The Hypomanic-Depressive – This Weird Depression



After 19 years with near persistent mental illness, last month I was diagnosed as having bipolar II. A diagnosis the more I learn about the more I am discovering so many difficulties I’ve faced over the years are associated with it. The most gut-wrenching of which is the long time between illness onset and receiving a correct diagnosis. On average, it takes 10 years for someone to receive a bipolar diagnosis, with the average slightly higher for those with bipolar II.

Given that, I wanted to start a series of blog posts on my experiences with bipolar and why its taken so long to get diagnosed. Firstly, because I am beyond sick at the prevalence of mental health awareness campaigns which in their focus on ‘mental health’ erase discussion of mental illness. I’ve spent close to two decades painfully aware of my mental health as more and more days, weeks, and months were dedicated to ‘mental health awareness’. An endless stream of campaigns that never helped me become any more aware of bipolar II. All nuance was subsumed in the mantra that ‘we all have mental health’. A mantra that in expressing a simple truth belies the fact that we don’t all have mental illness. And in seeking to highlight what we all share, casts an ever darker shadow on the complexity and diversity of mental illness.

Secondly, I despair at how mental health awareness campaigns convey just talking about mental health as a solution to the stigma of mental illness and a starting point for getting help. It expends time and energy on encouraging people to talk about their difficulties and to each other, eluding asking whether those with the resources to help are listening. It ignores the governments’ continuing underfunding of mental health services, the production line ethos dominating NHS services, and the dire experiences many have after approaching services for help. Mental health awareness campaigns never reduced the stigma I felt at repeatedly being dismissed, patronised, and ignored by mental health services – no matter how much I talked to them about the difficulties I was experiencing. Instead, the ‘inspiring stories’ of recovery tweeted to encourage #MentalHealthAwareness left me feeling utterly ashamed and alone in my suffering, re-enforcing the sense I was beyond help.

Thirdly, and most crucially, though is the failure of ‘bipolar II’ as a term to encapsulate and resonate with my experiences. There is a bizarre contradiction whereby the further I explore the clinical and academic literature and hear from others with bipolar II, the more certain I am that bipolar II is the correct diagnosis. Yet preceding these explorations the few times in my teens and early twenties when I suspected bipolar I’d search for and read the definition and symptom lists and dismiss the notion. The clear and concise way it is defined and explained obscured the intricacies, making it difficult to align the simple symptom list lexicon with the one I had developed to understand my experiences. I can see now how my experiences fit with the DSM-5 and ICD-10 criteria, but it first required a labour of translation.

So this (no doubt sporadic) series is dedicated to exploring this weird kaleidoscopic depression, with its ebbs and flows, spurts of energy and crushing lows, and everything that happens between the poles – including the vast array of varying configurations in which hypomania and depression can concur. As with those with bipolar I who prefer to retain the name manic-depression, I believe hypomanic-depression better captures and articulates the distinctive features of this illness and reflected this in the name of the series. Whilst it seeks to traverse the tapestry of hypomanic-depression, this series though will not, as has become standard with everything associated with ‘mental health awareness’, shy away from criticising mental health policy and services – especially their lack of mental health awareness.


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