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Dec 03

To Tell or Not – Part 1

tellOne of the hottest topics on our forum, and one that led to a request for a blog post ,is the topic of whether or not to tell someone about your moods, particularly if you have a mood diagnosis.

For mostly historical reasons, this issue is especially a concern for people with bipolar mood variations as opposed to unipolar moods (unipolar is depression without hypomanic or manic episodes, bipolar is depression with at least one hypomanic episode).

It is probably worth reviewing that history since it is part of the answer to the question of whether or not to tell.

Bipolar disorders were seen initially as disorders associated with episodes of mania  (an extreme mood state associated with great impairment, severely impaired judgment, and not infrequently psychosis) and as a result a bipolar diagnosis tended to be associated with a history of very bizarre and disturbing behavior.

Thus, the idea of having a bipolar disorder was not much different than having schizophrenia in terms of being associated with behavior that most people would call “crazy.”

The name for the condition at the time was manic depressive disorder.  It was renamed bipolar disorder to take away some of the stigma and also to reflect the fact that bipolar doesn’t require ever having had an episode of mania, it is enough to have had one episode of hypomania (a milder form of an energized state).

Nevertheless, the idea of bipolar disorder as a condition that it is associated with episodes of near psychosis has remained pretty strongly embedded in the mind of not just the average American but also in the minds of many mental health professionals.

It is still true that one of the most perplexing occurrences in my professional life is having to explain to a therapist who is seeing a patient of mine, what hypomania is.

Usually the therapist will begin by saying something like: “I’m sure that my patient doesn’t have bipolar, they never had extreme episodes like that.”

Never mind that hypomania is one of the few states described in DSM that doesn’t have to be associated with any impairment at all.  Obviously the misconceptions about the diagnosis are pretty rampant.

Thus the question of whether or not to tell is really first and foremost a question about whether the person who is going to be told something is likely to misunderstand what they are being told.

In other words, if you tell your new girlfriend that you have had bipolar depression, will she understand this statement as “Johnny is a crazy person?”

When considering whether to tell or not –

  1. Assess the knowledge base of the person you are going to tell – what do they know or think they know about mood disorders. Do they know anyone who had a mood disorder? What did they think about that person?
  2. Consider saying “I have a kind of depression” instead of “I am bipolar.”
  3. Know that generally saying something will reduce your level of stress (as long as you have not inadvertently conveyed the wrong message).
  4. Don’t feel ashamed – if the other person misunderstands what you said this is not your fault. Just explain what you meant in different language.

I hope that this post leads to more interaction on this site. Feel free to join our Forum and contribute to the ongoing discussion about this topic.

 

1 ping

  1. Coming Out - MoodSurfing ™

    […] To Tell or Not – Part 1 […]

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