. Kudos and well done.

    Liked by 3 people

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