May is Mental Health Awareness Month. Judging from some of the stuff that flies across my Facebook feed, there is a big need for such awareness. As an individual living with bipolar disorder, a psychotherapist, and a mental health educator, it astounds me how much intolerance and ignorance is out there. One such example is an Internet meme that’s been making the rounds the last few weeks: “I don’t know about where YOU live, but the weather here is somewhere between bipolar and downright psychotic this spring.”
My biggest concern with postings like this isn’t that they’re offensive. It’s that they perpetuate inaccurate information and ignorance. That increases mental illness stigma, which decreases the chances someone with a mental disorder will get help or try to create a meaningful life for themselves. The end result of such memes—as harmless as they may seem—is that more people suffer, live far beneath their potential, and die by suicide.
Someone who understands what bipolar disorder and psychosis are wouldn’t think of using these terms to describe the weather. Admittedly I have used the word “schizophrenic” to describe something contradictory—when I was in elementary school. Sometime around junior high I stopped using it that way because I learned what the word meant and didn’t want to use it incorrectly (schizophrenia has nothing to do with contradictory behavior). I hope with education others will stop incorrectly using mental health terms as metaphors.
I suppose whoever created this meme meant the weather is unpredictable and rapidly swinging from one extreme to the other.
Let’s take the term “psychotic” first. Psychosis is a loss of contact with consensus reality. It is part of dozens of medical and psychiatric conditions. Someone who is psychotic may see, hear, or believe things nobody else around them does. “Psychotic” is not a synonym for “erratic” or “violent.” It makes no sense at all to compare the weather to psychosis. How can the weather lose contact with reality? The weather is reality.
As for “bipolar” it’s not an appropriate way to describe the weather this spring either. Here’s why:
- Bipolar disorder isn’t necessarily unpredictable. Typically, bipolar disorder consists of episodes of mania (or hypomania, a less severe form of mania) and depression. Many people have episode patterns far more predictable than the weather. I can set my watch by my seasonal depression episodes.
- Most people with bipolar disorder do not rapidly swing from one mood extreme to the other. Despite Hollywood’s portrayals, dramatic mood swings from one moment or day to the next are not part of bipolar disorder criteria and are not the norm.
- In fact most of the time bipolar disorder does not involve swinging back and forth between moods. There are big individual differences in number and type of episodes over the course of a lifetime. Some people have had only one or two manic episodes but spend lots of time in depression. Others go long periods of time without any episodes. A small percentage have only experienced mania but not depression (one manic episode is sufficient for a bipolar disorder diagnosis). All told, outpatients with bipolar disorder seem to spend many more days on the depressive than the manic end.
- The term “mood swings” is itself a misnomer. Episodes of depression and mania are not just about mood—in fact mood changes aren’t always the predominant symptoms. They also involve changes in things like energy, concentration, sleep, appetite, and speech.
- At least half of people with bipolar disorder have had symptoms of mania and depression simultaneously, known as an episode with mixed features. I’m no meteorologist, but I’m pretty sure it’s impossible to have a mix of extremely hot and extremely cold weather at the same time.
- There are several types of bipolar disorder (I explain the major types in a video I made as part of a series called “Speaking of Symptoms”) as well as many variations or “specifiers” (for example, one person may have anxious distress during a depressive episode, another may have psychotic symptoms, another may have melancholic features). So if you’re going to describe the weather or anything else as “bipolar” you at least need to tell us what kind.
- Bipolar disorder is treatable. With treatment from a qualified mental health professional, along with an acceptance of their condition and a commitment to getting better, many people with bipolar disorder can live full, productive lives. Effective medications and therapies are now available (though for many people access to them remains limited). To my knowledge, there is still no means of controlling the weather.
So no, the weather is not like psychosis or bipolar disorder. You’re not “so OCD” because you alphabetize your spice cabinet. You’re not “having an ADD moment” because you forgot your keys. Let’s stop tossing mental health terms around haphazardly. And let’s all get a little more tolerant and a little less ignorant this Mental Health Awareness Month.
Here are 3 ways to start:
- Check out firsthand accounts of what mental illness feels like
- Take the Stigmafree Pledge
- Take a free mental health screening if you suspect you or your child has a mental health condition.
As for describing the weather, I’m sure we can come up with some better metaphors. I’ve got one: the weather is like the weather—a largely unpredictable, quite chaotic phenomenon that even the best meteorologists can’t fully grasp. That's why I always keep a jacket and umbrella in my trunk.
You can find the rest of Carrie’s IBPF posts here or read additional articles on her Addiction.com blog. You can also visit the website for Counseling and More, her private practice, or Bipolar Beast, a company designed to empower people with bipolar disorder.