Should People With Bipolar Disorder Really Relinquish Their Financial Agency?

By Erin Stewart

Regulating the spending of those with mental illness is disquietingly paternalistic. But solutions can be more empowering than they seem.

There was about a month of my life when I bought a ton of cringeworthy stuff on Etsy. There was a poster about parentheses that I never put up; a coffee-table book I’ve never leafed through; a brooch I’ve never worn; 100 yards of fabric, of which I’ve used 20; Czech glass beads that I’ve not used at all; a heavy typewriter I kept under my bed; non-prescription eyeglasses I thought would make me look older; a bandana for my brother’s dog; a $200 rug that’s impossible to keep clean; and a set of bangles I just realized I never actually received.

It was around the time I made this spate of purchases that I was diagnosed with bipolar disorder. And one of the first things I wondered while walking out of my diagnostic consultation was whether to cut up my credit card.

Out-of-control overspending is common for many people with a range of mental illnesses. In a survey conducted by the UK Money and Mental Health Policy Institute, 72% of respondents said that having a mental illness had made their financial situation worse, 93% said they spend more when they are unwell, and 92% divulged that being unwell makes it harder to make financial decisions. Fifty-nine percent of respondents had taken out a loan while unwell that they ordinarily wouldn’t have. To compound the issue, many people with disabilities such as mental illness find themselves unable to work, so they’re often spending on a more limited budget.

Overspending is so common in hypomanic and manic episodes of bipolar disorder that many health professionals ask about it in their screening questions. On message boards for those with bipolar, I’ve read stories of people overspending in severe ways — buying entire houses or companies, or entertaining foolish get-rich-quick schemes. During these emotional highs, worries smooth out and fall away. Reality is elastic. It feels like you’re vastly richer than you are and that it’s easier to acquire money than it is.

Many people with disabilities such as mental illness find themselves unable to work, so they’re often spending on a more limited budget.

I know from personal experience that, with this confidence, shopping for craft supplies and beautiful things can seem like A Very Good Idea. It is not. During my own spending spree, as my high mood dissipated, I became disturbed by the fact that it doesn’t take much time to unravel the future — the very future that, in the moment of overspending, seemed so bright. I was a student at the time with a modest sum of savings, made more modest by my purchasing frenzy.

To mitigate the damage of irrational overspending, there are potential solutions that limit choice when a person is unwell. Ordinary solutions include measures such as putting mortgages in the name of a partner to prevent yourself from borrowing against it, or tying savings up in non-liquid investments.

A more intrusive model is one of an external money manager. A nominated agent (often a family member) looks after your savings — which you can’t access. When well, you agree to terms — perhaps you access a regular allowance, or perhaps you need to get permission from the agent to spend anything.

A more technologically advanced solution was posited earlier this year in a consultation paper by the UK Money and Mental Health Policy Institute. It states that banks could provide special accounts that users sign up for when they’re well. The account monitors their normal spending habits and when some out-of-character overspending takes place, their account becomes limited. The user may be able to remove the restrictions, but only after someone close to them is notified, and/or there’s a cooling off period, and/or the user proves their capacity to make financial decisions.

When I first heard about these potential solutions, they made me feel uneasy. There’s a disquieting paternalism to these ideas (especially external money management), and I reject them for myself because I don’t believe that I’m doomed to bouts of irrationality. But these decisions are complex, and have to do with privilege as much as they do with claiming agency.

In certain circumstances, the solutions could be more empowering than they seem.

I have much more control now than I did those years ago on Etsy. I’ve been mostly responsive to medication and found affordable, practical therapy. That’s not to say my recovery has been easy or that the conventional meds/therapy route is the only one, but these resources have helped me stay grounded while unwell.

As a result, far from being doomed, I’ve slowly learned to speak back to my illness. I get impulses to buy things, but I know I don’t have to. Even when I’m very unwell, I can usually resist. I can realize that I’m unwell and try to tap into my enduring goals to figure out what I would do if I felt more stable.

When I was first diagnosed four years ago, I was fearful of what might be in store for me, but relieved that the mess I had made of my life wasn’t my fault. I didn’t have the tools or the chemistry to do better. Curiously, I gained a sense of empowerment by accepting my lack of agency.

I’ve slowly learned to speak back to my illness.

But as time passes, the idea that I’m irrational is more unsettling than soothing. I’m more committed to the goal of self-reliance, and maybe one day, home ownership. I never did cut up my credit card, because having some form of credit history is useful and I won’t deny myself that utility just because I have an illness. I know my mood may take me to difficult places, but I’m less inclined to see myself at the mercy of it. I want to be in control of my life — including my finances — even in the midst of a manic episode.

Having an algorithm or another person manage my money might’ve gotten in the way of this lesson. It may have also meant that my early fears of being incapable and irrational because of my mental illness wouldn’t have been challenged.

But saying all that, I also must acknowledge that this is not the answer for everyone. Privilege matters in recovery, of which learning financial management is a part. This makes certain questions crucial to the decision-making process surrounding recovery — questions like, what resources can you access? And what can you afford to lose when you make financial mistakes?

The scope of any potential debt I could accrue is contained by my savings, my regular income, and the fact that I live in a country where health care and other basic resources are free. This is not the case for everyone. According to the U.S. Federal Reserve, almost half of Americans couldn’t find $400 in an emergency — they would be forced to borrow money, sell something, or would be unable to pay. You can spend $400 very quickly if you don’t have a realistic view of your financial situation. Given this, it’s hardly surprising that, according to the Money and Mental Health Policy Institute survey, many people wish “their financial autonomy had been limited when they were unwell.”

In this context, deciding to reduce your access to funds can be a reasonable decision.

The varied potential paths forward tap into the complicated nature of agency. And really, agency is about working with reality.

I cannot change the fact that I have a mental illness. Likewise, there are limits on the money any one person has at their disposal — limits that are very difficult to substantially change. After assessing their reality, a person can only choose what’s right for them — and this decision, no matter what it is, is a reflection of a person’s ownership of both their powers and their limitations.

People may do destructive things that they come to regret, but that doesn’t mean that they are doomed to making poor decisions for the rest of their life. Whether I see someone trying to learn financial management while dealing with various difficulties or limiting their access to finances in the future, I see a person who has had to grapple with serious questions about personal choice, what is and isn’t beyond their control, and what they expect of themselves in the future. I don’t see many people without mental illness who are so tightly engaged with questions about their reality in this way. I wonder if the problems posed by mental illness actually help people to consider their agency, and to subsequently take it.

The havoc of overspending can be profound. Deciding what to do about it — what risks you can and cannot bear, what your personal needs are — in the context of your own life is the stuff of agency. And, I think, the stuff of recovery.

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