Bipolar Me

Actor/comedian Stephen Fry discovered at age 37 that he “had a diagnosis that explains the massive highs and miserable lows I’ve lived with all my life.” It was, of course, bipolar disorder. In documentaries, podcasts, and books, he has talked very openly about his condition, spreading the word about stigma and the necessity of getting help.

Fry once said, “You can’t reason yourself back into cheerfulness any more than you can reason yourself into an extra six inches of height.” And he’s right. If one could, I would have done so. With years of debate behind me and an extensive knowledge of rhetorical fallacies, I can argue nearly any proposition into the ground. I should have been able to reason my way out of depression.

But no.

Fry was right. There’s no way to reason cheerfulness into your life. Emotions are not so easily controllable, especially if you have bipolar disorder or another mental illness.

Nor can you reason yourself into having thicker skin. Throughout my youth, I was described as “too sensitive.” I was genuinely puzzled. I had no idea how to make my skin thicker (and it was never explained to me how such a thing could be done). It took a long time and many life lessons and mistakes to make any progress at all.

There are other things that won’t make you mentally well, either. Expecting the first medication you try to be the cure is unrealistic. It can take a long time (in my case, years) before a medication or even a combination of medications will ease your suffering. And if you can’t work out a medication regimen that works, other treatments such as ECT, TMS, EMDR, or ketamine therapy are not guaranteed to work, or at least not completely. If you go into those kinds of therapy expecting a complete cure, you may be disappointed.

Trying to wait it out or tough it out is likewise ineffective. Again, this is a strategy I have tried. I used to believe that my depressive episodes would abate if only I waited through them until they went away naturally. Eventually, my mood might improve slightly, but that was due to another mood cycle kicking in. Naturally, depression was still there, waiting for me to fall back into it.

I know this may be controversial to say, but religion won’t cure mental illness, either. Having a supportive religious community around you can be an asset—if you happen to find a church, synagogue, mosque, or other community that treats people with mental illness in a caring way. Prayer and sacred music can be a great adjunct to other treatments, but by themselves, they’re not a cure.

Exercise and yoga are not cures. They are also great adjuncts to other treatments. They can increase your number of spoons—if you have enough spoons to do them. But if someone with bipolar disorder or depression can’t manage to get out of bed, how are they going to avail themselves of the benefits?

Likewise nature. It’s a great way to lift your spirits to walk among spring flowers or autumn leaves or to plant a vegetable garden. But again, you have to be at a certain level of recovery to be able to do these things.

Changes in your physical circumstances may lighten your mood for a while, but they aren’t a cure. My mother used to believe that if only I got a better job, my depression would lift. And it did, but only for a little while. It certainly didn’t cure me. There were plenty of things about the job and about my brain that brought the depression roaring back.

So, what are we left with? Therapy and meds, and other medical treatments such as ECT, TMS, and maybe ketamine or other novel medications. One can hope that science will discover better ways, like fMRI, that can determine which treatments will be more effective. But it’s far from clear how soon that will be and when they will be available to the average person.

So, when is your reason an asset? When you’re deciding which treatment and which adjuncts are right (or possible) for you. For example, I had to think long and hard—and do extensive research—on whether I should try ECT.

I’m not a doctor, and Your Mileage May Vary, but for now, all I can recommend is to keep on keeping on with what we know can work. There’s no guarantee that these options will work, at least not for everyone. But they’re the best options we have.