On World Bipolar Day and Seeing People With Mental Health Needs as People

I don’t always look that mentally ill to strangers on the train. I hold a full-time job in disability advocacy. I have never been involuntarily hospitalized. It’s not as visible in public.

I manage to suppress the probable manic high from spilling out onto the strangers even though everything is moving too fast and I’m walking like everything I do is the most important thing in the world that needs to be done fast, faster, fastest, thoughts spinning like a coin on the table. When depressed, I just look tired on the train, dragging my feet a little, even though the thoughts inside percolate and drip slowly but insistently and repeatedly. My trauma-brains manifest only with certain circumstances that don’t happen in public.

My friends can always tell. But I don’t seem to look mentally ill to strangers on the train, and I have health insurance and a therapist. The psychiatrist in the psych ward called me vibrant and passionate. Even they didn’t think I counted as “like those people,” I know. I have had, so far, the luxury of checking myself in places instead of being taken there and laughed at by police.

Yet I have been hospitalized, am struggling to access the care I want because I am disabled and navigating systems is hard, am struggling to thus access the diagnosis of bipolar depression. It can be a hard one to diagnose and it took many outside observations of friends for me to first consider it. I am aware of the fact that I might yet be able to get a diagnosis is a privilege, as well as the fact that I will be able to negotiate a course of voluntary treatment.

People with bipolar depression are extensively stigmatized. I deliberately say “people” in there being stigmatized as opposed to the mental illness. Mental health needs occur in people, not a vacuum. Mental health needs occur in people with rich personalities and goals and dreams and we are not here to be told that everything about us is broken. Stigma is a concerning factor in seeking a possible diagnosis of it. So is the fact that I am not sure I have faith in a health care system that sees people’s complex personalities and needs as an afterthought to any mental illness.

In addition, those who don’t have access to a diagnosis, or those who are marked visibly in public as “one of those mentally ill” people, or those who want treatment and can’t get it, or those who are called non-compliant and forcibly medicated and/or placed in long-term care places — many of whom are marginalized in other ways, including having trauma histories, being non-white, having low incomes, or substance abuse issues — are the ones who are the most underrepresented in conversations on mental health.

You sometimes invite people like me to the table, people who don’t seem as “threatening,” people you can point at and insist our experience is “mild.” You think them incapable of advocacy and having ideas about what they want. You look at me and see someone holding a conversation and articulating ideas that you disagree with, but you look at them and see the reason for mass shootings and a return to asylums and restrictions on all of our rights. I align myself with the people who have it worse off in terms of being caught in a broken mental health care system, even though you look at me and see a person dressed in flats and slacks on the train on their way to work like you are.

On World Bipolar Day, I want to tell everyone: I might be getting a diagnosis of this, and I am still a person. And if you see me as a person, I demand you see others as people, even if they appear more visibly dealing with mental health needs or need more support than I do.