Lingering Myths About Bipolar Disorder

Sometimes, even people living with the disorder can get caught up with self-doubt and believe the exaggerations of their condition.

Myth: ‘My bipolar disorder is going to ruin any chance I have at a meaningful relationship’

FACT: While having bipolar disorder can present significant challenges to one’s romantic and intimate life, healthy, fulfilling relationships are absolutely possible.

Research does indicate that people with bipolar disorder marry and divorce at higher rates, are more likely to experience sexual dysfunction, and feel less satisfied in their relationships — but that’s not the end of the story.

When both partners have a continuing education approach to bipolar disorder depression, recognize what the early stages of bipolar disorder psychosis are, and learn how to predict or possibly prevent manic episodes, they can cultivate their relationship and adapt to whatever comes their way.

Myth: ‘I can drink alcohol or use cannabis as much as the next person who doesn’t have bipolar disorder — not that big of a deal’

FACT: Substance use is a serious and common co-occurrence among people with bipolar disorder. Research shows that alcohol, cannabis, and other recreational drugs can worsen mania and interfere with your meds.

Not convinced? Here are some stats:

• A review of multiple studies found at least 40% of people with bipolar I disorder will experience a substance use disorder (SUD) during their lifetime. At least 20% of people with bipolar II disorder will.
• An existing SUD can make managing bipolar disorder more difficult.
• Men with bipolar disorder develop an SUD more often than women with bipolar disorder.
• A high rate of manic episodes and suicidal ideations is also linked to an increased risk of SUD.
• Certain folks with bipolar disorder are uniquely at risk of an SUD, including veterans and transgender people.

You can manage bipolar disorder and also have a healthy and robust social life. Many people use substances to relax, or with the hope to calm an episode of mania, hypomania, or hypomanic symptoms. There are other ways to achieve the same goal, like with self-care and exercise.

Myth: ‘It’s not me, it’s bipolar disorder — I don’t have to apologize’

FACT: You never have to apologize for having bipolar disorder. But you can and should take varying degrees of responsibility for harmful actions that may stem from bipolar disorder episodes, treatment changes, or decisions to suddenly stop medication unsupervised.

If you’re comfortable sharing your diagnosis, letting people know you are managing a mental health condition can help them understand and contextualize what they might observe.

As Dr. Descartes Li, director of the bipolar disorder program at the University of California, San Francisco, and professor of psychiatry explains, sharing your diagnosis with select people may provide crucial support in times of crisis.

“Having family members or friends who are aware of your situation, who can jump in and help out when needed, can be literally a lifesaver,” he says.

For those in your life who may already know, and who were hurt or otherwise negatively affected by your actions, making amends in real time can help preserve those core relationships.

“Sorry goes a long way,” Li says, “but you don’t have to acknowledge a 100% responsibility” or apologize for having a mental health condition.

He adds that sometimes sudden changes in behavior can stem from recent treatment adjustments under your prescribing clinician.

But other times, people may still need to take a degree of responsibility for actions that may take place after stopping meds without professional supervision.

Myth: ‘My meds are going to make me less creative’

FACT: Medication may affect your life in unforeseen ways, but relying on bipolar disorder episodes for productivity works against overall well-being.

Evidence suggests people with bipolar disorder are highly creative, and in fact over-represented in artistic occupations at large. Worries about medications’ impact on creativity is a major contributing factor to some people with bipolar disorder when considering treatment via medication.

It’s also a prevailing inaccuracy. Some experts have said their clients find creative space to explore when on their prescribed medication since it provides clarity.

Taking medication is still considered the cornerstone of treating bipolar disorder in most cases.

Myth: ‘I can go off my meds when I feel better’

FACT: Stopping a medication “cold turkey” can be incredibly dangerous. Changes or adjustments to medication should only be made in full concert with your healthcare team.

Not taking medication as directed by your doctor is called “nonadherence.” It’s very common at some point or another while managing bipolar disorder long term.

Li observes that nonadherence can occur when people are far out from acute episodes, feel stable, and sometimes wonder why they’re still on medication: “I don’t even feel like I have an illness anymore,” you may say to yourself.

When that happens, Li urges, “What I want you to do is come and talk to me, and let’s have a discussion about it.” Clinicians are used to, and expect, patient needs and goals to change.

Ultimately, it’s important to always be transparent and honest with your doctor about how you’re feeling, and what you want out of your treatment.

Myth: People with bipolar disorder can control their moods if they really want to

FACT: Bipolar disorder is a very real neurocognitive and chronic mental health condition. It cannot be wished away with positive thoughts and requires a consistent treatment regimen.

Bipolar disorder develops in the very synapses of the brain and presents from the inside out.

You wouldn’t tell someone with a broken arm to control their pain, right? And so it is with bipolar disorder.

Myth: Bipolar disorder = swinging between depression and aggression

FACT: Mood shifts caused by bipolar disorder exist on a broad spectrum. It’s actually inaccurate to say all people with bipolar disorder go back and forth from mania and depression.

Different types of bipolar disorder include particular mood types. To receive a diagnosis of:

• bipolar I disorder, you must have episodes of mania. Bipolar I disorder may include depression but it’s not necessary to receive a diagnosis.
• bipolar II disorder, you must have both hypomania (a less severe presentation of mania) and depression (which can be severe).
• cyclothymia disorder, only some symptoms of hypomania and some symptoms of depression are needed to receive a diagnosis. These symptoms occur at the same time for periods on and off within a 2-year phase, each time.

In all three types of bipolar disorder, when a person is not having an episode, they experience what’s called euthymia, which is simply a calm state.

While depression is among the most commonly experienced mental health conditions, mania is rarer and less understood by the general public. The next myth on this list discusses mania in more depth.

Myth: Energy surge? Sociable? Confidence and spontaneity? Mania can’t be that bad

FACT: The energetic high of mania may seem like a plus, but it’s often misunderstood.

Some folks with bipolar disorder admit they look forward to manic episodes as they offer respite from depression and the invigorating benefits of euphoria, self-confidence, and increased productivity.

In her famous, radically honest account of her own bipolar disorder, Dr. Kay Redfield Jamison writes that mania can feel like becoming the best possible version of yourself, the “liveliest, most productive, most intense, most outgoing and effervescent.”

However, having a manic episode can be unsettling and exhausting, as manic or hypomanic symptoms can last for hours to months. When untreated, manic episodes can lead to hospitalization and trigger psychosis. Symptoms include but are not limited to:

• talking fast
• racing or intrusive thoughts, sudden flood of ideas or interest in new ventures
• insomnia yet operating on a “full tank”
• irritability, restlessness
• fidgety with clothing or having body tics (known as psychomotor agitation)
• impulsive behavior (like excessive spending or other conduct that can cause sexual, legal, interpersonal, or medical consequences)

Myth: Kids can’t get bipolar disorder

FACT: Bipolar disorder can occur at any age.

Some research has found that around 4% of kids under 18 have bipolar disorder. Children as young as 5 have been diagnosed and treated for bipolar disorder.

Confirming a bipolar disorder diagnosis in children can be particularly difficult as their moods already may change more suddenly than adults, and prescribing medication to young patients can be less optimal. Kids also demonstrate warning signs of bipolar differently than adults.

Myth: Bipolar disorder stems from childhood abuse or dependence on substances

Fact: Not necessarily.

Not all people with bipolar disorder have experienced both or either, but there are some links for some folks.

You can read more on all the evidence-based causes of bipolar disorder research has found so far here.

A family history of mental health conditions and the presence of trauma or adversity in childhood plays some role in the appearance and severity of bipolar disorder in people who’ve received a diagnosis.

And among the types of bipolar disorder outlined in the DSM-5, substance or medication induced bipolar disorder is also its own category.

Myth: Bipolar isn’t a ‘real’ disability

FACT: Bipolar disorder is a protected disability per the Americans with Disabilities Act and the Social Security Administration, though substantial documentation is required to access accommodations.

Many people with bipolar disorder experience severe impairment in multiple areas of their life. Adjustments and accommodations — particularly regarding work and interpersonal relationships — may be needed to allow some people with bipolar disorder to reach their fullest potential.

Bipolar disorder is a neurocognitive condition that can have serious impacts on everyday life when not treated. There are different types of bipolar disorder, and a person can receive a diagnosis as young as childhood. It’s more than mania and depression, and there are periods of calm.

Though lifelong, the condition is manageable with consistent routines and treatment. You can live with the condition and enjoy a healthy, creative, productive, and full life with meaningful relationships.