16 thoughts on “The Elephant In The Bipolar Room

  • July 23, 2012 at 9:12 am

    I like theory, Tom and I do think it is possible to be highly functional during manic phases and manage the depressive phases with medication and exercise. The fact is we are always responsible for our behavior no matter what cycle we are in. It is our life, our actions and our consequences to deal with. Having BP does not excuse us from being responsible. Responsibility =control and anyone with BP understands the struggle to stay in control.

  • July 23, 2012 at 3:55 pm

    I’d like some numbers to give me perspective and to see if this is something I want to explore. What percentage of people who have completed the training are able to stay in-order long term (5+ years)? How many/percentage of former followers return to the traditional treatment method within 2 years? While the unemployment rate of bp people is quite high, what percentage of bp people who follow your methods are able to return to work? If you could either link me some of your information or post some stats that would be awesome.

  • July 23, 2012 at 7:21 pm

    I’m delighted to find your post, Tom. I’ve been asking the same questions but from a different perspective.Although your post provides more questions than answers for me, I’d like to share my experience and get your (and others’) opinions.

    I have bipolar II and take SSNI/mood stabilizer faithfully. I am highly functional, but I haven’t always been. Finally, 25 years after diagnosis and a zillion meds, I’ve figured out how to cope with the (sometimes severe) depression using meditation and mindfulness techniques. I control my behavior – and if I think can’t, I disengage until I can again.

    But here’s the issue: I still go through seasonal depressions in which my *body* acts depressed – no energy, sleep and appetite issues, a few phobias, etc. However, my *thoughts* stay upbeat and positive and I push through as best I can for a few months until my body feels better. During those times I’ve disconnected my body from my mind and spirit. Is that a negative or positive state? Sometimes it seems negative: I fail to recognize cognitive issues (memory, concentration, withdrawal, comprehension) that other people see which keep me from being truly functional at a high level.

    I’ve never found a psych doc who understood how this happens, let alone help me figure out the best way to manage the situation. Thoughts?

  • July 24, 2012 at 2:32 pm

    I have bi-polar. I’ve been on meds for about 20 years. In my humble opinion, this is so unfeasible as to be ridiculous for most cases of bi-polar.

    When I’m depressed, I can do anything. Smile, host a dinner party, listen to a friends dismay that her favorite contestant didn’t win American Idol. But it comes at a real cost.

    It’s like living off of your credit cards. Deficit behavior. I can do it, but I pay. And, sometimes I crash. And the crashes come fast, hard and are truly life threatening. Luckily, I’m suicidal and not homicidal.

    Sometimes my anxiety is so severe (my mania is mostly an anxious feeling) that I can’t even figure out what do to with the shampoo bottle in the shower.

    And, that’s on a decent med regimen with near 100 percent compliance.

    So, it sounds cool, like Tesla’s ideas sounded cool. But I think they are just as impossible.

    Imagine the societal controls necessary to prevent the horrendous results of the inalienable reality that people who are bi-polar lose control. I’m a very strong willed person. I have great control. I put on a great front. But in my head, I burn in a hell of anxiety and pain and I suffer an inner dialogue that would put most horror films to shame.

    • July 26, 2012 at 3:19 pm

      I understand completely, and agree that although I
      can carry on in life as though everything is okay
      it is a real struggle of turmoil inside that is
      sometimes overwhelming. A few good days but more of
      the other…I used to work extremely hard in the
      medical profession and loved it, staying in mania most of the time. My employers and co-workers loved
      it because I did twice as much work as the others..
      I thought I was in control, and although I was working with physicians they let me work that way
      and so did my co-workers…Until one day I over did
      it and hurt my back. That was it, and then they fired me after 15 years of faithful service. I crashed for awhile and then did many other things for half the pay, but the hard work and dedication only hurt me physically and almost destroyed me emotionally. I would never work for another person again,,with them telling me what my limits are when
      they don’t know what my limits are. My limits may be all out this morning, and 3 hours later they may be 10%. I choose to go with NO STRESS and live a safe life, and not get thrown in jail for snatching someone bald headed which I have wanted to do on occasion…only God prevented it and got me away.
      Yes, I have been suicidal and my mind does go there
      but God keeps me in His Hands and His time, and my
      respect and love for Him will not let me go be with
      Him before He says it’s time. I take some meds..
      My age is 61…glad social security is there for me
      as I need it and certainly paid my share in, however, the new methods may work for the younger folks who haven’t already been through hell with
      this illness. If I put down everything that has happened to me because of bipolar people wouldn’t believe it…Not feeling sorry for myself here, just being truthful and speaking my testimony from
      the experience of one.

  • July 26, 2012 at 12:53 pm

    Interesting to a point.
    ‘BUT’ If we the sufferer’s of Bipolar were able to control our mood swing’s we then would not suffer or be medically diagnosed as having Bipolar and we would them have made mind control possible even though it may only be in relation to our own.

    • July 26, 2012 at 1:47 pm

      In my opinion, bipolar is like any other medical condition, say, type 1 diabetes. When your pancreas malfunctions, you take insulin to compensate. When your neural receptors malfunction, you take antipsychotics/mood stabilizers/anti-anxiety meds/ antidepressants/stimulants/whatever. BUT, a type 1 diabetic has to be extremely vigilant about making the right lifestyle choices(food, sleep, exercise, stress, etc.). If they don’t, they get sick. Same for us.

      But it’s more than that – as a bipolar, we must also make the right “thought” choices. It’s very, very difficult, but not impossible with meditation, practice, and a great deal of self-awareness and work.

      I’m not saying that I can completely control my emotions. I still go through depressions. But I don’t suffer the way I used to. And I don’t use my emotional swings as an excuse to abuse the people around me (or myself). I recognize what I am saying or doing that might be misunderstood or hurtful, and then–crucially–I recognize that the source is biological and not emotional. Then I take the appropriate response, whether it be walk away rather than continue an argument, or go meditate to deal with stress, or call my doc for a meds adjustment. And if I find myself unable to let go of negative or self-destructive thoughts, I recognize that those thoughts are not “real.” That hateful or suicidal person is not me. It’s my neural network reacting to over- our under-stimuli, and I can’t control that. But I CAN control how I react. I distract myself (sometimes Klonopin and a day-long nap) until the neural disruption passes and I can function again. It CAN be done. But you have to be willing to give up feeling like a victim, thinking you have no control, and using your emotions as an excuse. You have to be proactive, and not passively react.

      I know. I thought the same thing for 25 years (I’m 51). Let the hate mail begin.

      • July 26, 2012 at 2:09 pm

        Thank you.
        I do not disagree in any way whatsoever.
        i actually wrote something in reply to a post that someone made ( not here ) although the writing requires a lot of work.
        It actually concerned self help.
        Whereby i inferred that the individual should have something to occupy their mind when a mood change occurred-something strong enough to drag them out of bed and help beat the depressive thought’s.
        Farther to this i do not agree that we approach depression correctly although it is a terrible illness and this theory got me a lot of hate mail.
        I personally can control most of my mood’s depth although not 100% but only with the help of medication, simply because i learned long ago that i had to or my life would be controlled by medication and Bipolar.
        People don’t seem to realise that we can do more than we believe in controlling the severity of our symptom’s simply because they do not know how or where to begin.
        I am 54 and have suffered from Bipolar for over 40 year’s.
        Your writing’s are excellent and appear to be great debate issues-agree or disagree you keep the subject alive and people may not realise it at the time but you have made them think which keep’s them occupied

  • August 8, 2012 at 11:55 am


    I am BP2 and I have not been on medication for 5 years because 1) If I take medication I expect it to prevent mania and depression. It did not. 2) It made me so sick I couldn’t function anyway.

    I do not pass judgement on anyone. If medication helps you, please take it. I tried different combos with negative results. When I started having memory lapses, I stopped taking everything but my anxiety meds, cause I really need those to function or my anxiety is so bad I am worthless.

    I fully believe I can function when manic, and I sort of have trained myself to do so. It’s not completely effective, and I still do ridiculous things, and I pay for them, but that happened when I took medication, so it made no difference.

    I would agree that when depressed, I don’t think there is any type of therapy to make me functional, but if there were, and it didn’t require me to put something in my body, I would be the first to sign up.

    • August 8, 2012 at 4:46 pm

      Thanks for your comment Miss Shark, You can sign up now at http://www.bipolaradvantage.com because we teach exactly what you are asking for – how to be highly functional in both mania and depression. The only requirement is to believe that it is possible.

      • October 4, 2012 at 11:30 am

        I have BP2 and totally agree. I am high functioning and medicated, but I’m responsible for all my actions, even if the disorder made it more likely I would act. I have choice, habits can be learned, sober second thought can be learned. It’s a pain the neck sometimes but when I find myself excited about a purchase or some other change I give myself a couple of days and talk to friends about things to make sure its a good decision rather than committing impulsively. I have a job, even when I’m depressed work still has to be done, I still have children to feed. So yes, sometimes it’s still surviving and for me with high functioning BP2 I can do this through depression, but it’s me – and my decision not to make snarky nasty comments is mine. However. I don’t know that we know eveery individuals chemistry. I don’t know that we know every individuals place on the “spectrum”. How can we be sure? For me, the elephant model you suggest works. For others? Perhaps its more a case of the current model not being “incorrect” but rather too narrow?

  • August 31, 2012 at 11:25 pm

    I like this article, it poses some very interesting ideas. I agree that the current medical model is controlling, containing and in many cases simply unhelpful to a mentally ill person (I don’t like the word “ill” but I am tired of searching for new words!) So what if we accepted that states of mania and depression were acceptable and not something to be removed. Yes people with these “symptoms” would be held responsible for actions and they would not hold the title of being “disabled” as they are now. (I am bipolar so I will include myself here.) Certain issues arise as important if we accept this hypothesis – one – there is a coninuum with all mental illnesses. That is, some people deal with more depression, mania, anxiety, etc on a daily basis than others and this is important. I am one who, without medication, can become very psychotic to the point of endangering my life very seriously. So, yes, I understand that part of my mania as depremental to my health and I rely on medication to control these spells. Others might have less severe symptoms and their mania might fair better without meds, without outside control. We are not all the same, so these issues are hard to make universal. I believe there is a place for meds and alternative treatments. I might be dead without them.
    Finally, let’s look at how we can change things NOW. What we need are therapists (and of course psychiatrists but this is unlikely to happen) to bridge the gap between the current model with it’s heavy emphasis on medicine and labels, etc. to one of freedom from the whole system and client independence. I had a therapist (who saved my life) who said to me that he didn’t accept my diagnosis. It was the most liberating statement!!! Without his help, I wouldn’t be where I am today.


  • September 2, 2012 at 11:35 am

    I have often proposed a similar hypothesis. I am amazed at how many chat rooms and forums are chock-full of complaints about broken marriages/relationships, lost jobs, criminal history and financial ruin “because of Bipolar.” I say rubbish-you CAN learn to manage these intense emotions and fluctuations WITHOUT medication if you put the work in. To blame Bipolar for all the mistakes in your life is basically saying that you are unwell all the time, which obviously you are not. If mistakes are made, they can still be learnt from and avoided in the future-just like anyone else.
    Of course it does take a good long look at yourself and taking some personal responsibility for your actions/behaviours, AND extricating oneself from the victim mentality we are bombarded with. This is NOT easy, but something I have done, and I totally agree-you CAN function perfectly well WHILE experiencing “mania” “depression” “delusions” “psychosis” “anxiety” or whatever IF you have researched the coping strategies to do so. I know for a fact that there are literally thousands of people doing this every day, with or without meds, and though I am Bipolar 1, and permanently hear voices, I work fulltime and lead a very happy and fulfilling life BECAUSE I choose to.
    These theories of organic, physiological, biological disease are NOT proven, but they certainly allow people to wallow in self-pity and make excuses, which I also used to do, until I did my own research.
    Personally I believe my Bipolar to be psychologically-based, and a part of me rather than something that happened to me, which allows me to accept it, work with it (not against it) and get on with life.
    There are countless alternative methods of managing these experiences, and if this just happens to be the way many of us are “wired” so be it. Bipolar is only an illness when poorly managed and people don’t learn the lessons from the past to prevent repeating old behaviours. Very thought-provoking topic.

  • September 26, 2012 at 2:21 pm

    I’ve never heard anybody say anything similar about depression, which dominates the experience for a lot of people. I can see how this would work for some, but to start from the assumption that everybody has an equal capacity to deal with pain or with ideas that interfere with functioning, or with complicating factors like sped-up/depressive anxiety or OCD or job-threatening ADD, seems awfully unimaginative. One commenter says that when things get bad, he spends a day napping, and I feel ljke this theory kind of starts from the same place, with a basic assumption that people have jobs that give them room for something other than straitlaced, one-track, punctual functioning. You can be half-dead at these jobs, but you can’t be unable to remember more than half a sentence at a time.

  • January 5, 2013 at 2:29 pm

    while I agree that being bipolar is not an excuse for behaving one way or another… responsibility is key to living in recovery … however it is ridiculous to suggest that a true bipolar patient can chOose not to be manic or depressed in the midst of an episode any more than a heart patient can choose not to have a heart attack in the midst of one… certainly both patients have to be responsible in how we live our lives, eating properly & taking meds as prescribed… I am a high functioning type 1 bipolar. it is a disease often genetically predisposed. my grandfather, father, & uncle were all very successful men, famous even, & all committed suicide… because they couldn’t choose to not be ill, & failed & or were unable to get help…the stigma was a death sentence.. the belief that they could or should simply choose to control. that same belief almost killed me until I accepted that I had an illness & took the responsibility to get help & take my medication

    • January 5, 2013 at 2:36 pm

      Thanks for your comment Gisella. I wonder how you define “high-functioning type 1 bipolar” in the context of your comment. It sounds like you still have symptoms outside of your ability to function. I, and many that I have taught, function very highly while deeply depressed or highly manic. Calling us ridiculous for having such understanding is the ultimate form of stigma.

      You might find the article at http://blogs.psychcentral.com/bipolar-advantage/2013/01/measuring-functionality-in-depression-and-bipolar-disorder/ informative about what high-functioning means to those of us who function DURING mania and depression.


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