In some ways, my experience with my bipolar disorder has been like my experience with appendicitis: two years of intense symptoms then professional intervention only when things started to rupture. The difference, of course, is no one is going to someday bring me my bipolar disorder in a jar and tell me I’ll never have to worry about it again. 
 
The full story probably starts with mild symptoms in high school, but I only noticed those in hindsight. The actual story starts about midway through my junior year of college when my symptoms became severe enough that they were no longer dismissible. It seems incredible now, but I lived with perfectly textbook symptoms for nearly two years while convincing myself that I was fine. I somehow thought it was okay to feel that way because I had become so used to it. 
 
Ultimately though, it was my own internalized stigma that played a huge role in my staying miserable for much longer than necessary. 
 
Even though I was part of an extremely supportive friend group and volunteered with an anti-stigma peer education group at the campus health center, that little internal voice of shame was hard to drown out. I come from cattle ranch country, and my family always had the philosophy that medicine and doctors were reserved for emergencies only. If you could fix yourself, then you spared everyone the time and expense and just got on with it. Those kinds of lessons stick.  
 
Part of the reason that I spent too long expecting to be able to fix myself was because I refused to admit that I was experiencing anything more than the standard college stressors that everyone else was. It was easy enough to write off a few groggy days or impossible mornings as the result of the stereotypical college all-nighters and excuse the occasional teary breakdown as stress induced. 
 
But eventually my grades started dropping. The insomnia had gotten so severe that I was functionally nocturnal. Going to classes was next to impossible and missing one class made it agonizingly nerve-wracking to go to the next session because I didn’t know how to explain my previous absence. It all started to snowball. Every failed assignment was “proof” that I was as worthless as I felt. And the more worthless I felt, the more difficult my days became.  
 
And yet, I refused help for a long time because I was convinced I could handle it all myself. As many times as I had told others that there is no shame in having a hard time and reaching out for help, I still felt intense shame. Because even though I was starting to suspect I had depression, I figured it was mild enough that if I just tried hard enough, I could manage it alone. Every new episode felt like a failure. And the longer I waited, the weaker and more shamed I felt for both still having issues and for allowing fear and stigma to keep me quiet about it so long. 
 
I did end up going to therapy sessions with the on-campus counseling service eventually. I talked myself into it a hundred different ways. I told myself I didn’t really need it, that I was only going to encourage a friend of mine who was also struggling with depression that it was okay to ask for help, that I would go to a session or two to pick up a couple tricks and be done with it, etc. But it helped. I had completely underestimated how different it would be to talk about what had been happening with someone who had no connection to it all. Having an impartial perspective was a gift I didn’t know I needed. Having someone validate my symptoms was a little terrible but mostly wonderful in ways I still don’t quite have words for. And I wish I could say that was the point at which the stigma started to break, but that would be years later. 
 
As helpful and necessary as those counseling sessions were, I was still struggling with that persistent voice of shame and denial. Occasionally the counselor would discuss the possibility of medication as an option to help manage the most severe symptoms, and my heart would just drop. I knew it would probably be the best course of action; nothing I had been doing so far had made much of a difference. I just couldn’t stomach the thought because it felt like another failure, more “proof” that I was inadequate. Intellectually I knew that wasn’t true; I knew that it was no different than taking an iron supplement for anemia or a diabetic needing insulin. One of the strongest people I know takes medication for her depression, and I was thrilled when she made that decision to take care of herself. For some reason though, I just couldn’t let that sentiment apply to my own situation at the time. Even as I have made progress through the years, this particular piece has been a continued battle for me. 
 
Given my alternating states of compliance and resistance in regard to my mental health and treatment during those sessions, I understand why the counselor made the decision to give my diagnosis as they did. Even now, nearly a decade later, that understanding isn’t always enough.  
 
For some context, these days I typically describe bipolar II as manic depression with an emphasis on the depression. It’s characterized by the same cycling moods that all bipolar disorders share, but bipolar II’s defining feature is the major depressive episodes which are coupled with a milder form of mania, hypomania. In my experience up to the point of diagnosis, I hadn’t even recognized the hypomania episodes for what they were because I had been swinging from intense depression into hypomania and straight back into depression. To me, mania was what I thought “normal” felt like. I thought everyone had that kind of energy all the time, that I didn’t need to sleep because I slept so much during depressive episodes, that the racing thoughts were just anxiety about the mess my depression had put me in. The counselor agreed with me to an extent; they believed that depression was the major concern. So much so, they were willing to alter the diagnosis in my file. They explained that I most likely had bipolar disorder (although they did not explain the different types to me at the time), but that they were hesitant to write in a bipolar diagnosis because the mania was so mild. Not because they believed I didn’t have it, but because they didn’t want me to have to endure the stigma of that particular diagnosis if I didn’t have to. Instead, they told me they would prefer to write in a depression diagnosis since that was the major treatment concern. 
 
At the time, I had a hard-enough time accepting the depression diagnosis that I don’t know how I would have reacted to an official bipolar diagnosis. So, in that respect, I sometimes wonder if perhaps the counselor was right in trying to spare me as much as they could. And I did manage to agree to try depression medication before I left college a few months after diagnosis which may not have happened if I was still processing the fact that my “normal” was manic. I’m still not sure that makes it okay. 
 
Leaving college gave me an excuse to stop treatment. I didn’t stay on the medication for more than a couple months because I’d expected more of a change than it provided, and I was not at a point in my life where I could afford to keep going to the doctor to get it adjusted. I convinced myself that a change of environment would be enough to help me. And for a while it seemed to work. I had a new city to explore, a new job, and volunteer work that I loved. I was busy without feeling overwhelmed, and I had a roommate who was, and continues to be, a constant source of support and friendship. I felt better than I had in years. 
 
But I wasn’t better. Interestingly enough, it was the first moments of real recovery that convinced me how bad I had been and how far I had left to go. 
 
It was an otherwise normal day off work. I was cleaning and puttering around the apartment, and then about mid-afternoon I was halfway through an art project when it occurred to me that it was the first time in years that I could remember making something fun just because I wanted to. I’d been humming as I worked, but as soon as I had that thought I cried. I began to realize there were so many other parts of myself that I had lost without ever noticing. When was the last time I sang in the shower like I used to, or read a sci-fi novel, or called my friends just to catch up? Suddenly I was scared. If you’d asked me even an hour earlier, I’d have thought I was better. How was that possible when I was clearly still so broken? When had I somehow decided that acceptably functional was the best I was ever going to get? And worst of all, how long would I have gone on that way if not for one chance breakthrough? 
 
There have been lots of highs and far too many lows since then, but that little window of realization started the process of actually coming to terms with my bipolar disorder. I bought workbooks and psychology texts and tried to learn everything I could. I vividly remember the first days after I started to read more about the condition because every description of bipolar II was just so incredibly accurate that it felt like being seen for the first time. I began to wonder what my journey could have looked like if my counselor had been less worried about stigma. And I began to wonder what it would look like now that I knew I had a condition so terrifying to people that even trained professionals shied away from the diagnosis when possible.

I wish I could say that I’ve reached a well-adjusted state of acceptance, but I’m not there yet. I wish I could say I tend to use the outdated disorder name just because I’m a nerd who loves M*A*S*H and one of the surgeons sometimes introduced himself as, “Hawkeye Pierce, M.D. – manic depressive,” or just because the name manic depression feels like it fits my experience with the disorder better. Both are true, but it’s also because I can see my counselor’s face as they explained the kindness of letting me live the lie of “close enough” and hear the whispers that followed a high school classmate just because they refused to suffer their bipolar disorder silently.  
 
I’m hopeful most days because, fortunately for me, there are other faces and voices. A college theatre professor who, when I told them why I’d been missing class, hugged me, laughingly welcomed me to the club, and told me about their own struggles and medications they swore by. A family member who has no personal experience with mental illness but tries so hard to understand and be supportive. And, the absolute miracle, casual discussions of mental illness at parties with friends, commiseration amidst laughter, and not a shred of judgement. 
 
It’s a definite work in progress though. Or maybe, like one of my Dad’s various construction projects, it’s prog-mess. It feels like chaos most days, it looks like there may be too many or too few pieces, and no one else can make any sense of what’s being built, but someday the finished product will be worth it. And until then, I just try to believe that the process is usually the most fun anyway. 

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