#BipolarBrave: How I Became Comfortable Sharing my Bipolar Diagnosis

This post appeared on the International Bipolar Foundation website, here.

After my postpartum psychotic breakdown in 2008 and my time spent in a mental hospital for it, I was diagnosed with bipolar disorder.

That explained so much. When I returned home, I was elated. I was compelled to explain to everyone who had ever touched my existence that I suffered from bipolar disorder, and that was why I had acted so erratically my entire life.

#bipolarbrave - How I became comfortable sharing my bipolar diagnosis - CassandraStout.com

Clutching my newborn tight with one hand and opening my laptop with the other, I explained to my husband–with rapid, pressured speech due to a lingering manic episode, no less–my desire to email all my old college friends, strangers I had yet to meet, and everyone at church.

“Not all of them need to know, at least not right at this moment,” he said, trying to contain my compulsion. “I understand that you want to share, but explaining your diagnosis to all your old college friends, most of whom you’re not even in touch with, would be counterproductive.”

I bristled, but he continued. “You need to educate yourself about your diagnosis before you begin to share with others, so you know what it means. And, rather than focusing on sharing that you have bipolar disorder with everyone, you need to take care of yourself and our baby.”

That made sense to me. I reluctantly closed my laptop, and looked at my beautiful, fragile infant. He needed a mother who wouldn’t bend to every compulsion that struck her. I didn’t fully understand at that moment that I was compelled to share my diagnosis due to a manic episode. I wasn’t in my right mind; only halfway there.

My husband was right.

After I recovered from the manic episode, I no longer desired to shout, “I have bipolar disorder!” from the rooftops. When it came to my diagnosis, I became closed off. I would no longer spill my darkest secret–that I’d committed myself to a mental hospital and was separated from my 7-day-old baby because I was literally insane. I grew ashamed of my bipolar disorder.

Then I began writing my memoir, Committed, detailing my days spent in the psychiatric ward. I realized the story was compelling, unique, and could help people understand what it’s like to experience a bipolar mixed episode with psychotic features. And I realized that if I ever wanted to publish my work, my dream since I was a little girl, I had to be open with sharing my diagnosis.

A few months after I started writing, I formed a critique group, the Seattle Scribblers, who encouraged me to attend the Pacific Northwest Writers’ Conference in 2012. I pitched my not-yet-completed manuscript to agents and editors.

“After the birth of my son, I suffered a postpartum psychotic episode and committed myself to a mental hospital,” I told them in my elevator pitch. “My memoir, Committed, details the time I spent there while separated from my newborn.”

I explained to the agents and editors that I was grappling with a bipolar diagnosis, and that the mental illness had upended my entire life. I was met with a warm reception by some, but others were completely turned off by the “crazy” person sitting in their midst.

I wasn’t offended. Stigma is real, and I wasn’t going to change their minds about mental illness in the brief moments I had to make an impression.

Now, I have no problem telling people I’ve known even for a few weeks that I have bipolar disorder. When people ask me how I am, I tell them honestly: “I’ve been suffering from a depressive episode lately, but I’ll be okay. I have bipolar disorder, and that’s part of the cycle.”

The diagnosis is no longer shameful for me. It’s just a label that’s a reason behind why I sometimes act unpredictably#bipolarbrave - How I became comfortable sharing my bipolar diagnosis - CassandraStout.com. The explanation comes out naturally. Bipolar disorder is just a part of my life–a big part, to be sure, but it’s not everything.

My husband was right. Not everyone needed to know right then. I had to prioritize my own well-being and that of my infant.

But he was also wrong, in a sense. I had to grow into being genuinely comfortable sharing with my diagnosis eventually. I realized that by being open, I could help other people who might be struggling. So I started my blog, The Bipolar Parent, a comprehensive resource for parents with mental illnesses.

I faced my compulsion and my subsequent shame, conquered them, and never looked back.

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Dear Younger Me: You’re Bipolar, and That’s Okay

Dear Younger Me,
If someone were to tell you that by age 33, you would have a diagnosis of bipolar I, you wouldn’t be surprised. You would be surprised, however, at the fact that you have the wherewithal to treat your mental illness, both emotionally and financially.

You wouldn’t be surprised at the soul-sucking depression you feel now. You would be surprised that you haven’t felt this way in years, and that you are a productive, usually happy, stable woman. You’d be shocked at the fact that the meds have worked so well to control your bipolar disorder up until this point, and that adjusting them isn’t a major problem in your life.

You wouldn’t be surprised that you are a writer. After all, you’ve been writing since you were four and knew how to scribble letters, and wrote your debut “novel,” The Fish. You would be surprised that you are a) married to a wonderful man who would die for you, b) have kids, and c) stay home to take care of your kids. You’d be shocked to know you’re an amazing mother, with healthy, compassionate children.

cassandra stout photo
A closeup photo of author, Cassandra Stout, facing left. Protected under a Creative Commons license.

You wouldn’t be surprised to know that you are still attending the same church you grew up in, the church of Christ. You would be surprised at how much closer to God you’ve become. You’d be shocked to recognize how much He has guided your life, and worked out all things for good.

Younger me, you will be happy someday. You’ll escape the narrow-minded bullies of your small town, and establish yourself in a big city 2000 miles away. You’ll survive college–barely. You’ll suffer a postpartum psychotic breakdown, but that won’t stop you. You’ll just write a book about it.

Younger me, you have so much life ahead of you. A good life. Thank you for not giving up. You will face so many challenges and come out on top. Your grit, determination, and prayers will see you through.

Don’t give up. Don’t give up.

Love,
Cassandra Stout

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Book Review: Breakdown: A Clinician’s Experience in a Broken System of Emergency Psychiatry

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The front cover of Breakdown: A Clinician’s Experience in a Broken System of Emergency Psychiatry (affiliate link*), by Lynn Nanos, featuring a police car shining its headlights on a sleeping homeless person wearing a green hoodie. Credit: Lynn Nanos.

*Disclosure: Some of the links below are affiliate links, meaning, at no additional cost to you, I will earn a commission if you click through and make a purchase. Thanks for supporting the work at The Bipolar Parent!

America’s mental health system is broken. It has failed millions of people suffering from mental illness and will continue to do so unless sweeping changes are made. That’s the premise of Lynn Nanos’ Breakdown: A Clinician’s Experience in a Broken System of Emergency Psychiatry (affiliate link*).

I was offered a copy by the author in exchange for an honest review, which after reading the book, I am thrilled to provide. Nanos is a clinician in the field of emergency psychiatry in Massachusetts with over twenty years of experience in the field. She is uniquely qualified to write this book, having spent much of her life caring for the sickest of the sick.

According to Nanos, there are three core problems in the broken psychiatric system: a lack of inpatient beds due to deinstitutionalization; malingerers, who falsify claims of mental illness to request inpatient treatment; and that patients are “dying with their rights on.” The latter means that a prioritization of patients’ rights causes people suffering from psychosis who refuse treatment due to a lack of insight into their mental illness to be discharged from hospitals too early. These patients are often homeless and vulnerable to being attacked on the streets. Nanos’ solution to these problems is to promote a program called Assisted Outpatient Treatment (AOT), a court-ordered program which forces patients suffering from psychosis to comply with treatment when living in the community.

Nanos describes a condition called ansognosia, where patients have a lack of insight into their mental illness. This book has special significance for me because I have bipolar and have endured psychosis, like the patients in the many case studies Nanos covers in Breakdown. When I suffered a psychotic break, I had no insight into my mental illness, like many of the patients suffering psychosis that Nanos describes. I was fortunate in that, as I complied with treatment, I gained such insight and was able to take steps towards recovery before I left the hospital. Like Nanos points out, this is not the case with the majority of others.

What Doesn’t Work Well in Breakdown

Because I don’t want to end on a negative note, I’ll start with one item that didn’t work well for me in Breakdown.

  • Disclaimers: The opening chapter is full of disclaimers about what the book does and does not cover. These disclaimers are vital to understanding how the rest of the book works, but they make for dry reading, especially for a first chapter. However, I don’t know how else Nanos would have structured this. These disclaimers are necessary, and they need to be placed upfront.

That’s it. That’s all I didn’t like. If a reader can get past the tedious first chapter, the meat of Breakdown is brilliant.

What Does Work Well in Breakdown

As promised, here’s what does work well in Breakdown:

  • Fulfilled Promise: In the opening chapter, Nanos promises a solution to the issues she raises later on, and she delivers on this promise. The writing is accurate and engaging, with case studies of patients offering an emotional look into people who suffer psychosis and their mental illnesses. The book is a blend of clinical information and painfully personal writing, which is another part of what Nanos promises and delivers.
    Research-Backed Opinions: Nanos’ commitment to scientific research is admirable. She cites approximately 300 studies, and the last chapters of Breakdown are especially filled with mental health statistics, which back up her claims.
    Professional Formatting: Despite being self-published, Breakdown is professionally formatted. The cover, featuring a presumably homeless man being confronted by police while lying on a sidewalk, is well-drawn and fabulous. Not that I’m saying to judge a book by its cover, but Breakdown is visually pleasing inside and out.
    Case Studies: The most arresting parts of Breakdown are the case studies. Nanos demonstrates why psychotic patients need treatment through the examination of her encounters with them in a clinical setting. Some examples are: a woman who traveled from Maine to Massachusetts because a spirit called “Crystal” ordered her to, a man who smeared dead insects on his neighbors’ doors to help purify toxins in their apartments, and Lily, a woman who delivered dead dogs to strangers, among other stories. Most of these people refused adequate treatment due to ansognosia. A great number of them bolted before Nanos was able to arrange for transportation to hospitals. Some of them were violent, and a few went on to assault their loved ones, with two specific cases ending in death. The case studies are the most effective parts of Breakdown, and demonstrate why the AOT program is so important.

Final Thoughts

Breakdown: A Clinician’s Experience in a Broken System of Emergency Psychiatry (affiliate link*) is a fascinating book. It’s professionally written and formatted, research based, and effectively delivers its message. The case studies were especially enlightening, and are the heart of Breakdown.

Mental health issues affect all of us, whether we suffer from mental illness, have loved ones who do, or are impacted by the mentally ill people all around us. Read this book and see how you, too, can join the mental health discussion.

*Disclosure: Some of the links above are affiliate links, meaning, at no additional cost to you, I will earn a commission if you click through and make a purchase.

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Book Review: Dyane Harwood’s Birth of a New Brain

birth of a new brain
Dyane Harwood’s brilliant memoir, Birth of a New Brain.

*Disclosure: Some of the links above are affiliate links, meaning, at no additional cost to you, I will earn a commission if you click through and make a purchase.

Dyane Harwood’s brilliant breakout memoir, Birth of a New Brain: Healing from Postpartum Bipolar Disorder (affiliate link*), chronicles her heartbreaking struggle for stability after the onset of postpartum bipolar disorder. Dyane’s battle to reestablish her mental health from the ravages of mania and the pits of depression is recorded in a gripping account with an almost-journalistic flair.

An often overlooked and misunderstood perinatal mood and anxiety disorder (PMAD), postpartum bipolar disorder is listed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as part of the bipolar spectrum. In Dyane’s case, she suffers from a severe form of “treatment-resistant” bipolar I disorder, which spirals high into manic episodes and deep down into soul-sucking depressions.

Dyane deserves all of the praise her novel has received from various sources. It’s a fascinating account with a structure unique to memoir: Dyane takes us from her birth in the beautiful Pacific Palisades to her first boyfriends to her seven hospitalizations. She spends a great amount of time describing her attempts to live medication-free and the disastrous results. She deals with over-prescribing, unethical psychiatrists, powerful electroconvulsive therapy treatments to negate her suicidal thoughts, and, eventually, finds a medication that works: a monoamine oxidase inhibitor (MAOI) called tranylcypromine. Other useful contributors to her mental health are getting enough sleep, exercising thirty minutes for six days a week, and “forest bathing”–taking frequent long walks in a redwood forest.

Above all, Dyane is honest. She’s candid about her many failures–as well as her many triumphs!–on the road to recovery. She tells us about her relationships with her father–who suffered from bipolar I himself–and her mother, and their relationship with each other. Dyane even tells us about the fights she had with her husband. All of this contributes to a beautifully-written memoir.

Harwood’s book is crucial for understanding the postpartum bipolar experience. She references writers and doctors with experience dealing with bipolar disorder. Her memoir, Dyane Harwood’s brilliant breakout memoir, Birth of a New Brain: Healing from Postpartum Bipolar Disorder (affiliate link*), is one of the greats.

Disclaimer: Dyane is one of the frequent commenters on this site. She offered me a PDF of Birth of a New Brain for review, which I was glad to do. Dyane blogs at DyaneHarwood.wordpress.com.

*Disclosure: Some of the links above are affiliate links, meaning, at no additional cost to you, I will earn a commission if you click through and make a purchase.

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Book Review: Rock Steady: Brilliant Advice From My Bipolar Life

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Ellen Forney’s book, Rock Steady: Brilliant Advice From My Bipolar Life.

Ellen Forney’s self-help book, Rock Steady: Brilliant Advice From My Bipolar Life is everything this blog aspires to be. With clean-lined, funny art pieces and truly brilliant advice, Forney’s book is easy to read and will be one of the staples in my repertoire. I highly recommend reading it.

Forney’s primary goal is to encourage and instruct people who suffer from bipolar disorder to obtain and then maintain stability. She clearly loves people, and wants them to succeed. Her best advice comes in the form of an acryonym: SMEDMERTS, which stands for Sleep, Meds, Eat, Doctor, Meditation*Mindfulness, Exercise, Routine, Tools, and Support. Using this acronym as a basis, Forney explains which doctors are out there and how to pay for one, how to get to sleep and stay asleep, and how to manage your meds. She also offers an entire chapter of coping tools, as well as a chapter on “the danger zone,” where she offers advice about how to recognize your warning signs when sliding into an episode.

smedmerts
Forney’s acronym, SMEDMERTS, which stands for Sleep, Meds, Eat, Doctor, Meditation*Mindfulness, Exercise, Routine, Tools, and Support. Taken by Cassandra Stout and protected under a Creative Commons license.

Forney’s real talent lies in the unassuming artwork. This book is so much more than a list of to-dos. The art makes reading fun, and the information easy to digest. Each picture is clearly crafted to elicit a smile from the reader. The cover (pictured above) features the title in large, bold text, and an overwhelmed smiley face with a tongue sticking out. My toddler delighted in mimicking the emoticon, complete with sound effects.

Overall, I would rate Rock Steady a ten out of ten.

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