Labels & Contexts

By Rachel K.

They all call me a high-functioning bipolar. “They” are psychiatrists, psychologists, doctors, and researchers; the people who make the labels. I’ve officially been a high-functioning bipolar since the fall of 2006, when my erratic skipping between the realms of mania and depression became impactful enough for me to say, “Something is terribly wrong” to myself. Sadly, this was weeks after my family had already been saying this. But it’s only when you say it to yourself that you can say it to the professionals who can help you.

image of a waiting room

After weeks of labeling myself as simply “wrong”—wrong for drinking too much, wrong for not going home, wrong for being preoccupied with various random obsessions, wrong for sleeping no more than three hours, wrong for not being able to stop crying, wrong for feeling alone in crowded rooms, wrong for planning my suicide—I welcomed the new label of “high-functioning bipolar” with delight. It came with these shiny, organized pamphlets that described my unexplainable actions and feelings over the previous months (and years, upon reflection). It came with the beginning of forgiving myself for throwing a grenade into the middle of my life and all who moved within it. And it came with medicine that could help. Yeah, high-functioning bipolar was just dandy, thank you, doctors.

As I got better and learned to live a lifestyle that supported my high-functioning by managing my bipolar, I started to think about that label more. How should I feel about the pairing of those two words? Maybe I was high-functioning for someone with bipolar, as in, “Boy, she really gets shit done despite being all nutty and stuff.” Because I do get shit done. Or maybe it was dismissive of my struggle, as in, “Yeah, she’s bipolar, but not that bipolar. She’s still functioning. Like, a lot.” Because sometimes I am bipolar, but not that bipolar.

But sometimes, I’m super bipolar.

A good example of super-bipolar was four months after I had my second child. I had my first and high-functioned my head off by starting a doctoral program, building new friendships, making handmade Christmas cards, baking homemade bread… Bipolar? Pffft. But my son came into the world with a lot of drama, and a lot of emergency decisions, and then a lot of drugs. I remember talking to my sister-in-law from my hospital room hours afterward, while I tidied up my things and put on high-functioning make-up. “You sound really good,” she commented, and I could hear surprise in her voice. And it was no show; I felt really good.  I had just experienced the miracle of life! I had a newborn baby to add to our family! The surgery had gone well and the drugs minimized the pain! (And I was beginning a bipolar mania!)

I was in the high stage, in which everything is possible and transcendent and I am so full of ideas and joy and pretty much every breath makes me excited for the next. It’s an ecstatic state. And after twenty hours of labor ending with an unconscious slicing of my belly, ecstasy was maybe a little… surprising, yeah.

Several weeks later came the low stage, when every morning I woke to a weight on my chest that told me I could not do this thing they called life. When I am there, hopelessness pushes every other sensation out of my mind and body. I cannot find my joy, to the point that I convince myself that surely I have imagined anything resembling it. It is here that I become convinced that my family would be better off without me.

And it is here where the label confounds the doctors as well. At the valley of that low point, I sat in a chair across from the woman who ultimately saved my life (that time). She had the job of deciding whether or not I needed to be hospitalized. I was diagnosed as bipolar; I was suicidal; I had a plan. All of that should have sent me in. But I had a newborn and a two-year-old to think about, and parents just a few blocks away who had dropped everything to circle the wagons, and a husband who was willing to be on exclusive night duty with the baby so I could regulate my sleep patterns. And I was high-functioning, dammit, with a household to run and a dissertation to write.

What do you do with me then? Well, when you’re amazing you get me on Lithium, meet with my family to make safety plans, and send me home as I wish. Then you call me twice daily to make sure you made the right call. She told me later she was terrified about that decision. So you see, labels are tricky, even for those who use them.

But I’ve realized something as I oscillate between these two identities. The truth is, the high-functioning isn’t a caveat for the bipolar, nor the bipolar for the high-functioning. They are a single unit, and I don’t need to prove my case about either one. I am both.

When I can’t stop crying as I fix my family a well-balanced dinner, pack lunches, and answer emails, I’m both. The fact that I function doesn’t stop my tears from scaring my children about their mommy, and I don’t ever get those hours with them back. But the fact that I’m bipolar doesn’t make their carrot sticks and baked tofu any less healthy, make my response to the email any less helpful, nor negate the lesson I am teaching my kids about how sometimes our feelings are not rational and we need to muscle through them to do the right thing as best we can.

When I am sitting in psych ER at nine in the evening in the middle of teaching an intensive summer course at a prestigious university, I’m both. The fact that I function doesn’t stop the hospital staff from confiscating my things for fear of self-harm while I wait to see a doctor in a room full of people who look like they’ve seen the side of the curtain that I see. But the fact that I’m bipolar doesn’t change the fact that I get up the next day and teach twenty-five masters students for six hours and ultimately receive glowing reviews of my course, nor the lesson I learn that I can get emergency help without totally imploding my life.

I’m both.

So I am sort-of done with that question, and on to a new one. Yes, I am a high-functioning bipolar, and I am many other things. I am wealthy. I am employed with health benefits. I am well-educated. I am housed, luxuriously. I am free of addiction. I am safe from everything but myself. I am, to be clear, a high-functioning bipolar within a context of privilege, surrounded by caring, supportive family and friends who also exist in that context of privilege.

My next question concerns the same label, though. When I drive by the homeless man who sits at that exit ramp day after day no matter the heat or cold or precipitation, or when I walk by the man who is talking to himself outside of the hipster restaurant where I meet my friend for lunch, or when I read about the kid who went through with it as a teenager and didn’t live to blog about his struggles with bipolar… I wonder.

What are they?


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