Myths of Bipolar

Bipolar disorder is a serious and difficult illness that affects all facets of a person’s life: their education, work, relationships, health and finances, said Julie A. Fast, author of several bestselling books on bipolar disorder, including Loving Someone with Bipolar Disorder and Take Charge of Bipolar Disorder, and a coach who works with partners and families.

Fast was diagnosed with rapid-cycling bipolar disorder II at 31 years old in 1995, a time when very little was discussed regarding the diagnosis. Fortunately, knowledge and media coverage of bipolar disorder have improved dramatically over the years. “I’m astonished at how much more people know about the illness,” she said.

Looking back at my early childhood it is evident that I had bipolar, but it wasn’t until I was 24 that I was officially diagnosed and began my years of trial and error of medications.
Even TV shows are featuring more accurate portrayals of bipolar disorder. “In the past, people with bipolar disorder were practically frothing at the mouth,” Fast said. Today, writers and producers make it a point to get it right. Recently, Fast served as one of the advisors on the hit Showtime series “Homeland” and talked with Claire Danes about her character’s bipolar disorder.
While information has gotten much better, many misconceptions still exist and endure.
Below, you’ll find five persistent myths about bipolar disorder.

1. Myth: Bipolar disorder and depression are completely different diagnoses.
Fact: Bipolar disorder and depression — also known as unipolar depression — are not completely different illnesses, according to Francis Mondimore, MD, associate clinical director of the Department of Psychiatry at Johns Hopkins. In fact, he believes this is one of the most misunderstood ideas about bipolar disorder. (He blames psychiatrists for the misconception.)
Patients who believe this myth may oppose the diagnosis “if they don’t have the full-blown ‘manic-depressive’ picture and also resist taking “bipolar” medications like lithium,” said Dr. Mondimore, also author of Bipolar Disorder: A Guide for Patients and Families.
It’s more accurate to think of bipolar disorder and depression as “probably represent[ing] two ends of a spectrum of illnesses,” he said. “The designation ‘bipolar II’ has helped crack this a bit, but this is why the term ‘bipolar spectrum disorder’ continues to gain ground,” he said.

2. Myth: People with bipolar disorder experience dramatic mood swings followed by complete remission of symptoms.
Fact: Some people with bipolar disorder experience this pattern, Mondimore said. (Lithium is typically very effective for these individuals, he said.) However, “Many patients have periods of residual symptoms and less severe but still significant mood fluctuations between episodes of more severe symptoms,” he said. This is especially common if people don’t engage in healthy habits to manage the illness.

3. Myth: Medication is the only treatment for bipolar disorder.
Fact: Medication is an important part of managing bipolar disorder. But it’s not the only answer. Viewing medication as your only treatment option “can lead to fruitless reaches for the ‘right’ medication,” Mondimore said. And it can lead you to avoid making valuable lifestyle changes and seeking therapy, he said.

As Fast writes on her website, “Medications take care of half of the illness, the other half is management.”

Both Fast and Mondimore stressed the importance of leading a healthy lifestyle, including avoiding alcohol and drugs, cultivating good sleep habits, exercising and effectively coping with stress.
Fast includes medication and alternative therapies as part of her treatment plan. Still, she cautioned against thinking “that we can exercise, diet, meditate, walk and rethink our way out of this illness.” (In fact, this is another big myth that persists, Fast said.)
Think of bipolar disorder like any other long-term illness, such as diabetes and high blood pressure, Mondimore said: It requires commitment and comprehensive management.

4. Myth: After having a severe episode, people with bipolar disorder should be able to bounce back.
Fact: If a person with bipolar disorder experiences a severe episode — one that requires hospitalization, for instance — there’s an expectation that afterward they’ll be able to get back to their work and life, Fast said. However, she equated this scenario to people who’ve been in a car crash. You wouldn’t expect someone with broken bones simply to get up and start sprinting.

5. Myth: People with bipolar disorder aren’t trying hard enough.
Fact: People wonder why someone with bipolar disorder just doesn’t try harder. They think that if they exert more effort, they’d have the life they want. They wonder why everyone else who experiences mood swings can cope with them but someone with bipolar disorder can’t. Sometimes Fast has even wondered the same thing about herself.

But this implies that bipolar disorder is a choice, she said. “Would you ever say that to someone with diabetes or pneumonia?” she said.
People just don’t realize how serious bipolar disorder is, Fast said. Thankfully, though serious, it’s highly treatable. Managing the illness is hard work, and finding the right medication takes time. But as Fast said, “Keep trying. Never give up.”