What's it like?

What is it like to be a professional with a hidden mental health condition?

I was really young when my psychiatrist suggested that I likely had bipolar disorder. I had been on antidepressants for quite some time and while initially they seemed to help me after a while the effect would wear off and after we maxed out dosage we would try another kind. Rinse & Repeat. After testing out all of the available types of antidepressants, my doctor went back through the notes and realized that in most cases after a period of time I would report symptoms consistent with hypomania and they seemed to be increasing the older I got. So we tried out some bipolar medications, then combinations of bipolar medications. While they seemed to help more than the simple antidepressants, none of them lasted more than about a year before they became ineffective. At this point my doctor talked to me about the possibility that I may have refractory bipolar, in other words treatment resistant. When they say treatment they just mean medication. I felt like this was the end of my life, I imagined having to suffer for the rest of my life and not have any relief or improvement in my condition or quality of life. I know now that’s not true.

I made the decision to stop trying out medications because most of them caused more issues than they solved and I elected to manage my disorder with “alternative methods”. I can’t tell you how many doctors told me it was the wrong move. Every doctor I saw had the impression that they had the secret sauce to managing my mental health. I’ve never been able to decide if they were desperate to help me or if they were just beholden to their own egos. This was right around 2009 so there was not a lot out there about self-managed mental health conditions, not even within the medical or psychological fields. 

I didn’t come to this decision lightly. Fortunately for me I had adopted the practice of journaling early in my mental health journey and I happened to have years of journals to refer back to. When I read through my journals I began to realize that not only did the medications not work for me but they usually wreaked havoc on my life as a whole. Each time I started a new medication I could see a pattern of disruption, my moods rarely improved, sometimes the depressions were so bad I was barely functional and other times I was near-manic. For someone with a then confirmed diagnosis of Bipolar II, mania is a scary side effect of medications that were supposed to help. Other things in my life were also thrown into chaos, my relationships suffered because of my moods and intermittent lack of desire to be social or my total inability to pull it together for important things in my friends lives. My work was inconsistent, because I was so much more capable of over-achieving while near-manic than I was when depressed - something my capitalist overlords loved to use against me while denying me raises. It seemed that nearly everything in my life was harder because I was in a constant state of adjusting medication, which anyone who has ever switched meds can tell you sucks for as long as 3 months at a time per event. 

For me, it was clear that the correct path was to try something outside of medication to manage my mental health. This is obviously not the right choice for everyone and it’s a choice people should first discuss with their health care providers and then if they chose to stop medication they should be properly supervised by an MD to avoid all the scary shit that can happen when you quit cold turkey. As I was weaning off the latest cocktail of ineffective drugs, which took a full year, I dove head first into “alternative methods”. I became a regular gym and yoga rat, going so far as to eventually become a yoga instructor. I dug deep into nutrition and supplements for mental health with the help of a doctor and my trusty journal I was able to figure out all the things that helped or hindered my mental health, which was doubly helpful because I was also in the early years of what would be a decade long quest to discover what was happening with my gut. After a decade of misdiagnoses and probably 30 doctors telling me it was “psychosomatic” I’m thrilled to report that I actually have Crohn’s Disease. It was no surprise to me when I learned recently that people with chronic mental health conditions are more likely to ALSO have a digestive disorder than the normal population. If you don’t already know, there are insane connections and similarities between the gut and the brain. If you’re a major dork and you want to deep dive into the impacts of gut health and diet on mental health and learn the magic of the mitochondrial, check out the book Brain Energy by Dr. Christopher Palmer.

I’m not going to lie and say that it’s been smooth sailing being off medication and roughing it. Managing my condition with therapy, diet, exercise, supplements, routines and little helpful nuggets is not easy. It’s been incredibly hard and it is literally constant work and monitoring and eating healthy and listening to my body and spending extra time on self care and a thousand other things that all help just a tiny bit but collectively keep me from completely unraveling. I’m not going to pretend that I don’t still have depressive episodes that throw my whole life off track because I do. I am also constantly learning about new science and new possible treatments including microdosing and testing out anything that may help - in safe and controlled environments and with lots of research. Overall I still function better through those things than I did swinging from medication to medication. I’m getting better at it all the time the older I get and the more I learn it seems to feel more manageable. 

This is really the first time in my life that I have discussed my bipolar in the sphere of my professional life. It's a weird change for me and part of me is still freaked out about it being used against me in some way but I am very committed to the mission of eliminating the stigma around mental health. It’s not something that belongs in our modern society and I have the privilege of being able to talk about it as someone who is self employed and a bit more established in my professional life. I wasn’t always in this position and when I was young and feeling out of control of my own health I wish someone would have talked about it and stood up to say that they were living with mental illness and doing an okay job and that it was possible to have a pretty good life. I wish someone functional would have talked about how different any diagnosis could be from person to person and that what they show you in the movies isn’t true for all of us and for those who it is, usually it looks a lot different than it's portrayed. 

For years I hid my poor mental health and made up illnesses to have doctors notes for mental health days from work. I pretended to be in great spirits at work and at public events. I worked extra hard to prove that I was a good employee and that I was capable of whatever anyone else was. I showed up to every work-social function possible and socially lubricated as needed to have a good time. If someone at work was ever suspicious of me being sad I would quickly suck it up and put on my fun face. This was really easy when I was hypomanic, I was naturally buzzing around being hyper productive and the life of the office. When I was deeply depressed it was another story. Masking like this was really hard and took a lot of energy, on the weekends I would crash hard and mostly sleep or disassociate in front of the TV. I would bail on my friends telling them I had to work and bail on work friends telling them I had family stuff. I avoided family events too. I needed the whole weekend to recharge so I could mask again. At night I cried a lot. I’m pretty sure I would have had a full mental breakdown if it weren’t for my obsessive nutrition and exercise and journaling. 

When I was among colleagues I was careful not to show them I might be depressed and I was silent when conversation of someone else’s mental health would come up. I was silent when jokes about someone being bipolar were made. I was too afraid to defend anything because I didn’t want people to suspect that I might be bipolar or have mental health issues. I remember at one job a particular employee had a mental breakdown and once we got wind of it the chatter around the office was sympathetic but very judgmental. I already knew none of them really understood the mental health conditions they were talking about. I know they meant well and genuinely felt sorry for this employee but the things they were saying made me doubly sure that I couldn’t disclose my mental health conditions to any of them. There was a lot of talk about not letting clients know that this person was struggling with mental health because it might reflect poorly on the company, so we pretended the employee went on a surprise trip with their partner. There was talk about termination and whether they were a liability, would they be capable of carrying out the duties required for their role? The whole thing made my stomach turn. It was even worse after they returned to the office, everyone handling them with kid gloves and every word dripping with pity. It was the pink sequined elephant in the room no one even acknowledged, everyone opted to pretend to have heard the surprise vacation story and asked how the trip was because lying and avoiding the topic was more comfortable than having a conversation about mental health. WHY? Well because they felt shame for this person. They thought they were sparing them the “embarrassment” of admitting they had mental health issues. It came from a place of kindness but it was born out of shame. 

I felt conflicted and I didn’t know if I’d be able to pretend so instead I wrote this person a note and I let them know I knew what had happened, and let them know I was there to talk or to help out with their workload when things got too stressful. I gave them permission to ask me for help to relieve stress. I let them know I had bipolar and I understood the challenges of mental health conditions. I let them know I wouldn’t say anything publically to “out them” but that I didn’t think they had anything to be ashamed about. They wrote me back a very sincere letter thanking me for my honesty and kindness and letting me know it helped to have someone who knew the truth because hiding it was a lot of work. We often helped each other out from there forward and when I eventually left the company they wrote me a shining letter of recommendation. 

After that experience I understood that I couldn’t be honest about my mental health because it would likely cost me my job or at best the respect of my colleagues and clients. No one wants to be pitied. Over the coming years I would be very careful about who knew about my mental health and how I framed it when I disclosed it to those select few. I became a lot more open about it in my personal life which helped make it a little easier to mask for work related things. 

Years later when the consulting I did on the side began to overtake my day job, I decided to go full time with it and become totally self employed. I was really scared that I’d fail and not be able to support myself. I kept quiet about my mental health because I simply couldn’t afford to disclose it and cost myself clients. I got really good at being “on” at work events and tradeshows. I was careful how I presented myself on video calls and made sure to sound upbeat and look put together. I had a very carefully curated image. 

I was thrilled to not have to answer to a boss or show up to an office. It was a huge help to my mental health. All the energy I would have used to get ready every morning and commute into an office came back to me, along with the time commitment for those things. Instead of driving or taking a train to an office I went to the gym every morning and made breakfast. Instead of having to shower and do make up and hair and sort through my closet for something to wear I stretched and meditated. I worked in my yoga clothes. I scheduled in a few minutes before calls to brush my hair and throw on a normal shirt and a zoom filter. I was able to shower without worrying I would be late to the office, I didn’t have the stress of traffic or the commute in general. I was able to have lunch regularly and to be honest, I got more work done in less time when I wasn’t interrupted by coworkers. My mental health improved drastically and the most stable and joyful period of my life was those first few years of my business living in San Diego and focusing a large part of my energy on taking care of myself. I still had occasional bad days but they were manageable. I went 3+ years without a serious depressive episode - a personal record for my mental health. 

Even though I was still hiding my issues from my professional network, I was able to manage my life a lot better without the demands of being in an office and without having to be micromanaged by the corporate structure. This is why I’m such an advocate for work from home. It’s unreasonable to expect that employees should spend a full 8+ hours a day in an office plus for most 1 to 4 hours of commute time daily, plus the time to get ready for work, the expense of the commute. Those are all resources that could be conserved and used to maintain better mental health. 

Now I’m fortunate enough to be in a place where I am able to talk about my mental health and to be honest I just don’t have any more fucks to give about what people might think about it or how they might judge me. If they do, then those people are not for me and it will only leave room for the folks who are. While I’m committed to talking about mental health and helping to educate those who want to learn, I’m very aware that a lot of people are just going to continue to be ignorant and misinformed, and their stupidity is none of my business. 

Hopefully this has been an enlightening look at what the professional world is like when struggling with a mental health disorder. Hopefully it’s also a reminder for those who struggle that it can get better, and that despite what the world may say, you are quite capable of doing things and of being successful.

Take care of yourselves. <3