970x125
As with so many other forms of mental illness, the common understanding of bipolar disorder is wrong in a meaningful way. People tend to think the syndrome entails heightened sensitivities to one’s environment, so that whatever makes most people sad makes the individual struggling with this illness depressed, and whatever makes most people feel happy makes them feel euphoric. However, that’s a surface-level understanding of it. And the reality is much more complex, interesting, and even more challenging.
Bipolar disorder I and II are each marked by lengthy periods of a depressive episode, which is expressed in a change in appetite (more or less eating), a change in sleep (more or less of it), anhedonia (i.e., the inability to experience pleasure in activities in which one did), and apathy (i.e., not caring about anything, including, at times, even pursuing treatment). Mania for bipolar I and hypomania for bipolar II are marked by either grandiosity or elevated self-esteem, impulsivity (which may lead to extremely regretful decisions if bipolar I), increased energy and activity, diminished need for sleep, racing thoughts, and being talkative. For bipolar I to be diagnosed, mania has to last for at least a week; for bipolar II, hypomania has to last for at least four consecutive days.
Arguably, if one’s environment can make the individual feel good, the trade-off might, at least to some, feel worth it. But it isn’t the environment that tends to make one feel good; it’s one’s own mind. And it often isn’t one’s mind attached to an immediate reality, directly illuminating it with radiant colors. In contrast, it’s one’s mind injecting the present with the steroid of possibility. The euphoria stems, for the most part, from hope. So, the reality, regardless of form, is secondary—little more than a means to an end. As someone with bipolar II disorder, I can tell you that it’s difficult to enjoy much of anything for its own sake. When depressed, it feels as though nothing matters. And when elated, I’m just waiting for some great experience or reward.
Expectation vs. Possession of a Reward
We know this about dopamine: Most of it is secreted when we’re expecting a reward, rather than when we possess it. But this trend is amplified in each bipolar disorder. So, in my case, the expectation of a reward is increased because I idealize, and the reward itself is hardly ever appreciated because most of life can’t live up to my fantasy of it. Consequently, I always just hop back on the treadmill, hoping, again, for something to meet my expectation, to make my experience, or me, whole. That is perfectionism’s overarching goal—to finally achieve something that can make one relax, that can be a way off the treadmill, which one mistakenly believes they can just exit. Yet, fighting, trying, and exerting all go nowhere in any way that would matter. The exit is an illusion propped up by the immense optimism gifted by this purportedly sublime pursuit.
If anything, the individual with bipolar disorder tends to desperately hope for their environment to make them feel good. The crash occurs each time it fails to. Nothing is as good as it seems is the mantra we tell ourselves, not to degrade but to appreciate. If we fail to heed its warning not to obsess and idealize, the treadmill produces the same thought distortions—white transforms to black as the fantastical is slain by the fists of time, or our twisted version of it. We disqualify the positive, telling ourselves that because some achievement failed to heal us, then it must be worthless; we catastrophize, telling ourselves that we’ll never be happy; we overgeneralize, telling ourselves that nothing matters; and we personalize, taking on more responsibility to try to make ourselves happy.
The Paradox of Bipolar Disorder
All of this can easily make anyone feel hopeless. Bipolar disorder is a paradox: On the one hand, we’re overly dependent on our environments to make us happy, and, on the other, our minds can’t seem to access their gifts. We need it while simultaneously rejecting it. Again, the wish is often that there is an “overreaction” to some direct experience. However, making things worse, the inverse is true. Depression is more about one’s direct circumstances, even though one’s sense of them tends to be highly flawed.
To be clear, we can’t uniformly fit everyone with either of these diagnoses into a narrow framework—some with bipolar disorder tend to appreciate stimulating experiences. I, and others like me, just don’t happen to be among them, at least not for the most part. I can’t say whether I’ll someday have some experience that makes me feel past efforts were worth it. I can only tell you that several things have helped, but each involved an immense amount of effort.
I remind myself how far I’ve come, which takes work because I have to will myself to look back on much of my progress over the years. I lean on others, who also remind me of it while emphasizing what I’ve meant to them. And I remind myself that my inability to enjoy rewards is somewhat helpful because it keeps me from slacking, although I also remind myself that devaluing what I’ve done is a poor substitute for a better form of motivation, which doesn’t require shame. I can’t say that all of these methods work all the time, but I can’t stress enough how important gratitude is, especially if you’re someone like me, who always wants more.
