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There exists what I’d like to call the PHFBP, or the professional, high-functioning bipolar patient.
When looking at the PHFBP, it would appear that he faces few problems. He is compliant in his treatment. He is successful in his job; he may be married and have children; he has friends, and in essence, he is happy. For the therapist, this patient might be called "the model patient." In reality, although this patient is seen as a "model" patient, he still must cope with several, important life issues. (I know because I’m a PHFBP and have been one for several years.)
The issues are as follows:
1. Do I really need to take my meds?
Medication is a sticky subject. It’s usually visible, either sitting out or in a cabinet, just sitting there for any nosey guest to come along and read the bottle. Medication also can put on the pounds, like around 50. It’s a hassle to take it every day. A nuisance. Life would be much easier without it. Wouldn’t it?
2. Should I "come out" in my family, the neighborhood or at work?
I really want to tell people, but I’m afraid of the after effects. Will they lose trust in me? I feel like an imposter, like I can’t truly be myself. Who am I, really?
3. Can I take (normal and not-so-normal) risks?
I know that if I go to New York City, it might set me off. But I love New York City. There’s no other city like it. Should I go?
4. How do I cope if I start to get ill?
Who will watch my child? Can I work if I’m delusional? I’m in remission now, but there’s no cure to this thing. What will happen if I get sick?
5. Should I marry?
Who would want to marry me? How can I trust a total stranger?
6. Should I have/raise children?
Will I pass the illness to my child? Will children be too much stress? Will anyone let me adopt?
7. How much responsibility can I handle at work?
I love what I’m doing, but I feel like I’m on a tightrope, like I might fall off at any minute. Should I ask for a promotion or stay where I am? Will more work make me sick?
8. How does my illness relate to my spirituality?
I once thought I was Jesus. Does this make me closer or farther from God? If I can’t get out of bed to go to church, will I be pardoned?
9. Will I become seriously ill again?
I can’t go back in the hospital. Someone will find out. I hate how in the hospital you can’t lock your door. Will I survive another hospitalization?
10. Should I be proud of myself?
Does my sickness make me stronger than the average person? If I show the world how well I am, will the sickness come back and bite me in the butt?
Yes, I know what you’re saying. "Life isn’t perfect." This is true. And this is my message for today.
Life isn’t perfect.
You can be a model patient, but you can still live precariously amidst numerous difficult issues.
All we can do is our best with what we are given.
I'm a PHFBP.
Are you?
Add a Comment56 Comments
yeah, the sooner the better...
December 14, 2009 - 9:00amThis Comment
Thank you for this post. All of my fears and concerns as a (apparently) PHFBP -- I'm finishing my doctorate right now -- are laid out here; it is very reassuring to know that I'm not alone in all these concerns. I'm going to send this to my family; I think it will help them to understand my plight.
December 3, 2009 - 9:38amThis Comment
"We are blessed and cursed with an extremely responsive brain. bipolar have a brain like a modern F22"
I get this and thanks for your thorough reply to my question. Although I don't view myself as a bipolar person it is for a few reasons that I don't do this. Bipolar is a label based on behavior that is undesirable to society and for the most part implies brokenness and freak. Although their may be some genetic reason for the sensitivity a bipolar person has, I have never seen a person with bipolar who did not have life issues, ptsd or relationship issues that were contributors to the triggered undesirable behavior. This is based upon my interviewing several thousand people. The best medication in the world will not eliminate threats from unresolved triggers. This is why I practice life coaching because I want to offer a more comprehensive approach to living with bipolar. I also educate doctors and therapists. I have heard so many stories, even today, where a doctor prescribes a medication and sends a client onward. Best practices must be established and I feel the life coaching model is excellent. How about goal setting which is a major element to my coaching. How many people with bipolar that you know were directed to a life coach or to become an expert in goal setting... none that I know of. It is important for the person with bipolar to know that they can have goals... empowerment number one... It is important to know the obstacles that may stand in thier way and come up with action steps too.... this is empowerment number two and three. The number one goal for clients I deal with is to get their life back... and they can.
Bipolar is an ugly label and perhaps in the future their will be another. Perhaps a better word for identification sake once someone becomes high functioning would be "Brilliant."
Thanks,
November 25, 2009 - 4:21pmDavid Mariant
[email protected]
www.thebipolarcoach.com
This Comment
"Being bipolar is not a defect, it's a genetic aspect of who we are, completely embracing it and learning how to embrace it is our great struggle."
What do you mean by this? I am especially interested in what you mean by "its a genetic aspect of who we are"
Thanks,
David Mariant
November 21, 2009 - 11:37pmwww.thebipolarcoach.com
This Comment
I'd reference my comments below for further reading of Lakoff and Johnson "Philosophy in the Flesh" which is odd in that I have a BA in Religion from a moderately conservative evangelical. Although I've been working as a Project Manager in Construction for many years. I've been off meds for about 12 years and I am bipolar I do not have bipolar disorder.
Every person on this planet is a prisoner of their genetics, biology and there is no independent objective view that is rational or developed apart from their genetics. Correspondence theory in philosophy is a container schema of limitations it and of itself is not objective or independent of biology. Correspondence theory is actually how this fit's to that with no meaning. Like how a vertical 2 + 4 meets a horizontal top plate and a bottom plate, one corresponds to the other. So now we can look at the term bipolar disorder and split the two words out and rationally look at them more closely. Bipolar is understood to be genetic related this is true, we have a correspondence between our biology and bipolar. Since every human at point self is genetics we can say across a spectrum of emotional detachment to the left is aspergers/autism and to the extreme right Bipolar and possibly Schizophrenia. Every person is on this spectrum, no one is independent from this spectrum. So on this spectrum I have to ask, If I'm bipolar, I"m functioning, not only functioning but highly functioning where does the term disorder come in? How does the word relate to the entirety of the spectrum of the human framework of thinking and functioning? the word disorder seen this way is irrational, illogical and nonsensical. Did someone independent from this spectrum create the label maybe they are rational, but to perceive that they are independent from this spectrum is irrational in and of itself. So we have people giving us a label who perceive that they are rational independent from this spectrum which means they are irrational in their perceptions in and of itself. No one is independent, and to perceive that there is an objective reality independent from our genetics is absurd but that's the world in which we live. So we are given a label that is 1/2 true, and depending on how we approach life, how much work we put into educating ourselves, how much we explore and think of what exactly is that mania experience and what that implies determines at what level are we capable to function. We are blessed and cursed with an extremely responsive brain. bipolar have a brain like a modern F22 that is so unstable that it requires computers to help fly it, directly so that it stays flying correctly. All of the work above goes directly into computer system so to speak of control we call that our conceptual framework and getting that functioning is really the the work for bipolar it's very hard.
"We are here to awaken from the illusion of our separateness"
Thich Nhat Hanh
That is the mantra for virtually every person on this planet that sense of separateness is purely illusionary and that is who they are and Thich Nhat Hanh is absolutely spot on in this statement. Cognitive science embodied realism is heading towards this. Correspondence theory which is old dating back into ancient Greece is starting to be contextualized as true but only true in an extremely limited fashion. It's logic but that is all no emotional content at all. The Bipolar problem with mania is to come to grips with our experiences of when our brain breaks that illusion of self separateness, exactly what does that mean. So we need to both reject how we contextualized during the experience and at the same come to terms with that underlaying experience in and of itself.
David I am incredibly encouraged to know that there are people such as yourself who are treating bipolar as coachable it absolutely is. Finding that point of balance between our emotional/spiritual and analytical/scientific tendencies is the trick for us just like everyone else, no one is independent from that path or journey. Bipolars have a few things to consider, and in fully considering them they can be profoundly liberating which can allow us to both soar and yet remain stable at the sometime. A delicate balance but one worth pursuing and at the same time the only way that we can really be both bipolar and truely high functioning at the same time.
November 22, 2009 - 11:05amThis Comment
I wanted to add a note to my posting. To willfully go off medication must be taken very very seriously. So let's say I take an action in a state of psychosis and I have no idea of what is going on no diagnosis no previous history, that is like taking LSD and flipping out except I've not willfully or done this intensionally, so that has to be treated as insanity when this occurs and a treatment plan is set up. If I hurt someone in this condition, I've not willfully or by any degree selected to act out, it's a state of biological imbalance so in these cases the individual is held to be not directly responsible for their actions this is correct and this is good. Now if I go off my medications, I have willfully taken action and ALL actions the individual takes after that they are now held to the same level of responsibility as everyone else regardless. So going med free must and always be seen in a larger social responsibility. If it is not, then you really are not able I think to fully embrace your genetics in a responsible way. It's irresponsible to not take full responsibility, that sense of deep responsibility helps keep you aware of your environment and what is going on with you at a much much deeper level I"m completely responsible for my actions after I am off meds this I know to my core to it's full depth.
November 22, 2009 - 12:56pmThis Comment
I forgot to add this quote
"We are here to awaken from our illusion of our Separateness"
This sense of mindfulness is important, and I might add being trained in Christian apologetics, living a life for 15 years embedded into Christianity my break was a break from the perceptual framework of Christianity, it was never a break nor would it ever be a break from the New testament. That is a work of art to me that is meaningful and profound, independent of all interpretations.
November 17, 2009 - 11:45amThis Comment
Yes, and I related to all of them. I have been off medication for about 15 years after an incredibly serious episode that I thought at the time was a life ruined. I simply stopped taking medications after 2 years of re balancing. I needed to know can i go without meds, with a plan. My life had been dominated to that point by BiPolar, I recieved BA in Religion simply based on an experience and was seeking understanding. My break was my lack of developing any clear understanding and that then set me with an undertanding of the biological nature of who we are. 15 years of random reading, introspection and simply not buying the purely scientic view of reality, or the religous view of reality and simply going my own path I finally had a major experience last year that synthesized the who framework for me. you might say my amygdala was finally balancing itself. I was self aware, knew it was a biological experience, went to bed and slept much of it, and through that, in allowing my biological come into balance I came into balance. I have made over 200K per year over the last 5 years, I realized that living on the crazy train of our culture is not healthy, have stepped off, and am allowing my life to become more balanced and in a very real way stepping back from our culture and simply understanding it from a larger perspective is all. Being bipolar is not a defect, it's a genetic aspect of who we are, completely embracing it and learning how to embrace it is our great struggle. We need to stay true to our religious tendencies we need to understand that in a larger context, church is beautiful for those who are not bipolar it's dangerous for us who are. We can become confused in what is being taught from a distinctly different experiential framework than our own.
November 17, 2009 - 11:41amThis Comment
This was a wonderful article. I was just looking up high functioning bipolar and found this. I looked up these key words because I just ran a life coaching ad on Craigslist for people with bipolar and depression that want to have a highly functioning life.... I do... I refer to myself as "TheBipolarCoach." I authored a book "Surviving Bipolar's Fatal Grip" to interviews on tv, radio and love to help others...
This was one of the best articles I have ever seen about bipolar... kudo's to you... For the author, send me an email and I will send you a gift copy of my book. I appreciate you taking the time to write what you did.
David Mariant
November 10, 2009 - 8:46pm[email protected]
www.thebipolarcoach.com
This Comment
i'm a high functioning bipolar. diagnosed at 26 after working fulltime going to school three nights a week to finish a bachelor's degree while raising a 3yr old and getting divorced. i often wonder if i had been better taken care of during that time, if the bipolar would have "surfaced". hmm. since then several high profile professional positions, bought a house solo and raised a boy through college. 3 hosps in 20 yrs. now? at 45 finding things more difficult perhaps beause of long term effects of meds? went on ssdi and now work part time. trying to keep the house and my sanity with low paying but low stress job and boy grown and gone. sometimes i wonder if its all worth it? but not plagued with any other bad habits ie dont drink or smoke, worst thing i do is drink coca cola...will i ever meet someone is my cry. i live in remote area with lots of seniors. best to all . j
September 9, 2009 - 5:02pmThis Comment