Vincent Van Goh once said, “Many people seem to think it foolish, even superstitious, to believe that the world could still change for the better. And it is true that in winter it is sometimes so bitingly cold that one is tempted to say, ‘What do I care if there is a summer; its warmth is no help to me now.’ Yes, [darkness] often seems to surpass [light]. But then, in spite of us, and without our permission, there comes at last an end to the bitter frosts. One morning the wind turns, and there is a thaw. And so I must still have hope.” Despite the challenges that have affected my journey over the last seven years, I attribute much of my peace and stability today to hope.
Over a hundred quotes on peoples’ interpretations of this powerful concept are saved on my phone. Some describe hope as initiating light when all else in the surrounding is darkness. Some elaborate on how hope tackles despair, and how repeated reflections on hope develop strength and endurance in people. My favorite definition is whereby hope is described as an emotion brought on by life for life to defend itself. The list goes on. However important hope may be to an individual without a chronic illness, it is a necessity for someone living with bipolar disorder.
I live my life believing that we are capable of handling the difficulties that fall upon us. Nevertheless, this ability to face challenging times is highly dependent on being strategic and resourceful. Hope is the fuel behind being resourceful; it is the spark behind every gesture toward an improved quality of life, and hope has been the foundation of my motivation in this journey with bipolar disorder.
I received my diagnosis of bipolar disorder when I was just 20 years old. At the time, I had finished my second year of undergraduate studies with a 93% average while taking more than a full course load and being in one of the most competitive science specialties at my university. I was volunteering heavily in my community, and had meaningful relationships with my friends and family. I had also signed up to take the Medical College Admission Test (MCAT) that summer and was paving my path toward a career in medicine. Maybe naive, but I had never heard of bipolar disorder prior to my diagnosis and did not have any relatives who had experienced this condition. So as you might imagine, I was unaware of the difficulties that lay ahead, nor had much knowledge on what my new condition would entail. In hindsight, this may have served me well because my ignorance of bipolar disorder prevented other people’s perspectives of the condition to affect my trajectory forward. In other words, I was able to pave my own path and give my own definition to this new diagnosis.
When reflecting on my seven years with bipolar disorder, I often divide my journey into three time periods: (1) the time period of non-adherence with medications and a misunderstanding of the condition; (2) the period of adherence, but an unoptimized medication regimen; and finally, (3) stability.
Non-adherence and a misunderstanding of the condition led to repeated manic episodes. As an academically oriented student, this not only took a significant toll on my education, but also affected my personal relationships. Adherence, but an unoptimized medication regimen resulted in impaired functionality in school and at work, but at least I was out of the hospital. Finally, stability was brought upon by a joint effort from my psychiatrist, family, friends, and my own advocacy. I have now been living free of manic episodes for over five years, and performing well in a rigorous academic and professional program. Hope, regardless of how you choose to define it, was the driving force behind every step, turn, end, and beginning.
When I decided to take a medical leave of absence from my professional program in order to sort out my problems, the world seemed to close in. Countless courses, exams, tens of thousands of dollars of educational debt, and a degree later to get accepted into this program, and all of it felt meaningless. I’d often think “I had worked so hard to get here, and I let myself and those around me down.” The high dose of my medications had caused a brain fog that was not conducive to performing in this challenging program. But for whatever reason, I could not accept this defeat— this would not be the end of my journey and certainly not how I closed this chapter. And so I resorted to my one source of relief: my journal.
With reflection, the clouds of darkness soon vanished. I stopped attributing this lack of performance to a character flaw: my unoptimized medication regimen was not my fault. I compared past challenges to the one I was currently facing. Those challenges had felt insurmountable at the time but in hindsight, were manageable. Therefore, I thought I could overcome this challenge too. I started paying attention to the good that was happening in my life, such as my supportive circle of friends, fiancé, family, and my new psychiatrist who was willing to tackle the medication regimen. I was grateful and felt in control of what steps I could take next. As my medications changed, I regained my cognitive abilities—I had once thought that they were gone forever. I could focus, learn, and study productively again. A year later, I re-entered my program and I achieved a competitive A- average at the end of year one.
In my experience, the feeling that I have some control over a situation has been of utmost importance in tackling challenging times. Research supports this idea: when taking part in any decision, we make a calculated prediction about how likely we are to achieve a favorable outcome. If the outcome of a decision is highly valuable to us and we deem ourselves likely to achieve it, we will be more inclined to be proactive in reaching that outcome. This prediction is subject to Illusion of Control (IOC) where individuals are more likely to predict favorable outcomes in situations where they choose the circumstance rather than it being imposed on them (Kool, Getz, and Botvinick 2013). In my personal life, when I feel in control of a situation, I am more likely to act as opposed to feeling powerless about a predetermined outcome.
And so I want to remind you that although receiving the diagnosis of bipolar disorder is not in our control, how we choose to move forward with the diagnosis is something we do have control over. This disorder is undoubtedly a chronic and more often than not, difficult condition. Its depressive symptoms have made me bedridden, forgetful, neglectful, and often living in a haze. Its hypomanic and manic episodes can cause me to act irrationally and impulsively. And please do not get me started on the side effects of the medications used to treat this condition. However, once you find the right treatment plan, and people that care, this “scary illness” becomes manageable. The challenges that once felt insurmountable become a part of the past; they were unfair, but happened. The difficult times have made me more experienced, resilient, and introspective—qualities I may not have asked for—but have gained anyway. More importantly, I have developed insight on how to tackle future challenges and a better understanding of my condition.
As I continue to share different parts of my story, I hope that you will find comfort in knowing that bipolar disorder is not a definition but a treatable and manageable condition. I hope that one day, you will find peace with the diagnosis, and be content with the perspectives and strengths it has provided you with. I hope that one day, you will define your version of bipolar.
References:
Kool, Wouter, Sarah J. Getz, and Matthew M. Botvinick. 2013. “Neural Representation of Reward Probability: Evidence from the Illusion of Control.” Journal of Cognitive Neuroscience 25 (6): 852–61.
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Reading your story has reinforced my hope that it is possible to live well with bipolar disorder and have productive lives. I have an abundance of hope after reading this. So eloquently written. Thank you.