My father sat back in his chair at the opposite end of the table and expelled breath. It was not a sigh as such (like the sigh of disappointment over my school reports, or when my eight-year-old self announced that mathematics wasn’t important for I was destined to be a rock-star), rather it was the articulation of the clerks in his head sweeping all current matters off his inner desk with a swoosh. His eyes fixed on mine, as his quick, engineering mind recalibrated.

It was at this precise moment I realised that, for the first time, I’d just told someone outright I’d been diagnosed with Bipolar Disorder.

Now, when you say this kind of thing out loud, most people do exactly the same thing: look blank. If you’re not familiar with a particular medical term, you can’t gauge its severity, so you can’t react appropriately. The very few people I’ve told have all reacted in this way and, if the roles were reversed, so would I. The fun starts at this point, as you go on to explain that it is a mental illness that used to be described as Manic Depression.

In my (so far limited) experience, people’s reactions to these words are as individual as they are. I guess this is because few of us know anything about mental illness in even general terms. In day-to-day life, it doesn’t seem the kind of thing you need to know about, or encounter frequently. After all, people with mental illnesses get carted off and locked up in asylums, don’t they?

I think the term “manic depression” has gone out of fashion mainly because it is so widely misunderstood. The combination of those two words tends to generate an image of someone who is perpetually miserable… kind of like Eeyore. Plus, we’re all familiar with the feeling of being depressed (in the popular and conventional sense of the word) and, in the long-run, it’s not all that bad or serious. In fact, it’s perfectly natural to feel depressed when bad things happen: if you didn’t, you’d be delusional. But what we’re talking about here is something else - the difference between being depressed and any form of Clinical Depression is that, if you’re affected by the latter, you can’t “just snap out of it” like you can with the former.

Curiously, even though saying “manic depression” is out of fashion, being depressed, it seems, is spectacularly fashionable. In fact, Bipolar Disorder carries with it a certain (and ever-so-slightly annoying) celebrity prowess. There’s another parallel with homosexuality here but, just as not all homosexuals sing like Freddy Mercury and die of AIDS, not all those with Bipolar sing like Kurt Cobain and die of a self-inflicted bullet to the head. I have wondered whether, like being slim, the popularity of depression is a link to youth — for many, the teenage years are also amongst the most depressing they shall ever experience. But I digress.

The contributing factors to the onset of Bipolar Disorder, so far as I understand, are many and complex. While symptoms of the condition may have been observed as early as the second century, the causes are not clean-cut as yet. This is similar, again, to homosexuality. I wonder whether this is exactly what it is that has caused historical stigma against both those with psychiatric conditions and those who are homosexual. Humans seem to carry this need to understand the causes of things in a reasonably transparent way - this could explain the practices of both science and religion. Only in modern, liberal societies are people becoming comfortable with things being the way they are for no better reason, for now, than that’s the way they are. So without any clear cause, there is no cure for Bipolar Disorder, although there are various methods of treatment targeting the symptoms.

Incurable is an ominous word, isn’t it? It summons images of people in great suffering, afflicted with cancerous growths on the brain, or organ failure, or something equally horrific. Maybe surprisingly though, as was highlighted in Stephen Fry’s documentary about his own experiences with Bipolar Disorder, many of those with the condition have accepted it to the point where they wouldn’t want to be without it. Were an out-and-out cure made available, many (most, if not practically all) would reject it.

That, in and of itself, is fascinating to me. There aren’t many medical conditions I can think of where the patients would almost universally refuse a cure, unless the side-effects of that cure were worse than the condition itself. But the thing about Bipolar, from my own experience and what I’ve heard, is that it is an important and significant part of what makes the person what and who they are. In this way, it seems to share less in common with a medical condition and more, again, with the phenomena of homosexuality - I’m certain that if I were able to offer a complete fix-and-forget cure for cancer, the take-up would be very high… were I to offer a way for homosexuals to be somehow converted to heterosexuality, I suspect the enthusiasm for it would be very low. In fact, the thought of the latter is rather distasteful to my modern mind, as I’m sure it would be to many.

The idea, then, of psychiatric conditions forming an essential component of the self is curious indeed, and could open a very long discussion on what it is to be mentally ill at all (a discussion I am currently avoiding). There is a well-documented but mysterious link between Bipolar and heightened creativity, for example. I think of myself as a highly creative person and, while I am unconvinced as to whether the source of that creativity could so easily be identified, I do know that the cyclic nature of the condition does have a significant impact on the way I have conducted (and continue to conduct) my life.

I’ve drawn parallels between Bipolar Disorder and homosexuality, and this may be quite dangerous (given that my knowledge of what it is to be gay is unresearched, and is largely anecdotal or assumed), but I do so only in specific, mainly sociological areas. Of course, there are areas where parallels cannot be drawn. Humans, it seems, are basically equipped to conclude that they are gay for themselves. Being sexually attracted to the same sex or possibly being sexually unattracted to the opposite sex is a pretty good indication to oneself that you ain’t straight. Bipolar Disorder, however, is not that way.

People don’t walk into surgeries and suggest they might be Bipolar, as you might do with chicken pox or a sprained ankle. Often, one who is later diagnosed with the condition will have initially reported something quite different, and not immediately related. In my case, for example, I approached medical professionals with insomnia, which was put down to professional stress. A good while later, while one such professional was reviewing my notes and examining the seemingly unconnected list of ailments for which I had sought advice, was the suggestion made that all of these things could be connected. In the first instance, I was marginally offended - the suggestion that it could be some kind of mental thing seemed to imply I was making it all up. But, after I accepted psychiatric examination, a pattern started to become clearer.

I say that cautiously, because even now the diagnosis is far from hard-and-fast. On paper, it would seem, I have met all the criteria (read: ticked all the boxes) to qualify for our current understanding of Bipolar Disorder. It may transpire, in time, that my condition fits more comfortably with the milder Cyclothymia. It may even turn out, I suppose, that it’s neither.

That said, diagnosis is more than just sticking a name-tag to something. Much more importantly than this is the fact that, in the time that my case has been treated as Bipolar, it has certainly been much easier to manage. That alone may justify the diagnosis, and treating such a condition (including learning to live with it), rather than just naming it, is what it’s really all about.

I first went to see a doctor in late 2001, and the diagnosis was made some four years later. It was a stroke of luck, I was told, that I lived in north-west London, as this appears to have become the mental health capital of the country ever since Dr Freud chose to settle there. It took another two years before I told anyone other than my partner and my psychotherapist, and the person I happened to tell turned out to be my father.

I probably winced.

I can’t say exactly what I feared would happen next. Maybe an argument. Regardless of what I expected, what I got (and continue to get) was rock-solid, but passive, support. Anyone who knows him will tell you that’s the mark of the man, and it’s what I’ve had from him my whole life.

Since that day a little over a year ago, the few people who know about it have found out just as accidentally. I don’t think I’ve ever been particularly secretive about it, you understand. It’s just that it has been a long and drawn-out journey to be at the point where I have something tangible to say. Plus it’s not the kind of conversation you strike up with people unless they know you well, for obvious reasons.

However, this presents a problem. With increasing frequency, I forget who knows and who doesn’t. This causes two varieties of social faux-pas: the one where you make casual reference to it in general conversation (this one I call the “you never told me that…”), and the one where you find yourself doing the same, then asking whether or not you’d mentioned this before (the timeless classic “yes, and could you stop going on about it now…”). This, incidentally, also applies to writing about it. Or, indeed, any part of my life. I guess the hiatuses make a little more sense now, huh?

So, I decided to tackle it by no longer asking people if they know or not and, for the benefit of those who don’t, writing it down. There’s a hell of a lot to say, frankly, and the vast majority of it hasn’t been said here. I just wanted to be able to say that it is out there, so that I can tiptoe around it a little less.

And, with that, I’m out.


Afterword

In the above, the author has drawn parallels between Bipolar Disorder and homosexuality in five distinct areas. These parallels are:

  1. the act of “coming out” and the state of “being out” about either being gay or having Bipolar Disorder;
  2. the number of people in the public eye identified as being gay or having Bipolar Disorder;
  3. the fact that the causes of neither homosexuality nor Bipolar Disorder are fully understood and, in all senses other than the academic, are not particularly relevant;
  4. were it possible for homosexuals to be in some way converted to being heterosexual, most (in this author’s opinion) would choose not to – theoretically similar to how most of those with Bipolar wouldn’t accept a “cure” for their condition; and,
  5. the fact that both homosexuality and mental illnesses such as Bipolar Disorder have carried a historical stigma that is still upheld (in varying degrees) today, mainly through lack of knowledge and/or public exposure.

These are the only connections that have been made. Homosexuality provides probably the best example of a phenomenon that has become more widely accepted in civilised cultures through wider acceptance and understanding. The author does not believe, nor has attempted to suggest, that homosexuality could be considered to be in any way connected to mental illness other than in relation to the sociological issues surrounding both phenomena in modern society.

The author respectfully requests that readers note that what is published here is an opinion based on personal experience. Also, it is the opinion of a patient and not a doctor.

Finally, it took over three years of procrastination to get this online. The relief is immeasurable.