In Search of a Non-stigmatizing Diagnosis

I have found on Bipolar and other mental health forums around the Internet a good deal of searching for validation of the Bipolar diagnosis –in other words, there seems to be some hope and desire out there for the diagnosis (although of course not the symptoms/experience of it, I certainly don’t think anyone wants that).

My feeling is that on the one hand there is the natural desire and curiosity to know why one feels and thinks and behaves as one does, along with the desire to find others like oneself.

But on the other hand, I personally think the desire for this diagnosis stems from the commonly accepted notion that it is ‘biological,’ that it means that there’s something messed up with your brain, but not something messed up about you as a person. Therefore –according to this logic- behaviors associated with Bipolar Disorder are not one’s ‘fault’ (that's one way of looking at it, anyway).

I think it’s an unfortunate dichotomy -some diagnoses are associated with “bad” behavior and others with “not bad” behavior -with Bipolar, you’re not a ‘bad’ person, your behavior is not your fault (it’s your brain not you). I think this is especially true when you compare the perceptions of those who are diagnosed with Borderline Personality Disorder vs. those diagnosed with Bipolar Disorder. My point is that I think it comes down to how responsible one is perceived to be for one’s behavior. I think we’re all ultimately responsible, however you want to define responsibility, but the reality is, some diagnoses carry more stigma than others even if some of the behaviors can be similar. (For the record, I think BPD and BP are very different illnesses, even if they share, at least superficially, some symptoms in common).

In any case, if I’m truly honest with myself I’d have to say that although I certainly do not want the experience of Bipolar episodes (I am diagnosed with Bipolar I) I do not mind so much the diagnosis of Bipolar, or at least as compared to some others out there. Of course I do realize there is still stigma associated with this illness and I do for the most part keep it to myself.

I’m interested to know if some of you agree that this is sometimes a sought-after diagnosis and if so, why. Do you think it has something to do with stigma, perception of personal responsibility, etc.?

I’m looking forward to your thoughts on this!

I don't have the foggiest idea of why anyone would "desire" a diagnosis of bipolar disorder. There's plenty of stigma to go around, and some of it lands on those of us who live with the condition. Yes, the dx does solve a lot of mysteries about life---especially those who live with it for decades without being properly diagnosed---but it doesn't absolve anyone of their responsibility to try to be a decent human being.

ouch!!!! that hurts.... it physically hurts.... my greatest achievement in life is i haven't "yet" cut myself..... i think about it almost every single day... its like there is this voice whispering in your head telling you how bad you are and must punish yourself..... i don't know whats so great about pretending bipolar.... and those who have bipolar 1 they might need to be admitted because of episodes.... think about stigma of that... i spend half of my life in depressed state because of my bipolar 2 but at least i can hide it from everyone else... nobody knows i have bipolar except me and my pdoc....

you are just over thinking all of this... when you have bipolar you just cant trust your brain completely.... sometimes its mania speaking and sometimes its depression......

I never sought it out, it found me, and I don't want it. The stigma of bp is really harsh. Some get by without experiencing too much of the stigma, but not my family. Watching the rumors, the fear, the chastising in my local community has been especially horrible for my 2 bp teens. Mean robot insensitive people out there.

If I have to have a dx, yes I'm going to "seek" one that explains all my symptoms in the lightest possible form but also the one that give me the help I need. This is both for myself and my family. The whole this has more stigma then that I don't believe. It depends on what's the popular dx to vilify is at the time.

Seriously?! You found evidence of people WANTING to be bipolar? lol....

Outside of Psychcentral, I have found no community, nothing to partake in. There is, of course, counseling and pdoc appointments, but anything after that, there really is no group to join or fellowship to be had by having this mental illness.

So.... what would be to gain? To tell your friends? Ha! That would get old. I couldn't imagine getting any personal self gratification out of it if a person knew they were full of it.

I don't think any of us actually seeked out the diagnosis. I went in only to prove to my wife that I was, in fact, OK and had the sole intention of hearing that she was the 'crazy' one lol. This caught me so off guard.

I don't like hearing that there are fakers. I think that there should be a law condemning anyone faking mental illness because, after all, it IS exploitation and it makes it hard if someone thinks that you are faking.

Ugh. Disgusting is the right word. Absolutely disgusting.

I'd much rather have a bipolar diagnosis than a borderline (or any personality disorder) diagnosis. There is less stigma associated with axis 1 disorders like mood disorders. We're seen as decent people who are sick. People with personality disorders are demonized by both society and mental health professionals. They are denied treatment that they desperately need, because they are seen as "hopeless" or "attention-seeking".

Call me naive, but I don't even know how you COULD fake it. Let alone why.

I could fake depression, really, if I'm being honest. I wouldn't WANT to, but hypothetically I could. But as for being manic... or even hypo? That would get exhausting after about 15 minutes. Let alone weeks as my episodes tend to go.

I've heard far more people tending to ignore their diagnosis completely (myself included!) rather than actively seeking it out. As landskaperdan said, it's just disgusting, really. After going through over a decade of actively trying to cover up my bipolar symptoms from everyone, it kind of makes me a sick to hear that some people fake it.

I don't regard the stigma as existent except in people who are either uneducated, have serious problems of their own, or are unaware of what bipolar illness really is. The most well-educated people are generally free of a stigma, period. That has been my experience, and I have never regarded anyone who has a stigma as really capable of evaluating who I am or what I am in terms of the me that I know myself to be.

In most cases, stigma is really a lack of knowledge about the illness. I know that some have the problem, but it's their problem, not mine. And I don't let it interfere with my life. I choose the people whom I want to be friends, and those who object simply live their own lives any way they can.

Please don't ever evaluate yourself based on somebody else's opinion of who you are. People don't reveal the real truth about much of anything when they talk; they really reveal more of themselves than anything else. Don't even judge yourself; just live by your deepest inner principles and you'll be fine. That seems to work for many, I think.

Take care and feel good about yourself, because you really are a good person. You know your limitations, as all intelligent people do, and you're very capable of being successful and helpful in life to many, many others. That's our purpose in being, in my view.

No. The idea that bipolar disorder is "biological" doesn't comfort me or even alleviate any responsibility or stigma in my mind.

When I was younger I had a room mate who admited she was jealous of my bipolar diagnosis. Not because of what I would go through but because it made me interesting also some idiot childhood friend of hehad thought he had it too and felt "closer" to me than her because of it. She actually admitted these things too me then went and pretended to be bipolar for about 3 days. I'm not sure why, it clearly got exhausting for her especially when nobody gave a damn.

I think it's a chemical imbalance. That's been my experience; I'm sure others have different views. Because it's chemical, in my view, I find diet plays a very significant role in feeling tone.

I've always wondered why it is necessary to prescribe such high dosages of Lithium, for example, when the brain can use only a very tiny level for functioning. Something else is happening for the brain to require that much. Same is true of other meds. I think things are interfering with the metabolism which is more related to gastric circumstances than anything, IMHO. I have lived long enough to experiment and found diet a strong factor in this illness.

Just for kicks, the highest number (about 95%)of neurotransmitters are in the digestive system, not the brain. I've read that knowledge of that may lead psychiatry to take a different stance on the treatment and medications of bipolar illness.

i agree here wif you.

i used to know someone with BPD that said pdocs and therapists saw them as attenion seeking.

but i do read about it online too. so i believe you are right that many professionals may think that idk about all but perhaps many.

thats...EXTREMELY insulting.
to me it would be.

i had a someone like that in my life do that to me. like you said. they would say im interesting and only because my dx. they tried to mimic me/the dx and it didnt last but maybe some odd number of days.

it made me feel like my problems were downplayed by them and made into a fashion statement.

it really made me sick. because i had considered them a friend too.
it made me lose some hope there in people.

My husband was jealous when he was considered mdd. He use to tell me at least I know it'll go away and replaced with "happy fun time" (euphoric mania) for weeks. All he can look forward to is a couple of "good" (hypo-manic) days. We only realized the euphoria as mania everything else we considered depression.

I was incredulous and taken aback when my psychiatrist first suggested that I may be on the bipolar spectrum. To me, bipolar was crazy and intractable. I felt bad for people with the diagnosis, I knew that I never wanted their struggle.

Soon after that I researched online the bipolar spectrum and bipolar 2. After the initial reluctance, there was a revelation that was exciting and comforting in the sense that I had made a step forward in understanding myself. So many months later my psychiatrist decided that we had enough evidence that I was bipolar, and my diagnosis was changed. The diagnosis has not changed what I experience, even though earlier in time I thought that a bipolar diagnosis was to be avoided. I'm still depressed and anxious. The struggle exists regardless of a label. The benefits of the diagnosis is that I have a mode through which to understand myself. I have a direction to take in terms of treatment. I don't have to blame myself.

In terms of stigma. I feel as though there is less stigma towards bipolar being medicated versus receiving medication for depression. Bipolar may have more of a 'crazy' stigma, but depression has more of a 'you're just weak' stigma. Which is the lesser of two evils?

There are immature reasons to hide behind bipolar diagnosis: It's okay to be medicated, at least my disorder sounds as bad as I feel, people know I'm sick and that I'm not as responsible, etc

But there are also great reasons to receive the diagnosis: Understanding, more effective treatment course, more realistic understanding of blame and responsibility, and hopefully acceptance.

I don't believe that having any biological disorder makes you less responsible for your actions. However, I do believe that we aren't 'responsible' in the sense that we never created our disorder and we do not have to blame ourselves for how we feel. We have the responsibility to make every effort to experience successful treatment. We have the responsibility to take care of ourselves, our life, and to take care of the people around us as well.

That is COMPLETELY opposite of me. I'm STILL coming to terms with it. I have had at least 4 doc's in my life think I was bipolar. I thought no I'm just passionate, sensitive etc. I hate the meds and their side effects. I feel embarrassed and thought for yrs it was borderline personality disorder. Then 2 yrs ago went into a psychosis and was diagnosed with bipolar and PTSD. I was in heavy denial about both of those. However I read every book I could find on Marilyn Monroe yrs ago (who was diagnosed with borderline personality disorder) and I was like see that's what I have. Family, friends, doc's would just shake their heads and be like okay.

I feel there is a huge stigma (I hope I don't offend anyone). Most ppl imo, think bipolar' s are crazy. Just my opinion. I hate all the meds, giving up my hypomanias, ALL that comes with it. My therapist thinks I need to grieve all the positives, u know increased energy, imagination, ideas that I can do ANYTHING, for instance when I ended up in the hospital last time at first I went into a hypomania. Well I bought all these pics online of big cats (I love them). I couldn't afford them and had the idea that I was going to decorate my apt as a big cat sanctuary. I thought it was brilliant idea. The problem is some are huge, I can't afford frames for them....anyway it's just not very realistic. That was just one of the many unrealistic things I have done in hypomanias. But it feels good at the time, lol. I'm gonna miss that.

Although BPD may be caused by something external that triggers it, I still don't believe that it's the person's fault. Also, I do believe there must be some sort of biological something with them as well, which means person A has a biological trigger that causes BPD but person B doesn't ahve taht same biological trigger despite having the same environmental trigger.

It's all very complex.

Also for people with BPD I believe most of it is caused by some type of abuse or something happening in childhood, which in no way is the person's fault. So, although the key is learning new ways to go about things, they are pretty much just like us with BP. And in the end, it's really up to all of us to learn about our dx regardless what it is, and the best strategies for us to find wellness.

I think we're all in this together and stigma is stigma. BP people get told we're fake all the time. I think we with mental illness are all brothers and sisters and need to stick together.

I get confused when people describe mania as 'happy fun time.' For me there is the euphoria aspect, but I experience it as just way way way too much, I'm literally jumping out of my skin, it's 'fun' in a way but also horrendous at the same time. I don't mean to invalidate the fun aspect of it people can experience, but then I think that if that's all it was then it wouldn't be a disorder -symptoms/experiences cross over to becoming disorders when they negatively affect you in very big ways, and I don't just mean the aftermath/in retrospect. Or maybe it's a matter of the difference between mania and hypomania? Or at the end of the day everyone's experience is different. I definitely do not look forward to manic states, whether I'm currently depressed or not -one reason amongst others being that the fact that no one else can think at the lightning speed I do/can in that state irritates the cr - ap out of me.

Hi guys,

I actually wasn't referring to people faking it at all. I meant truly having symptoms that might point towards the diagnosis but not to the point of fitting the criteria. People who do and truly suffer (to a greater or lesser degree) and seek out a reason for this in a diagnosis that carries less stigma than some others (some here have mentioned BPD and depression). I do agree there's a big 'crazy' stigma with Bipolar and that there's so much stigma regarding any mental illness at all that many of us hide it, don't share it, etc.

I guess I'm also referring to what some have called the fashionable, interesting-ness associated with the diagnosis. So if someone is very distressed they might gravitate towards thinking it is bipolar for these reasons, even if it isn't, and of course not knowing how awful it is having it (including the medication issue, I hear you guys on that one). And to the extent that a small minority of people might gravitate towards it, I really don't think it's on a conscious level.

So, no, not faking, true distress, just erroneously thinking one has the illness.

Wanted to add that I mentioned the 'biological' source of Bipolar as many people's perception of it, but it's not my own. I personally think it's a combination of biological (whatever that really means) and environmental influences. I think most mental illnesses are some combination/interraction of the two.

I definitely don't think BPD is the sufferer's fault, whether child abuse contributed to it in any given person or not, it's just that there's very unfortunately some awful and ignorant perceptions out there. I think PD's are given a bad wrap especially vis a vis other mental health disorders and no it's not right/fair.

I thought having a diagnosis would help. It helped me only in the way that my suspicions of something being wrong we're true. It hurt me in that now I sometimes excuse my behavior because "I can't help it". Also, I fear telling anyone. I told my mom and husband but that's it. Before, telling people like my inlaws, that I had anxiety and had some trouble with depression was easy. It was /is normal. Now I just feel crazy. The diagnosis was painful for me, at best. I feel more broken than ever. People who want the diagnosis are ok with it because they not really have to live with the destruction it causes. They can be all " yeah, I'm bipolar" and because its not true they can feel comfortable in the lie. While those of us with it, are afraid because we know its true and there's no getting away from it.

At least that's how I see it.

Yes, it was and I exacted my revenge a few times over and passive aggressively tortured her for a few months until she moved out. I really did a mind **** on that one but that's what happens when you mix a 20 year old, bipolar, Prozac (no mood stabilizer), and dumb *** comments.

I find that all mental illness gets treated as if it's fake by a vast majority of people. I think the only ones that are less stigmatized are actually schizophrenia and autism, and I think that's because both of those manifest themselves very clearly as something else and end up in the news.

I have heard more than one comedian make fun of bipolar as "today I'm happy, now I'm sad. I must have bipolar." It's really annoying because there is a lot more to it than that.

i wouldnt say they are less stigmatized. especially schiz.

but taken as less "fake" yea prob so. i mean i see a lot of disorders made fun of cause people think they are crap. its really sad. people do take my health more seriously if they know i have schizophrenia though.