Denial in Bipolar Disorder: The Manic Fallacy of Wellness

Last Updated: 7 Aug 2024

During my first manic episode, I was convinced I’d finally recovered from my chronic depression. But my therapist saw symptoms of bipolar disorder.

I’m a doctor by training, so you’d think I would have guessed I had bipolar disorder, for heaven’s sake. I certainly manifested every symptom of mania in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), from boundless energy and soaring spirits to severe insomnia.

I should have known something was up when I treated myself to a $4,000 antique French buffet table. (The credit card company considered shutting down my account, but I convinced them that my finances were under control.)

I subscribed to delusions of grandeur, scouring my home for a spot to exhibit the writing award I was guaranteed to win. My sexual appetite spiked to new heights, too (no complaints from my guy on this point).

Friends and Loved Ones Were Baffled by My Behavior

Certainly, my friends and loved ones noticed a bizarre new me bursting onto the scene. One friend, irritated by my self-absorption, said she felt I had come across “like a bomb exploding in my face.”

My boyfriend raised his voice at me for the first time in our friction-free relationship, because I was passionately scrubbing his bathroom at 3 a.m.

A fellow choir member, flabbergasted at what I took to be my brilliant plans to eradicate mental health conditions in the world, shot me a disbelieving look and said, “I’ve never seen you like this.” I wasn’t sure whether he was worried or jealous.

RELATED: Do You Know These Symptoms of Bipolar Mania?

Delusions of Wellness

To me, it just seemed like I had reached a pinnacle in my life after years of chronic depression. I couldn’t wait to thank my psychiatrist for his contribution to my greatness. I wrote him a card saying I had completed my arduous journey to wellness and would no longer be requiring his services.

Instead of clapping and stomping his feet for me, my doctor became more and more appalled as I tried to convince him of my freedom from the frenzy. I, in turn, became furious at the party pooper for raining on my parade.

It wasn’t until he called my sister and begged her to come watch over me that I began to entertain a sliver of doubt.

My sister, a family physician, hopped on the next plane and flew down to Toronto to babysit me and dispense copious amounts of medication and advice. If anyone can convince me of anything, it’s my sister. (She persuaded me that I was adopted when I was 12 — it took my parents months to undo the damage.)

Bit by bit, her certainty that I was experiencing a psychotic episode superseded my insistence that everything was great.

Before 24 hours had passed, I was loaded up on heavy-duty doses of antipsychotics. I actually slept through the night.

By the end of the week, I had come down to earth.

Lack of Insight and 20/20 Hindsight

Looking back on my current (and carefully managed) stability, I’m still blown away by the depths of my denial. After all, I had been exhibiting a textbook case of mania. Why hadn’t I used my medical judgment to uncover my self-evident diagnosis?

I was so certain that I was just happy, at last, and I was furious at those who wanted to pathologize my well-earned contentment.

My sister reminded me of something I already knew: My lack of insight was not my fault; my delusion of wellness was part of the symptom package of mania.

I shudder to think what might have happened if my mania had continued unchecked. My psychiatrist told me I was hours away from requiring urgent hospitalization. I’m lucky that he and my sister prevailed on me to accept that I was unwell instead of special.

I’m also fortunate that my first manic episode led to a diagnosis of bipolar. With my new drug regimen (including a mood stabilizer) and lifestyle changes (regular running, a balanced diet, and mindfulness meditation), I feel a sense of peace I’ve never experienced before. For the first time in my life, I have faith that I will be okay.

UPDATED: Printed as “On My Mind: Queen of Denial,” Summer 2013

June Rawlston

June Rawlston is a pseudonym for a Toronto physician who is forging a new career as a writer.

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When you’re manic you think you are on top of the world, magnified creativity, and know better than others, rarely listen to logic when it comes to your behavior, quite simply you don’t want the high to end. The truth is it always ends and the higher you go the further you fall. When you fall you may find yourself disoriented, or not knowing where you are, It’s extremely frightening.

Recovering from a manic episode depends on how hard you hit the ground and what happened while you were manic. The recovery time could take months possibly even longer. It’s a long climb up. This is why I keep a close look each day to see if my mood is elevated, it can go from joy to sheer madness very quickly. The key is to track your moods, be aware that your mood is escalating and reach out for help if you continue to escalate.

I spent close to 10 years hypo manic or manic before I fell down the rabbit hole. Crawling out was not pleasant and I spent several weeks in a Psychiatric Hospital to recover.

Stay aware and don’t be tempted by the escalated state, it will bite back.

Melinda