I often wonder what people – those who do not know the intimate details of his struggle with mental illness – see when they look at my husband.

Surely they notice the times when he’s sleeping through family get-togethers, when it’s obvious that he hasn’t shaved or probably showered for quite a few days or weeks on end, when he gazes in their direction without the slightest hint that he understands anything they’ve just said to him. Just a bad day, they think. Maybe he’s working too much and needs to catch up on his sleep.

I know they don’t see these times: when he’s raging, so confused that he doesn’t even know where he is, convinced that his wife is his mortal enemy trying to stifle his creativity, or as he calls it “squashing all my ideas.” No, they don’t see this; it’s reserved just for me. I’m so special! They don’t see this because it’s right before I drag him off to the doctor for a med change.

Depression is almost his identity in some circles, with intermittent breaks of quick wit, a happily helpful attitude, a hard worker although at times easily distracted by details, and a tendency to take on more obligations than he has time for.

I wonder what they think when they see me, sitting next to this catatonic man like it’s the most normal thing in the world to be snoring through church, requiring him to ask before making a purchase, whispering to him at the New Year’s Eve party that half a glass of wine is indeed enough for him. I wonder if they think, no wonder he’s depressed…she’s such a nag, such a control freak, and why doesn’t she wake him up, for Goodness sake!

They don’t understand that this system of checks-and-balances, and at times, turning a blind eye, is in fact agreed-upon by both of us, that this is what we’ve found that works to make “us” work. I know a little of what they think – I’ve heard it a couple times from naïve therapists he visited prior to his diagnosis, and I’ve heard it a few times since, from those out-spoken enough to comment on our relationship quirks.

They rarely see the manias, but the depressions occur often enough and long enough that they’re hard to hide. They might think he’s just that way, but then they see the stable moods, sometimes pushing a gregarious and cheerful hypomania, so they think that there must be a reason – an external factor – that’s causing him to act so depressed when he does. Then, they see me trying to maintain a constant balance between too soft and too hard. To them, I’m sure, it looks as if I can’t decide whether to “act like his mother” or to “ignore his antics.” What I’m doing doesn’t appear to make sense to outsiders, and behavior that doesn’t make sense signals “crazy.” So, in their minds, I suppose my husband acts the way he does because I’m the crazy one.

This used to bother me quite a bit. I didn’t ask to be put in this position. They’re not seeing him when he’s obviously out of control. For the longest time, I wanted to be acknowledged for the sacrifices I’ve made to stay in this marriage – namely the sacrifice of my outward appearance of “a great wife.” I wanted those who blame me to grovel, or at least apologize, and give me credit where credit is due. But that never happened, even when they learned what was really going on.

A huge part is this misconception of what bipolar disorder and adult attention deficit disorder really are. Generally, it seems people have one of two different views of bipolar – either you’re a homicidal maniac, or it’s just a little depression mixed with some ultra-fun times – and the overall view of ADD is that it’s an overdiagnosed childhood disorder imagined by quack psychiatrists to give an excuse for those kids whose parents didn’t give them enough discipline to be able to sit in their desks at school. I think that in an effort to de-stigmatize mental illness, what’s been fed to the media is a watered-down version of what’s going on with these disorders. We want people to seek help, unabashed, so let’s not give them the full picture.

Celebrities “come out,” admitting that their recent retreat was actually a stay in a mental hospital for the treatment of depression as part of their bipolar disorder. But do we hear what that depression really looked like? Other well-known figure heads get on TV during commercial breaks and tell us that it takes an average of 10 years for someone to be correctly diagnosed with bipolar disorder. But do we hear what those 10 years of bipolar hell look like? I remember, years ago, seeing ads from a pharmaceutical company advising depression patients to talk to their doctors about their “up” moods. But do we hear exactly what these “up” moods look like, that’s it’s not some constant party with a little over-the-top charging to the credit card and higher-than-usual energy?

On the other hand, popular TV dramas like to portray those with bipolar as ax-wielding psychos.

What we need is a revolution in society’s view of mental illness. And I do think we’re getting there, slowly. A few less unrealistic TV dramas might do some good, but with celebrities coming out of hiding, it’s helping. It’d be better if they could give a few more of the gritty details of their illness – that the depressions aren’t just bad days but actually crippling, that the manias aren’t just super fun times. We need more recognition of the role these disorders play in relationship troubles, substance abuse and other addictions, cases of domestic violence, college drop-out rates, bankruptcies, virtually every part of our lives. We need adult ADD added officially to the DSM.

I think the recent lifting of the taboo of diagnosing children with mood disorders will help. It’s alarming to see the increasing numbers of children being treated for psychiatric conditions, and it won’t take long for officials to want to get to the bottom of it…and then to hopefully follow the concern up through the adult generation.

In many ways, there has never been a time with so many effective treatments for and recognition of mental illness. But in some ways, we’re still living in the Dark Ages of understanding.

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Management Options in Bipolar Disorder – MedIndia - Medical treatment News (December 10, 2011)

    Last reviewed: 10 Dec 2011