bipolar parent

Disclosing Your Mental Illness Masterpost: How, When, and to Whom

Photo by Matthew Ball on Unsplash

Disclosing your mental illness to other people is a huge decision. You have to consider not only whether your friends/employers will support you after you disclose, but also how and when to do so.

I tend to disclose within the first or second meeting, before I’m even attached to a friend. I am open about my bipolar disorder to almost everyone I meet.

Bipolar disorder is just a label; it’s a part of my life but it isn’t everything, and it explains why I’m sometimes unpredictable. And I have a strong support system, so I have little to lose by disclosing.

For further reading on how I became more comfortable sharing my bipolar diagnosis, click here.

I live in a liberal area of the U.S. and have had various reactions to my admitting that I have bipolar disorder, most of which were positive but some of which were disheartening. There are often three ways that friends and family react:

  1. They are comfortable with your disclosure, nothing changes for the worse, and sometimes they’re better at supporting you.
  2. They are incredibly uncomfortable and take steps to end the relationship with you.
  3. They say that they are comfortable with you telling them this and then proceed to fade slowly from your life.

Obviously the first outcome is the best and most hoped for. While ending relationships are a concern, it’s entirely possible that they wouldn’t have been able to support you anyway, so it’s probably best that they disappear from your life.

When to Disclose Your Mental Illness

Telling someone about your mental illness takes a lot of courage. And you don’t have to tell anyone right away–or at all. Not everyone can live as openly as I do.

If you want to tell someone about your mental illness, tell them when:

  • You are well. You don’t want to wait until a mental health crisis hits to disclose to your friends that you have a mental illness. Disclosing when you’ve got your illness under control will give the people you disclose to time to adjust to the fact that you suffer from a disorder.
  • When you need people to understand. Sometimes, people who suffer from mental illnesses need special accommodations at work or school. Letting friends know the reason behind why you don’t want to hang out with them during a depressive spiral can prevent them from thinking you’ve grown distant. Telling people you have a mental illness is better when it serves a purpose.
  • When you’re ready. Disclosing your mental illness to friends, family, or even an employer is an intensely personal decision. Write down exactly what you want to say, and practice your words, either in front of the mirror or with a licensed professional. Talking to a therapist about your concerns may help put your mind at ease.

Although the “perfect” time to disclose depends on your relationship to the person and whether you’re well, honesty is almost always the best policy.

People don’t “need” to know that you’re mentally ill. Disclosing is your decision alone. But it may help explain some of your more erratic behaviors to the people you impact with them, which may help them give you grace when you suffer mood episodes.

When you choose to disclose is up to you. I’ve personally found that letting people know upfront that I have challenges they (usually) don’t is beneficial to both of us.

And if you’re dating someone, it’s always best to disclose that you have mood episodes sooner rather than later. For a more specific post on when to disclose your mental illness to your dates, click here.

Now that you know when to disclose, how do you do it?

4 General Tips on How to Disclose Your Mental Illness

You may have been curious to know how to disclose your mental illness to the people around you. Here are some tips to do just that.

1. Bring Your Disorder up in Casual Conversation

When I disclose my mental illness, I tend to bring it up in casual, low-stakes conversation.

If a potential parent friend asks about my children, I tell them a few facts about them (I have two, these are their names and ages, blah blah blah). Then I sometimes mention that the baby years were especially difficult because the sleep deprivation tended to make me manic, because I have bipolar disorder.

Despite its massive effect on my life, treating the illness as just something I have to deal with on a regular basis helps me.

I try not to trivialize the disorder–which is why I also sometimes bring up my postpartum psychotic break and how serious and painful it was–but I also tend to talk about my disorder as just a part of me.

This strategy normalizes the mental illness and allows you to determine the terms of how others perceive your bipolar disorder. If you treat the illness seriously but with grace, then other people may as well.

2. Describe the Steps You’re Taking to Manage Your Condition

Bipolar disorder is only as shocking as you allow it to be.

If you describe your bipolar disorder as this awful, paralyzing albatross, then both you and the person you’re talking to will form an opinion of you as being ravaged by your disorder and out of control.

Don’t let bipolar disorder rule your life even in the way you talk about it.

Try to describe the steps you’re taking to manage your bipolar disorder. Try to say things like, “I have bipolar disorder, which means I have to take medication and be vigilant about how much sleep I get.”

This lets people know you’re actively working towards stability, a heartening sign. Being friends with someone who’s unmanageable may scare some people away, as they might not be ready for a commitment like being constantly impacted by your wild moods.

Remember, managing bipolar disorder successfully is work no matter how you slice it, so be proud of that work!

3. Demonstrate How Your Bipolar Disorder Gives You Empathy

Even when getting to know my close friends, I would say things like, “Oh, yes, I understand a lack of focus–I have bipolar disorder and that makes focusing difficult.”

Mental health challenges are growing more and more common. A huge percentage of people struggle daily with problems like inability to focus, insomnia, or even mild, high-functioning depression.

Because your bipolar disorder is a series of mental health challenges itself, it has likely given you empathy for people who currently struggle with them. Don’t be afraid to show that empathy and let people know you understand their issues.

This shows them that you will not patronize them for their struggles, which may endear you to them.

4. If You Need it, Ask for Help

If you have a close relationship with someone, don’t be afraid to ask for help, especially from your employer (more on that below). If you believe they will be receptive, suggest ways your audience can support you.

This can involve asking for more breaks or other accommodations at work or school, or simply asking a friend to understand why you can’t hang out as long, especially at night, when you need more sleep.

You can also ask your loved ones to help you find a doctor and follow through with an appointment, if you feel that your friend or family member will understand and be helpful.

Set boundaries here, too: you know yourself best, and you need to explain whether you need advice or just need your audience to listen.

I have often “vented” to my close friends about how my mania makes me feel, especially when I’m in a manic state. I am upfront with my friends and family about whether I’m entering a mood episode, especially mania, and I describe the steps I’m taking to stabilize again.

4. Keep in Mind Your Boundaries on What to Share

You definitely don’t need to share everything. Plan ahead as to what you feel comfortable sharing about your experience. It’s perfectly reasonable to explain that you don’t feel like talking about something in particular.

If you do feel there are good parts to your illness, like things you’ve learned, try to share those. Remember, how others perceive your bipolar disorder is often about how you frame it, and what details you are comfortable sharing will shape how others feel about you.

I rarely have reservations when talking about my bipolar disorder, but there are friends for whom I wouldn’t go into detail about my postpartum psychotic break.

When I asked friends to read my book about the experience in the past, they frequently couldn’t read past the first paragraph because it was too painful for them to think of how much agony I experienced.

Some people can’t handle the nitty gritty of my illness and that’s okay. I still refer to my breakdown in general terms, but I don’t tell certain friends everything about it unless they express interest in reading my book (at which I warn them about how intense it is).

When sharing details about your mental illness, consider not only your comfort levels, but also your friends’, and what opinions you want them to have of you.

Disclosing your mental illness can be a deep and intense process, but it doesn’t have to be. Try bringing up your bipolar disorder in casual conversation, describe the steps you’re taking to manage your condition, demonstrate the empathy the illness has given you, and keep in mind your boundaries and your friends’ comfort levels.

If you’re disclosing to an employer, however, that’s a completely different ballgame. Here’s how to do that:

How to Disclose Your Mental Illness to an Employer

You know how and when to disclose your mental illness, and even if to disclose to family and friends. But what about your employer? Read on to learn how to protect yourself.

When choosing to disclose a mental illness at work, there are several factors to consider. You might face stigma from your coworkers–or worse, your bosses. Those you work with might not understand, or even want to understand, your daily struggle.

However, with disclosure might come special accommodations–like extra breaks–which are part of your civil rights. There are certain protections available to you.

You absolutely deserve those protections. If you’re in the US, don’t be afraid to disclose your condition to your employer so they can treat you fairly under the law.

Americans with Disabilities Act (ADA)

The Americans with Disabilities Act (ADA) is a protection that you should be familiar with. The ADA is just like it sounds like: a federal law that protects Americans with disabilities at private employers with more than fifteen employees, as well as state and government employers. There are two conditions you must meet for the act to apply:

  1. Your disability impairs your life, essentially making working difficult. This condition applies to difficulties with regulating emotion, concentrating, and other ways your mental illness interferes with your ability to work.
  2. That, while your illness makes working difficult, you can get the work done.

Rehabilitation Act of 1973 (Rehab Act)

The Rehabilitation Act of 1973, or Rehab Act, is a federal law very similar to the ADA that applies to schools. Any agency that receives government funding is covered under the Rehab Act.

Family Medical Leave Act (FMLA)

The Family Medical Leave Act (FMLA) is a useful law that helps people keep their jobs while taking an extended leave of absence. The FMLA only applies to companies with over fifty employees, and after you have worked for the company for a year minimum. The FMLA lets you take up to twelve weeks of unpaid leave to care for a sick family member or recover from an illness yourself.

States also have their own protections for Americans with disabilities.

What Accommodations Can I Receive? How?

Under these laws, you can receive special accommodations: working from home, flexible start times, written directions, feedback from your bosses and coworkers, more breaks, and quiet places to take those breaks. These changes to the workplace are intended to be an aid for you so that you can complete your tasks.

But how do you apply for these accommodations? The process isn’t difficult, but the onus is on you to ask. Once you do, your employer is mandated to talk with you.

  • First, contact the human resources (HR) department and ask them what channels you need to go through to apply.
  • Write down your request. Be very specific as to what accommodations you need, and explain to HR how these will help you in the workplace.
  • Talk with your treatment team–therapists and psychiatrists–to see if they can offer any proof that you suffer from a mental illness.
  • Take notes at every conversation you have with your boss. Do not delete any emails that apply to the request.
  • Be reasonable and flexible. Your strongest advocate is you, so be prepared to negotiate.

 Discrimination

What if you’ve been discriminated against because you suffer from a mental illness? There are legal protections available for you:

  • If the employer is a private one covered by the ADA, then you have to reach out to the Equal Employment Opportunity Commission (EEOC). File a complaint at the EEOC’s website, www.eeoc.gov.
  • If, however, the employer is a federal agency, like a school or governmental employer, then you must reach out to the Equal Employment Opportunity Office (EEO). File a complaint at the EEOC’s website, federal division.
  • States have protections as well. If you’ve been discriminated against despite these laws, look up your state’s Fair Employment Practice Agency (FEPA).
  • The Department of Labor manages the FMLA. If you’ve been denied your legal right to twelve weeks of unpaid leave, then contact them.

There are several protections available to you should you choose to disclose your mental illness to your employer. Whether or not you should is completely up to you. As we said, you might face stigma from your coworkers or bosses, but if you’ve been discriminated against, you can file complaints. You have a right to accommodations. All you have to do is take that step forward.

Final Thoughts

How and when to disclose your mental illness can be intense, deeply personal decisions. But they don’t have to consume you. Here’s an overview of the masterpost:

When to Disclose:

  • Whenever you’re well.
  • When you need people to understand.
  • When you’re ready.

How to Disclose to Friends:

  • Bring your bipolar disorder up in casual conversation.
  • Describe the steps you’re taking to manage your condition
  • Demonstrate the empathy the illness has given you.
  • Keep in mind your boundaries and your friends’ comfort levels.

How to Disclose to Your Employer to get the Accommodations you Deserve:

  • Contact HR
  • Write down your specific request.
  • Get proof of your mental illness from your treatment team.
  • Take notes at every conversation you have with your boss. Do not delete any emails that apply to the request.
  • Be reasonable and flexible in advocating for yourself.

Only you can decide when, how, and to whom to disclose your mental illness. You may face stigma and discrimination for it. But those true friends who do stick around–and those accommodations you’ll earn from your employer–are worth it, in my opinion.

Best of luck disclosing your mental illness.

I wish you well in your journey.

Related Posts:

bipolar parent

National Prevention Week: How I Prevent Oncoming Bipolar Mood Episodes

The week of May 12-18 is National Prevention Week, so I’d like to talk about how I try to prevent oncoming bipolar mood episodes. Because I was diagnosed at twenty-two and started medication and therapy, I have a decade’s worth of experience in managing my bipolar disorder. Read on for a roadmap discussing how to tackle the prevention of mania and depression head on.

Fight Self-Stigma

Self-stigma is when you have absorbed the negative, inaccurate messages about your mental illness around you. This affects your perception of your mental illness and your need to treat it, which in turn affects your behaviors and actions in terms of seeking treatment. In order to face taking medication every day for the rest of your life, you need to fight stigma, especially self-stigma. The way I fought it was to recognize that I needed to be my best self for my newborn son, which entailed taking medications and going to therapy. I needed to treat my disorder so I could properly mother my son. It wasn’t just about me.

If you have a reason outside of yourself, awesome, but if you don’t, you still deserve treatment. You are better than your disease. You are a human being, a precious individual. Caring for yourself, especially in the pit of depression, is one of the hardest issues you’ll ever face. But you deserve proper care, even if it’s mostly self-care for a while.

Medication

I can’t recommend medication enough. In combination with therapy, medications saved my life. When I was first diagnosed, Depakote toned down my psychotic mania, and two years later, lithium lifted me from the black sucking hole of suicidal depression. Now I’m on Risperidone and Wellbutrin, and the combination has enabled me to be stable for over six years. Taking my medication daily has prevented the dizzying spin of mania and the pit of depression. Part of this is my fighting self-stigma, as I said above.

Therapy

Another tactic that has helped me remain stable for the past half-decade is attending counseling sessions with my therapist. Therapy has helped me learn coping mechanisms to handle my day-to-day life, including emergencies. I’ve been able to treat my manic and depressive episodes, and learn how to flourish. I am thriving, and I wouldn’t have thrived so successfully without those weekly appointments with my therapist.

Sleep

Proper sleep is crucial for managing your bipolar disorder. Sleep disturbances trigger bipolar mood episodes, especially mania, and too much sleep triggers the crash of depression–usually following mania. Problems with sleep are a common symptom of bipolar disorder; in a future post, I’ll be looking at how common insomnia is for this specific mental illness.

To ensure I sleep as well as I can, I practice what’s called good sleep hygiene. I don’t drink water or caffeinated beverages right before bed. I wind down before bed, taking a bath every night. I wake up every morning at 8:30am, if not earlier. I try to go to bed at the same time. I wake up frequently in the middle of the night with a racing mind, but I try to calm myself by praying or meditating. Generally, that works, and I’m able to get back to sleep within fifteen to thirty minutes; I recognize that I am lucky in that manner. Try to practice good sleep hygiene, and you, too, might be able to prevent oncoming bipolar mood episodes.

jessi RM
A picture of a smiling woman next to a frowning woman, in black and white. Credit to fliclr.com user Jessi RM. Used with permission under a Creative Commons license.

Final Thoughts

Fighting self-stigma, getting proper treatment for your disease (including medication and therapy), and sleeping properly are some of the best ways to prevent oncoming bipolar mood episodes. If you’re looking for a post on how to manage the most common bipolar triggers, click here.

You can do this.

Related:

bipolar parent

“How Do You Define Mentally Ill?”

“What do you mean he’s mentally ill?” the woman said. “He just needs to get his act together!” I was sitting in an Olive Garden the other day, and overheard part of a conversation from a very loud patron. I tried to ignore her, but she said something that caught my attention: “Well, how do you define mentally ill?”

Hearing that made me think about what a good question it was. How do you define mental illness? Mental disorders are more prevalent than heart disease, cancer, or diabetes. Twenty-five percent of American adults and thirteen percent of American children are diagnosed each year with a mental illness, per the National Institute of Mental Health (NIMH). The causes of mental illnesses are still unknown, though recent research points to genetics as well as environmental stressors.

According to the Mayo Clinic, “Mental illness refers to a wide range of mental health conditions–disorders that affect your mood, thinking and behavior.” Generally, these illnesses cause dysfunction in your life. Examples include schizophrenia, eating disorders, bipolar disorder, phobias, unipolar depression, and many more. These conditions are classified in the Diagnostic and Statistical Manual of Mental Disorders, 5th. Edition (DSM-V). Published by the American Psychiatric Association, the DSM-V is considered the guide to mental health issues. It covers five dimensions of mental illness:
• clinical syndromes, such as bipolar disorder
• developmental disorders and personality disorders, such as autism and borderline personality disorder
• physical conditions
• severity of psychosocial stressors
• and highest level of functioning in the last year, which is a measure of the mentally ill person’s ability to meet life’s demands on an annual basis.

dsm
Credit to flickr.com user Richard Masoner. Used with permission under a Creative Commons license.

But how does society define mental illness? There are stereotypes of the disordered person ranging from unpredictable to slovenly. Countless news stories report people with mental health issues as violent, while research shows that they’re no more violent than the general population. In fact, they are more likely to be the victims of violent crime. Thesaurus.com even lists “crazy” as the second synonym for violent.

What’s even worse is how society has treated the mentally ill. In Ancient Greece, physicians used to drill holes in people’s heads to let the evil spirits escape, and ostensibly cure their disorders. Institutionalism was rampant from the 1800s to the 1950s, and some patients were even chained to their beds and left in filth. It was as recent as the 1930s that lobotomies and malarial infections were the leading treatments for the mentally ill.

So, when the woman in the Olive Garden spoke about her friend’s husband, putting him down for suffering from mental health issues, I was irritated with her. People who endure these grueling conditions and their families have enough to deal with without others questioning their diagnosis.

Most people with mental illnesses are aware that they can sometimes be inappropriate or different than others. Mental disorders are not something you can just will yourself to cure. They require treatment ranging from talk therapy to medications, and some are even treatment resistant. Many people who do not receive treatment are unable to cope with their lives, which in turn causes them to not be able to keep the house clean or hold down a job. Many more can control their mental illness, or mitigate symptoms—with treatment.

Treatment has come a long way since the insulin-induced comas of the 1930s. But it’s not far enough. Communities have been slow to offer housing support and life skills training for the mentally ill who were deinstitutionalized in the 1950s. People who suffer from mental health disorders need more care than society has been willing or able to give.

Better funding for research into disorders would be a good start. The National Institutes of Health (NIH) estimated that the organization would spend $396 million on mental illness research in 2016, compared to $1 billion for diabetes research.

But what can individuals do for those of us who suffer from mental illnesses like bipolar disorder? Be kind to the mentally ill. Learn about various diagnoses and the stresses that trigger them. Advocate for better housing options and more funding for research. With these efforts, concerned people can make the world a better place for those with mental health conditions.

How do you define mental illness in your life?

bipolar parent

Are You “Covering” For Your Illnesses?

Credit to flickr user christine zenino.  Used with permission.
Credit to flickr user christine zenino. Used with permission.

Covering is a unique trick-of-the-trade known to anyone who has been chronically ill–mentally or otherwise. It is the art of straightening ones shoulders and schooling ones features to show that, no, really, we’re fine, so please don’t fire us or ask us to explain what’s going on. In short, we’re actors donning the mask of normalcy.

The first psychiatrist I met with outside of the mental hospital called it my “manic happy cheerleader face.” Julia Kovach touches on the subject in her post Being Bipolar, where she describes reactions to her diagnosis:

And because people don’t understand what they can’t see and sometimes say stupid things; like I look so normal that I must be mistaken. I guess I don’t act crazy enough. Ha ha. And if they should get a glimpse? They run. Fast and far.

The brilliant Ari Flynn, who suffers from chronic depression and on whose blog I first heard the term, offers a more complete description:

Telling your friends to treat you like everything’s normal is equivalent to playing a never-ending round of the Elephant Game (don’t think of an elephant — whoops, you lose!), so the only way for you to avoid that particular soul-sucking bog is to learn how to control how much information other people get about your internal state. It’s something nobody ever really talks about, but the bipolars and chronic depressives are all nodding to themselves — do it long enough, and you get very, very good at it. You have to; it’s a survival skill.

After a while it gets to the point where being able to cosplay as a functional human being is the only thing you feel like you can do even kind of right.

They are absolutely right. It is easier to pretend everything is fine than to explain why you had to limp to the shower due to fibromyalgia or why you bought $700 worth of chocolate in one go. Anything you say is by no means the complete picture, and often won’t alleviate your pain. The ability to cover is a hard-learned skill, due to fear of stigma, rejection, or unwillingness to overwhelm other people with your own suffering.

Additionally, this role is draining to play. We all have different strengths and weakness, but constantly monitoring speech and behavior is exhausting for anyone. Under stress, the performance breaks down. With regards to mood episodes, the lack of self-awareness during mania and the lack of grooming during depression are strong indicators that the mask is slipping.

Celebrities like Stephen Fry and Brooke Shields have started paving the way for discussions about mental illnesses. The more we all talk about bipolar to those who have it and those who don’t, the more people may understand and stick around. Building a community of peers is the best way to counteract this strenuous protective mechanism.

You’re not alone in hiding, so why not surround yourself with people who understand that burden?

When do you find that you cover the most?

bipolar · bipolar parent

Why Medicinal Weight Gain is Devastating to the Mentally Ill

“Watch out,” the mental ward’s psychiatrist gently cautioned me. “It’s true that Depakote will stabilize you, but you’ll gain a lot of weight. Plus, anything you pack on will be harder to lose. Are you sure you want this medication?”

“Pish posh,” I said, manic and therefore invincible. “I don’t care about a measly ten pounds.”

At the time, I was seething. Were we, in considering my treatment plan, really going to prioritize my weight over my mental health? In the midst of my psychotic breakdown, I’d just realized that I was insane enough to need serious medical intervention. Was that really the time to caution me about maintaining thinness—especially considering I had given birth two weeks prior? And why were there no other options to treat my condition?

Sixty pounds and a few years later, I care a great deal about my muffin top. So much so that it has started to negatively affect both my health and self-esteem.

I’ve had young children ask if I have a baby in my belly.  I’ve been laughed at and called “fattie!” when dancing.  I’ve even had a certain insensitive business owner look at my four-year-old debit card and declare, “You used to be so skinny!  You know, when you were a teen.”

Ouch.

No one can tell from looking at me what my diet is or what medications I may be taking. Despite that, they feel free to comment on my body. I fully admit that my new curves are not entirely due to my nightly med cocktail. I am largely sedentary and my diet consists of the three major food groups—Grease, Sugar, and Dairy—both issues which I am addressing. But even with that lifestyle, I should not have gained thirty pounds in a year.

Weight gain is a huge factor preventing people from complying with a long-term drug treatment plan. In a 1999 study of the adverse effects of antipsychotics, more than seventy percent of participants reported weight gain as “extremely distressing”—far greater than any other side-effect.

Depakote, a gold standard in the treatnment of bipolar disorder, is one of the worst offenders. Studies have even suggested that women on the drug crave carbohydrates up to ten percent more than men do, and tend to gain more.

This is a three-fold problem:

1.  The mental health industry is a fledgling one, even though its business is currently booming. We just don’t know what a lot of these compounds do to the body yet, especially when blended. And not all drugs work for everyone. I myself am allergic to entire families of medications, including most of the new atypical antipsychotics and serious painkillers.

2.  People stop taking their prescriptions when they feel that the diseases are easier to bear than the side-effects.  In addition, this is often done abruptly, which can be dangerous as it may trigger a severe mood episode.

3.  Despite not being able to tell how healthy someone is by looking at them, many cultures shame fat people.

There is a stigma against having a mental illness. There is a stigma against needing medications to survive. There is a stigma against being fat. But what if you are the first already and have to choose between the second and third?

This is the kind of choice that breaks a person.

What sorts of things have you had to deal with on your meds? If you can bear to part with the numbers, how many pounds have you gained?