"Funny, You Don’t Look Bipolar"

A Personal Perspective: Stereotypes about mentally ill people still prevail.

• Many of us have expectations about how a mentally ill person looks.

• People with mental health diagnoses—one in five of us—usually look like the rest of the population.

• Mental health stigma, like racial bias, can be subtle but damaging, and needs to be addressed when it happens.

The other night I told a woman I’d just met at a party that I’ve written three memoirs about being bipolar. “I’d never have guessed,” the woman said. “You certainly don’t look like you’re bipolar.”

At the time, I thanked her, because I couldn’t think of what else to say. But later in the evening, I started to wonder what the hell she’d meant.

It’s true, some mental illnesses come with preconceived notions of how an afflicted person might look. Take depression, for example—we may expect it to be accompanied by a gloomy expression, slumped posture, and cast-down eyes. People with untreated schizophrenia occasionally exhibit a lack of grooming—unwashed hair or unkempt clothing. But bipolar disorder? What does bipolar typically look like?

I suppose it depends on where you’re at on the spectrum. When I’m manic, for example, I dress and look very differently than when I’m depressed. I’ll wear upbeat colors like gold and coral, or a medley of stripes and bright prints. I’m usually feeling sexy then, and my clothing reflects it: it says, “Hey, look at me, I’m pretty.” Even my eye color changes, I’m told, from hazel brown to a gold-flecked green.

Of course, when I’m depressed I turn New Yorker in a flash. Thank God black is always the new black; I can look in style, even when I’m suicidal. I do the minimum of maintenance then, which means I’ll run a comb through my hair, but that’s about it. Without any makeup, and swathed in funereal colors, I’m so pale I look like I’m practicing to be a corpse. And since that’s exactly how I feel, somehow the fashion fits.

But the night of the party where I met that woman, I didn’t suit either stereotype. Yes, I was in a little black dress. But I was also wearing leopard print shoes, and a bold statement necklace. The outfit didn’t scream, come get me; but neither did it warn all approaches away. I don’t know what color my eyes were that night. But whatever the woman saw in them, to her I must have looked sane.

Maybe that’s why I thanked her. But on reflection, I wish I could take that thank you back; I wish I could say to her, “What exactly does bipolar look like?” Maybe I would have made her squirm, but then maybe she would be one less person assuming that mental illness looks the same on everyone.

Sometimes it’s only by asking uncomfortable questions that we can worm our way into the dark heart of stigma. Like racial bias, stigma about mental illness can be very subtle; and it can afflict even the most well-meaning, educated, liberal people. Let’s say you’ve never met someone who’s openly bipolar before; maybe you’re a bit apprehensive. What will they say? How will they act? Will you be able to cope? That fear and uncertainty may drive you to stereotype.

It’s understandable—but it’s also wrong, and it’s destructive.

The truth is, people with mental illness usually don’t look any different from the rest of the population. After all, one in five Americans takes some kind of psychiatric medication. That means your boss, your next-door neighbor, your doctor, a family member, a friend—a lot of them have a diagnosis. It doesn’t always show on the outside. But just because mental illness is invisible doesn’t mean it’s not entitled to the same respect and courtesy as more visible conditions.

That woman at the party didn’t mean to hurt my feelings; but ultimately, she did. If I’d told her I had cancer, she wouldn’t have said, “Funny, you don’t look sick.” It wouldn’t be polite. But I contributed to that awkward moment, too, by not calling her out on her ignorance. Instead, the teaching moment passed, and I was just left with a nagging discomfort.

We can’t leave it up to the uninformed to eradicate mental health stigma. It’s everyone’s responsibility—mine and yours—to seize the opportunity whenever it presents itself, whether that’s at a lectern or a cocktail party. Let’s make the world squirm a little bit, for the greater good of us all.

Terri Cheney - Book -