Stigma matters. As a psychiatrist, I’d love for people to realize just how much it matters.
Stigma — negative and often untrue beliefs society holds about someone or something — impacts the thoughts and feelings people have about those who have certain health conditions. While these negative attitudes can be hurtful for anyone with a health condition, they have broader and more profound effects for those living with bipolar disorder and their loved ones. They can worsen a person’s mental, physical, and social well-being.
In other words, the stigma associated with bipolar disorder can actually make both the symptoms and impact of the condition worse.
We can change this.
By improving the public’s understanding of bipolar disorder — which affects 2.8 percent of the U.S. population, according to the National Alliance on Mental Illness — and being conscious of the words we use when talking about it, we can help promote healing instead of judgment.
First, What Is Bipolar Disorder?
Bipolar disorder is a mental health condition in which people experience intense shifts in mood, energy, activity level, concentration, and ability to carry out daily activities.
These shifts in mood — called mood episodes — can last several days to weeks at a time. Bipolar mood episodes are either manic (defined by elated or irritable mood as well as increased energy and behavior), hypomanic (a less severe version of a manic episode), or depressive (defined by low mood and decreased energy and activity).
There are several types of bipolar disorder — bipolar I, bipolar II, and cyclothymia — all of which manifest symptoms somewhat differently. Alternating episodes of mania and depression are typical of the disorder overall, but different types are associated with more manic or depressive episodes, and vary in the frequency and intensity of episodes.
The ‘What’ and ‘Why’ of Bipolar Disorder Stigma
Stigma in mental health is when someone views a person in a negative way because they have a mental health condition. When it comes to bipolar disorder stigma, many people make negative assumptions about individuals with this condition merely because they have the condition.
When people stigmatize a disorder like bipolar disorder, they tend to over-identify a person with their condition. That means they think the person’s condition is the most important or defining thing about them instead of just being a condition they have.
Stigma comes in two major forms:
- Public stigma How members of a society view and act toward someone with bipolar disorder.
- Self-stigma How people with bipolar disorder feel about themselves. Self-stigma can happen when someone with bipolar disorder starts to internalize the negative views that society holds about them.
Both forms of stigma can have a profound impact on those with bipolar disorder. According to research published February 16, 2022, in the Australian & New Zealand Journal of Psychiatry, stigma can lead to:
- Increased bipolar symptoms
- Decreased chance of receiving bipolar disorder treatment
- Worse work-related outcomes
Stigma exists for all mental health conditions. But in my experience working with people diagnosed with a variety of mental health conditions and their loved ones, a couple of things have stood out to me as to why bipolar disorder is associated with so much stigma.
Bipolar Disorder Is Misunderstood
The media often depicts people with bipolar disorder in a seemingly out-of-control, dangerous, and manic state. In reality, most people with bipolar disorder spend the majority of their condition in a depressive state. The percentage of time people living with bipolar disorder spend in a depressive episode is three times higher than the amount of time spent in a manic episode, according to a study published in Bipolar Disorders.
Additionally, bipolar disorder consists of several potential symptoms that can range from mild to severe. Assumptions about how someone’s condition impacts them and their behavior are problematic, because two people both diagnosed with bipolar disorder can have distinctly different experiences.
Lastly, having bipolar disorder does not mean someone is “moody,” “unreliable,” “flighty,” or “dangerous” — all common stereotypes about people with bipolar disorder. As a psychiatrist, I hear many people call someone else “so bipolar,” meaning the person is “hot and cold” or “unpredictable.”
This use of the word “bipolar” is both wrong and harmful for several reasons. First, bipolar isn’t a character trait; it’s a disorder a person can have.
What’s more, bipolar episodes don’t just come and go throughout the day; rather, they’re extended episodes that cause a person to think, feel, and act in ways that are much different from how they usually would. Most people with bipolar disorder say they don’t feel like themselves when they’re having a manic or depressive episode, and often feel saddened and embarrassed by their behavior once an episode is over.
Many People Have Difficulty Empathizing With Someone With Bipolar Disorder
Even though a person without a mental health condition may not know exactly what certain mental health conditions — say, major depressive disorder or an anxiety disorder — feel like, they’ve likely felt at least some of the symptoms of those conditions, such as feeling down or hopeless or worrying about something so much it affects the way they feel physically.
But bipolar disorder is a more unique experience, and most people cannot imagine what it’s like to experience mania. On one hand, they may falsely romanticize it and expect it to be wonderful to have seemingly endless energy. On the other hand, they may falsely scandalize it and expect someone with mania to be dangerous or violent.
In reality, neither of these reflect what it’s really like to have this condition.
As a result, it may be easier for people to relate to or empathize with those with depression or anxiety than those with bipolar disorder. And instead of viewing the behavior of someone with bipolar disorder with care and compassion, a person may look on with judgment.
But the next step in destigmatizing mental health conditions is to offer grace even when we don’t relate to the experience. In short, you don’t need to totally understand something to be understanding.
4 Ways We Can Better Support People With Bipolar Disorder
So how can we commit to destigmatizing bipolar disorder? Here are some actions you can take starting today.
1. Choose Your Sources Carefully
Unfortunately, entertainment media — whether social media, TV shows, or movies — are often not trustworthy sources of mental health information. So when you see celebrities with bipolar disorder being talked about on social media, or a made-up character on a show, realize that the information being shared and assumptions being made about bipolar disorder are very likely false.
Instead of consuming and reposting false information, look for more trustworthy sources of information. If you’re looking for places to turn, try the National Alliance on Mental Illness (NAMI) or the Depression and Bipolar Support Alliance (DBSA).
Alternatively, consider reading a memoir such as An Unquiet Mind by Kay Redfield Jamison, PhD, an author and clinical psychologist who herself has bipolar disorder.
2. Don’t Make Assumptions About Someone Because of Their Diagnosis
Keep in mind that all mental health conditions, including bipolar disorder, have a range of potential symptoms and severities. The way one person experiences a mental health condition may be very different from the way someone else with a similar diagnosis experiences it. Don’t assume that because one person has certain symptoms, this will be the case for everyone with the condition.
It also helps to keep in mind that certain behaviors, such as violence or outbursts by celebrities with mental health conditions, are more likely to make the news than the more typical — but often less “newsworthy” — symptoms of bipolar disorder.
3. Realize That Your Words Matter
Because bipolar disorder is so misunderstood, you might not even realize that someone you know either has or is close to someone with the condition. The words you use to talk about bipolar disorder or people you see with the disorder, like celebrities, have a lot of power.
The old adage “Think before speaking,” is an important one!
4. When in Doubt, Extend Kindness
When a person has severe bipolar disorder, it can impact their life in big ways. For instance, a severe manic episode can strain relationships and have consequences that may persist long after the episode is over.
You may not truly understand this or know how to separate someone’s behavior when in a manic episode from their true self, but you can choose to be kind. This may mean educating yourself about bipolar disorder so you can better understand, avoiding making judgmental statements about bipolar disorder, and reminding yourself and others not to make assumptions about someone’s condition.