“Here’s How I Knew I Had Bipolar Disorder”: A Patient’s Story with a Doctor’s Insights

Bipolar disorder is a biochemical, genetic and environmental mood disorder that includes episodes of mood swings ranging from depressive lows to manic highs. “It is important to understand that bipolar can appear differently in different people. It’s often confused with symptoms of other disorders, including ADHD and PTSD, but this diagnosis has many biological markers—so many that there are actual blood tests to test for bipolar,” says Amelia Kelley, PhD, a therapist, a researcher and psychology professor with the Traumatic Stress Research Consortium at the Kinsey Institute.

The main difference between bipolar and other mood or cognitive conditions is that these aren’t the same “mood swings” many people experience. Dr. Kelley explains that for some sufferers of bipolar disorder, the lows can last days and months and lead to suicidal thoughts and extremely negative symptoms like a lack of energy or an inability to take care of one’s self. The highs, which are often referred to as mania or manic episodes, commonly include a lack of need for sleep, dysregulated sleep, increased anxiety and restlessness and impulsive behavior, which can range from hypersexuality, impulse spending or making drastic life-altering decisions.

If you think you or a loved one has bipolar disorder, it’s important to seek treatment from a qualified mental health professional. “Many who leave bipolar untreated can make detrimental life choices, end up in dangerous relationships or circumstances, lose things that are important to them and also become self-harming as the lows of depressive episodes dramatically increase the likelihood of suicidal thoughts,” Dr. Kelley says.

Breana Grayson, a 34-year-old woman from St. Louis, understands this firsthand. Grayson has experienced symptoms of bipolar disorder all her life, but she wasn’t diagnosed until age 25. This is her story of how she discovered she had bipolar disorder and how she manages her symptoms with care.

Here’s how I knew I had bipolar disorder: One patient’s story

By Breana Grayson as told to Charlotte Hilton Andersen

I made my first best friend, Lisa, when I was 17 years old. It had taken me years to find a close friend, and I was ecstatic to have someone to bond with on that level. And then, I lost her.

It’s not that Lisa passed. Instead, I’d pushed her away, along with everyone else in my life. It was December 2017 when I had that realization, sitting in my empty apartment in Florida, 1,000 miles from home, pondering how exactly I had ended up in this place. I was all alone, and it was all my fault.

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Bipolar disorder can affect relationships

The final disconnect with Lisa happened over a small thing. She posted a group picture on social media, and I commented something a little snarky, writing, If your friend posts a pic where she looks good and you don’t, then she’s not a friend. I meant it as a compliment, but she was hurt. Instead of apologizing, I let the distance grow. I was in such a low place that I didn’t even care when she stopped calling.

Lisa wasn’t the only one this happened with. It became a pattern with all my close relationships whether they were people I was dating, friends, family or coworkers. Eventually, my mood swings would cause a clash, which would grow until the relationship exploded.

But while the mood swings seriously messed up my relationships, they really affected every aspect of my life. I’ve always been “moody,” and while I was a hardworking and studious child, these mood swings increased in frequency and severity as I got older. On my good days, I felt like I could conquer the world, but on my bad days, I felt like a total failure.

Bipolar disorder can affect decision making

When I say that my moods changed, I mean they were extreme. During one “high,” I decided to move 1,000 miles away to a city where I knew no one and didn’t have a job, and I quickly got into a relationship. When the “low” hit, it was just as extreme, and I ended up losing my job, breaking up and moving back home with my mom. Another example is when I started college and made it all the way until my last semester when I quit—just three credits shy of graduation. (I did finally finish those three credits in 2017.)

These highs and lows made it nearly impossible to consistently hold a job, maintain a romantic relationship, stick with hobbies, or achieve all my goals—all things that I knew I was quite capable of achieving, if I could just stop self-sabotaging.

During these times, I didn’t understand what was happening inside me. I felt scared and out of control, and my family reinforced my fears by telling me, “Something is wrong with you.” It made me feel bad and broken, but I didn’t know how to fix it.

Hitting rock bottom

After my realization in 2017, I moved back home to St. Louis. I was 27 years old and didn’t have a job, a family, a partner or anything else I’d hoped to achieve by this point in my life. Normally, I was driven, studious and hard-working, and now I didn’t even have my own place.

The scariest part was I didn’t even care anymore. I became very promiscuous and impulsive, doing risky things that I knew weren’t who I really was, but what did it matter? I wasn’t really living; I was just existing.

Eventually, I fell into a deep depressive episode. These dark feelings culminated with me attempting to end my own life. I decided to mix a bunch of my mother’s medications, and thanks to a combination of luck and circumstance, it was unsuccessful.

It was the wake-up call I needed, and I knew something had to change. My mother had been pushing me to go to graduate school, and with her help, I enrolled…although she had to wake me up and force me to go to my first class.

Getting diagnosed with bipolar disorder

I’ve had these mood swings for as long as I can remember, but I didn’t have a name for them until it all started to fall apart in 2016. As I sat at rock bottom, I finally looked up a therapist online. That person referred me to group therapy, and from there, I made contact with a psychiatrist. That was when I was officially diagnosed with bipolar disorder. I wasn’t broken! I had a diagnosis!

Of course, I started to research: What is bipolar disorder, exactly? It’s a mental illness that causes me to have trouble regulating my mood and energy levels. It’s characterized by fluctuations between manic episodes (or “highs,” as I’d called them) and severe depressive episodes (or “lows”). I think of it like a house in the Midwest with no air conditioning or heating. This is fine and good as long as the environment is stable, but once the weather hits, the house overheats or freezes. I’d gotten to the point where my “house” nearly always felt intolerable to live in, one way or the other.

To help regulate the extremes, along with weekly talk therapy, my doctors put me on medication—an antipsychotic and a mood stabilizer. Finding the right mix of medicines took some trial and error, but once we did, I began to see a huge difference. I finally began to feel like my true self again, the person I knew I was deep down.

Living with bipolar disorder

I wish I could say that everything was smooth sailing from that point forward, but I had periods of doubting my diagnosis and going off my medications. For instance, the crisis culminating in my suicide attempt happened in 2018, after I’d been diagnosed. It didn’t help that I was ashamed of my mental illness and hid it from everyone, even those closest to me. Finally, in 2020, I realized I needed to really commit to treating my disorder and making the lifestyle changes necessary to stay healthy. I had a job I loved, a new relationship I wanted to keep, and I was rebuilding my group of friends. I simply had too much at stake to risk losing it again.

Since then, I’ve been consistent about taking my medication and getting regular checkups with my psychiatrist. I also go to therapy a couple of times a month (or more if I need it), journal daily, get at least eight hours of sleep a night (lack of sleep is one of my top triggers for manic episodes), eat a healthy diet, avoid processed foods and make time for my hobbies.

I’m finally living the life I’ve always wanted, but none of these things have been easy for me. While I no longer have full-blown depressive or manic episodes, I still feel doom and gloom fairly often. I’d say for every five good days, I’ll have one when I fantasize about not being alive. Thankfully I can recover faster these days and the mood swings aren’t as debilitating. I’ve come so far that people are often surprised when I tell them I have mental health struggles and are confused because I seem like I “have it all together.” But mental illness doesn’t mean you’re broken. Taking the steps and the responsibility to manage it is proof that I do have it together.

I’m doing well now because I put the work into it every single day. It’s not a cure, it’s maintenance. It’s frustrating because I feel like I have to work 10 times harder than everyone else just to be “normal.” I often feel like a duck—serene on the surface, but paddling like crazy underneath, where no one can see.

Talking about bipolar disorder

One thing that’s been difficult about my diagnosis is that bipolar disorder isn’t as easy to talk about as a condition like anxiety or depression, which are getting the attention they need these days. Most people don’t know what bipolar is, and if they do, they still seem to want to approach the topic with caution, or they can seem a little untrusting of me.

This has led me to want to hide it from nearly everyone for years. But one day last year, during the midst of a difficult depressive period, my boyfriend pleaded with me: “What did I do wrong?” I realized that he thought my mood was his fault, which broke my heart. I realized I still had one thing I needed to do to manage my bipolar disorder: Be open and honest about it with my close loved ones and with others.

I’ve lost so much to bipolar disorder, but I’ve also gained a lot of wisdom and experience. That’s why I’ve decided to share my story here. I want everyone to know that having bipolar disorder isn’t shameful or a failure of character. If you suffer from it, you are not bad, broken or a failure. And you are not alone. There is no cure for bipolar disorder, but there is hope your life can get better. Today, I can say that while my life isn’t perfect, I do work I love, I have great friends in my life, I’ve reconnected with my family, I’m mentally stimulated, I have creative outlets…and while I did end up parting ways with that boyfriend, it was on good and healthy terms.

As for Lisa? I ended up sharing my diagnosis with her. While we talk occasionally and she’s supportive of me on social media, I’ve had to accept that she doesn’t want to be close friends again. Thankfully, I do have friends who have stood by my side before and after my diagnosis.

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