"Bipolar with rapid cycling" is BPD. I suspect some of these people are just trying to avoid admitting they have a personality disorder. Those are still generally looked down upon, even by the most progressive among us.
The only truly unforgivable disorder is being unsociable. As long as you're pretty/charismatic/martyred enough to get by, your actual problems are irrelevant.
As I have commented on a previous thread, in Australia the "social justice movement" perspective on autism has gone beyond what you might hear at a party in one of our Greens-voting inner suburbs and has been picked up seamlessly by our national public broadcaster. Hence the feelgood story on the morning news show about a kid in Queensland who had set a world record for pogo stick jumping, accompanied by an interview with the articulate (albeit quirky) kid and a comment by the reporter that "because [name of kid] is autistic, he has a few superpowers" that enable him to set world records. For people who don't trouble to dig deeper about the issue, or who have no experience of friends or family with less glamorous versions of the condition, this has become the cultural orthodoxy about autism.
Sure. Or similarly, you could be me, a gay parent of an ebullient daughter who told me at 11 she was gay and then at 12 told everyone that she was trans and miserable. And it took thousands of dollars of therapy for her to be deprogrammed back to just being a happy gay kid again. Woke identity politics is a grotesque curse. (Ban me for talking about my family. I don't give a shit).
This is not me shit-stirring: genuine question. How did your 11 year old get exposed to woke identity politics? Like, I just don't remember engaging with political stuff at that age. I know a 7 year old who says they're a girl now, and I don't know what to make of that claim, but I'm pretty sure they didn't get it from tik tok influencers.
Between TikTok and middle school teachers, 5% of her class changed pronouns for a year or two. I asked her therapist to try to get my kid happy again number one, and number two to make sure that she was exquisitely educated on gender and sexuality because where my kid told me she got her info was TikTok, Internet, and other middle school kids. Maybe the 7 year old really is trans. It happens.
I don't doubt your personal experience here, but I think it's fair that Freddie asks people to stay on topic in the comments - especially as he is one of the only writers talking about the stuff about, while there are hundreds and hundreds of writers talking about whether kids are being indoctrinated into being trans or not.
Years ago, I asked my doctor if I might be bipolar. His response, “No, you’re just extremely neurotic.” I’ve always related this to friends as a charming joke. But it’s not, and he was right.
I am curious - how would the support groups from before this change have refused to tolerate someone who showed up with a fashion diagnosis? How would that have manifested? (Or, if you saw it happen, how did it?)
At the risk of broaching The Forbidden Topic, I feel it, even if it's not an identical pain of course. Tiny obscure majorly life-altering diagnosis -> fight for tolerance if not acceptance via biologic basis etc -> suddenly self-diagnosis and social contagion -> And That's Good Actually, who would want to be [normie], how oppressive and unliberated. And it's like...what the fuck happened? Why would you *want* to roll this particular Sisyphian rock if you don't actually have to? There's so many other less-destructive, less-disrespectful ways to throw off the shackles of stodgy conformity, man. (While so often being boringly stereotypical, just in the opposite direction.) People volunteering themselves for a disorder may or may not actually have *that* disorder, but they certainly *are* disordered. It's just tragic all around, and yet I still check myself from eye-rolling when ~40% of young coworkers introduce themselves with some DSM or other. Fine line to walk between patient rebuttal and mockery; there's still some sort of real suffering going on behind that cluelessness, sadly.
(Nevermind the whole coming up with backhanded non-falsifiable rationalizations like "internalized ____phobia/ism", which is a whole other tallcircle of surprise noodles...)
We had a (thankfully now former) young boss awhile back who'd literally announce over the store's PA system "don't talk to me while I'm counting money in the office, I have ADHD and get distracted easily". And made sure similar notices were posted to the official company bulletin boards, etc. Alternatively it was prefacing/suffixing conversations with "I have anxiety and/or depression" as an explanation for...anything really. Simply could not be held to the same standards as anyone else, you see.
It's not usually that blatant, but as a synecdoche...just too perfect. Took me awhile to figure out, no, this is not some ironic bit she's performing, this is like actually happening. People like this actually exist! Yet still took months of complaints and a huge backlog of HR paper trail to get her <s>fired</s> to voluntarily step down. Those protected-class accommodations were hard-fought, which I'm grateful for, of course (God knows the company puts up with lots of, uh, "quirkiness" from me)...but it feels, I dunno, weird/wrong/breaking kayfabe to just so blatantly weaponize it that way.
Being Oppressed is a positional good. Call it grievance politics, call it victim mentality, call it decadence. People insist on adding moral axes to things that never should have had them in the first place.
Boutique diagnoses remind me of interactions with people who are ostentatiously religious, spiritual, woo, etc, where one is coerced into nodding along purely as a polite social agreement. People shouldn't be harassed for their private beliefs sua sponte, but when they implicitly opt others into their version of reality, I draw the line. It's coercive for someone to say "I have [insert fake diagnosis]" knowing that propriety forbids correction.
I also have bipolar 1, but I demographically fit the "diagnosis as identity" cohort - young, female. I have found this fuzzing of the meaning of bipolar disorder to be deeply frustrating in my personal life. I don't discuss my history much, but when I do want to open up to a new partner or friend, I need to block out a long discussion to explain that my bipolar disorder is not at all like their friends' ex's "treatment resistant rapid cycling bipolar 2." I have a pretty classic presentation of bipolar 1 and my extended family has been landing in hospitals in our late teens and early 20s floridly manic for over a century, with full recovery for years between episodes, but that is no longer what any of my peers imagine when they hear bipolar disorder or manic episode.
I once had a friend who'd been diagnosed with rapid cycling bipolar attempt to armchair diagnose my brother with schizophrenia because he did not believe that you could have grandiose religious delusions from "just bipolar."
A bad therapist or psych NP, most likely. A lot of them are lax with diagnostic standards, as are a fringe of psychiatrists. He'd also picked up Autism, ADHD, and BPD labels.
Thank you. Everyone's mileage varies, of course--but your experiences are kinda sorta similar to my own. So thanks for describing the indescribable as articulately as possible, and for your courage in sharing your insights with a wide audience.
A few points from 30 years of psychiatric practice.
1) In psychiatry we are supposed to distinguish between mood and affect. Mood is the overall tone of a person's emotional experience and it changes slowly. Affect is the emotional tone of the moment. The analogy often used is that mood is like climate and affect is like weather. (So "bipolar affective disorder" should really be called "bipolar mood disorder".) "Rapid-cycling" bipolar disorder is considered a subtype of bipolar disorder but "rapid cycling" means four mood changes per year. Any emotional shifts that occur on the time scale of minutes or hours are not from "bipolar disorder".
2) Part of the blame for the self-diagnosis is shared by the psychiatric profession. The ever-expanding list of diagnoses over the last 3 decades seems to involve quite a bit of invention by the psychiatric profession, so why shouldn't other groups get in on the action?
3) The DSM is the diagnostic manual for identifying mental illnesses. It contains lists of symptoms that can be used to identify each mental disorder, and distinguish mental disorders from each other or from medical disorders which have psychiatric symptoms. People often use these checklists for making a diagnosis, however, the DSM itself warns that it is not to be used as a checklist of symptoms. The patient's symptoms must be seen in a clinical context and the symptoms and context must both be consistent with the diagnosis. This means that is takes a lot of clinical experience to sort out whether someone has recurrent major depressive disorder, bipolar disorder depressed, adjustment disorder with depressed mood, depression secondary to a general medical condition, or substance induced depression.
4) People who report rapid shifts in mood do not always have a personality disorder. Borderline personality disorder, or BPD, as one commenter mentioned also requires a number of other symptoms. The symptoms must have been present since adolescence or young adulthood and be present in a variety of contexts. Just because someone is emotionally disregulated in some contexts doesn't mean they have BPD or any other personality disorder.
5) Years ago I was working with a patient who had rapid emotional swings (in minutes) and a tendency to react very abrasively to people who she felt had crossed her. In one session she said "Maybe I'm manic". We had a good relationship and I responded "You know, have you thought of the possibility that maybe you're just an asshole?" She stopped, paused a bit and then laughed "You're right maybe I'm just an asshole." I replied "And that's a good thing because we can fix that without medications." She went on to make significant positive changes.
“ Being diagnosed with a mental illness is (…) a deeply traumatic event. And the way that you deal with that trauma - if and when, in fact, you are finally ready to deal with it - is by learning what you can learn.”
This one sentence is worth my paid subscription for the whole year. Thank you.
I'm really sympathetic to this piece in some ways, but—and I hope this isn't too picky—haven't you considered the possibility that many of these folks reporting "ultra-rapid cycling" are suffering from things that haven't yet been named as discrete mental illnesses, and perhaps never will be? What about the reality that mental illness can manifest in ways that our diagnostic framework can't contain?
Example: what has happened, and can still happen, to me has been called "mania," "hypomania," "psychosis," "dysphoric mania," and probably other things that I've now forgotten. I was once diagnosed with "Bipolar Type II," and when I reported symptoms that invalidated that diagnosis, the shrink appended "atypical presentation" to it.
All I know is that when It happens, I have loud, racing thoughts, acute physical repulsion, strange and scary physical symptoms, and yes, a fast and recurrent alternation between euphoria and horror. The most succinct and accurate way to describe It is, "like being on acid without having taken acid." There are similar instances of atypicality when it comes to my cognitive abilities and other issues of "neurodivergence." Maybe there is a diagnosis for It, and possibly for the whole cluster of mental problems I have; I kind of doubt it, though.
Beyond the personal insult to people who really suffer with severe forms of mental illness, trivializing mental illness and insisting "its all good" or "society needs to adjust to me" makes it easier for society to not come up with the support that's needed.
My nephew recently got into a board and care for people with mental illness and drug problems. He was institutionalized for four years. Two years was necessary to stabilize him, but he should have been in a less restrictive environment a long time ago. It took so long because there weren't the facilities.
All the cute "vibes" and "I'm so cool" garbage has real world effects. We aren't a particularly generous society and it is further excuse to keep the wallet closed tight.
I don't really know what to do with this. Best I've got is to try to clear a little space for those who have it bad and a little extra space for those whose bad is made that much worse by others.
My stuff is small potatoes. I don't really know what to do with that either except state it and try to not to conflate occasional, deep frustrations with real suffering. But fuck. It is tempting.
"Bipolar with rapid cycling" is BPD. I suspect some of these people are just trying to avoid admitting they have a personality disorder. Those are still generally looked down upon, even by the most progressive among us.
The only truly unforgivable disorder is being unsociable. As long as you're pretty/charismatic/martyred enough to get by, your actual problems are irrelevant.
As I have commented on a previous thread, in Australia the "social justice movement" perspective on autism has gone beyond what you might hear at a party in one of our Greens-voting inner suburbs and has been picked up seamlessly by our national public broadcaster. Hence the feelgood story on the morning news show about a kid in Queensland who had set a world record for pogo stick jumping, accompanied by an interview with the articulate (albeit quirky) kid and a comment by the reporter that "because [name of kid] is autistic, he has a few superpowers" that enable him to set world records. For people who don't trouble to dig deeper about the issue, or who have no experience of friends or family with less glamorous versions of the condition, this has become the cultural orthodoxy about autism.
Delusion: kinda something we all have to deal with. I guess it the intensity of the delusion that separates us.
Sure. Or similarly, you could be me, a gay parent of an ebullient daughter who told me at 11 she was gay and then at 12 told everyone that she was trans and miserable. And it took thousands of dollars of therapy for her to be deprogrammed back to just being a happy gay kid again. Woke identity politics is a grotesque curse. (Ban me for talking about my family. I don't give a shit).
This is not me shit-stirring: genuine question. How did your 11 year old get exposed to woke identity politics? Like, I just don't remember engaging with political stuff at that age. I know a 7 year old who says they're a girl now, and I don't know what to make of that claim, but I'm pretty sure they didn't get it from tik tok influencers.
The past four years forced identity politics on everyone in the United States. There wasn't even an opt-out scenario.
Between TikTok and middle school teachers, 5% of her class changed pronouns for a year or two. I asked her therapist to try to get my kid happy again number one, and number two to make sure that she was exquisitely educated on gender and sexuality because where my kid told me she got her info was TikTok, Internet, and other middle school kids. Maybe the 7 year old really is trans. It happens.
I don't doubt your personal experience here, but I think it's fair that Freddie asks people to stay on topic in the comments - especially as he is one of the only writers talking about the stuff about, while there are hundreds and hundreds of writers talking about whether kids are being indoctrinated into being trans or not.
They say a fanatic is someone who can't change their mind and won't change the subject.
I'm not going to try to talk you out of your views, but maybe you could make at least a token effort to stay on topic?
Years ago, I asked my doctor if I might be bipolar. His response, “No, you’re just extremely neurotic.” I’ve always related this to friends as a charming joke. But it’s not, and he was right.
I am curious - how would the support groups from before this change have refused to tolerate someone who showed up with a fashion diagnosis? How would that have manifested? (Or, if you saw it happen, how did it?)
At the risk of broaching The Forbidden Topic, I feel it, even if it's not an identical pain of course. Tiny obscure majorly life-altering diagnosis -> fight for tolerance if not acceptance via biologic basis etc -> suddenly self-diagnosis and social contagion -> And That's Good Actually, who would want to be [normie], how oppressive and unliberated. And it's like...what the fuck happened? Why would you *want* to roll this particular Sisyphian rock if you don't actually have to? There's so many other less-destructive, less-disrespectful ways to throw off the shackles of stodgy conformity, man. (While so often being boringly stereotypical, just in the opposite direction.) People volunteering themselves for a disorder may or may not actually have *that* disorder, but they certainly *are* disordered. It's just tragic all around, and yet I still check myself from eye-rolling when ~40% of young coworkers introduce themselves with some DSM or other. Fine line to walk between patient rebuttal and mockery; there's still some sort of real suffering going on behind that cluelessness, sadly.
(Nevermind the whole coming up with backhanded non-falsifiable rationalizations like "internalized ____phobia/ism", which is a whole other tallcircle of surprise noodles...)
I'm kind of mind-boggled by the idea of people telling their coworkers about their DSM labels...we're really not in the 1980's anymore....
We had a (thankfully now former) young boss awhile back who'd literally announce over the store's PA system "don't talk to me while I'm counting money in the office, I have ADHD and get distracted easily". And made sure similar notices were posted to the official company bulletin boards, etc. Alternatively it was prefacing/suffixing conversations with "I have anxiety and/or depression" as an explanation for...anything really. Simply could not be held to the same standards as anyone else, you see.
It's not usually that blatant, but as a synecdoche...just too perfect. Took me awhile to figure out, no, this is not some ironic bit she's performing, this is like actually happening. People like this actually exist! Yet still took months of complaints and a huge backlog of HR paper trail to get her <s>fired</s> to voluntarily step down. Those protected-class accommodations were hard-fought, which I'm grateful for, of course (God knows the company puts up with lots of, uh, "quirkiness" from me)...but it feels, I dunno, weird/wrong/breaking kayfabe to just so blatantly weaponize it that way.
Being Oppressed is a positional good. Call it grievance politics, call it victim mentality, call it decadence. People insist on adding moral axes to things that never should have had them in the first place.
Boutique diagnoses remind me of interactions with people who are ostentatiously religious, spiritual, woo, etc, where one is coerced into nodding along purely as a polite social agreement. People shouldn't be harassed for their private beliefs sua sponte, but when they implicitly opt others into their version of reality, I draw the line. It's coercive for someone to say "I have [insert fake diagnosis]" knowing that propriety forbids correction.
I also have bipolar 1, but I demographically fit the "diagnosis as identity" cohort - young, female. I have found this fuzzing of the meaning of bipolar disorder to be deeply frustrating in my personal life. I don't discuss my history much, but when I do want to open up to a new partner or friend, I need to block out a long discussion to explain that my bipolar disorder is not at all like their friends' ex's "treatment resistant rapid cycling bipolar 2." I have a pretty classic presentation of bipolar 1 and my extended family has been landing in hospitals in our late teens and early 20s floridly manic for over a century, with full recovery for years between episodes, but that is no longer what any of my peers imagine when they hear bipolar disorder or manic episode.
I once had a friend who'd been diagnosed with rapid cycling bipolar attempt to armchair diagnose my brother with schizophrenia because he did not believe that you could have grandiose religious delusions from "just bipolar."
How did he get "diagnosed with rapid cycling bipolar" in the first place?
A bad therapist or psych NP, most likely. A lot of them are lax with diagnostic standards, as are a fringe of psychiatrists. He'd also picked up Autism, ADHD, and BPD labels.
Thank you. Everyone's mileage varies, of course--but your experiences are kinda sorta similar to my own. So thanks for describing the indescribable as articulately as possible, and for your courage in sharing your insights with a wide audience.
A few points from 30 years of psychiatric practice.
1) In psychiatry we are supposed to distinguish between mood and affect. Mood is the overall tone of a person's emotional experience and it changes slowly. Affect is the emotional tone of the moment. The analogy often used is that mood is like climate and affect is like weather. (So "bipolar affective disorder" should really be called "bipolar mood disorder".) "Rapid-cycling" bipolar disorder is considered a subtype of bipolar disorder but "rapid cycling" means four mood changes per year. Any emotional shifts that occur on the time scale of minutes or hours are not from "bipolar disorder".
2) Part of the blame for the self-diagnosis is shared by the psychiatric profession. The ever-expanding list of diagnoses over the last 3 decades seems to involve quite a bit of invention by the psychiatric profession, so why shouldn't other groups get in on the action?
3) The DSM is the diagnostic manual for identifying mental illnesses. It contains lists of symptoms that can be used to identify each mental disorder, and distinguish mental disorders from each other or from medical disorders which have psychiatric symptoms. People often use these checklists for making a diagnosis, however, the DSM itself warns that it is not to be used as a checklist of symptoms. The patient's symptoms must be seen in a clinical context and the symptoms and context must both be consistent with the diagnosis. This means that is takes a lot of clinical experience to sort out whether someone has recurrent major depressive disorder, bipolar disorder depressed, adjustment disorder with depressed mood, depression secondary to a general medical condition, or substance induced depression.
4) People who report rapid shifts in mood do not always have a personality disorder. Borderline personality disorder, or BPD, as one commenter mentioned also requires a number of other symptoms. The symptoms must have been present since adolescence or young adulthood and be present in a variety of contexts. Just because someone is emotionally disregulated in some contexts doesn't mean they have BPD or any other personality disorder.
5) Years ago I was working with a patient who had rapid emotional swings (in minutes) and a tendency to react very abrasively to people who she felt had crossed her. In one session she said "Maybe I'm manic". We had a good relationship and I responded "You know, have you thought of the possibility that maybe you're just an asshole?" She stopped, paused a bit and then laughed "You're right maybe I'm just an asshole." I replied "And that's a good thing because we can fix that without medications." She went on to make significant positive changes.
“ Being diagnosed with a mental illness is (…) a deeply traumatic event. And the way that you deal with that trauma - if and when, in fact, you are finally ready to deal with it - is by learning what you can learn.”
This one sentence is worth my paid subscription for the whole year. Thank you.
I'm really sympathetic to this piece in some ways, but—and I hope this isn't too picky—haven't you considered the possibility that many of these folks reporting "ultra-rapid cycling" are suffering from things that haven't yet been named as discrete mental illnesses, and perhaps never will be? What about the reality that mental illness can manifest in ways that our diagnostic framework can't contain?
Example: what has happened, and can still happen, to me has been called "mania," "hypomania," "psychosis," "dysphoric mania," and probably other things that I've now forgotten. I was once diagnosed with "Bipolar Type II," and when I reported symptoms that invalidated that diagnosis, the shrink appended "atypical presentation" to it.
All I know is that when It happens, I have loud, racing thoughts, acute physical repulsion, strange and scary physical symptoms, and yes, a fast and recurrent alternation between euphoria and horror. The most succinct and accurate way to describe It is, "like being on acid without having taken acid." There are similar instances of atypicality when it comes to my cognitive abilities and other issues of "neurodivergence." Maybe there is a diagnosis for It, and possibly for the whole cluster of mental problems I have; I kind of doubt it, though.
Beyond the personal insult to people who really suffer with severe forms of mental illness, trivializing mental illness and insisting "its all good" or "society needs to adjust to me" makes it easier for society to not come up with the support that's needed.
My nephew recently got into a board and care for people with mental illness and drug problems. He was institutionalized for four years. Two years was necessary to stabilize him, but he should have been in a less restrictive environment a long time ago. It took so long because there weren't the facilities.
All the cute "vibes" and "I'm so cool" garbage has real world effects. We aren't a particularly generous society and it is further excuse to keep the wallet closed tight.
I don't really know what to do with this. Best I've got is to try to clear a little space for those who have it bad and a little extra space for those whose bad is made that much worse by others.
My stuff is small potatoes. I don't really know what to do with that either except state it and try to not to conflate occasional, deep frustrations with real suffering. But fuck. It is tempting.
" But even in the midst of that growth, if you read the previous paragraph, can you maybe understand why this all feels like a violation?"
Yes.