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High-Functioning Bipolar Disorder

January 17, 2011 Natasha Tracy

I have 'high-functioning' bipolar disorder so people think I'm not mentally ill. But the ability to function in public comes at the price of private pain.

Sometimes people don’t believe I’m particularly sick. They meet me, I look fine, I interact, I charm, I wit and all seems, if not normal, at least something reasonably normal adjacent.

And that’s fine. It’s by design. Being a high-functioning mentally ill person, I can’t really afford to run around with my hair on fire. But faking normalcy, happiness and pleasure is a tricky and very expensive bit of business.

Being a “high-functioning” bipolar doesn’t really have a definition, per se. The term indicates that I’m not in a mental hospital, and I do things like live on my own, pay rent, work and whatnot. I would suggest that being “high-functioning” seems to indicate that I can fake not being a crazy person.

High-Functioning Bipolar Weekdays...

It’s really important that I be able to put my bipolar on the shelf. I have to be able to put the crazy away so that I can talk to people, engage in business, produce technical documentation, write articles and so on. I wrote about 12,000 words last week for clients. You can’t do that if you’re pondering where on your wrist the best place to slice is.

...Followed by Low-Functioning Bipolar Weekends

I have 'high-functioning' bipolar disorder so people think I'm not mentally ill. But the ability to function in public comes at the price of private pain.

The trouble is, using all my control, sanity and energy during the week to try and produce enough work to pay my rent then leaves me with a really large deficit when I’m not working. I’m crazy. Remember? Not normal? I’m just faking the normal. And faking normal requires more effort than you can possibly imagine.

So then, as soon as I’m not working, I break into a thousand pieces all over the tiles on my kitchen floor.

Sure, you go out Friday night with friends. My Friday night is usually spent fairly catatonic trying desperately not to get suicidal.

Bipolar, High-Functioning Or Low, Is Exhausting

As I see it, everyone has a similar tank of energy. We expend that energy in lots of ways. We run after kids, we go to the office, we jump out of planes. All fine uses of energy. Me, on the other hand, I spend a massive amount of energy just trying to keep my brain in one place. I have almost no energy, or brain left, outside of that.

I Give Up a Life to Survive

I do know wonderful people and I do adore them. But that doesn’t overcome the inertia of having every drop of energy sucked from me so I can pay rent. So all the appearance of my functioning is paid for by utter decimation and exhaustion the rest of the time. I don’t have energy or brain space left to read, see friends, date or do pretty much anything else. The last thing I want to do is leave the house. I want to sleep. Forever. And ever.

Bipolar Sucks the Life You Don’t See

I’m the least fun person in the world. I work. I sleep. I have a schedule. I keep that schedule. I’m tired. I make excuses not to go out. I’m sort of the lamest person ever.

But that’s the mental illness sucking the life out of my ears. I want to go out. I want to see my friends. I want to do something fun. I want to have a drink with you after work. I just can’t. I’m too tired.

So yes. I’m capable. I’m talented. I work hard. I produce stuff. Yay me. But the price I pay for that is not being able to be anything else.

You can find Natasha Tracy on Facebook or GooglePlus or @Natasha_Tracy on Twitter or at the Bipolar Burble, her blog.

APA Reference
Tracy, N. (2011, January 17). High-Functioning Bipolar Disorder, HealthyPlace. Retrieved on 2022, August 10 from https://www.healthyplace.com/blogs/breakingbipolar/2011/01/high-functioning-bipolar-disorder



Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate, and author of Lost Marbles: Insights into My Life with Depression & Bipolar. She's also the host of the podcast Snap Out of It! The Mental Illness in the Workplace Podcast.

Find Natasha Tracy on her blog, Bipolar BurbleTwitter, InstagramFacebook, and YouTube.

steven
April, 12 2013 at 2:14 pm

Miranda,
I hope you read this. How long you have been teaching? I am a secondary science educator and have taught for 12 years in an inner city high school. I have lived through the things you mentioned in your post about pencils and failing students. I have even provided pencils to students to use, only to have them break it into several pieces and then say it was an accident. To make it worse, they then they ask for another pencil and state that "if you don't, then it be your fault that I couldn't do my work". The whole concept of the "no child left behind" legislation made all teachers the scapegoats if a student did not pass their course. I believe in the statement that "you can lead a horse to water but you can't make it drink". With NCLB teachers are forced to trick the "horse" to open its mouth and splash some water in. I have felt what you have gone through and after making it till June I gave in... I am very glad that I did not succeed and that after 4 weeks of being in the hospital I was diagnosed BP2 and am now in the treatment of an excellent therapist and psychiatrist. I had to take a one-year leave of absence. Check to see if your school district will let you do this. A year off from teaching and getting help for my illness enabled me to understand and accept what it means to be a bipolar educator. I returned with a renewed vigor and passion that I had not had since my first teaching year. I was once again bright eyed and eager to help the next generation of students successful in learning.
I also know the deep-seated fear of having my administrators, fellow teachers and possibly students or parents finding out about my mental illness. Getting a better handle on how to maintain and cope with the mood swings seems like an impossible task (like grading 100 tests in one plan period) but it can be done. Look into taking a year off (leave of absence or sabbatical) to try things like those suggested above by Natasha. You still have over six weeks until your self-imposed deadline. Remember you stated that you are a "perfectionist"; so take the time to make your therapy and maintenance of your illness perfect.
Remember that perfect may not mean that you get all the questions right on the chapter 4 math test, but that you understand the process and therefore had the opportunity to get it perfect. Perfect may have been the target, but process and success is the true goal. After all, what is the difference between a 90 or 100? Both are still an A in the realm of education and ultimately the world.

Natasha Tracy
April, 11 2013 at 5:54 pm

Hi Miranda,
First off, it's important that you know you're not alone. I know it probably feels very lonely - I get that, I really do - but you're not alone. I'm standing with you, and so are so many others with similar struggles.
I understand your battle with work. It sounds very difficult. I know what it's like to be a perfectionist and I'm sure it's very difficult seeing kids fail but not everything is your fault, and clearly you know that, even if the people around you aren't clear on it.
The first thing that strikes me about your comment is that you seem very overwhelmed by all of this. And I understand that, life can be very overwhelming. What I would suggest is getting some therapy from someone who specializes in bipolar disorder. You need someone with whom you can be open and honest. You need someone you don't feel you have to hide from. You need someone to help you work through these difficult times and emotions. They can help you. Really.
And please know that while I think it's completely reasonable to feel suicidal - that's your illness talking. That's the overwhelmedness talking. That's not you. That you wanting a life with less pain. Which is completely understandable.
And you can get there. I know you said that you have seen "shrinks off and on for 15 years" but maybe that hasn't been the best tactic. Maybe a better way of handling it is to get one doctor who specializes in treating hard-to-treat cases of bipolar disorder and working with him. I have spent _years_ of my life being treatment-resistant but believe me when I tell you - every time, something, eventually, works. I know it can feel endless and I know it feels like you can't be "fixed" but treatment is possible. It always is. I know that because not only are medication combinations almost endless but there are other options like ECT, VNS, rTMS, and so on. You do not have to live like this and you certainly don't have to die like this.
Things can get better. Things will get better. But you need to reach out to make it so. Please find yourself a quality doctor and therapist and be open about your struggles. It's very, very hard, I know, but it's worth it. Those kids of yours (biological and at school) need you to live. You touch more people than you can possibly imagine.
- Natasha

Miranda
April, 7 2013 at 6:15 pm

I know all about the lying. I've made up illnesses to cover for absences, and my college days were a sea of lies (Especially when I got my master's). I couldn't tell my prof that I had spent the entire day before staring at my computer trying to work, intermittently distracted composing my suicide note, and contemplating ways that I could hide that it was suicide, nor could I explain that in my manic perfectionism I had spent 4 hours on my introduction, so I ran out of time to get the paper done on time. I manufactured so many car problem stories, illnesses, family emergencies, and so on. The sad part was, I really was a hard worker...just crazy. My work never lost points, but my late submissions did. Now, I'm a high school math teacher. Pretending to be calm, cool, and collected takes everything out of me. It's so hard for me to keep organized, and it seems I have to work more hours than anyone, because of my disorganized thinking - everything just takes me longer. A couple of years ago, I told my principal and those that asked in my department that I was severely anemic, because my depression was making me late occasionally. When I finally wound up in the psych ward for a week, I said it was for tests, because the docs weren't sure what was causing it. I really should do more research so I can make up a better cover story if/when it comes up again. But a bipolar teacher would scare people. They'd have visions of "teacher goes crazy and shoots up school" or something. Now comes the scary part, please feel free to give me any advice you can. I really want to end it all. I feel like I work round the clock. Even when I'm not working, I'm stressed about the fact that I can never be good enough. I'm tired of the media, parents, administrators, and general public blaming me (teachers in general) for things that I can't control. When I have tried ten different ways to encourage, explain, differentiate, coax, lead and anything else you can think of to get kids to learn, and they won't bring a pencil to school, or do an assignment, it's still my fault. I'm a bipolar, perfectionistic, dichotomous thinker. I can never succeed at this job, because scores of kids will fail each year no matter what I do. Then my principal asks what I'm going to do differently next semester so more kids pass. Like I'm not doing everything I can, researching, trying new things. It's never-ending failure. Add to that the fact that I'm not qualified to do anything else, my kids are grown, my husband deserves the chance to find someone who can be happy with him, not bring him down. I hate my life, and don't know that I've ever truly been happy. I've always felt like I'm just faking my way through - hell, I am just faking my way through. I've tried all kinds and combinations of anti-depressants and mood stabilizers, gained 40 pounds on them, and hated them. They didn't make me happy, I just existed. I don't know what to do. I feel so alone, and hopeless. Sorry to ramble on so long, but I don't know what to do. I know I have to wait until June, because if I ended it now, there's no way my students wouldn't find out - assuming I can't hide the fact that it's suicide, but I could quietly pass away over the summer, and all they'd know is that I didn't come back next year. My family would be sad initially, but I think it would be better for my husband in the long run. I know people will all tell me not to, but I can't be fixed. I've seen shrinks on and off for 15 years. They can't fix me or my life.

Angie
April, 2 2013 at 8:46 am

Thank you for this post. I am interested in starting a group for "high functioning" individuals with mental illness. I have bipolar type I, but I would like to keep it broader. Like some of you have said, everytime I find a group, and everytime I go inpatient, I find myself immersed with a population significantly lower functioning that am I. This is a serious gap in the mental health community; there is no place for people who "fake it til we make it" to find others who live similar lives. If anyone knows of any such initiative, please let me know. If not, please let me know if you would be interested in looking into this with me. You may contact me at amarielanger@gmail.com
Best,
Angie

michael
March, 29 2013 at 10:07 am

I identify so much with the crashing on the weekend posts. I get home 5PM and I just crash till 10PM. Then I can't sleep Friday night. Actually its Friday 4PM now. I need to make sure I stay up tonight.
But when I stay up to a normal hour I can't sleep so easy.
I need to avoid get depressed about this.
All the best
Yitzy

Linda Ann
March, 21 2013 at 5:26 am

I am very much like this. I pour all of my energy into college classes, helping take care of my niece, my aunt, and other family affairs. By the weekend I am finished. My bedtime is somewhere between 9 and 10. I am 22 and the energy I have left at the end of the day is just enough for me to eat dinner and climb into bed. Bipolar does suck the life out of you. It really does.

Christina Rose
March, 20 2013 at 3:45 pm

Hey.
I found your post intriguing. I resonated with it, as about 2.5 years ago, I was in your exact same position... had lost my job years prior to deteriorating mental illness, Bipolar, fluctuating over time from low-high functioning Bipolar and I really just felt that was how my life was going to be. High functioning was just as high as you described it. I wished it would have meant more.
Somehow, I beat the odds. I am still in awe of all of the events leading to my wellness. Wellness! And I am actually functioning back in my job in the health care profession. I have my life back. I know that my "recovery" is rare, but because of my journey, I truly believe that recovery is possible, beyond what we believe of ourselves. I treasure life, health and wellness, and everything under the sun that I am capable of doing because of where I have been and how everything had been taken from me.
I still have to maintain my health. I have to set a lot of boundaries, and I do have limitations, to keep my stress at a reasonable state. I have to take my medications each day. And slowly, I get to decrease them.
Anyway, thank you for your honesty and insight and for sharing it with others. It is so valuable!!
~Christina Rose xo

aulpn
March, 19 2013 at 8:55 pm

When I finally told my family, all nurses, that I was DX with Bipolar. They claimed to always support me, but when I told them, I was pushed out of the family and ostercized. Grandpa told me Both Mom and also Grandma had it. I put the pieces together, their medications and actins. Grandpa was right! Now it is only my husband and I, and He and my friends, doctor are my support team! I can make it, I have meds and a NEW family I choose! I live my life like any other high functioning person! I just hate those peoople who say they 'have a touch of Bipolar! Thanks friends!

Delaney
March, 13 2013 at 8:15 pm

It's 1:00 AM, and once again I find myself reading old posts and trying to make some sense out of my bipolar life. I am what people would call "high functioning, but it comes at a very big price. I should have never had kids....
I feel so sad right now about my latest outburst with my daughters. I'm on the verge of a hypomanic episode and agitation is severe. Things that should not bother me are making me scream like a demon.
I had a bad depressive episode in December and January, and since the fog lifted I have felt really well and had a lot of energy. That is a good things when it comes to work, but a very bad thing at home.
My 14-year old daughter told me recently that she likes me better when I'm depressed because I am nicer.
I could go on and on. Also, I have a business and I have made some big mistakes recently which makes me question if I really am high functioning enough to maintain it.

Steph
March, 5 2013 at 5:46 am

Thank you for this. I have a great meds cocktail and am pretty high-functioning. I'm so used to living my "normal life" that I don't even notice I'm doing it anymore. Except that when I get home at night, my brain shuts down. Every weekend, I want to sleep all the time and my mood takes a nosedive. When my baby goes down for his nap, I collapse too. A break from my "get up and get the baby to day care and go to work" routine leaves my brain confused. I hate it because I feel like I miss out on life, but it's the best I can do.

Sara
February, 28 2013 at 5:50 pm

Natasha, thank you so much for this article. I was beginning to think that I couldn't find the words that describe my life, but you took them out of my mouth. Thank you. I was recently diagnosed with bipolar II, or bipolar depression. I was relieved by the clear examination of my condition, but I am also not sure what the future holds. I can completely relate when you talk about not having enough energy to just be normal. I wake up some days and feel the vigor to go the gym, run my errands, go to work and make lots of money, pay my bills, etc. But it scares me how quickly that low sneaks up on me and I crash. I don't leave my house, except for fast food, those days. I stay in my sweats. I watch TV all day and don't bother to shower or brush my teeth. And then I have to go make money at my job and I can barely muster up the strength to put baby powder in my dirty hair. I understand completely where you're coming from. Hopefully, there's a light at the end of the tunnel for all those suffering from bipolar disorder. Thanks again for your post and good luck!

Mary
February, 21 2013 at 3:48 pm

So glad to have found this site. I was messing around on the computer trying to "prepare" for my psychiatrist appointment early tomorrow morning. I hold a full-time job as a licensed psychologist. I have never been hospitalized for anything...I have been trying to figure out how I can do this and still get other things done. I gained 70 pounds on Zyprexa but it wasn't until I withdrew from it that I began to "feel" like I was mentally ill. I developed a TD from the Zyprexa withdrawing-incessant "humming." It sucks. I have been rather crazy lately- on lithium now. Had to raise it two weeks ago. I feel so vulnerable. I'm not manic and I'm not depressed. But at the same time, I'm not well or "normal."

Penny
February, 15 2013 at 2:51 pm

It takes a tremendous amount of energy to be high functioning. I think the ones who suffer the most are family when we come home "wrecks" at the end of the day. It is very hard to be "normal" and keep up the facade.

Betty Farnsworth
February, 14 2013 at 8:57 am

This is a problem for me. When I've attended group therapy, most are lower functioning people. They admire my knowledge about mental illness. I search for someone that understands how it is to pretend all day. I'm glad they like me but they can't understand that underneath I am a wreck too.

Sheryl Nelson
February, 7 2013 at 4:27 pm

I run around all week and Friday night I crash till Monday. The weekend is me in bed, barely eating and feeling like life is passing me by. Acting normal only helps when I don't get or stupid people make me angry.

Natalie
February, 7 2013 at 5:46 am

Wow... is all I can say. Two years or four or maybe six or eight or ten years of little episodes of high bursts of energy that I used to be able to attribute to the end of the semester, the impending project deadlines and the self-imposed deadlines to be productive, used to leave me feeling completely empty at the end of the day. Lying on the floor, the bed, wrapped up in whatever I was wearing, I had slept in, skipping showers, skipping meals and losing track of days at a time. The energy it took to function in school/work/home so that no one would see the crazy just kept increasing, until the recovery time it took to build myself back was insurmountable. As a freelancer, I could hide out in the lack of a regular schedule, but now with a 9-5, its increasingly difficult. And as a result of the transparency and accountability, as well as a boss that has openly commented derisively on the mental health status of a previous employee, its all I can do to just get through the week to the safety of my bed on the weekends. And my relationship is a similar rollercoaster of mood swings and behaviour that was just unexplainable before.
Thank you for this eloquent and honest description of your circumstances, in a way that brings me comfort to begin the next part of my journey.

Maya V.
January, 28 2013 at 10:40 pm

Thanks Natasha,
You wrote this 2 years ago and it still is so helpful. In the middle of the night I'm browsing posts because I am so upset and with reason. I have bipolar, I used to be on disability, but could not survive on the "mercy money". I have to work 50 hours a week to be able to afford my life. I used to be on 5 medications, but they raised my blood pressure so high I figured I will drop dead within a few years. I also did not have health insurance at the time and could not afford medications, So I quit them all. While I am exhausted, I can sleep on my own and not in an Ambien induced stupor for one good thing, However, I am constantly low on energy to the point of collapse. My workplace is extremely stressful, but I deal with it, as well, or better than "normal" people do. Some had been saying for a good while now I looked exhausted. But here is a new one for me: "You look stoned"-I was told yesterday. STONED???? I never used drugs, I despise drugs; I don't even drink alcohol. I am sick and am trying to function in a society that has no tolerance for mental illness. I can't even have a reasonable relationship because I have no energy to maintain one. I can't even make myself go out once a week to a trivia game because I need every ounce of my energy to exist; and guess what, my friends are resentful because of it. ("Try to make it next time" -they say) They "understand" but they do not. Now that I'm told I "look stoned" I will have to get back on medications before I get fired.
You are damned if you do, you are damned if you don't, Just how much more can one human being aspire to do? I am so angry.
Thanks guys, for listening.

Myan
January, 28 2013 at 8:07 am

ryanjones -
I feel that same way...colors are brighter, I feel so clear and alive...until the crash comes, at the end of my depression, with the shaking and crying and babbling and hopefully I've remembered to put away the knives this time. Then I think that the blue haze I live in with pills just might be worth it. At least, that's been my choice so far. We all have to make that choice. I'm hoping there will be better options soon.

Sarah
January, 26 2013 at 3:05 pm

Hi Brizzy,
I hear you mate. You're in the middle of hell right now, and you've lost so much.
You're on the right track though. You've worked on your addictions. You admit your mental health problems, something that is very hard to do but necessary if you are to improve. You've sought help, and you're keeping on seeking help until you find the right help.
Hang in there! You've shown amazing strength in the face of adversity. Believe it or not there is something to look forward to in this life. The right help is out there.

Brizzy
January, 26 2013 at 2:08 pm

I fear I might be bipolar and I am losing my life. I am 26. I literally have done next to nothing in 4 years. I have multiple addictions that have subsided and stabilized but I continue to struggle with sexual compulsivity. I literally wave up and down all fucking day and I'm tired of it. I've tried to get help and I usually am diagnosed as depressed and then put on medications that result in psychosis. I used to have so much ambition, pride, and zest for life and I have nothing now accept a really bad life hangover and a lot of fantasies.

sandymc31466
January, 23 2013 at 10:34 am

Natasha, I so relate to you. My bipolar has been untreated for most of my life. I am 46 and have finally surrendered to my diagnosis. I am exhausted. I can't keep up the "act" of being normal anymore. I have always worked and have been working for the same man for five years now. I am a perfectionist so for the past five years my work performance reviews have been exceptional. After two failed marriage I am finally in a healthy relationship with my husband of 8 years. All of our kids are grown and I have dubbed 2013 as the year to take care of "sandy". I am beginning my meds today. I have a good psychiatrist and an excellent therapist now. I just want you to know that I relate to you. Living "normal" is exhausting!

ryanjones
January, 8 2013 at 7:20 pm

Thank you Natasha. You are very brave and spot on. I have friends that I tell them I am bipolar and they say they understand, but they dont,just like the rest of my family. I was not going to say this but ive had a glass of wine or three. Like most people afflicted with this disorder we self medicate to calm the gerbils in our head. Alcohol is instumental in this process. I don't want to drink but i hate antipsychotics. Have you ever been put on pills and if so did you like the end result? Because I was and I felt like a zombie. Give me manic 20 days out of a month and 10 days of sevier depression over pills and ill take my bipolar anyday.

Kim
January, 7 2013 at 12:25 pm

Thank you, thank you, thank you for writing this. I have always felt the same way. I work full time and am exhausted everyday just to maintain and sustain being functional. To me, it is integral that I can be productive. But it is so taxing at the same time. I feel completely unworthy if I am unproductive. It is a double edge sword. There is no one in my close circle of friends who is bipolar or even suffers from depression so it is hard to try to convey just how difficult it really is to keep this up. People say, "No one is normal," but they don't get the spontaneous moodiness and mental distortions of everydayness that I experience. There is my immediate, innate reaction, and then there is my medicated, subdued response. This is a continual, minute-by-minute process everyday. So, thank you again for sharing your experience here. It has helped me more than I can say.

sweetp
January, 3 2013 at 6:20 am

Natasha,
Thank you for publishing this statement. I can so relate, and am so relieved that I am not the only one. I too work as a night shift nurse for 12 hours a shift. I too, put away my crazy up on the shelf as I walk into the hospital. I am able to serve and care for others with complete compassion for those that are suffering, alone in a hospital bed. It is the ONLY thing that I do right in my life is to nurse. It gives me stability, and sanity, otherwise when I'm off Im a wreckless, hopeless being. I spend 12-15 hours in bed on my days off. I am not able to do the basics of life like: Fix food, walk my dog, take a shower. Thank God I have a partner that does these things for me. I am embarressed to say that I am unable right now. I am so depressed, I know I need to quit smoking, eat healthy, EXCERCISE, walk my dog, listen to music, garden. These are the things that would make me happy, but for now I can only think about them, I physically cannot act upon them and it frustrates and angers me beyond belief.
I feel like such a lazyass, but I do get up and work 12 hours taking care of patients. I give my all, and have nothing left. I have such fatigue its scaring me. I'm so tired of being in bed, because of my meds (seroquel) I have gained 65 pounds, I have hypothyroidism and Lymes disease, which adds to the baseline problem of my depressive bipolar state. I am so unhappy, and overwhelmed. My doctor says it will take time to reach a therapeutic state and to hold on. I am relying on seroquel to break my bipolar beast right now. Thank you for the assurance that I am not the only one with no energy to carry on. I'm at the point where I am fighting for my life to improve in quality, happiness, and peace.
Pam

lonelycowboy
December, 31 2012 at 4:28 am

thanks for the article. i can relate so much as well. i had my epic break-down about 3 years ago. i'm grateful to say i'm in a much better place now. but i just have this gnawing feeling inside that is like "yeah, i'm doing much better, working, living on my own, etc, but i still feel weak and vulnerable to my bipolar symptoms." i hate feeling like i have to fake it to make it. i just want to be. what helps is to recognize that looking back things do gradually get better (with bumps in the road), if i take my meds regularly, communicate with others who understand me and my bipolar, and generally attend to the basics of normal life (eating, sleeping, staying somewhat organized, etc.). while i still have big dreams for myself, i try to keep my expectations in line.
thank you again for sharing. it helps me.

chance
November, 27 2012 at 2:30 pm

This made me sad, because it rings so true.
I am a "high-functioning" bipolar too. I am fortunate to be a well paid advertising writer, freelance after many years as a creative director in an insanely demanding corporate job. It's astounding to me that I'm even alive at this point.
Managing terrible depressions is hell enough; fitting it in around deadlines is heroic, though it certainly doesn't look that way. I am a practiced liar. All sick days and vacation time are spent fighting demons - not the most restorative way to take time off - but I lie to coworkers about my "free" time. I have worked through flu, lyme disease, pneumonia -- because my precious sick/vacation time had to be preserved for the real problem of being a crazy person.
And yet I am a lucky one; 15 years ago in a hospital I was told I should go on disability and live in a halfway house. Basically I was told that's the best I could hope for. It's a terrible thing to tell an ambitious type, mentally ill or not. Would I have had a better life had I taken the advice? I doubt it. At least in the struggle to maintain some sense of "normalcy" and drive toward success I have some creature comforts, a 401k, a supportive and loving husband. But the tiredness is monumental - then and what seems always. It's a frantic existence and I doubt it will ever be anything else. This is success.

Michael Hullett
October, 19 2012 at 5:26 am

I know that pretending to be healthy is an integral part of remaining stable. It shouldn't be, but it is.
When I was first diagnosed, I tried being honest, and it was an unmitigated disaster. Even people who truly care about you have such a difficult time understanding this illness, and most of the people we're around aren't the ones who truly care.
You don't get to be ill, and still function. Those are the rules. If you have a brain based illness, and you don't look and act like you need perpetual care and control, then there's nothing really wrong with you.
Those of us who live with Bipolar illness know how ridiculous that belief is, but it exists nonetheless.
The time I look forward to the most these days is every other Friday night, when my wife goes to visit with her mother. That night, I get to sit with a large glass of wine, and be me for a night. I get to let it out. The next day, I start the play all over again. If I didn't, I would lose my pretend world, and I would die.
Those of us

Bibiana
October, 13 2012 at 5:30 am

This article was so sad. I truly understand, because I am also "high functioning ", but somewhat less so than the author. I cannot work full-time, and am doing a part-time job with a job coach -supported employment. People don't get why I don't work full-time, and why I tire easily. Just because I look nice, have friends, and have a couple of hobbies doesn't mean I am 100%! They don't realize how hard I have to work at wellness -or how far I 've come.

Sarah
October, 9 2012 at 11:10 pm

My normally supportive family member got upset at me this morning. I broke the towel rail in the bathroom by leaning on it. Stupid, huh? Well, I was daydreaming and the towel rail was a convenient support for drying my toes. So he had to fix it for the tenth time this month. Perfectly understandable he was annoyed.
He doesn't know, nobody knows how upset I am because he was upset at me. I can rationalise it in my mind, I know that he doesn't think I'm stupid. But it's triggered bad memories of the past, like the time my boss shouted at me. All day my emotions have been going back and forth and I've been on the verge of tears. Nobody knows. I've functioned all day.
I'm holding onto reality by a thin thin thread...
Curse this bipolar!!

Julie Cochrane
October, 9 2012 at 8:01 am

But anyway, I do know it's incredibly hard when people who are disabled like me push themselves to fake sane enough to function.
Some of them don't know or accept, when they make comparisons, that when my ability to fake sane enough to function falls apart and I quit pushing (for fear of the morgue), that it's not my fault I got sicker. I do that sometimes. (I used to be high function. I relapsed, badly. I'm still struggling to work my way back.)

Julie Cochrane
October, 9 2012 at 7:56 am

What I hate with high functioning is the comparisons. "You don't know how hard it is for me to get up every day and go do X."
Sometimes I'm high functioning and I'll get stuck in a loop of "doing" and I'll be able to "fake sane." Other times, since I'm type 2, I'll get more depressed and my ability to fake sane will slip, I'll relapse/decompensate/worsen, and I won't be able to do things.
I'll be in a state of mind where if I push myself to do anything I'm going to collapse crying on the floor in hysterics and maybe "just" have a horrible fit and cry myself into exhaustion, maybe harm myself, maybe someday end up in the ER, maybe someday end up in the morgue. Ugly truth.
So I don't push myself in that state. I just don't.
*Sometimes* I function well enough to fake it, and sometimes I don't.
It's such a tiny, fine line between the two. And it makes it look like I'm touchy over little things, because people don't realize that when they look at me "normally" that I'm not normal at all. Ever.

Natasha Tracy
October, 8 2012 at 6:46 am

Hi Pam,
I'm not sure I quite get the order of events but if you're saying that you had a breakdown after a job and home loss "even though you weren't working" that's completely understandable. It's not work, per se, that tends to trigger people, it's stress and I would say that job and home less is exceptionally stressful.
And, keep in mind that sometimes episodes have no external cause. Sometimes they just happen.
Working part-time is a good idea, so you can see how you handle it. Easing into life is never a bad thing to do.
I recommend you seek out a support group, therapy or both to help you accept what has happened and what changes you may have to make to stay well. It's very confusing on your own, but less so with others.
- Natasha

Pam
October, 7 2012 at 2:35 pm

Natasha,
Thank you for writing this blog. I am 42 had my first breakdown at 40 after isolating myself unintentionally after job loss and loss of my home. I had a second episode was not on meds as they took me off of them now I was diagnosed bipolar 1. Hard to wrap my head around this been reading your blog. Decided to give part time work a try to build confidence as this occured when I was not working so still not sure what the reason is or was...confused about the whole thing.

seriouslyjai
October, 7 2012 at 11:28 am

""I can certainly understand how a doctor (and most people), would not be able to see beyond the high-functioning part of you. Being high-functioning is a real catch-22, because you desperately need to receive help, but appear too well to be extended the kind of help you need. I am sorry that you struggle so much without many people there to comfort you at the level you need to be comforted."
That catch-22 is a killer! I also have a problem that NOBODY believes me! I don't often ask for help. I/m so used to covering/masking/denying the sick part of me, that people BELIEVE that's who I am. They don't see the sheer force of will it takes JUST to get through the day
I asked my friend a couple of months ago (before I got REALLY crazy) where was the support for people like us? The groups that I've tried to go to are definitely NOT for me.
But that doesn't mean we don't need help. and aren't entitled to it!
AA has special groups for airline pilots, doctors and other professionals. Why doesn't the MH movement have the same??

Brenda
August, 14 2012 at 6:41 am

To Natasha and everyone else:
Do you feel that you were always high functioning even as a child? As a child I know I would have moments of creativity and write plays for family and friends to perform but inbetween those times I found myself to be more at home as a loner, shy, afraid to be in public places and I would have to say that I showed symptoms of ADD when it came to school subjects with the exception of sewing, art and typing classes. I know I felt even as a small child very depressed and sometimes invisible. Now at age 52 I am now being diagnosed as Bipolar II which is complicated with an autoimmune disease which attacks my thyroid. After reading your blog about being high functioning at work or anything you do and about the suicidal feelings I felt a connection.
I was just wondering if any of you can remember always being this way or did it come on later in your life?
I know there is a connection with Bipolar and Thryoid problems and the doctors don't know which one to treat but I do know that regular antidepressants and even trying Lamictal and Symbyax only caused more hightened side effects. 15 years ago I did find a Psychiatrist that did agree to treat me with Adderall along with Paxil and the combination of the two seemed to have the best effect with little to know side effects. Today my doctors are disagreeing with the Adderall and Zoloft treatment and insist on replacing it with drugs like Abilify, Wellbutrin.....which have numerous unwanted side affects. One bad side effect of thryoid disease is that your body becomes extremely sensative and intensifies known drug side effects making it very undesirable to want to switch my medications. I noticed that Natasha mentioned she was on Adderall in addition to other drugs. Does the Adderall help you with your depression symptoms? I know when I cut back or even try stopping the Adderall I become more depressed and find it very difficult to just get out of bed.
Currently my GP and Psychiatrist don't agree with any of my thoughts regarding my depression and its probable link with my thryoid disease. There are many things on the internet about Bipolar vs. Thyroid disfuction.....anyone else suffering from the two??? and what medications seem to work for you???
Sincerely,
Brenda

John
August, 13 2012 at 1:43 pm

I know exactly what you mean. That was the story of my life until a few years ago. You might want to try some strategic changes to your diet. I found that avoiding starches and eating more greens left me feeling much less drained. Though it's still challenging, I do have something resembling a social life since I started eating better.

Suzanne Carter
August, 13 2012 at 11:52 am

This is great! My son and daughter in law forget I'm not normal, since I am high functioning and treat me as normal. That never works to a position solution and yet I am the judged.

b21wayne
July, 29 2012 at 2:58 pm

I can relate so much to what everyone has said. I was initially diagnosed Bipolar I with mixed episodes in 1982, and was hospitalized about 10 times in the 80s and on disabiity from '88-'97. Since 1996 I've been able to maintain a full-time job, after getting an MSW. It takes a tremendous toll on me psychically and energy wise, to function "normally" at work all week. When the weekend comes I normally become a hermit so I can regroup, recover and reenergize. As the work week goes on I usually become more irritable with each day. It seems like it has gotten more difficult to keep a game face on all week as I've gotten older (52 now), and my isolation when not working has increased much more then 5 or 10yrs. ago. Taking meds for the last 30 yrs. has probably taken a toll as well. It is so easy for me to get down on myself for getting burnt out living in my head.

Kim Hart
July, 25 2012 at 12:58 pm

I've been diagnosed with bipolar for approximately six years now. Since that time, after being off work for a full year, I've only worked very part time -- generally about 10-15 hours a week, with a day off in between shifts. If I don't have that day off, the time at work gets increasingly difficult. This past week, I had 21 1/2 hours, working four days in a row. By the last day, I was jumpy, grouchy, and trying to keep it all together. I stayed polite to my guests, didn't get crabby with my coworkers, and managed to not mess things up -- but I felt myself coming loose.
When I got home, I ended up taking two naps before bed, then went to bed early. Today, I slept in until 12:30 and have had one or two naps as well. This is with just a mild work-week, and most of my symptoms under control. I do have course work every day as I'm finishing my college degree, but like you, it takes it out of me to be out and be normal and interacting, when I'm most comfortable where it's quiet and I'm interacting when *I* want to.
Thank you for addressing this, because it makes me feel like I'm not being such a wuss about being a bipolar that also tries to work...but not making it full-time.

Natasha Tracy
July, 24 2012 at 6:45 am

Hi Sue,
Yeah, it's tough and other people really don't see how hard it is. But hopefully now that you have a diagnosis you can get treatment that will make things not so hard.
- Natasha

Sue
July, 22 2012 at 6:23 pm

Every word you wrote describes me. Everyone I work with thinks I'm the most creative and hardest working person on the planet. I always joke that it's a sickness but no one gets it. While I work hard to work and have fifty million thoughts in my head I wear myself out. Then I can't sleep at all which makes everything worse. But boy I'm good at appearing normal. That is so exhausting. Thank you for sharing this. I've just recently been diagnosed so all this is new to me. I thought all this crap was normal!

Ernie Richards
July, 21 2012 at 11:52 am

This article fits me like a well made glove. I am always drained of energy (except during a mania) and my friends still don't understand why I want to stay inside. Thanks for helping to explain things in a way that I can show my friends.

Always Lurking Behind the Scenes | Suddenly Bipolar
July, 14 2012 at 8:36 am

[...] I read this article again: ‘High Functioning’ Bipolar Disorder . A gentle reminder that it takes Tons Of Energy to make my brain work and to appear normal and [...]

Oh here it comes… unwanted visitor « spiralofdarklight
July, 4 2012 at 7:29 pm

[...] High-Functioning Bipolar Disorder | Breaking Bipolar. Share this:TwitterFacebookTumblrEmailPrintLike this:LikeBe the first to like this. This entry was posted in Uncategorized. Bookmark the permalink. ← -Sighs- [...]

angie
June, 30 2012 at 1:25 am

Hi, I just found this website this morning and I realized when reading your blog about being high functioning bipolar is that I am exhausted by how much mental and physical energy I put into being well. I'm working really hard to learn how to be gentle and kind with myself. My mom had very intense ups and downs with bipolar and I grew up with her insanity. She did become medicated but was so lethargic she was like a different person who had no spark left. A new doctor changed her meds in 2000 and she had a bad reaction and ended up overdosing.
After that I went through a terrible terrible time. I had my first big bipolar mania that i remember. I was really breaking down and detaching from reality right along with all the grief and loss and horror about what had happened. I tried to run away from it and go to LA to start a new life but I just got more and more depressed and tried to kill myself. It really was horrible.
Fast forwarding I've spent the time since then learning how to be well. I finally got professional help and that was a huge step considering how much I didn't want to accept that I was like my mom. I am on medicine that mostly works for me. The only downside being I have trouble with my memory which I think is the Lamictal and that makes working really tough.
I always worked and worked hard. This year I finally quit my stressful job and I've been supported in my goals to become a writer by my husband. Now that I've quit I realize what a thread I was hanging on with pushing myself everyday because the work I was doing didn't come naturally to me and I really really had to push it to be "normal"
I am lucky enough to have a wonderful therapist who uses psycho-drama and not just talk therapy. My meds seem to keep me in check. I started exercising and I write and talk to people to get out all my junk. But still there is always that internal struggle for balance. The chatter in the brain and all that scattered junk all over the place.
I really resonate with the people who were talking about being actors because that is so true and it is so hard to let down and expose yourself. you really have to find safe people that you can expose yourself to and be real with.
it is tough for my family to understand that I am bipolar because they don't see me falling apart. They don't understand how I feel inside and bipolar is a condition that is a "feeling"condition. We really FEEL things in this heightened, sensitive way and because of that we need to give ourselves the special care we need, be kind to ourselves and make sure we keep reaching out for help.
I'll never give up on myself. I'm too important. We all are. The beautiful thing about being bipolar is that just in these posts above so many people have mentioned they are in fields where they help people. We are really caring and feeling people and do bring a lot of light and good things to this world.
No matter how crappy I am feeling inside I will always strive for that light that is in there somewhere. I am so thankful for all of you and your honesty and your stories. This is a great blog!

Reece
June, 11 2012 at 7:35 am

Thanks for your story, and for the replies. Yes, I could be described as high functioning- at work. The post about staying all night and colleagues looking at you askance in the morning when they arrive and it is obvious you have not been home. But it all crashes down around at home - total disaster and curled up in bed for most of the weekend. The problem I have is that I am training to be a psychiatrist- yeah ironic. Just I feel so vulnerable 'coming out' at work. I feel it's a lonely place to be -being diagnosed with a mental illness as a mental health professional.

Natasha Tracy
May, 27 2012 at 7:50 am

Hi Danielle,
Like you (and many) I did online research into bipolar disorder before seeking a diagnosis. And, like you, I was pretty sure I had it before I walked into a doctor's office. I remember the night I figured it out - I cried and cried over the realities of what it meant. I think it's completely normal and rational to be scared to death. It's OK to feel that way.
But understanding and accepting bipolar disorder (or any illness) is a process, and you might be in partial denial now, but eventually you will move on to feeling other things about it. (The stages of grief are generally what people experience as getting a chronic illness diagnosis is very much a loss.)
And it's normal to _not_ understand how you could be sick in the periods when you don't feel sick. Many people feel that way. You're not alone there.
All I can suggest is to take it one step at a time. First, see a professional and see if you even do have the diagnosis - then work from there. There may be other things going on that you don't know about so try not to get too worked up until you know for sure.
And try to remember that you're not alone. Out here in the world are thousands of people going through exactly what you are. And it will get better once you deal with the issue.
- Natasha Tracy

Danielle
May, 26 2012 at 7:21 pm

I stumbled apon this while researching whether I was Bi-Polar or not. I have to say that I am scared to death after reading this. I am almost positive that I suffer from this illness, but still feel in denial that I might actually have to own it. It seems silly to me that I can not control myself and when I AM feeling normal tend to forget how bad it can get.

Emily
May, 9 2012 at 6:40 pm

Hi Natasha,
I just found your blog and it is a breath of fresh air. I was diagnosed Bipolar II three years ago. I am graduating with straight A's from college and have two part time jobs. I really struggle with my identity as someone with a mental illness. I seem normal and people treat me like I'm normal. Whenever I run into my limitations, it is hard to accept because I feel like I should be able to have the stamina that other people my age have. I get home from my overnight shifts at work,hyperventilate, take an anxiety pill, and then crash. I am still living with my parents because, though I don't admit it to anyone, I don't know how I would cope on my own. My public and private self are so completely different, it's hard to tell which person I am. I sometimes trick myself into thinking there's nothing wrong with me at all until I run into my limitations. Thanks for sharing
Emily

Natasha Tracy
May, 7 2012 at 8:22 am

Hi Julie,
No, I‘d definitely say you‘re not alone there.
I know exactly what you mean when you say it‘s painful to shatter a therapists ideas that the treatment is working. The same goes for doctors I‘ve found. You want to be a good little patient and you want to please them and you want to get better so saying these things aren‘t happening (or you‘ve gotten worse) is really hard. But that‘s normal.
Telling a kid there is no Santa Claus is an apt analogy but providing that realization is just something we have to live with because it‘s the uncomfortable truth.
- Natasha Tracy

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