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High-Functioning Bipolar Disorder

January 17, 2011 Natasha Tracy

I have 'high-functioning' bipolar disorder so people think I'm not mentally ill. But the ability to function in public comes at the price of private pain.

Sometimes people don’t believe I’m particularly sick. They meet me, I look fine, I interact, I charm, I wit and all seems, if not normal, at least something reasonably normal adjacent.

And that’s fine. It’s by design. Being a high-functioning mentally ill person, I can’t really afford to run around with my hair on fire. But faking normalcy, happiness and pleasure is a tricky and very expensive bit of business.

Being a “high-functioning” bipolar doesn’t really have a definition, per se. The term indicates that I’m not in a mental hospital, and I do things like live on my own, pay rent, work and whatnot. I would suggest that being “high-functioning” seems to indicate that I can fake not being a crazy person.

High-Functioning Bipolar Weekdays...

It’s really important that I be able to put my bipolar on the shelf. I have to be able to put the crazy away so that I can talk to people, engage in business, produce technical documentation, write articles and so on. I wrote about 12,000 words last week for clients. You can’t do that if you’re pondering where on your wrist the best place to slice is.

...Followed by Low-Functioning Bipolar Weekends

I have 'high-functioning' bipolar disorder so people think I'm not mentally ill. But the ability to function in public comes at the price of private pain.

The trouble is, using all my control, sanity and energy during the week to try and produce enough work to pay my rent then leaves me with a really large deficit when I’m not working. I’m crazy. Remember? Not normal? I’m just faking the normal. And faking normal requires more effort than you can possibly imagine.

So then, as soon as I’m not working, I break into a thousand pieces all over the tiles on my kitchen floor.

Sure, you go out Friday night with friends. My Friday night is usually spent fairly catatonic trying desperately not to get suicidal.

Bipolar, High-Functioning Or Low, Is Exhausting

As I see it, everyone has a similar tank of energy. We expend that energy in lots of ways. We run after kids, we go to the office, we jump out of planes. All fine uses of energy. Me, on the other hand, I spend a massive amount of energy just trying to keep my brain in one place. I have almost no energy, or brain left, outside of that.

I Give Up a Life to Survive

I do know wonderful people and I do adore them. But that doesn’t overcome the inertia of having every drop of energy sucked from me so I can pay rent. So all the appearance of my functioning is paid for by utter decimation and exhaustion the rest of the time. I don’t have energy or brain space left to read, see friends, date or do pretty much anything else. The last thing I want to do is leave the house. I want to sleep. Forever. And ever.

Bipolar Sucks the Life You Don’t See

I’m the least fun person in the world. I work. I sleep. I have a schedule. I keep that schedule. I’m tired. I make excuses not to go out. I’m sort of the lamest person ever.

But that’s the mental illness sucking the life out of my ears. I want to go out. I want to see my friends. I want to do something fun. I want to have a drink with you after work. I just can’t. I’m too tired.

So yes. I’m capable. I’m talented. I work hard. I produce stuff. Yay me. But the price I pay for that is not being able to be anything else.

You can find Natasha Tracy on Facebook or GooglePlus or @Natasha_Tracy on Twitter or at the Bipolar Burble, her blog.

APA Reference
Tracy, N. (2011, January 17). High-Functioning Bipolar Disorder, HealthyPlace. Retrieved on 2024, April 23 from https://www.healthyplace.com/blogs/breakingbipolar/2011/01/high-functioning-bipolar-disorder



Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate, and author of Lost Marbles: Insights into My Life with Depression & Bipolar. She's also the host of the podcast Snap Out of It! The Mental Illness in the Workplace Podcast.

Find Natasha Tracy on her blog, Bipolar BurbleTwitter, InstagramFacebook, and YouTube.

Sandra Sweeney
September, 14 2011 at 2:04 pm

Hi, Natasha,
Thanks so much for this article. I have BP and am currently out of work (but hopefully not for long - I have a second interview tomorrow regarding part-time employment as a special ed teacher). My current unemployment was caused by a car accident in March, but I've felt so much better since the accident; I haven't had to contend with colleagues each day, and that is much better for me. I am also awaiting a decision regarding disability insurance.
What struck me about your article, besides the topic, was how difficult it is to look and behave high-functioning yet have this level of living suck us dry. I cannot live like those without BP - it's too hard. I need to be alone more, to be more protected from "normal" situations (for example, I am better off teaching in private schools rather than public due to the variety of personalities and problems in public schools). One evaluation I received said, "May be too sensitive to work in a public school setting." I agree. But I am good - very good - at what I do and I want to teach and help kids achieve their full potential. I just cannot do that like most teachers can. Part-time employment sounds like the perfect answer, teaching in a private school without having a co-teacher (as I had for the last five years - only one of those years was wonderful and my co-teacher felt the same way; we both just clicked beautifully together, but we couldn't stay partners longer than one year.) I want to finish my master's degree in special education, I want to teach and I want to live my life to the best I can possibly live it. It's just taken me a long time to realize that this means living as only I can live it, and that is different from most of the other teachers working out there.

Kris
September, 15 2011 at 8:02 am

You nailed it with this posting. Right now my brain hurts. I

Carolyn
September, 17 2011 at 2:31 am

Hi Natasha
This is my first entry on any blog ever but I was drawn to this topic as I was diagnosed with bipolar in 2008. My heart goes out to you for your pain and reading some of this blog has actually made me feel very fortunate that my brain feels normal nearly always. I've only had one manic episode when I had post-natal psychosis 6 weeks after the birth of my child in 2008 (and about six episodes of major depression). I understand but I also think it's sad when people have to fake being ok. Hopefully as the stigma of mental health problems continues to reduce we will one day reach the time where we can all be open and honest with anyone about how we are holding up. I admire you for working as it sounds like it is really hard sometimes. Please forgive my lack of knowledge about your past treatment
as I have only read a few of your entries, but are you continuing to see your doctor to trial new medications that may reduce your pain and struggle?
Carolyn

Natasha Tracy
September, 17 2011 at 5:45 am

Hi Carolyn,
Thanks for the comment.
Yes, I continue to work with a doctor to find the right treatment. I suspect the struggle is infinite but I hope treatment will alleviate some of the symptoms.
- Natasha

Casey
September, 21 2011 at 1:32 pm

You have described "Me" completely and to the tee. I work a hard 40 hours a week and dive on the couch as soon as I walk in the door. I am so totally exhausted from the "show" I put on all day at my job. I, like you, have no energy to date, socialize, etc. I am just too tired. My weekends are to quiet my mind and body and withdraw from the noisy world.
Thank you so much for your "very real" portrayal of your life.
Casey.....

HG
December, 10 2011 at 9:48 am

Oh my goodness I relate to this like crazy (ho ho). I strongly suspect I have Bipolar II but have been telling myself not to be stupid because I have a job and a boyfriend, and people I know think I'm odd but not insane, and surely I couldn't manage that if I was Really Sick. But this post describes exactly how my life often is.
'I spend a massive amount of energy just trying to keep my brain in one place' - god yes. Just because I do usually succeed, doesn't mean the struggle isn't real.
Thanks so much for this. I really have to get my shit together and see a doctor, and this helps with the 'But I'm not really ill' gremlins.

Caroline
January, 15 2012 at 6:47 am

Looking fir support. I am a high functioning bi-polar, who luckily mostly "just"has a psychotic break every 5 years. A year an d a half ago I had a manic episode after only two years of sanity. I live in a very isolated place and I can't drive due to heavy medications I am on now. My doctor has given me samples of Saphris which seems to be helping me. Lately I am aware of how slowly time passes for me. I am aware of my craziness. People say they will call and don't and that drives me crazy. People think I look normal and speak normally (which my doctor says is a good thing). My sister who is in the mental health field wanted me to drive three hours to be with her three young children. My family is in denial about how ill I am. I can really related to the part about the weekends being tough.

Natasha Tracy
January, 15 2012 at 8:20 am

Hi Caroline,
I'm sorry to hear you're in this situation. I know how tough it can be. It sounds like you're in a rough part of the illness, but I can tell you it won't always be like this and I can tell you that you're not alone.
You might find the support you are looking for in the HealthyPlace forums here: http://www.healthyplace.com/forum/
Good luck.
- Natasha

Butterflywings
January, 15 2012 at 8:21 am

So true. I thought hibernating all weekend was just what people *did* for...well, since I started working. In the end a stressful job led me to have a breakdown. I now only work part-time which does allow me the energy to be a whole person - ish, just barely. But it means less money. I am on benefits which limit the hours I can do (I actually do far less, for my sanity). If I didn't work I'd get ill due to having too much time on my hands, but I have to be very careful not to do too much as stress also makes me ill. There is no easy answer!

Butterflywings
January, 15 2012 at 8:30 am

I wanted to add that I understand why you work full-time, and I wasn't criticising that, or anyone's decision to do so. I mean, I did for years, and would like to do so again, so I can sympathise.
Also, a really well-written piece which I will bookmark to send to those who don't get it.

Natasha Tracy
January, 15 2012 at 8:41 am

Butterflywings,
Thanks for the compliment and for stopping by with your support.
- Natasha

Butterflywings
January, 15 2012 at 8:49 am

Hi Caroline. I just wanted to say you're not alone. I am another high-functioning something (maybe bipolar, the docs can't decide) and people expect too much of me too. I too appear 'normal' - except when I don't, and then it gets labelled as moody, difficult etc, instead of what it is, which is 'used up all my energy trying to function and have overdone it, am overwhelmed and overstimulated'. Sorry your family aren't understanding - asking you to drive when you're on meds so you're not supposed to is just so unfair.
I can reccommend Twitter as a place to get support and information, there is a *great* community of people with mental health issues on there.

Butterflywings
January, 15 2012 at 8:59 am

Natasha, no prob! :-) Thank you for writing this blog, have lurked for a while and found it so informative and helpful!

Lisa
January, 15 2012 at 10:23 am

I would like to say Thank you for this article. I collect disability & some feel I have nothing wrong, or that I am takeing the easy way out. It has taken me years to except that I do have an illness. I don't beat myself up for not being able to hack a full time job, anymore. I am still learning my limitations, but am haveing a tough time with it. I isolate, avoid people & just don't care what people think anymore.

bill
January, 15 2012 at 10:30 am

Hi Caroline,
Oh, you're there? So I am not alone! So you are not alone in your marathon. Even though, I feel alone even when I have support from some others. Who understands really? I'm a rapid-cycler w. mixed states, they say, and labelled acute. I have gotten better, over the years, at getting up and having a life between the regular slam-dunks, though honestly I never have a day completely free of being on 'the ride'. Hang in there. Make the most of what you have when you have it. I can do that really well on a fully part-time basis -- always part-time. That's the best. I hate it. But looking back, I am glad of the bits that I have had of tolerable life. Glad I am not alone either. Nope. You aren't alone. Keep up the good work.

Lisa
January, 15 2012 at 10:41 am

This year for some reason, I feel the depression more. I'm not sure why. Was hopeing to find an open chat. I have had no luck yet.

Judie
January, 15 2012 at 12:14 pm

I can relate to so many of you on here...i too worked full-time all my life until i finally quit in 2004....i just couldn't take it anymore...and to tell you the truth at the time i really wasn't sure what all was going on for me except that once i crashed in 2003 and went thru treatment & am now a recovering alcoholic...i finally got my disability benefits from work (legal process for mental health issues doesn't get the "ok" without a huge struggle on the person who is already down & out trying to get time away from work to work on getting better!!!)
I have been diagnosed with PTSD, adult survivor of childhood sexual abuse, Major Depression, Generalized Personality Disorder....and it's finally taken til this past year to find a psychiatrist (at least 4 years ago been struggling to find a psychiatrist because i know i still not thriving & feeling down more than up and feeling suicidal notions all the time) Plus before all this when going thru the toughest times 2005-2007 no family doctor either.
Sorry to go on but since finding your blog here Natasha a couple of months ago & since being medicated now since last spring for bipolar (Divalproex) but not exactly "diagnosed" although i see it as bipolar II & cyclic from all i am reading.........i am struggling to get moving all the time. I remember in my mid 30's how i all of a sudden felt not wanting to be around people and it was getting harder and harder to be always the one who people counted on to SMILE...as if i was a robot they were expecting to be HAPPY everyday......so when i had moods i was NOT ALLOWED.
I struggle with organization & motivation & i too get people seeing me as "ok"/normal/doing alright" when i am around friends & family but it's the when i get home i have nothing in me to want to do anything....I have wanted to get to a point of doing some part-time with what i would like to do but not enough energy or motivation to be consistent enough to actually go & "do it".
I do volunteer work at the Health Centre where i am also a client now since 2007...i chair the mental health advisory group committee there which i find helps me to get out of my self and help others and to feel somewhat "normal" like others "normal" around me...said with a sarcastic tone!!! I also have taken a course on self-managing Chronic disease & now help co-facilitate it at the Health Centre & that too helps to PUSH ME to get outside and also helps me to realize i am doing the best i can do and to keep myself in check as to how I am doing helping others self-managing with their chronic illnesses.
Another thing that does keep me coping and moving and pushing me is that i have taken on a dog (mine passed away in 2009 - Smokey was 15 1/2...she got me thru the years where most of my craziness of drinking and doing really stupid things and was blessed she was able to stay with me thru my recovery so she could have a less crazy time with me in a more healthier state. Healthier meaning not drinking that would lead to to other stuff...i have a part of me that still feels guilty because of who & what i was then...) The dog i have now Kala, she is 12 (long story short, took her on from a homeless person who now has a place but still struggling to provide a stable home for Kala) Not that i have money cause i am on a limited income, but am doing as best i can with what i can do! Kala gives me reason to get up out of bed every morning now especially with the last year & half before getting her, i was really going downhill with my depression. Still struggle everyday with it but with Kala & my psychiatrist i feel more hopeful.
I relate to/identify with so much of what everyone says here, i just had to say thank you all for sharing and am glad to know others are going thru some of the things i am going thru. One person here said they are a "rapid-cycler, mixed states" and that is what i feel is always goin on with me. i cannot commit to anything fully. i have appt. & for the most part i get to them but when left to my own device to make an appointment sometimes it doesn't happen, or if it does it takes forever.
I really do get so upset and down when people friends...& most of my family to not "get it" about my mental illness even when they do have some of their own, but i at least am admitting mine and i know that a lot of what is going on for me isn't just like "everyone else has their problems" or " that's life, get used to it"...comments like this that just push me more & more into want to just curl up in my own little world & stay there....feeling unsupported!
Will keep checking in on your blog Natasha and reading others comments as it really is giving me some hope and helping me to cope.....
Again sorry for such a long comment. This is my very first time talking about the bipolar and only starting to understand what it really is & realizing more & more i am a person with bipolar charicteristics, but it's hard to understand......and having an extremely hard time explaining to others, when for the little amount of time "others" see me, it just really isn't the "REAL" ME!!!

paul
January, 15 2012 at 1:11 pm

was 1st diagnosed bp 1992 aged 30 and am now aged 50 this month. during this time i have had over15 hospital stays and the majority being manic highs and sectioned many times.
The past 8yrs i have been employed part time working with adults with learning disabilities, (blind leading the blind says ignoramous). I love my job but even though i have escaped hospital clutches for 4yrs now i am really struggling with lows and all the nasty trait like impatients, bad temper and dreading going to the job i truly love.
I am trying to keep up appearances of this with it person but at the same time dreading an innevitable break down. I am exhausted ment and phys and my body aches.
surely this wretch is not the same person who drives a minibus picking up bros and sis to church and the same who is the concert chairman at the social club , but surely does his bit for society and gathers alluminium cans littered on streets and parks.
society cannot keep up with me and i struggle to keep up with me and the pressures of fiscal constraint and the pressures society's ignorance and discrimination against dissability and unemloyed.

paul
January, 15 2012 at 1:20 pm

Straight from confussiuos, I wanted to escape public and government pressure by applying for work in a care home but needed my current employers oppinion and guidence on this issue, and would they give me a possitive refferance.
I wasbemused when my boss said i was his best employee but could not reccomend i do full time employment????
Catch 22 or what?

Lori
January, 15 2012 at 4:40 pm

I had always wondered if there was a name for how I function, now I know there is. I sometimes work 24/7 and when I'm not actually working I go to school online. If I'm not running the NC Association of Peer Specialists, I'm working for my own company, or I am in a Board Meeting, or I am taking care of my ailing grandma. I am always busy and have to stay that way. I fall to pieces on the weekend and during the early morning hours because those are the times when I am not working. I don't know how to stop until it's crash time.
My family is often on edge with me. Half says nothing is wrong with me and I don't even have Bipolar but then the other half is right there with me to make sure I stay out of suicide or self-harming mode. They go with me to Doctors appointments, check in often, and help me get my medicine when I can't. I am very thankful for them.
I literally crash and burn around November of each year and stay that way until Feb or April. I still go to therapy and attend groups, my cocktail being changed often doesn't help as it aids in my crashing. But then I do realize sometimes I need that.
Thanks for aiding me in putting a name to it.

jscruggs2003
January, 15 2012 at 5:51 pm

I agree with your article. I’m not going to drown everyone in words, but I have been BP for 27 years and highly functioning. I’ve held many management positions over the years, from ten years as a Claims Manager, to seven years as a Finance Director, and finally six years as a Logistics Manager. I have really never let anyone in that I have an issue with the exceptions of close friends and family. I generally put in more than 80 hours a week, and rarely show any signs when I’m at the office. Some people get somewhat suspicious when you work through the night and you are still there in the morning when they return to work.
Other than working hard, I go to the gym, I go groceries shopping, I pick up the kids from school, and I take them to soccer and so on. Always with a façade on. Not something I really work at, more of a learned thing that I have always had to do. I use to be able to manage everything, the work-life and the personal-life without any issue, but as I’ve grown older, lost a bit of my metabolism, taken on an extensive amount of responsibilities, and am now medicated, the front takes its toll. A toll that I do not like at all.
I explain to both my psychiatrist and psychologist about the issue. After all, I’ve always been very hyper and skinny, then I’ve became a bit lethargic and a bit chunky. The MDs solution during med check was 120mg Adderall and 300mg Nuvigil a day mixed with supplements like BSNs Endorush and BSNs NOExplode. A bit excessive if I must say, after all I don’t want to be in the ER with chest pains. Now I’m on my own personal quest for the right mix, I will update you when I find the right it.
But overall a great article Natasha. Don’t let all the secrets out. The others still think I’m Superman.

Dr Fred Von Gunten
January, 16 2012 at 3:07 am

Natasha...I'm back again to support you ( and all the other Bipolars,here), with a little more positive insight to what a "Highly Functional Bipolar" can work toward and achieve. When I was last in the hospital (1984), I told myself I will never return to this kind of place. I also told myself that I will never use the word "crazy" to describe myself. And I started to develop a positive plan to work toward an achievable goal of stability. Those were my positive challenges. I first had to believe in myself to prove that stability was possible,in order to become that True "Highly Functional Bipolar"...So I told myself that in needed to acquire,what I classify as "Episode Free Emotional Stability". That is building on each year with no episodes of any kind. With compliance of medication,Family support,and always keeping a positive attitude,I have achieved almost 28 years of "Episode Free Emotional Stability !
I know that this is possible...Because you are almost there, and you just need to stay away from thinking ....Crazy !
Remember the next step is : Functionally Cured !
Dr Fred

Cristina Adkins
January, 16 2012 at 11:00 am

Hi Natasha!
I am a frequent reader of your writing and I cannot praise you enough for what you do for your "family" of Bipolars.Now I am crying...I hurt for you because of what you go through...I never would have guessed this was your situation...Thank you for sharing because your article and all the responses have been such an encouragement to me....
I too am what I have always called a lucky bipolar,I guess maybe because I can hide it most of the time...I don't tell people...only three people at my work know ...they do because it took me a year to get my meds in order after me and my son were diagnosed at the same time ,and they let me take that time ...I was welcome back when I was able...
What keeps me going is that even though the day can be totally exhausting I get to be myself when I get home...my boyfriend at the time kept me alive and supported me through all the "ups and downs"you can imagine what he went through...I wouldn't be here if it were not for him and I am grateful everyday...he lets me be myself when I am with him...if i get a little too "exuberant" or melancholy,he will check with me to see if I ahve remembered my meds. my family doesn't really understand my illness,except of course,my son...
about him...He couldn't hide it as he had explosive and violent manic episodes and we could not control his illness through traditional meds...the reason I am bringing this up is that finally hie Psych Dr. at a large HMO here prescribed medical marijuana...It has been like magic...he presents like a "normal" calm friendly and even cheerful person...he still has his ups and downs as do we all..Has anyone out there tried it if you would be willing to share your experience I would love to hear it...

Blanche Couture
March, 10 2012 at 11:48 am

Wow!...I don't know what I am --- I am old now but my life basically had been good except the episode of mania and the depression. The depression did not stick around for long either. Now that I am 70 years old I seem to be sicker when I do get sick and I am retired and stay home and see some of my friends sometimes. I am fine physically I still can work but here work is hard to find. I feel sorry for the young people with this disorder it's no picnic.

Christina Collins
April, 9 2012 at 6:37 am

I can completely relate to your article and so thrilled that you could articulate so well my experience. I am very fortunate to have a devoted, and loving husband, but it is very difficult on relationships when you are able to give and participate so well, but are unable to keep up the "show" when you are home. It is painful and very hard to see someone settling for less than a fully functioning partner in life. He always seems to get the worst of me.

jacqui
April, 9 2012 at 8:07 pm

Hi Natasha,
I can certainly understand how a doctor (and most people), would not be able to see beyond the high-functioning part of you. Being high-functioning is a real catch-22, because you desperately need to receive help, but appear too well to be extended the kind of help you need. I am sorry that you struggle so much without many people there to comfort you at the level you need to be comforted.
I believe it is almost like being split in two. One part (the sick part) desperately needs help, but the other part (the high-functioning part), has learned how to "act" well. The sad irony is that psychologists may never get to see how desperate you really feel, because some of us are consummate actors/actresses. I believe you have to learn how to suppress the healthy, high-functioning side of you when you are with a psychologist...allow yourself to act as ill as you are going to feel, as you walk away from yet another session of not being truly misunderstood.
In the past, in order to get help, I would pre-meditatively and purposefully act out to "prove" and demonstrate the degree of mental anguish I was feeling. (BTW, no borderline personality disorder here - just a very ill person who was forced to think "out of the box")! The healthy part of me was embarrassed and humiliated by things I did to express how ill I was. Needless to say, desperate acts are generally a "red flag" to most psychologists, so for a time, I received the help I needed.
For a while, whenever my high-functioning self kicked into over-drive, I suppressed it intentionally, in order to get the help I needed. Yes - it was SUPER-embarrassing to "watch" myself doing crazy things, just so professionals would finally "get it". I could NOT face going home at the end of a session having being misunderstood yet again, but then having to deal with the aftermath of my tortured mind completely alone.
It still baffles me that a very ill individual needs to sometimes "act" ill, if they are to receive help from professionals. So, if the alternative is suicide, then I advocate a little "acting out" in front of professionals in order to wake them up a little! It is very, very hard over-coming your inhibitions in order to act as crazy as you feel. It can be very liberating though:-)
All the best,
Jacqui

Scheduling Nightmare | Suddenly Bipolar
April, 29 2012 at 11:53 am

[...] an interesting article from Natasha Tracy’s Breaking Bipolar that might explain why I feel more tired AFTER the [...]

Linda
May, 5 2012 at 1:23 pm

Hello Natasha,
Thanks for your courage to post (and all who have shared on this blog)...My hubby and I are on the way to the hospital to see our 26 yr. old bipolar son (for his 5th hospitalization.) He was diagnosed at 21 yrs.
He is very creative & intelligent--even got a BS degree in his chosen field--exercise physiology/PE. Even though, at his best, he can intellectually handle college course work, though his social skills have digressed to practically 'zero'. His dream is to teach, though some miracles would have to transpire before that could happen.
As for insight, most of the time it is nonexistent with our son. Dr. Xavier Amador's book "I Am Not Sick I Don't Need Help!" is a real eye-opener. Also the free 12 week NAMI Family to Family workshops were so helpful to us.
Some psychiatrist are incorporating EmpowerPlus supplements into their practices. The founders of www.truehope.com have compelling evidence, with studies, including some double blind research. Definitely worth checking out.
Thanks for all the encouragement on this blog, and hopefully our son will find his way.
The best to you, Natasha, and all who've shared here.
With hope for the best to come,
Linda

Julie
May, 7 2012 at 5:45 am

So I'm not alone in faking stable but hanging on by my fingernails? I've gotten better, over time, at leveling with my mental health professionals. "Look, I know you look at self-care and so forth, so this is how I'm dressed today, and I'm good at faking good. Here's what's really going on at home...."
It is incredibly painful to tell them the truth. It's painful to shatter the therapist's illusions about how well the treatment is "working" as I become better compensated to "fake good." Since when I came in the doors, I was totally broken down, beyond faking good, as I've recovered that ability, it looks like a lot of improvement.
Well, it is improvement. It's the improvement most of us get in therapy. It's the difference between compensating and decompensating--it's not how well are we really living, it's can we hold it together enough to fake it for the outside world. Our poor therapists and other providers just aren't used to knowing that harsh reality.
Sometimes, when I tell them how I'm really doing, I feel like I'm telling a kid there's no Santa Claus.

Natasha Tracy
May, 7 2012 at 8:22 am

Hi Julie,
No, I‘d definitely say you‘re not alone there.
I know exactly what you mean when you say it‘s painful to shatter a therapists ideas that the treatment is working. The same goes for doctors I‘ve found. You want to be a good little patient and you want to please them and you want to get better so saying these things aren‘t happening (or you‘ve gotten worse) is really hard. But that‘s normal.
Telling a kid there is no Santa Claus is an apt analogy but providing that realization is just something we have to live with because it‘s the uncomfortable truth.
- Natasha Tracy

Emily
May, 9 2012 at 6:40 pm

Hi Natasha,
I just found your blog and it is a breath of fresh air. I was diagnosed Bipolar II three years ago. I am graduating with straight A's from college and have two part time jobs. I really struggle with my identity as someone with a mental illness. I seem normal and people treat me like I'm normal. Whenever I run into my limitations, it is hard to accept because I feel like I should be able to have the stamina that other people my age have. I get home from my overnight shifts at work,hyperventilate, take an anxiety pill, and then crash. I am still living with my parents because, though I don't admit it to anyone, I don't know how I would cope on my own. My public and private self are so completely different, it's hard to tell which person I am. I sometimes trick myself into thinking there's nothing wrong with me at all until I run into my limitations. Thanks for sharing
Emily

Danielle
May, 26 2012 at 7:21 pm

I stumbled apon this while researching whether I was Bi-Polar or not. I have to say that I am scared to death after reading this. I am almost positive that I suffer from this illness, but still feel in denial that I might actually have to own it. It seems silly to me that I can not control myself and when I AM feeling normal tend to forget how bad it can get.

Natasha Tracy
May, 27 2012 at 7:50 am

Hi Danielle,
Like you (and many) I did online research into bipolar disorder before seeking a diagnosis. And, like you, I was pretty sure I had it before I walked into a doctor's office. I remember the night I figured it out - I cried and cried over the realities of what it meant. I think it's completely normal and rational to be scared to death. It's OK to feel that way.
But understanding and accepting bipolar disorder (or any illness) is a process, and you might be in partial denial now, but eventually you will move on to feeling other things about it. (The stages of grief are generally what people experience as getting a chronic illness diagnosis is very much a loss.)
And it's normal to _not_ understand how you could be sick in the periods when you don't feel sick. Many people feel that way. You're not alone there.
All I can suggest is to take it one step at a time. First, see a professional and see if you even do have the diagnosis - then work from there. There may be other things going on that you don't know about so try not to get too worked up until you know for sure.
And try to remember that you're not alone. Out here in the world are thousands of people going through exactly what you are. And it will get better once you deal with the issue.
- Natasha Tracy

Reece
June, 11 2012 at 7:35 am

Thanks for your story, and for the replies. Yes, I could be described as high functioning- at work. The post about staying all night and colleagues looking at you askance in the morning when they arrive and it is obvious you have not been home. But it all crashes down around at home - total disaster and curled up in bed for most of the weekend. The problem I have is that I am training to be a psychiatrist- yeah ironic. Just I feel so vulnerable 'coming out' at work. I feel it's a lonely place to be -being diagnosed with a mental illness as a mental health professional.

angie
June, 30 2012 at 1:25 am

Hi, I just found this website this morning and I realized when reading your blog about being high functioning bipolar is that I am exhausted by how much mental and physical energy I put into being well. I'm working really hard to learn how to be gentle and kind with myself. My mom had very intense ups and downs with bipolar and I grew up with her insanity. She did become medicated but was so lethargic she was like a different person who had no spark left. A new doctor changed her meds in 2000 and she had a bad reaction and ended up overdosing.
After that I went through a terrible terrible time. I had my first big bipolar mania that i remember. I was really breaking down and detaching from reality right along with all the grief and loss and horror about what had happened. I tried to run away from it and go to LA to start a new life but I just got more and more depressed and tried to kill myself. It really was horrible.
Fast forwarding I've spent the time since then learning how to be well. I finally got professional help and that was a huge step considering how much I didn't want to accept that I was like my mom. I am on medicine that mostly works for me. The only downside being I have trouble with my memory which I think is the Lamictal and that makes working really tough.
I always worked and worked hard. This year I finally quit my stressful job and I've been supported in my goals to become a writer by my husband. Now that I've quit I realize what a thread I was hanging on with pushing myself everyday because the work I was doing didn't come naturally to me and I really really had to push it to be "normal"
I am lucky enough to have a wonderful therapist who uses psycho-drama and not just talk therapy. My meds seem to keep me in check. I started exercising and I write and talk to people to get out all my junk. But still there is always that internal struggle for balance. The chatter in the brain and all that scattered junk all over the place.
I really resonate with the people who were talking about being actors because that is so true and it is so hard to let down and expose yourself. you really have to find safe people that you can expose yourself to and be real with.
it is tough for my family to understand that I am bipolar because they don't see me falling apart. They don't understand how I feel inside and bipolar is a condition that is a "feeling"condition. We really FEEL things in this heightened, sensitive way and because of that we need to give ourselves the special care we need, be kind to ourselves and make sure we keep reaching out for help.
I'll never give up on myself. I'm too important. We all are. The beautiful thing about being bipolar is that just in these posts above so many people have mentioned they are in fields where they help people. We are really caring and feeling people and do bring a lot of light and good things to this world.
No matter how crappy I am feeling inside I will always strive for that light that is in there somewhere. I am so thankful for all of you and your honesty and your stories. This is a great blog!

Oh here it comes… unwanted visitor « spiralofdarklight
July, 4 2012 at 7:29 pm

[...] High-Functioning Bipolar Disorder | Breaking Bipolar. Share this:TwitterFacebookTumblrEmailPrintLike this:LikeBe the first to like this. This entry was posted in Uncategorized. Bookmark the permalink. ← -Sighs- [...]

Always Lurking Behind the Scenes | Suddenly Bipolar
July, 14 2012 at 8:36 am

[...] I read this article again: ‘High Functioning’ Bipolar Disorder . A gentle reminder that it takes Tons Of Energy to make my brain work and to appear normal and [...]

Ernie Richards
July, 21 2012 at 11:52 am

This article fits me like a well made glove. I am always drained of energy (except during a mania) and my friends still don't understand why I want to stay inside. Thanks for helping to explain things in a way that I can show my friends.

Sue
July, 22 2012 at 6:23 pm

Every word you wrote describes me. Everyone I work with thinks I'm the most creative and hardest working person on the planet. I always joke that it's a sickness but no one gets it. While I work hard to work and have fifty million thoughts in my head I wear myself out. Then I can't sleep at all which makes everything worse. But boy I'm good at appearing normal. That is so exhausting. Thank you for sharing this. I've just recently been diagnosed so all this is new to me. I thought all this crap was normal!

Natasha Tracy
July, 24 2012 at 6:45 am

Hi Sue,
Yeah, it's tough and other people really don't see how hard it is. But hopefully now that you have a diagnosis you can get treatment that will make things not so hard.
- Natasha

Kim Hart
July, 25 2012 at 12:58 pm

I've been diagnosed with bipolar for approximately six years now. Since that time, after being off work for a full year, I've only worked very part time -- generally about 10-15 hours a week, with a day off in between shifts. If I don't have that day off, the time at work gets increasingly difficult. This past week, I had 21 1/2 hours, working four days in a row. By the last day, I was jumpy, grouchy, and trying to keep it all together. I stayed polite to my guests, didn't get crabby with my coworkers, and managed to not mess things up -- but I felt myself coming loose.
When I got home, I ended up taking two naps before bed, then went to bed early. Today, I slept in until 12:30 and have had one or two naps as well. This is with just a mild work-week, and most of my symptoms under control. I do have course work every day as I'm finishing my college degree, but like you, it takes it out of me to be out and be normal and interacting, when I'm most comfortable where it's quiet and I'm interacting when *I* want to.
Thank you for addressing this, because it makes me feel like I'm not being such a wuss about being a bipolar that also tries to work...but not making it full-time.

b21wayne
July, 29 2012 at 2:58 pm

I can relate so much to what everyone has said. I was initially diagnosed Bipolar I with mixed episodes in 1982, and was hospitalized about 10 times in the 80s and on disabiity from '88-'97. Since 1996 I've been able to maintain a full-time job, after getting an MSW. It takes a tremendous toll on me psychically and energy wise, to function "normally" at work all week. When the weekend comes I normally become a hermit so I can regroup, recover and reenergize. As the work week goes on I usually become more irritable with each day. It seems like it has gotten more difficult to keep a game face on all week as I've gotten older (52 now), and my isolation when not working has increased much more then 5 or 10yrs. ago. Taking meds for the last 30 yrs. has probably taken a toll as well. It is so easy for me to get down on myself for getting burnt out living in my head.

Suzanne Carter
August, 13 2012 at 11:52 am

This is great! My son and daughter in law forget I'm not normal, since I am high functioning and treat me as normal. That never works to a position solution and yet I am the judged.

John
August, 13 2012 at 1:43 pm

I know exactly what you mean. That was the story of my life until a few years ago. You might want to try some strategic changes to your diet. I found that avoiding starches and eating more greens left me feeling much less drained. Though it's still challenging, I do have something resembling a social life since I started eating better.

Brenda
August, 14 2012 at 6:41 am

To Natasha and everyone else:
Do you feel that you were always high functioning even as a child? As a child I know I would have moments of creativity and write plays for family and friends to perform but inbetween those times I found myself to be more at home as a loner, shy, afraid to be in public places and I would have to say that I showed symptoms of ADD when it came to school subjects with the exception of sewing, art and typing classes. I know I felt even as a small child very depressed and sometimes invisible. Now at age 52 I am now being diagnosed as Bipolar II which is complicated with an autoimmune disease which attacks my thyroid. After reading your blog about being high functioning at work or anything you do and about the suicidal feelings I felt a connection.
I was just wondering if any of you can remember always being this way or did it come on later in your life?
I know there is a connection with Bipolar and Thryoid problems and the doctors don't know which one to treat but I do know that regular antidepressants and even trying Lamictal and Symbyax only caused more hightened side effects. 15 years ago I did find a Psychiatrist that did agree to treat me with Adderall along with Paxil and the combination of the two seemed to have the best effect with little to know side effects. Today my doctors are disagreeing with the Adderall and Zoloft treatment and insist on replacing it with drugs like Abilify, Wellbutrin.....which have numerous unwanted side affects. One bad side effect of thryoid disease is that your body becomes extremely sensative and intensifies known drug side effects making it very undesirable to want to switch my medications. I noticed that Natasha mentioned she was on Adderall in addition to other drugs. Does the Adderall help you with your depression symptoms? I know when I cut back or even try stopping the Adderall I become more depressed and find it very difficult to just get out of bed.
Currently my GP and Psychiatrist don't agree with any of my thoughts regarding my depression and its probable link with my thryoid disease. There are many things on the internet about Bipolar vs. Thyroid disfuction.....anyone else suffering from the two??? and what medications seem to work for you???
Sincerely,
Brenda

seriouslyjai
October, 7 2012 at 11:28 am

""I can certainly understand how a doctor (and most people), would not be able to see beyond the high-functioning part of you. Being high-functioning is a real catch-22, because you desperately need to receive help, but appear too well to be extended the kind of help you need. I am sorry that you struggle so much without many people there to comfort you at the level you need to be comforted."
That catch-22 is a killer! I also have a problem that NOBODY believes me! I don't often ask for help. I/m so used to covering/masking/denying the sick part of me, that people BELIEVE that's who I am. They don't see the sheer force of will it takes JUST to get through the day
I asked my friend a couple of months ago (before I got REALLY crazy) where was the support for people like us? The groups that I've tried to go to are definitely NOT for me.
But that doesn't mean we don't need help. and aren't entitled to it!
AA has special groups for airline pilots, doctors and other professionals. Why doesn't the MH movement have the same??

Pam
October, 7 2012 at 2:35 pm

Natasha,
Thank you for writing this blog. I am 42 had my first breakdown at 40 after isolating myself unintentionally after job loss and loss of my home. I had a second episode was not on meds as they took me off of them now I was diagnosed bipolar 1. Hard to wrap my head around this been reading your blog. Decided to give part time work a try to build confidence as this occured when I was not working so still not sure what the reason is or was...confused about the whole thing.

Natasha Tracy
October, 8 2012 at 6:46 am

Hi Pam,
I'm not sure I quite get the order of events but if you're saying that you had a breakdown after a job and home loss "even though you weren't working" that's completely understandable. It's not work, per se, that tends to trigger people, it's stress and I would say that job and home less is exceptionally stressful.
And, keep in mind that sometimes episodes have no external cause. Sometimes they just happen.
Working part-time is a good idea, so you can see how you handle it. Easing into life is never a bad thing to do.
I recommend you seek out a support group, therapy or both to help you accept what has happened and what changes you may have to make to stay well. It's very confusing on your own, but less so with others.
- Natasha

Julie Cochrane
October, 9 2012 at 7:56 am

What I hate with high functioning is the comparisons. "You don't know how hard it is for me to get up every day and go do X."
Sometimes I'm high functioning and I'll get stuck in a loop of "doing" and I'll be able to "fake sane." Other times, since I'm type 2, I'll get more depressed and my ability to fake sane will slip, I'll relapse/decompensate/worsen, and I won't be able to do things.
I'll be in a state of mind where if I push myself to do anything I'm going to collapse crying on the floor in hysterics and maybe "just" have a horrible fit and cry myself into exhaustion, maybe harm myself, maybe someday end up in the ER, maybe someday end up in the morgue. Ugly truth.
So I don't push myself in that state. I just don't.
*Sometimes* I function well enough to fake it, and sometimes I don't.
It's such a tiny, fine line between the two. And it makes it look like I'm touchy over little things, because people don't realize that when they look at me "normally" that I'm not normal at all. Ever.

Julie Cochrane
October, 9 2012 at 8:01 am

But anyway, I do know it's incredibly hard when people who are disabled like me push themselves to fake sane enough to function.
Some of them don't know or accept, when they make comparisons, that when my ability to fake sane enough to function falls apart and I quit pushing (for fear of the morgue), that it's not my fault I got sicker. I do that sometimes. (I used to be high function. I relapsed, badly. I'm still struggling to work my way back.)

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