Bipolar 2 From Inside and Out

Posts tagged ‘high functioning’

Functioning While Bipolar

Bipolar disorder is a funny thing. Mine leaves me alone part of the time. Until it doesn’t.

I have had full-blown depressive episodes, with the sobbing and the immobility and the wretchedness and everything else associated with it. I have had one major episode that lasted for three years straight, plus everything else from minor breakdowns to that vague, lingering miasma that comes when you’re untreated and you don’t know that what is really happening to you is clinical depression.

I have also had full-blown anxiety attacks, the sort that leave you twitching all over, feeling like you’re about to jump out of your skin, gasping for breath, and imagining that every driver on the road is swerving into your lane. I’ve twitched and shaken and stammered. I’ve scratched myself. I’ve hidden under the covers until I can’t breathe. I’ve taken anti-anxiety meds that did nothing at all.

Right now I am sufficiently medicated and have been relatively stable long enough that I think what I have is functional depression or maybe high-functioning depression, or whatever you want to call it. I have enough wherewithal to work part-time from home, do other writing-related projects (like this blog and my other one), and do assorted tasks like paying bills and making business-related phone calls. (Occasionally, if the phone tree is lengthy enough and the person on the other end is uncooperative enough, I have a small-scale meltdown. My voice goes up in pitch and tears start rolling down my face. My husband takes over the transaction when he notices that.)

But secretly, I know depression is lurking and can rear its ugly head again with little or no provocation – a trigger or nothing at all. So can anxiety, which is how my brain usually responds to hypomania. It’s a little like those commercials for psychotropic meds you see on TV, where the person has a little sign with a smiley face and hides behind it. Except that’s not quite accurate.

I understand that high-functioning depression is also called “smiling depression.” That’s not my experience of it. I’ve almost never been able to “fake it till I make it,” slapping on a happy expression when inside I’m dying. Besides, it doesn’t work, as far as I can tell. The depression or the sorrow always leaks out around the eyes. I’ve seen this in myself and in other people.

Before I was treated, I used to have what you’d call “resting sad face.” Once a boss of mine encouraged me to smile more (and is there anything more annoying?). I didn’t feel particularly sad at that moment, though I’m sure that I had at least a low-grade depression, like a low-grade fever. But I was at my job, and functioning even then, if not very well or cheerfully.

The phrase “high-functioning” gets used a lot to describe certain varieties of autism. I don’t have autism and I’m not an expert on it, but my suspicion is that high-functioning depression is similar in some ways. I don’t always react the way other people expect me to. I feel out of my depth a lot, especially in environments with lots of people or lots of noise. But that doesn’t stop me – or lots of other people – from carrying on with what I need to do to be a functioning member of the populace.

But back to bipolar disorder. Even if someone seems to be “high-functioning” doesn’t mean he won’t have a meltdown sooner or later. Even someone who “slaps on a smile” may let it drop once she is alone. Even someone who is “coping well” may not be coping at all tomorrow or next week or next year. Sometimes you can’t tell on the surface what someone is going through inside. Like I said, bipolar disorder is a funny thing.

How I Function (When I Do)

I recently was involved in an online discussion. I probably should have been doing something else at the time, but it caught my interest and I jumped in.

It was (or at least became, in part) about getting up, getting dressed, and doing the work (or art or whatever). One person stated that she worked at home, but she needed to get out of her pajamas and get into regular clothes as a signal and reminder to herself that it was time to work.

I work at home too, and when I can make myself do the work, I do it in my pajamas. I reserve getting dressed for when I have to go outside the house – maybe three or four times a month. Pulling myself together that way takes much effort, many spoons, that I need to invest in doing the work.

So am I high-functioning or low-functioning? Yes.

We also discussed Dale Carnegie’s admonition, “ACT enthusiastic and you’ll BE enthusiastic.” This advice comes in various forms: Fake it till you make it. You get good at what you practice.

It doesn’t work that way for me. I can pull myself together for a limited time and on the phone, talking to a client, for example. I can fake it for that long. In my pajamas. A few months ago I had to drive to a face-to-face, multi-person business meeting – all together, about a half a day. By the time I got home, I was not just fried, but extra-crispy. Even the next day, I was too exhausted to do much more than get out of bed. It did not result in my being any more pulled-together thereafter.

So I was high-functioning for half a day and low- to non-functioning for a day and a half.

I suspect that most of us go bouncing back and forth between high- and low-functioning, with an occasional pause in the middle. It probably goes with the mood swings.

There are high-functioning activities I can (sometimes) do: earn money and blog, for example. There are also ones that I used to be able to do, but now can’t: cope with taxes, travel abroad or on business, tolerate crowds. And there are things I can do for a limited time or with help: grocery shop, cook a little. Also things I can do, but not as well as I did before my brain broke: solve puzzles, analyze, concentrate.

I suppose you could count napping as something I can do better now. I am a truly high-functioning napper. Not much of an accomplishment, maybe, but it beats the hell out of insomnia!


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