Disappearing Acts: When Friends Are Gone After a Diagnosis of Bipolar Disorder
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A young woman loses her friends after a diagnosis of bipolar disorder and feels angry and disappointed
QUESTION
Dear Dr. Levine,
I am reeling from the awareness that certain friends who meant a great deal to me have abruptly turned their back on me now that I have revealed and declared my struggle with mental illness.
I was diagnosed with a form of bipolar disorder after weathering several years of depression alongside “up” periods. When it was just garden-variety depression, I believe the problem had been more acceptable to these individuals, who are mostly male.
Now, having spent almost two weeks in hospital, the tables have turned and folks have run for the hills. I mean nothing: No phone calls, no cards, unreturned e-mails. These relationships, mind you, go back almost 20 years. I’ve spent most of my time being the “counselor” to these folks. Still, for the most part, I gained a lot from the relationships: mentoring, laughter, contacts, learning, etc.
So, I’m not sure how to proceed from here.
My self-esteem is shot, and I really haven’t much patience right now for grown people’s childish ways. Over the years, I’ve observed that people who “hide” from others’ adversity find some way to wheedle back in after it seems like the coast is clear.
I’m pretty clear about wanting to cut these folks off since there’s really nothing to be salvaged except my self-worth. I am angry, and I can’t guarantee that I still won’t be angry when they inevitably return to my world. How would you suggest I handle this?
Signed, Alone
ANSWER
Dear Alone:
When someone has a serious medical condition, deciding whether or not to tell others is never straightforward.
This is compounded when it comes to disclosing mental or emotional disorders because of the pervasive misunderstanding, stigma, and discrimination commonly associated with disorders of the brain.
As you found out, there is even a pecking order among mental illnesses. People are generally more understanding and accepting of depression and anxiety disorders than they are of bipolar disorder, schizophrenia, or schizoaffective disorder. This is simply because of the dismal lack of mental health literacy among the general public.
When considering whether or not to tell, it’s important to think through whom to tell (the answer might be different for different family members, friends, employers, and acquaintances) and how much information and detail to provide (e.g., the name of the disorder, the nature of the treatment, specific vs. general information, etc.).
Decisions like this are deeply personal. Ultimately, individuals need to make decisions that feel comfortable to them! There is no right or wrong.
Getting back to your specific situation: You made the decision to be candid with friends whom you trusted, hoping they would understand and rally around you. This wasn’t the case, so I understand your disappointment. But consider the possibility that these friends weren’t ill-intentioned. They may simply have felt uncomfortable and didn’t know exactly how to react or what to say—because they don’t understand bipolar disorder, its course, or its treatment.
Perhaps you could seize this as a teachable moment, focusing on one or two of the individuals with whom you feel closest and helping them better understand your experience. After you speak, you could also direct them to online resources for information, such as booklets made available from the National Institute of Mental Health or the National Alliance on Mental Illness.
Being hospitalized for a mental disorder often feels like a setback to the individual (although it shouldn’t be that way!). Admittedly, it is an unplanned disruption to work, study, and/or friendships. You say your self-confidence is shattered, so give yourself the gift of time and allow yourself to slowly get back into a normal routine. Try to hold back your anger towards your friends, which may turn out to be misplaced. You may find that some of these friendships were tenuous and aren’t worth resurrecting, but I sincerely hope that at least a few of them will be recoverable.
You signed your letter “Lonely.” Simultaneously, when working on your old friendships, you may want to get involved in a support group such as those sponsored by the Depression and Bipolar Support Alliance. This will allow you to meet other people who have struggled with similar issues and who can support you as you get back on your feet. I hope you also have the benefit of a relationship with a mental health professional who can help you get over this trauma.
Remember that lifting the veil of secrecy and shame that shrouds brain disorders can only be accomplished one person at a time. I applaud your honesty and your posting this letter.
Warm wishes for your recovery,
Irene
P.S. In my book (co-authored with Jerome Levine, MD), Schizophrenia for Dummies, on P. 216-222, there is an extensive section on “Breaking the News,” the pros and cons of disclosing mental disorders. Since it provides far more detailed advice than I could post here, you may want to glance at the book in the library. Although my comments in the book are focused on schizophrenia, they are just as pertinent to bipolar disorder.
Updated 4/24
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Category: KEEPING FRIENDS
Hi Alone,
I could’ve written almost exactly the same letter 27 years ago. I hate to say it, but it still hurts. I’ve been in therapy and on meds all this time. I have 2 close friends and am married 23 years. Please join groups, book clubs or whatever you’re interested in. Do not let this define you. People, especially young ones are fearful and stupid. You deserve a happy life. Believe me, many normal people don’t get how rough this illness can be, never mind the rejection. Do not tell people you are bipolar unless you get to know them well. I’m sorry that thsese weak people hurt you. Be brave and move forward. They lost you, too, and they will miss you.
I am also alone, not any friends , no boyfriend and no job … I am unable work anything. I feel I am so stupid ( even many peoples say I am very inteligent person) but when it cometo work, I just run away ….
I have a sad life , I am not still in depression, but I try to survive in some ways that are not so normal or not normal at all. I do nothing illegal, but I try always to find peoples to help material, to can survive. I dn’t do this for sex , I am not involved in this kind of things, I tell them my story, I tell them I no have a job and my sad past ( which is really sad and probably from this developed my condition ) and ask them to help me. Some help me, sincerly and from heart, others play my time and affect me more then…
When I was 18 years old, finished my high school, my parents forced me to go to work in jobs that I never wanted and liked ! My mom woke up me in morning and send me on the streets to go to find a job ! My country is not well developed and hard to get job if you no have a relationship there up somewhere. I was so depressed on the streets, I didn’t eat anything for hours, I cried and buy newspappers to read to find jobs ads. I failed find jobs and back home and every day they asked me ” did you got a job today? ” this question was sooo stressful for me and gave me big depress always. I am also ill of Endometriosis, this illness made me so painful , all my body and around period and not only. I can’t stand up for hours, but my parents forced me work jobs as seller in shops where I only have to stand up… Later I got kidneys problems, gallbladder ( I had surgery to remove it) and many others. Then my parents never believed I am relaly ill and Endometriosis made my life a Hell. They contnued torture me ! to find jobs and jobs…. To any job I felt depressed , because was not what I liked and in special because I felt bad almost every day due to Endometriosis and bones poliatritis. With all this, I had a big dream. I always wanted to come to China , for living here and working here… I made this dream come true ! I am here not since 10 years, but unable to work ! Endometriosis still make my life a Hell and I can’t take care of myself ! I can’t have a relationship, I can’t marry. I no like sex, so how can I marry ? how can I have a relationship ? I no like sex because Endo give me pains and discomfort and because I don’t feel much pleasure with a man. All this, nobody can understand .,… and I am unable explain also. If you tell someone you are ill, no matter of what, they all go away…
I was never diagnosed with Bipolar, but reading about it, I see I am right there too ! … I was tortured to work , I didn’t received a good education as I wished, I wanted go to university to learn Chinese and other foreign langiages, but parents did not allowed me, sending me to work for giving them money. When I was working, they took all my money alwyas…
In one day, I met someone who gave me some connections to China and in this way I came here. I am here since 10 years , but I was never able to work ! I hate work , of any kind now, even I wish have a job. I think this is because I was being tortured o work in my country. I think I developed Bipolar , from al this depressions . I had many surgeries on my body for many things and always I was alone in hospitals and so on.. I can’t keep any relationship with anyone. And the most painful thing is, I met the love of my life here , he is a Bipolar too himself. He disappear from me 3-6 months at once then come back again and again… This relationship , if can call it like this, is since 3 years like this. His moods made me more depressed. He don’t know the truth about me and my condition here, we are in different cities. I always try to support him , but nobody support me. He always offend me, treat me bad, then he feels sorry for it. I always pass over everything, I forgive easy, even at the moment I was so sad when he treated me bad, but I can forgive. I don’t know if this is also a Bipolar characteristic . Is like I delete my mind and want him back. He is the same . Nothing can definitely separate us. He told me last time, he has depression illness an after that disappeared again. PRobably he wanted let me realize this and see if I can accept him or not after he told me this. But for me he is the same, and I can’t make any difference to leave him now.
My family never support me with any thing, no words, nothing. They no talk o me for months. They know other “truth” about me here and I am unable tell them that I am unable work now .
When I had Endometriosis surgery, I was in so big pains as I felt I die every day …. I was in hospital alone here, but there was a good girl , a really stranger met her instantly, and she helped me with the hospital and at home after surgery. God bless her !
I think all this afected me so bad. I amconscient I may have Bipolar . My cycle is short, I am now angry to death, and tomorrow I am ok, I want to talk again with the person I had a quarrel But my loved one is not like this, he keeps for months this distance. HE no dare to come back and usually I send him a signal of support, then he will come back soon and is like nothing was happened. Maybe I am the single one who understand him as I may have the same condition as him.
I really don’t know if medication can help me in some way or others. I am just afraid do not be dependent of it. I am also afraid to start medication for this ( I would accept it ) because I don’t have a job and in some days I may not be able procure this medicines, pay them and then I must stop the treatment. IS the same as happen for my Endometriosis. Sometimes I can’t pay the medicines and stop the treatment until I can get some money again.
I am not shy to say my story, I think I tried my best to arrive here where I always wanted to live, to work and to marry and have a family. But I wish be able go to a job. I try hard help myself in this way, but I feel I can’t do this alone. There are always peoples who help me material here, God bless them for their hearts ! But I don’t like what I am now , I feel so low and unhelpful ! I wish to pass over the trauma my parnets gave to me about work , but I don’t know who and what can help me.
I can say , I am a miracle to survive in a foreign country, alone, and without a job ! Or better say, there is God who make miracles for me !
I try my best to do something to survive , to find a job, but is very hard alone and without any friend, and very alone…….
I had never told to anybody my story, I write it here to let others to ses that they are not alone with all this problems and I think I am the worst now from you all….
Hope there is a chance for a better life for you all and for me too !
Hi Jas,
Is it realistic to suggest that she look into a bipolar support group?
One strategy that helps with down-grading the intensity of a friendship – which is your intention – is putting a viable alternative before them by explaining that you feel you can’t be the friend that they need but that you don’t want to abandon them in their need and that you want them to have the best kind of support, which would be someone who’s walked in their shoes. Also, give them the example by you yourself engaging in a support group for people with your anxiety issues since it would help you and also show that you take your own advice.
Hope that this helps.
Irene,
I am friends with a woman who shared, after a couple of years into our freindship, her bipolar diagnosis with me. I had always valued our friendship, and her disclosure explained a lot of things to me… our friendship had felt very intense, lots of emotional highs and lows -but very few plateaus. Sometimes I felt very drained after spending time with her. Often she would disappear for months, declining invitations-I never took it personally, but I noticed it. These things, I didn’t mind. But the anxiety I experience when she is in crisis due to her (at least what I judge to be) impulsive decisions has proven to be the hardest thing to handle because of my personal history.
I often feel deep anxiety when she comes to me for support after making a choice that I feel is going to have drastic consequences. For example, in a couple of days she is leaving the country with a man she just married after only knowing for 8 weeks. I try very hard not to be emotionally invested in her choices, and that is my issue- I was raised by a single parent who made very similar impulsive choices- which had major consequences in my life as a child, and sometimes her behaviour triggers me. I want to go in and fix/prevent/save which isn’t fair to either of us. Yes I’m going to therapy- I know it’s me, a more objective, healthy friend would just wish her well and hope for the best…
I have decided that I want to take a step back in our friendship, and keep it to mostly public functions. I care for her, but I just find it too difficult to be authentic and support her, be her confidant, when her decisions often trigger my most primitive fears – and I feel that when I have been honest with her and try to broach my reservations she gets defensive and makes light of it- I worry too much. I am also not sure how she would react if I told her why I was taking a step back.
I am sharing this because I hope maybe some of the readers here can see the other side… it’s not that I want to abandon her, it’s actually because of my personal history, it’s just too hard. I want to be in a place where I can care for her but have a healthy detachment.
Thanks for listening
Jas
Hi Julie:
I’m sorry you are feeling so sadly and disconnected. You should talk to your therapist about it and you also might want to find out if there are any peer support programs in your area to help you get over the hump. I know you will feel better over time.
Best,
Irene
I could have written the same letter as the original poster. I received a bipolar diagnosis last June. I am so alone with this. So alone. I have never not had friends; right now, I don’t have any at all. I regret trusting them, although I had no reason not to, I thought. It is so painful, that even writing these few sentences makes my throat tight and my eyes well up.
Thank you for taking the time to respond to my letter, Dr. Levine. I do have a trusted professional with whom I am engaged in therapy. I expect the healing process to continue. Your kindness and candor are greatly appreciated.