[MBM17]

Lately we've been talking about "high functioning." BipolarChic asked about being "high functioning" and not being taken seriously. Vertigo asked how we each define "high functioning."

My issue is this:
I LOOK high functioning but I'm really barely able to function. Providers don't believe me. They only believe what they see. As my therapist said, "You look like you could hop off the couch and go plan a dinner at church for 150 people. But you aren't able to do even close to that."

I keep getting the borderline personality disorder diagnosis because providers think I'm lying about how badly things are and trying to manipulate them.

It may be connected to how I grew up. The military, my religion, and my family culture all promote a "keep your chin up" attitude, so at this point trying to look put-together and capable is so automatic that I can't turn it off.

Who else is totally disabled by bipolar but outwardly looks fine so providers think you're lying?

[NoIdeaWhatToDo]

On the upbringing side of it - I was raised in a family with a military officer for a father and a mother who had been raised in a very strict Catholic home by an immigrant mother and an American father who owned a prominent business and whose family was in local politics. Appearance was EVERYTHING for both my parents. Like you said in the other thread - couldn't turn it off if I tried.

It's funny, I didn't think of the military side of it until you posted about it in this thread. I have always thought it was mostly my mom driving that, but I hadn't connected my dad's contribution. He was always focused about about women's physical appearance. He came from a family where that was a primary focal point - to a creepy extent, in my opinion. Nonetheless, appearances were everything, from beautiful women in the family, to having classic sports cars (which we couldn't afford and were bought on a whim), to putting our talents on display whenever summoned (play the piano for everyone!) despite being a painful introvert.

The other same with the other side of the coin. As much as we were supposed to show our best side all the time, we were also supposed to hide anything negative. I was ridiculed for crying, punished for getting angry, and the mere thought of not doing what I was told never even crossed my mind.

So, yes, now no one can tell (not even my husband, much of the time) when I'm not doing well. The facade is cast in stone - immovable.

That said, I did have a T that understood all this. I have always been unable to lose the 'right presentation' when interacting with someone I know and/or may see again. With my T, I didn't know her anywhere but in therapy, and I went to her out of desperation. For probably the first year, I cried in her office during every visit. She really got to the bottom of a lot of the things that felt crushing to me, including the pressure to keep myself on the pedestal of the family. After months and months of breaking that down and years of working through my emotional states and my various moods, she was very supportive and understanding of what I was going through. She listened to me intently, she believed me, and it made all the difference for me to be able to develop the coping skills I have today.

I hate that so many here in desperate need of that kind of understanding and care aren't getting it.

I'm driven by fear. I'm so tired and fatigued but I'm afraid of what my parents would do to me if I refused to get out of bed, or go to school, so I do so.

[Victoria'smom]

I have my make up tattooed . Yes I'm at that point. I look fine, Shower and dress appropriately. Because of the way I talk I'm believed. At least that how my old team was. I have to wait and see how this team reacts to me. On the other hand my husband looks the way he feels. We were both raised to keep things under wrap.

[gina_re]

Personally, once I start going into my mental health history is when I get the reaction kind of like "oh ok, she actually does have some issues" look on the face of whomever I am seeing at the time. What happens during your visits that they don't believe you?

[OctobersBlackRose]

I put myself.togwther for appointments, but am not high functioning at all, no job, on friends on SSI etc. Idk if they even believe my symptoms, I think my therapist does, but idk if my psychiatrist does, since I can articulate well and look.nice, idk if you'd call showing up in the same two.shirts every other week and yoga pants "looking put together" I really don't have many clothes. But I was on Wednesday talking about my psychotic symptoms, and that I've still had hallucinations and currently believe we live in a computer simulation and have something or someone controlling us and don't have free will (I firmly believe this, no matter what facts are presented to me that don't support it) and it controls my life at the moment I don't even think my family or cat are real. But since I make my appointments on time and look "put together" and can articulate well and have some insight into my illness idk if my psychiatrist really believes me on my depression or psychotic symptoms. Sigh, I may never know what my therapist, psychiatrist or case manager really think about me and my symptoms. But I may look high functioning based on my physical appearance, but I'm not high F at all... Sorry this is so long, I write too much trying g to get my story out there.

[bioChE]

My father was in a military program in HS, and always kept that temperament through my formative years, all the way until I moved out and went to college. Because of him, I decided to go to college three states away instead of going to an in-state university. Appearances were everything, and to this day I present well, or as well as I can.

No idea what my pdoc thinks of me, as I've been stable for the entire time I've been seeing him. Time will tell.

Sent from my iPhone using Tapatalk

[wildflowerchild25]

I was embarrassed by my mother who suffered from depression and would not shower and wear the same clothes for days. I was also bullied in fifth and sixth grade for not washing and wearing dirty clothes (because my mother did so I didn't realize the importance). Because of that I always wash my hair if not shower even when I am extremely depressed. The most I'll go without washing my hair is three days, and on the third day I'm wearing a bandana. But I may not shower for a week to ten days and just keep washing my hair. I always wear clean clothes and change my clothes daily even when depressed. But if I'm seeing a doctor or therapist I can no longer lie about how I'm doing. The truth comes spilling out. So even if I'm looking the part, they know I'm not doing well.

I get people who have the attitude "you look okay, so why arent you working!?"

I also had this very conversation this week with a family member who said they are never quite sure what state of mental health I'm in.

[JustJace2u]

As I told my t yesterday during our weekly session, I do tend to hide things well, especially my emotions. Not many people know the struggles I've faced.

[Wild Coyote]

I've recently had some degree of a reprieve from severe depression.

This reprieve has helped me to realize how bad off I was. Wow. It's embarrassing. I cannot tell my pdoc/therapist if I don't really know it for myself. He does not see me at my worst... ever. He knows I'm trying to "hold it together," so he does not push beyond whatever I present.

Today he said I look more clear, more animated, more focused. Okay.

Disbelief? No. Thankfully.

I am sorry you are met with disbelief.
Not helpful!


WC

[Hashi/bipolar mom]

My DH, son, and I moved here a few years back. I don't really have close friends here. I hide all of this from them. They don't know I'm a recovering alcoholic either. I look totally put together and look like a typical SAHM. Secrets, secrets. The only place I'm truly myself and show how bad things are is at home with my DH, therapist, and pdoc. I guess those are the most important people to be completely honest with. Now, from my hometown, I have a couple of really close friends that know the truth. I walk into my therapist and pdoc's office and literally break down. They see it up close and personal. They are the only people besides my DH that I can talk to here. Sorry, that they don't believe you.

[scatterbrained04]

I look fine when depressed. Kind of just look a little tired.

Originally Posted by MBM17

Who else is totally disabled by bipolar but outwardly looks fine so providers think you're lying?

(Speaking significant to severe depression here...)

I usually look "better" than I'm doing, but that is with a broad definition of "better"and probably denial because I usually won't look at a mirror*. "Fine" not so much. I can sometimes fake it for very short bursts because it was ingrained growing up to never let on anything being wrong. Smiles are clearly forced to anyone the least bit attuned. But it's my voice that gives it away. Cannot seem to overcome the monotnous robotic flat tone.

Seeing a mental status report was puzzling once because it said I was presentable and with clean clothes. I'd been wearing the outer layer for God knows how many days and they had food stains (work clothes, totally don't care). Go figure.

But I've never had anyone think I'm lying. (Except in the sense of seeing through me saying I'm ok when I'm not.)

Milder depression I can usually hide well enough to pass as ok.

(*Though there was a time to check that my face wasn't a skull with eyes set inside, because I couldn't shake the feeling and was afraid they could see my thoughts --which is weird because I very rarely make eye contact anyway.)

[gubernova]

I can't hide it. My physical appearance takes a serious hit. I wear the same clothes (pajamas all day), don't shower for days, don't shave, and I start losing weight.😞

[piano97]

I get really flat if in more severe depression and that is definately noticeable. If on bad manic side I know my eyes go really weird.

[Gabyunbound]

I can hide -more or less- being mildly depressed, but if I'm really sick, on either end of the spectrum, I think people around me see it, unfortunately. I admire your ability to be strong when things are terrible (another way of looking at it, anyway) but I'm sorry it's caused you so many problems.

As far as the BPD diagnosis, it could also be because you cycle so fast (by your dx, I assume you cycle multiple times a day) and this can be really hard to differentiate with BPD, because often times in BPD people's mood go up and down all day; this may be because they're diagnosing you like this, perhaps even more so than because you seem so put together. Just a thought.

I have gotten very good at covering my true state of mind up. I do believe that has caused people to doubt my diagnosis. I cry to my therapist about this a lot. If I'm really low i avoid situations where i have to pretend as much as i can because it takes so much effort and energy.
At home i try but if things are bad their just bad i just use physical issues as the reason for my appearance and lack of activity. I have kids... I don't want to embarrass them in public or cause them to worry too much about me.

[MBM17]

NoIdeaWhatToDo, it's so cool to find someone with as many similarities to me with military and strong religion and appearances! If you want to or can talk about it, what kind of stuff did you do in therapy to work through it? EMDR? CBT? Conversations with family members?

[fishin fool]

I seem to hide it well.
Good or bad ? who knows.

[Unrigged64072835]

I used to. I don't anymore.

[Miss Laura]

Yup I can fool people into thinking I'm good if I'm manic but not depressed they see right through me

[bioChE]

I used to have a psychiatrist in front of whom I could act any way I wanted to get him to tweak my meds. I later found out the hard way that wasn't the best approach.

[Wild Coyote]

Originally Posted by MBM17

Lately we've been talking about "high functioning." BipolarChic asked about being "high functioning" and not being taken seriously. Vertigo asked how we each define "high functioning."

My issue is this:
I LOOK high functioning but I'm really barely able to function. Providers don't believe me. They only believe what they see. As my therapist said, "You look like you could hop off the couch and go plan a dinner at church for 150 people. But you aren't able to do even close to that."

I keep getting the borderline personality disorder diagnosis because providers think I'm lying about how badly things are and trying to manipulate them.

It may be connected to how I grew up. The military, my religion, and my family culture all promote a "keep your chin up" attitude, so at this point trying to look put-together and capable is so automatic that I can't turn it off.

Who else is totally disabled by bipolar but outwardly looks fine so providers think you're lying?

I am sorry you go through this.

I present well, am articulate and insightful -- and have never been accused of lying or diagnosed as borderline-- while sharing my challenges honestly.

It strikes me as very odd you'd get a BPD diagnosis for presenting as "together." It's not a BPD diagnostic trait per se. Many ppl present as "together."

I hope you find the level of care you desire/deserve.


WC

[mtnannie]

Maybe ask your t and pdoc to take a functioning test. They have those. Also you can just ask them and if you are strong enough you can correct their impressions.