I Was Diagnosed As Bipolar — But Really, I Was Just Bisexual
I’ll be the first to admit the title sounds ridiculous. Funny “bi” puns aside, how can anyone get these two things confused? Hear me out.
The conflict I experienced around my identity led me to a lot of harmful behaviors as a teenager and young adult. Many of those centered around substance use and misuse. I started drinking as a fourteen-year-old, around the time I hit puberty. I had just experienced my first sexual assault, though like many sexual experiences for young, queer men, at the time I thought it was something I wanted and didn’t recognize the inappropriate nature of the sex with a much older man, until years later. Cannabis use followed, then party drugs like Ecstasy, GHB, methamphetamine, and ketamine. I played around with Oxycodone and various pills as the opioid epidemic ramped up in South Florida, where I grew up. Eventually, cocaine allowed me freedom, though only ever momentarily, from the shame I experienced around my sexual identity, and I embraced the numbness I felt from Xanax and other benzodiazepines as I started to receive treatment for various mental health challenges that I didn’t quite understand.
Substance use meant I could not experience shame for short periods at a time, and allowed me to explore things that I wanted, like sex with men, that I was too scared to do anything about, sober. Of course, that led me to dangerous situations, posting up in dirty video booths in the back of seedy adult bookstores, fetishizing and exploiting transgender sex workers as a means to my exploration, and anonymous rendezvouses with strangers that I met in chat rooms on America Online. All things that made me feel 100x the shame after the fact, which resulted in more use of dangerous substances, thus beginning the cycle that led to hospitalizations, suicide attempts, and multiple mental health diagnoses, the most impactful of which was bipolar disorder. Had I existed in a world that supported me in exploring who I was, this all could have looked a lot different.
It’s important to acknowledge that each of our journeys with our identity is different from the next person’s. Exploring those differences as an adult has been great fun and has resulted in lots of positive self-reflection and personal growth, but ya’ll, I’m lucky I’m alive to explore.
Some experiences may look similar, may even be similar. For example, I imagine that most men who identify as bisexual, on more “hetero leaning” dating apps, experience similar judgment from straight women and gay men. I doubt I’m the only one who’s heard, “That’s cool you’re bi, I fully support the LGBTQ+ community, love is love and all that, but I could never date a bi guy, eww.” Others fear a bisexual man’s inability to remain faithful if monogamy is the chosen path or the assumption that men who have sex with men must have diseases or even just the thought of two men being together is somehow gross. Some nuances exist for bisexual men who come out that may look different than those of bisexual women or gay men.
After years of navigating substance use, I found myself hospitalized far too often. The first hospitalization I remember, I was put on a 24-hour hold in a psychiatric wing of a hospital near my parents’ home. I pleaded with them to get me help for suicidal thoughts and paranoia. What I was experiencing was cocaine withdrawal-related psychosis. After twenty hours alone in a small room, laying on a couch that couldn’t fit my entire body, I was visited by a physician who determined there was no reason to keep me any longer.
A few weeks later, I was admitted to detox, then a fancy Ft. Lauderdale treatment center a few blocks from the beach. I had an experience there that sent my life into a spiral. My very first therapist, an openly gay man, told me that based on recent research, I couldn’t be bisexual, physiologically. He said since I was attracted to men, I must be gay, and too uncomfortable to come out. The therapist assured me that many men had similar experiences and that they were too scared to embrace their gay identity. I was young, vulnerable, and confused. I did what anyone would do? I came out as gay, to the other folks in treatment with me, then to my family and friends. It never felt right, though I tried. I found myself in a relationship with a woman, questioning how I could be attracted to her if I was gay. This was as confusing for her as it was for me. But for the first time in my life, I felt supported in my exploration, and for a short time, was able to remain sober.
During that time, I looked for support from gay men, specifically in twelve-step recovery communities. “Bi today, gay tomorrow, which was my experience, so it must be yours,” was the consensus. How can this community be so judgmental? I wondered. Having overcome their discrimination and marginalization of their own? The way I see it now, from the other side, is that as a person who’s always navigated the center of the spectrum, the people who have the hardest time seeing the center, are those on its furthest ends. I don’t fit in with the straights, or the gays.
Due to the lack of support, and judgment, I didn’t stay sober for long. I found myself hospitalized again, this time after a failed attempt at suicide that consisted of me taking a few handfuls of prescription medication and washing them down with cheap, Russian, vodka. Bipolar disorder can be difficult to diagnose, and most screenings include the questions, “Have you been hospitalized for mania? Have you been hospitalized for depression?” Since I answered yes to both, it was easy to roll with the diagnosis and carry it from city to city, doctor to doctor, without anyone questioning it, including myself. Rarely was I honest with medical professionals about the depth of my drug and alcohol use, and I liked some of the medication that doctors were prescribing so I didn’t have much reason to question the diagnosis.
When I was thirty-seven, I was admitted to substance use treatment, as of this writing, for the last time. It wasn’t so much that I trusted the professionals any more this time, but that I was no longer suicidal and was beginning to see the value in living. I knew if I didn’t get honest, I would not have a chance, so I started to open up. I was honest about my substance use, and some elements of the conflict around my identity. Just before I questioned my diagnosis, my psychiatrist, having worked with me for three months and completing a thorough history said, “Casey, I don’t know if this diagnosis is correct. All of these things you’ve experienced, the mania, the depression, the hospitalizations, could very well be related to your substance use, and not symptoms of bipolar disorder. There’s only one way to find out. We can wean you off these medications and you just have to be diligent and honest about how you’re feeling. What do you think?”
Three months later I was medication free. Around that time, I dove headfirst into substance use recovery and came out publicly as bisexual. I began to live authentically and connected with others. I found a secular recovery path that was much gentler than I had experienced with twelve-step groups. I started a secular meeting specifically for queer folks that identify all different ways. I discovered the “queer” community and others who navigated the center of the spectrum, not straight, not quite gay. I received all the validation I was lacking for so long. Most importantly, I had conversations with other bisexual men and with women who not only accepted that I was bisexual, but who supported it. I found a therapist that supported my exploration of my identity.
While I still have challenges, and some are still related to my mental health, it’s been almost three years since I’ve received treatment specifically for bipolar disorder. I have sustained abstinence from drugs and alcohol. At forty years old, I am more passionate about my life than ever before. I have found my community and strive to help others to find theirs. Mental illness can be difficult to diagnose and easily confused with so many other things. In my case, I’m comfortable saying that I was never bipolar, to begin with, I was always just … bisexual.
Casey Cannizzaro (he/they) is a recovery & lifestyle coach, writer, and substance use disorder counselor. He has been navigating substance use recovery for the majority of his adult life. He’s especially fascinated by the intersection of substance use and identity. He came out publicly as bisexual in 2019. He lives in San Diego with his partner, Shannon. They plan to move to Portland, Oregon in October. Casey serves on the Board of Directors of the secular recovery organization, Lifering, and is a member of the Bi+ Mental Health Justice Coalition. Follow him on Instagram or Medium or hit him up on Facebook. Feel free to say hello — his DMs are forever open.
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