Should We Be Concerned with the Label, Bipolar Disorder?

Labels, labels, labels. There is an unending narrative on how bad labels are. We shouldn’t label people, we shouldn’t be judgmental. We should just accept people how they are.

Contrary to that opinion, labels are pretty important, especially when it comes to identifying, treating, and recovering from mental illness.

The most common example I can cite is the misdiagnosis of Bipolar Disorder as Major Depression. The distinction between these labels is vitally important. Why? Because if a doctor treats a Bipolar person as though they had Major Depression, there is a strong chance that person’s brain is going to run screaming into instability and chaos. How can people know which is which? By looking at the label and analyzing the behaviors of the person in question.

Time and again, I hear people scream about how the DSM is awful because it tries to categorize mental illness. “I’m not my mental illness!” “I can’t be defined by a book!” This narrative misses the point. It’s so medical science is on the same page in how they are working towards treatment.

“But these labels are used for people to point the finger and look down on us!” So? If it wasn’t your mental health; it would be your sex, religion, race, economic background, or political background. I don’t know when the last time you cracked a history book was; but humanity has always found reasons to hate and look down on one another. The idea that we can all get along, all be accepted, is ridiculous. There are literally tens of thousands of years of precedence that demonstrate this.

The world can’t be changed because it does not want to be changed. This is why we celebrate great and kind thinkers. This is why we quote Gandhi, Dr. King, Mother Teresa, and other humanitarians. They stand out because they are a light in the bleak sea that is humanity.

What we can do is change the way we view others and relate to ourselves. It’s not the label that is trying to do harm to another person when used in anger. It’s the person using it. Forcing people to stop using a word we don’t like does nothing to address the actual problem of the person using it.

I can’t tell you how many times I’ve been told by other Bipolar people that I shouldn’t say “I am Bipolar.” Even though “am” includes the definition of “having the quality of,” as in having the quality of Bipolar Disorder. These people are often struggling to find their own identity, to separate themselves from their mental illness. Quite often, they have life experiences where those words were used as weapons against them. They think they are helping to end stigma by trying to alter the words people use. And more than a couple of them expressed I would feel better about myself if I did.

The assumption is that because I use a phrase, I must not feel good about myself. That isn’t about me. I know they are transposing their own journey, suffering, and pain on to me. I think they normally have good, if not misguided intentions.

I’m at peace with myself because I understand myself. I don’t have the internal conflicts that racked up massive casualties in my mind like I used to. I understand Bipolar Disorder. I understand how my mental illness affects me. I know how to respond to the problems it gives me. And I use my pain for something positive, which makes it worthwhile in my eyes.

So, no. We are not our mental illness. Our mental illness is just one facet of who we are. Putting the responsibility of our own happiness and peace of mind on everyone else is a sure recipe for failure. That’s a lot of responsibility to put on someone else.

The final thing I would like to point is that the waters are typically gray and murky around these labels. Many of the loved ones of the mentally ill that reach out to me believe that they can look at the label for a mental illness and understand how that person functions.

Sort of, but not really. Essentially, it can serve as a rule of thumb for what the person could possibly experience; but the way it comes through is going to entirely depend on the mentally ill person. It’s a circumstance where things look one way on paper but function differently in practice.

As an example. The difference between Type 1 and Type 2 Bipolar Disorder is psychosis. I identify as a Type 2 Bipolar because 99% of my unwellness and unwell cycles have not included psychosis. However, the time immediately after the Disorder started emerging in me and the time that actually prompted me to get screened for mental illness would have fit Type 1 psychosis criteria.

Similarly, I had a full-blown anxiety attack while I was coming down with the stomach bug I recently got over. I’ve had about 3 full-blown anxiety attacks in the past 20 years. Would that qualify as an anxiety disorder? No. It’s not really affecting me enough to warrant the need for medication or therapy to cope with it. Anxiety attacks are an anomaly for me.

I regularly see people put more importance on Type than is warranted. It’s not really that important because the DSM is mostly a general guideline to get a medical professional in the ballpark. Medication and treatment addresses the symptoms of mental illness that are out of control in an individual.

Let me give you an example.

The first is myself. I’m a Type 2 Bipolar with a severe Depression component. I spend probably 80% of my time in some form of depression – mild to severe. A mood stabilizer to cap the top end and an antidepressant to bring up the bottom end is a typical treatment.

On the other hand, I have a friend who is also a Type 2. But the way that person’s Disorder manifests is that they spend 80%+ of their time either fine or mildly escalated. The only time that person really swings into a depression is after a post escalation crash, which happens about once or twice a year. For that person, a mood stabilizer makes sense but an antidepressant may not be necessary.

We both have the same diagnosis but the Disorder functions differently in practice. We both require different treatment regimens to address the problems Bipolar Disorder specifically causes.

This why it is so important that we understand how our diagnosis and mental illness affects us as individuals. We each need to find our own peace with the circumstances we were given and not require others to feel good about ourselves. A lot of fear can be dispelled with knowledge. Each of us should learn everything we can about the Disorder so we can identify how it manifests and meaningfully communicate that to our professionals and loved ones.

As for labels used as weapons – shrug and move on. They only have power if you let them bother you. Responding with anger just feeds the ego of the person using it and gives them control over your emotional state.

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