The Stigma Associated With Having Bipolar Disorder

The stigma associated with bipolar is a big problem.
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Although there is often a stigma associated with all mental illnesses, bipolar disorder can be especially stigmatizing. Individuals with bipolar are often portrayed as "crazy" in books and movies and quite often, these individuals commit crimes or aren't able to live independently. 

According to the dictionary, stigma is defined by " a feeling that something is wrong or embarrassing in some way." 

Unfortunately, for some individuals with bipolar, that feeling can cause them to hide their diagnosis or it may create a great deal of shame. Consequently, many individuals with bipolar don't get the treatment or the support they need to manage their symptoms. 

Stigma and Discrimination in Mental Illness

A person who has been stigmatized on account of mental illness, real or even only perceived, often suffers discrimination at work, in school, or in other social situations such as churches or clubs. They may be shunned by acquaintances, friends and even family; they may be laughed at behind their backs or to their faces.

Stigma usually stems from ignorance, prejudice or fear. For example, when a person tells a friend or coworker that he or she has bipolar disorder, the response might be:

  • "Oh, everybody's a little bipolar, why are you so special?" (ignorance)
  • "Oh, man, you're one of them? Gee, that's tough," followed by shunning. (prejudice)
  • "You mean you might flip out and start shooting people?" (both ignorance and fear)

People with mental illnesses may be rejected by others in their lives because of the perception that they are dangerous, irresponsible, or just too difficult to deal with—all without any real understanding of the illness.

 

The Link Between Bipolar and Substance Abuse

Coping with bipolar disorder can be difficult, especially when an individual feels ashamed or embarrassed. Consequently, some people self-medicate with drugs or alcohol in an attempt to help themselves feel better. 

At the U.S. Psychiatric & Mental Health Congress, Kathleen Brady, M.D., Ph.D., an associate professor of psychiatry at the Medical University of South Carolina, reported that substance abuse occurs in 30 to 60 percent of patients with bipolar disorder, adding abuse "is more likely to coexist with bipolar illness than with any other Axis I psychiatric disorder." According to Dr. Brady, "two to four percent of alcoholics and up to 30 percent of cocaine abusers meet the diagnostic criteria for bipolar disorder."

For the most part, higher rates of substance abuse in those with bipolar disorder are generally believed to stem from either biological or physiological causes. However, there are social and psychological causes as well. If you've had a difficult time coping with bipolar disorder, you may be more likely to self-medicate or try drugs in the first place.

You then may continue to use drugs if you notice you get a short-term release from symptoms of your mania or depression.

This can begin a cycle of substance abuse. Unfortunately, the reality is that the relief of symptoms via self-medication is most often short-lived. Those with both bipolar disorder and a history of substance abuse tend to have the following in common:

  • Dysphoria during manic phases (More than 90 percent)
  • Other serious comorbid mental disorders (50 percent)
  • Slower recovery time 
  • More lifetime hospitalizations
  • Earlier age of illness onset.

How to Cope With Bipolar Disorder

It's important to find people who understand what it's like to live with a mental illness. Ask your doctor about local support groups where you can meet other people who have bipolar disorder.

You also might join an online support group.

Meeting others who have undergone similar experiences can provide you with the emotional support you need to deal with the stigma. Other people may also be able to share valuable resources that you might find helpful. 

You may also want to consider talk therapy. Meeting with a therapist can help you decide if you should tell your boss, family members, or friends about your illness.

It's also important to consider telling romantic partners. There are many ways bipolar disorder may affect your sex life and ensuring your partner understands this can be key to maintaining a healthy relationship. 

Therapy or a support group can also help you find ways to deal with any discrimination or prejudice you might experience. 

How to Combat Stigma in Bipolar

To fight stigma, it can be helpful to educate and inform others. Once people understand more about your medical condition, they will begin to see you realistically, rather than through the lens of their fears.

You also need to combat negative feelings in yourself: believe that your mental illness doesn't define you, and the people around you will sense that self-confidence and learn from it.

Neither of these things is easy, and they may challenge you. But combating stigma isn't an instant process, anyway—it will take time. The more you feel you can do, the more it will help both you and everyone else with bipolar or another form of mental illness.

Sources

Firmin RL, Lysaker PH, Mcgrew JH, Minor KS, Luther L, Salyers MP. The Stigma Resistance Scale: A multi-sample validation of a new instrument to assess mental illness stigma resistancePsychiatry Research. 2017;258:37-43.

Messer T, Lammers G, Müller-Siecheneder F, Schmidt R-F, Latifi S. Substance abuse in patients with bipolar disorder: A systematic review and meta-analysisPsychiatry Research. 2017;253:338-350. ​