Why Bipolar Disorder Stigma Exists

Bipolar disorder, previously known as manic depression, is a mental health disorder characterized by extreme changes in mood or energy levels. The classic symptoms are alternating episodes of mania (elevated mood), followed by periods of severe depression.

Far too often, bipolar disorder is portrayed in the media in exaggerated form, with inaccurate depictions, violent images, and demeaning language. This creates a stigma that harms people living with the condition.

Read on to learn more about bipolar disorder stigma, including where it comes from, how to reduce it, and effective coping skills.

Where Does Stigma Come From?

Stigma generally stems from fear and a sense of discomfort with something unknown. Researchers have identified some causes of stigma, including:

• News reports sometimes sensationalize or wrongly depict mental illnesses.
  
• When people do not have an actual experience or knowledge of someone with a mental health illness, they may have limited information about mental illness, which leads to inaccurate representation.
• People with a mental illness are often portrayed as incapable of holding down a job, unable to sustain long-term relationships, unpredictable, and nonfunctional. However, in many cases, with effective treatment, people with bipolar disorder can be employed, sustain relationships, and function well.
• People with bipolar disorder are often depicted as aggressive and violent. While the manic state may cause agitation or unusual, escalated behavior that impairs decision-making, far more often the person with bipolar disorder is more likely to hurt themselves before they hurt someone else.

What It’s Like to Live With Bipolar Disorder 

Bipolar disorder affects 2.6% of people over 18 in the United States. Typically, people are diagnosed in their teens or early 20s but can be diagnosed into middle age.

Types of Bipolar Disorder

There are two main types of bipolar disorder: bipolar 1 and bipolar 2. Both include mood shifts, but in both types, there can be alternating periods between the manic, hypomanic (less severe manic symptoms), and depressive episodes when people experience times of stability with fewer symptoms

The two main types of bipolar disorder are characterized by:

• Bipolar 1: Includes episodes of mania and often severe episodes of depression.
• Bipolar 2: This type involves hypomania alternating with depressive episodes. However, the depressive state can be just as severe as bipolar 1.

Facts About Living With Bipolar Disorder

Other characteristics of bipolar disorder include:

• More than two-thirds of those diagnosed also have a relative with bipolar disorder, indicating a possible genetic or hereditary link.
• Manic episodes cause people with bipolar disorder to feel overly excited, extremely productive, and invincible.
• Depressive episodes cause people with bipolar disorder to feel extremely sad, fatigued, and hopeless. They may isolate or avoid friends, family, and activities they usually enjoy.
• Bipolar disorder may be caused by disruptions in the brain's neurotransmitters. There is some evidence that mania develops when the neurotransmitter noradrenaline is too high, and depressive episodes may be linked to noradrenaline levels being too low.

Examples of Bipolar Disorder Stigma

Stigma is an intolerant, prejudicial, discriminatory view or behavior toward others who are different from you. Bipolar disorder stigma can occur in many different ways, including:

• As teasing, bullying, or harassment about the illness
• Unfair treatment or rights being denied due to the condition
• Restricted work opportunities
• Family members expressing stigmatizing attitudes, comments, remarks, and questions
• From caregivers toward patients with bipolar disorder
  

Reducing Bipolar Disorder Stigma

Researchers increasingly indicate that educating the public about mental illness is one of the best ways to overcome mental health stigma. A few ways that stigma can be reduced include:

• Circulating media reports about bipolar disorder that are accurate and balanced help communities better understand the experience of people living with bipolar disorder
• Including the viewpoints of people who are living with bipolar disorder and highlighting stories of successful treatment to encourage help-seeking behavior for others with the disorder
• Helping others understand that people with mental illnesses such as bipolar disorder are capable of being active participants in their communities and workplaces, and are able to live functional, productive lives
• Highlighting challenges faced by people with a mental illness in a positive light

Reducing Stigma in Relationships

With the impact of stigma, it can be difficult to determine when and how to disclose a personal diagnosis of bipolar disorder. It's important to know that it's possible to have strong, supportive long-term relationships while also living with a diagnosis of bipolar disorder.

When you're starting a new relationship, it's not necessary to disclose your personal health information right away. But as the relationship develops into a greater commitment, it's important to think about having the discussion.

Reducing Stigma at Work and School

Bipolar disorder stigma can pose challenges at work and school. While in some instances it may be wise to conceal a bipolar diagnosis, if accommodations are needed to perform job duties and make work or school functioning easier, you may need to consider disclosing your condition. With your treatment team, discuss if it's time to disclose your illness to an employer or school and your needs for accommodation.

The Americans with Disabilities Act (ADA) has provisions for people living with a mental health illness in arranging reasonable accommodations in the workplace. It's worth discussing with your healthcare or mental health provider if speaking to your employer and disclosing your illness is the best course of action.

Coping Skills for Bipolar Stigma 

Here are some important skills for coping with both bipolar disorder and its stigma:

• Manage and reduce stress: It's normal to need help with stress management. Working with a therapist, learning mindfulness techniques, using coping skills, and taking steps to calm the nervous system through breathing and yoga can be excellent ways to manage stress.
• Take care of yourself: Making sure that you take care of yourself by eating well, getting regular exercise to reduce the physical effects of stress, keeping a regular routine, and making consistent sleep a priority can make a difference in how you manage each day.
• Journaling: If you can take the time to track or log how you feel each day, this may help in noticing triggers, how your medication is working, and how you're feeling overall. On good days, it may be helpful to jot down encouraging words and motivational messages so there's something positive to read on the tougher days.
• Find your tribe: Having supportive connections with the people in your life can make a difference. Finding connections through support groups or groups where you share a common interest may be helpful.
• Develop a hobby or interest: While bipolar disorder may impact your life, when it comes to a hobby or interest, you get to choose what impacts your life. There are lots of online resources, groups, and even free classes to help develop an interest.

Benefits of Therapy 

A combination of medication and therapy has been shown to be the most effective treatment for bipolar disorder, including:

• Talk therapy: Psychotherapy can provide a space in which people living with bipolar disorder can express frustration, gain emotional support, and learn skills to improve relationships.
• Long-term treatment: Although there can be times between episodes when someone living with bipolar feels fine, therapy is most effective when continued long term. This reduces the frequency of mood swings, as well as the intensity and severity when they do occur.
• Mindfulness-based cognitive therapy: Mindfulness-based cognitive therapy (MBCT) may be especially helpful for people with bipolar disorder. In one study, three months after the study ended, participants showed increased mindfulness, lower depressive moods, fewer difficulties with attention, increased emotion-regulation, and improved psychological well-being.

Being an Advocate 

There are ways that people can advocate for those living with bipolar disorder and work toward reducing stigma. These can include:

• Change the language: One of the easiest ways to advocate for others and reduce stigma is shifting language so that people with bipolar disorder don't become identified as their illness.
• Education: Educating the public about mental illness is one way of overcoming stigma. This is a shared goal among researchers. Educating yourself and others can be part of the stigma solution.
• Get involved: Getting involved in events focused on reducing stigma, including World Mental Health Day, is a way to advocate for others.

Summary

Bipolar disorder is a mood disorder caused in part by chemical imbalances in the brain. A perceptible stigma of this disorder exists, and studies indicate that media influence public perceptions. Researchers believe educating the public about mental illness is one of the best ways to overcome mental health stigma.

A Word From Verywell

Feeling stigmatized because you have a mental illness can be upsetting. Remember that mental health illnesses are often due to factors outside your control, including brain chemistry imbalances and even genetics. Stigma or past experiences should not be a barrier to treatment. Healthcare providers and mental health professionals are available to help you live with bipolar disorder and cope with its stigma.