I am Bipolar
Questions of an existential nature fill my mind as my awareness continues to perpetually fuel the inquiry into the disassociation and unreal feelings of my surroundings. Do I exist? What does it mean to exist? Where do I exist? Is this all a fabrication of mind? Am I my mind? What is mind? Who am I? Most of the time the questioning is not even linguistically formulated, but is simply a process of thoughtless analytical observation where my awareness silently questions my experience through experiencing the experience itself, by becoming vividly aware of the contents of my consciousness and watching them play out in an endless cycle of disassociation that is felt throughout my body and mind. (Random Scribbles 2008 July 20)
Iambipolar.ca is a Canadian website created as a resource for those who are diagnosed or believe that they have bipolar disorder or some variation of the mood disorder. The website offers a variety of resources to its visitors, including articles, videos, podcasts, suggested readings, a blog tree and a forum. It is not immediately clear who runs the website, but from the manner in which many editorial paragraphs are written I have deduced that the website is created and maintained by one or several individuals out of personal interest and a desire to fulfill a perceived responsibility to network and communicate with other individuals afflicted with the same disorder. Their front page greets visitor with a short introduction:
Welcome to I Am Bipolar!
I Am Bipolar is an online resource for family, friends and people who are dealing with Bipolar Disorder. Here you will find news, videos, articles, book reviews, a forum and many other resources to help you cope with a difficult and sometimes confusing mental illness. You will also find my bipolar blog called Random Scribbles where I'll be writing my about my experience with bipolar disorder, books that I've read and other random thoughts that cross my mind (I am Bipolar 2008 October 21).
Within this paper, I will examine the variety of networking opportunities created for people who find an interest in bipolar disorder, be they individuals who have it, their families or individuals looking to educate themselves on the disorder. Through the blogs and forums I will make an extensive examination of how people relate to the disorder, their understanding of how it operates within society and how they relate, through the internet medium, with other people with the disorder. I will first discuss bipolar disorder and analyse the foundations of the website, what it purports to provide and how it operates for its visitors.
Bipolar Disorder
Bipolar disorder is a psychiatric diagnosis that describes a category of affective mood disorders bipolar disorder is a spectrum disorder that is characterised by periods of mania and depression (Wikipedia 2008 October 21). The disorder has a long history of recognition in a variety of forms, and it's psychiatric definitions have greatly changed to finally arrive at its contemporary diagnosis. Bipolar disorder is no longer seen as a cycling disorder, where depression and mania alternate, but rather a single episode of either within a specific time period. The Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association categorizes four subtypes to the affective mood disorder. Bipolar type 1 and Bipolar type 2 are both characterized as having manic and major depressive episodes, where Bipolar type 2 has a less intense hypomanic trait. Type 2 also displays no mixed episodes and at least one major depressive episode. Cyclothymia is the third subtype that contains hypomanic episodes and depression that does not meet the criteria for major depressive episodes. There is one last category, Bipolar Not Otherwise Specified (NOS), which is a catch all category for individuals suffering from mania and depression, but do not fit in the first three categories.
Bipolar Spectrum disorder has a genetic component, and is currently believed to be influenced by a single nucleotide polymorphism (Baum 2008). Due to the varying symptoms observed in identical twins, the theory of stochastic neurobiological effects being a major factor has favour over a genetic causation theory.
Entering the iambiolar.ca Website
Iambipolar.ca begins it impression on a visitor simply with its name. The phrase I am Bipolar connotes an identification with those who have the disorder and immediately positions itself as more than an informational site. As an emotional, subjective and identifying phrase, I am Bipolar brings a sense of bio responsibility to creating a fragment of ones identity as bipolar. Questions of who a person is and how they are identified are on the surface as one navigate further into the website. Through the access of information this website highlights what Rose describes as a neurochemical individuality [that] becomes a field of choice, prudence and responsibility. One of the major themes of the website is the experimentation and contestation that is packaged with that neurochemical identity (Rose 2007: 40).
The typeset for the website title is handwritten and scratchy, bring both a sense of individuality and non-conformity with a touch of the “insane”. Only those who are unwilling or unable to follow the rules write outside the lines. There are only two other images on the front page: a post-it looking image, complete with a thumbtac, inviting visitors to enter the forums to communicate and network with other bipolar sufferers and a small picture of the human brain with different areas of it highlighted in a variety of colours. This pictoral “map” of the brain is reminiscent of early scientific maps used to categorize the brain into sections that control different aspects of the body, personality and all abstract aspects of life. Juxtaposed with the opening statement, the connotation is that bipolar disorder, its effects and its relationship with the person are conceptualised through this abstract and scientifically objective form called the human brain, and that the brain can be split up into readily identifiable and understandable areas.
As the website prompts one to visit the forums quite prominently, that was the first area of the website I ventured into.
Iambipolar.ca Forums
The iambipolar.ca forums are frequented by 111 registered users and a number of guests. Most of the registered members who have listed their location in their profile are from different areas of Canada (I am Bipolar Forums 2008 October 21). There are six subforums titled General Discussions on Bipolar Disorder, Treatment Options, Personal Stories, Diagnosing Bipolar Disorder, Family and Friends (helping someone with Bipolar) and Jokes, Humorous Stories, Etc. The most topics are posted in the General Discussions subforum and it also has the most number of posts.
Within the General Discussion subforum there are many threads of introduction, articles of interest and quick and interesting discussions. One of the leading threads that caught my eye immediately was titled “best type of work?” (I am Bipolar Forums 2008 May 5). In the thread, the original poster (OP) asks a general question to other members of the forum:
Have there been any studies or articles published on what type of careers tend to fit people with bipolar (I am bipolar Forums 2008 May 5)?
The answers vary from personal accounts to different books read by individuals that helped to shape their decisions on their work and careers. Many members were quick to point to creative and low-stress jobs, as people with bipolar have a perception of being quite creative (almost to the point of genius during manic and hypomanic periods), and unable to deal with stress during low periods. There is very little discussion talking about medication and it's ability to mediate problems with work, except to say that it does very little to stabilize some of the major symptoms of the disorder. One member discussed their previous work history and how they eventually came to choose their career path:
Before diagnosis following an incredibly prolonged mania three years ago I worked in a fairly uncreative marketing position for a high tech company... I was never fully happy in the role but stuck with it as it seemed the best possibility out there at the time. For seven years attendance was definitely an issue for me. I didn't know I was bipolar, so didn't know the reason, but I would often just not be able to go into work and it was frustrating to say the least to try and explain what was going on to my employer when I didn't have a clue myself. In hindsight, all my manias and depressions directly affected my work performance. I just didn't know it at the time.
Post-diagnosis and during recovery I thought it best to look for a career that I could control better. My major motivation here was to reduce the amount of stress I'd have when faced with yet another situation of not being able to go to work or to perform at my regular level, and avoid also having to explain the reason why to a future employer. In my last job I went on short-term disability following a manic episode and the response from my boss and colleagues was completely negative. Then the insurance company rejected my claim based on a technicality ... I decided I should work for myself, and in something far more creative than what I had previously been embarking on.
While working for yourself includes a huge amount of stress, it's at least stress that seems manageable to me. I'd rather feel guilty to myself and myself only when I'm unable to perform at work than have to answer to a boss and a group of colleagues that may and most likely not understand. Most people in my experience just don't get bipolar... I can't say I love every minute of it, but I love a big part of it. I love the freedom and the challenge and the room for creativity. I'm figuring I'll start loving it fully once I get through the "start-up" phase of owning and operating a business. (I am Bipolar Forums 2008 May 22)
The sentiment of being misunderstood in the workplace, being unable to keep a consistent schedule and the negative influence an uncreative job has on a bipolar person was repeated by most members replying to the thread. There was an undercurrent of difficulty and isolation, but also extreme individuality. The bipolar individual can not be tamed and will not fit into the regular mould. For some members this was the crutch of their difficulty, while for others they saw it as a mark of pride and the difficulty lay with hegemonic conceptions of their disorder.
One short, concise reply came from an individual that dissented with the idea that profession was chosen by one's mental disorder:
My feeling is that one's diagnosis should not influence one's choice of occupation, except to the extent that shift work is probably not healthy for us. Practically speaking, one's career is probably already chosen long before the diagnosis, given the typical 8 year lag between onset and correct diagnosis, by which time most are in their late 20s. (I am Bipolar Forums 2008 August 27)
The argument that one must live by the rules of their disorder, or that bipolar is an overriding personality disposition that must take priority over other decisions fell moot on this particular poster. Their one precondition, of course, was mitigation of some of the more undesirable physical side effects, like insomnia.
Within this thread, another member discussed their job and how they felt it encompassed a return of the experiences they had with mental illness in the form of positive information, empathy and counselling for other people seeking help with a variety of psychiatric disorders. This person works as a peer support counsellor at her local hospital and describes their experience:
Here is one job where living with a mental illness is a benefit... I find that there are a lot of common experiences...feelings...emotions and fears that can be mutulally shared. I offer hope by example... I offer whatever positive examples I have experienced. I try to play down the negative side of the illness and show the postive side of the illness. I also [offer] whatever coping skills I have to help manage symptoms. (I am Bipolar Forums 2008 September 4)
In the Diagnosing Bipolar Disorder subforum the administrator of the forum describes Bipolar disorder as a managment disorder that includes medication, therapy, eating healthy, proper sleep patterns and learning what in one's life will act as a trigger for different episodes (I am Bipolar Forums 2007 October 30). This sets the tone for the subforum, as discussion about medication and pharmacology are expanded to include genetic factors, environmental factors and the difficulty in getting diagnosed. With anti-depressants being one of the highest prescribed medication in the United States, the forum members skeptically view the pharmacology industry and their motivatons in providing bipolar medication. The administrator comments in this subforum, and their blog, that the medication for bipolar disorder is not 100% effective and should never be perceived as a miracle drug (I am Bipolar Forums 2007 October 30; Random Scribbles 2008 August 17).
The I am Bipolar Forums engage its members in conversation on a variety of related topics to their disorder. As one member comments:
This definitely is the most supportive and informative site I've found. (And Canadian! Yay!) It has really been a great help for me to come here and read that other people are going through similar situations as me. I feel less like a victim and more empowered to improve myself (I am Bipolar Forums 2008 July 9).
Through this peer networking there is a desire to remove some of the vunerabilities associated with mood affective and psychiatric disorders. The expression of hiding oneself from coworkers, friends and society due to this disorder is common, with a subsequent expression that the anonymity of the internet allows a forum for these discussions to happen with the fear of ostricisation removed from the equation. Through this networking portion of the website these individuals have located and further developed a safe social space for themselves that is both socially engaging and informational.
Blogs
Iambipolar.ca offers a page with a link tree to other blogs written by individuals with bipolar disorder. They range from individual accounts of living life with an affective mood disorder to advocate journalism on pharmaceuticals and psychiatry. The main blog of the website is Random Scribbles, written by the site author.
Random Scribbles takes a name with an unfinished, draft and automatic art (such as that utilized by the Surrealist art movement in the 1930s) connotation and captures an element of the subconscious nature of bipolar disorder – many afflicted with the disease feel it's beyond their immediate control and is an intricate part of who they are as a person.
The latest entry posted was entitled To Tell or Not to Tell and examined bipolar disorder, secrecy and the event of telling those around one of the affective mood disorder that one has been diagnosed with. As in the forums, the author of Random Scribbles points quickly to the workplace relationship with mental disorders. They highlight how confiding in a employer and/or coworkers about ones disorder can have one of three effects: A negative reaction where the employer and coworkers begin to treat the person afflicted differently, by thinking they can't do anything for themselves or actively discriminating against them out of fear or misinformation. A neutral reaction where the employer or coworker seem to think the disorder has very little to do with their employment (the author then points out, while not an outward act of negativity, this can be negative as people with bipolar disorder often need special consideration when it comes to mood episodes, stress and attendance). Lastly, a positive reaction where the employer and coworkers empathize with the afflicted individual and take care to help them have a healthy work environment to minimize their episodal triggers (Random Scribbles 2008 August 17).
The author laces this article with their philosophical and personal perspective:
It is unfortunate that revealing bipolar disorder needs to be considered so carefully, but until it is accepted in the mainstream as just another aspect in the spectrum of being human then it will remain hidden in the shadows of daily life. The reality for reaching this mainstream acceptance is kind of a catch 22 though because in order for bipolar disorder to become mainstream and accepted, people suffering from it need to speak out, but by speaking out you potentially face being persecuted for the natural biological functioning of your brain because it does not function exactly like the brains of the majority. (I am Bipolar Forums 2008 August 17)
There is a real sense of fear in this article, brining to light the authors view of the marginalised nature of mental disorders like Bipolar. Throughout the blog, the author's articles are spotted with a sense of isolation and fear, as well as caution. As the author builds a website to bridge this isolation, they can not help but discuss the existing rift between what is perceived as our contemporary hegemonic society and the negotiation of people with bipolar within it:
It sometimes seems like the world isn’t made for us. Like we don’t fit the mold of what a human being should be. Employers don’t want workers who will suffer uncontrollable bouts of depression or mania and exhibit associated behaviors. Friends don’t want the unpredictability of friends who one moment are filled with energy and excitement and the next moment won’t leave their house or talk to anyone because they are so depressed. They want consistency. They want reliability. They want to know that who you are now is who you will be tomorrow and 6 months from now (Random Scribbles 2008 July 20)
Conclusion
Biopolar Spectrum Disorder is a neurological disease that effects an indeterminable amount of people, it is a disorder that is often misdiagnosed and inaccurately medicated. The most common confusion is diagnosing individuals with bipolar with a depression disorder, as the American Psychiatric Institute identifies that most people seek help when they are in a depressive period and tend not to see manic (and especially hypomanic) periods as a serious threat to their mental wellness. This affective mood disorder, as with most similar disorders, is open to constant contestation; within diagnosis criteria as well as the classification as a disorder. Bipolar has many myths and preconceptions that come with it, including the idea that the greatest creative genius in the Western world has come from persons suffering from the disorder and so, by extension, all those who go through manic episodes must also have the potential for equally creative persuits.
There is a negotiation that individuals with bipolar disorder go through with their identity, their mental disease and the perception of that disease. These human dramas, understandings and relationships are played out in several different ways on the iambipolar.ca website. Through the blogs and forums, individuals with similar issues and common neurological and biological interests meet each other through the anonymity of the internet. They tell their stories, critique articles on their disorder in the media and try to find a sociological common ground for their circumstances. Simultaneously, they highlight their differences and enjoy the freedom of their individuality, not only within themselves in relation to other members, but also in the social order of individuals with bipolar and all those who do not have and continue on with “normal” actions in society. Individuals see their fitting a social mould as a reliable, working and emotionally stable citizen as both a difficulty and an undesirable path to embark on. Many revel in their “fringe” lifestyles, while others want nothing more than empathy and understanding, while still other yearn for a sense of normality and happiness. There is a consensus that the affective disorder is generally misunderstood and misportrayed in popular culture and media and they discuss the variety of ways they view and live with the disorder.
Bipolar disorder is a highly contested disorder, leaving those who have it with contested identities. Due to their contested neurological individuality, and the experimentation and negotiation happening with the definition, effects and understanding of the said neurological disorder, these members get together to exist within this contestation and to relate to others that allow them to feel part of a larger, and less vunerable social group. This group's primary purported purpose is to inform, but the relationship delves deeper into a biosocial sphere created by the participating members.
References:
Baum, A.E., et al. (2008). A genome-wide association study implicates diacylglycerol kinase eta (DGKH) and several other genes in the etiology of bipolar disorder Molecular Psychiatry, 13(2), 197-207.
I am Bipolar. “Welcome to I am Bipolar!” Canada: Retrieved October 20, 2008 (http://iambipolar.ca/).
I am Bipolar. “To Tell or Not to Tell.” Canada: Retrieved October 20, 2008 (http://iambipolar.ca/blog/?p=51).
I am Bipolar. “Consistency is Key.” Canada: Retrieved October 20, 2008 (http://iambipolar.ca/blog/?p=52).
I am Bipolar. “Pervasive Emptiness.” Canada: Retrieved October 20, 2008 (http://iambipolar.ca/blog/?p=50).
I am Bipolar Forums. “Hi Everyone.” Canada: Retrieved October 20, 2008 (http://iambipolar.ca/forum/viewtopic.php?id=71).
I am Bipolar Forums. “Best type of work?” Canada: Retrieved October 20, 2008 (http://iambipolar.ca/forum/viewtopic.php?id=58).
Rose, Nikolas. 2007. The Politics of Life Itself. Princeton, NJ: Princeton University Press.
Wikipedia. “Bipolar Disorder.” Retrieved October 20, 2008 (http://en.wikipedia.org/wiki/Bipolar_disorder).
