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“The Professional, High-Functioning Bipolar Patient”

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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

EmpowHER Guest

"I once thought I was Jesus" --- had me cracking up out loud at work. I have been there =) Thank you for such a great post.

Always struggle with telling others about my illness. As a consultant it is rough and
I wish I had people to look up to. Apparently I come from a long line of "crazy" and am the first in my family to make it to a professional career. It would be great to speak to others with like situations. Thanks!


[email protected]

May 5, 2015 - 11:04am
EmpowHER Guest

Yes, thank you for articulating this so beautifully. It is still a difficult and often fraught road for the high functioning bipolar, and a lot of hard work. The anxieties and worries you mention are very real for us.

November 29, 2014 - 10:57pm
EmpowHER Guest

I absolutely cannot thank you enough for this! I have been looking everywhere for someone I can relate to and look up to as proof that one can be successful in life despite having bipolar disorder. I have a professional career and, for the most part, maintain stability. But every concern you mentioned, I have experienced and continue to do so. The very fact that I am not alone gives me hope. Thank you!

October 15, 2014 - 9:57am
EmpowHER Guest

Wow! This article is extremely helpful.
I am a 35yo PHFBP (since 2008), pastor by profession, wife, and mother of 2.

Thank you to the author, as well as to other comment-makers, for your refreshingly honest writing.

July 29, 2013 - 12:36am
EmpowHER Guest

I love love love #1! I am a Corporate Manager and have been diagnosed with Bipolar Disorder for 7 years. Triggered by a trauma with our youngest child. I do not question whether I need to take my medication or not ............ I remember too well what it was like without it. I never took time off of work, I would grit my teeth and work through those days, weeks, months, years of 'testing' meds until the correct one was found for me. Coming to terms with the weight gain haunts me daily. As a woman that weighed no more than 125 lbs for 40 years of my life, increasing to 175 at my highest [regardless of exercise] was depressing in itself. Changes in meds has caused weight loss as well as weight gain over the past 7 years. I just recently decided to take control and responsibility for my weight. With a supervised medical diet I have dropped 9 lbs in 2 weeks. Down to a 'round' 155;-) My intent is to continue decreasing to a comfortable 140. Only I can make the change. Only I can chose on a healthy path for myself. Cheers to bipolar medications, without them we'd be nuts!

October 18, 2011 - 5:37pm
EmpowHER Guest

Excellent article. Thank you for stepping out of your comfort zone to write it.

March 24, 2010 - 10:40pm

Hi... This is David Mariant. It is absolutely imparative that people who provide services to patients who also struggle with bipolar or mental illness get optimal care. What you described begs the question of you whether this is true or not for your husband. I for instance have a lovely wife of almost 25 years and five children. I wrote in my book and speak to many people about the following point: I have the responsiblity for getting the best and most comprehensive help I can for my families sake and of course my own. I also work with a lot of families and indivuduals with bipolar and coach them to achieve optimal life results. I owe it to each and everyone of them to have my bipolar under control. The flip side of a person not having their bipolar under control could be devistating and life threatening. Recently I shared the same thoughts with a psychiatrist who had bipolar and was obviously not stable. Some do consider it irresponsible and neglegent to be in a capacity of providing health care and have bipolar. Higher Functioning Bipolar Life Coaching is not only possible it is my suggestion for all professionals with bipolar.

I am adding this point now. Their is hope for more stability, their always is to some degree. A person needs to begin with a belief that this is true, then, work toward finding out how to do it and what help they need. Unfortunately people have been dooped into believing that medication is the magic we need and of course it doesn't work like that and we may become robbed of our hope. A comprehensive approach to bipolar life management is the only way to achieve optimal results... their just isn't any other way...

David Mariant

"The Bipolar Life Coach"

February 5, 2010 - 6:29pm
(reply to dmariant)

Hi David
I am the father of lovely girl her age 26 years old she start suffered from bipolar disorder since 9 years now she has diagnosed before as hypo mania
she has graduated from her college she is working now as a pharmacist dealing with different types of medications and drugs her status unstable where she diagnosed now with mixed status her regimen of treatment with tegratol 400 mg +antidepressant daily morning and at night same tegratol +zyprexa 15 mg i mean both phases depression and mania her mood is so bad i failed to cope with her her mood severe swinging up and down with weight gain and heavy smoking her rate of smoking more than 120 cigar ates daily ? how can i cope with her really i appreciate your highly coordination and cooperation thank you

January 9, 2012 - 9:03am
EmpowHER Guest

My husband is a bipolar doctor. When he is hypermanic, he actually functions quite well and is very well liked by co-workers, patients, and families. But we still have a lot of struggles. We have 9 kids, and sometimes it is hard for them to see their have rapid cycling to irratable episodes. I would love to hear from any other family like mine.

February 4, 2010 - 3:38pm

Hi, this is David Mariant. Email me and I will send you a link.

David Mariant
The Bipolar Coach

January 7, 2010 - 7:28pm
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