My Diagnosis

Because it’s always “talk about mental health” and never “write at length about your specific pathology”

Three years ago this summer, I jumped out of a U-Haul on the New Mexico interstate and ran into the desert thinking I was going to meet Jesus. 

I took my laptops and my identification down to my expired passport, and disappeared into the fields outside Albuquerque. My mom, who was driving the U-Haul, was not a fan. 

A few weeks later, once I had started sleeping and stopped reading hidden meanings into street signs, I hopped onto a telehealth service that shall remain nameless to have my first call with a nurse practitioner. The first thing she said, once I got done describing what had been going on with me lately: 

“How long ago were you diagnosed bipolar?” 

The thing is, I hadn’t been, yet. No one had used the word “bipolar” around me at all—not to refer to myself anyway. Everyone was so preoccupied with keeping me from running across highways, putting a name to what was going on with me had fallen pretty far down the list of priorities. But there they were, those three syllables: bipolar. 

I’ll admit I went through a mourning period. There’s a certain grief that comes with realizing that you have to take meds indefinitely and be vigilant about moods and energy levels for the rest of your life. But there was relief there, too: after thirty-odd years spent dipping in and out of mental health services on an as-needed basis, here was something deeper, more enduring—a diagnosis. I felt like Rebecca Bunch in Crazy Ex-Girlfriend:

Three years, many medication providers, and many hours of therapy later, I am comfortable saying: yes, I have bipolar disorder. Yes, I experience prolonged periods of depression interspersed with spikes of mania. Yes, if I don’t monitor my sleep, stress, and substances, I can find myself wandering the fields of the southwest until I’m rescued by a man in a pickup with a chihuahua mix named Chavez. 

I talk about “my psychotic break” openly with my friends—partly because I’m just a pathological oversharer and partly because I love a good story. And it is a good story once you know it turns out okay.

But in a work context, I’ve never told anyone in the three years I’ve known my diagnosis. I’ve never even disclosed it on Greenhouse or BambooHR or whichever other ATS I’ve applied through. 

And there are reasons for me to hold back. After all, studies have shown that “people with bipolar are 48% less likely to be employed compared to people who have no mental health diagnoses.” I worry about being seen as less capable, less promotable. I worry about being “managed out” of any business once they know the truth. I worry about the whole litany of things you have to learn to worry about when you cross the threshold in society’s taxonomy from “healthy” to “having a disability.” (For more on the complexities of disclosing bipolar disorder and other major mental health conditions in the workplace, I recommend this article.) 

It’s  become trendy in recent years to say “talk about mental health.” But it always seems to be  “talk about mental health generally” and never “talk about your specific pathology and the very real ways in which it impacts your life.” It’s like we as a society want the credit without actually going through the course. We want to feel better without doing the hard work of going through therapy.

So here I am, talking about my specific bipolar disorder and how it has impacted me, how I work, and how I think about work moving forward. No more Ohio girl taking my feelings and pushing them down; it’s time to take those feelings and shove them in everyone else’s face.  

Is this mania, what I have, or is this productivity?

The other day, a friend who also has bipolar slid into my DMs saying she noticed I’d been really…productive on the posting front and asking if I was getting enough sleep. That question may sound simple to some, but to us, it’s loaded. It’s shorthand for, Are you okay? Are you sure you’re still in control of this energy?

This is something I have to be mindful of: productivity and mania can look very similar, at least on the surface. The difference is in the sustainability and the cost. When I’m in a manic phase, my brain hums with ideas and plans. Everything seems possible, and not only possible but urgent. If you had the misfortune of working anywhere in my vicinity circa July 2021, you got to witness this firsthand. 

The key for me is learning to ask myself, Is this productive, or is this a warning sign? Productivity leaves me feeling satisfied, accomplished, like I’ve put in good, valuable work. Mania, on the other hand, often leads to a crash—a wave of exhaustion, unfinished projects, and a kind of mental hangover that can last for days. The cycle is seductive because the high feels amazing, but I’ve learned to recognize that what goes up must come down, and the crash isn’t worth the rush.

That’s why I have to check in with myself constantly. When I notice I’m plowing through tasks at breakneck speed, I stop and ask: Am I still in control of this, or is this starting to control me? I check how much I’m sleeping, how I’m eating, whether I’m getting outside, and if I’m still making decisions from a clear, steady place.

It’s a delicate balance that I must maintain to protect not just my work but my overall well-being. Learning to know when to rein it in, when to pause, and when to ask for help has been one of the most crucial lessons for me as a person who works who is also living with bipolar disorder.

Sleep when the baby sleeps  

This is something you hear when you’re an expectant parent but believe me: when it comes to living with bipolar, you are baby. 

Bipolar disorder means I have to pay close attention to my energy levels, almost the way you would with an infant's nap schedule. Sometimes, high-functioning periods are followed by low energy or depressive dips. Understanding that both phases are part of your cycle can help manage expectations at work and avoid guilt or burnout. 

Early on, I tried to fight it, to push through the dips and keep up the momentum. I saw rest as something I didn’t have time for, and I feared that if I stopped, even for a moment, I might never get going again. But I’ve learned over the past few years that rest isn’t just a luxury—it’s a necessity. The alternative is getting stuck in overdrive, building speed until I spin out. 

This is a huge part of where the shame comes from when it comes to working with a disability: we’ve all been conditioned, on some level, to equate our self-worth with our ability to produce. And when I’m at the bottom of the depression hole, the last thing I feel like being is a productive cog in the wheel of capitalism. But alas, bills must be paid, dogs must be fed, meds must be afforded. 

And this is where the real tension lies. The world we live in doesn’t much care that not everyone can operate at 100%, 100% of the time. For people with mental health conditions like bipolar disorder, there are periods when functioning at full capacity just isn’t possible. But capitalism isn’t set up to accommodate that kind of variability.

Even as society starts to talk more about mental health, it’s often in the context of getting people “back to work” or “back to normal.” The expectation remains that you’ll find a way to manage your symptoms and keep producing—because the bills, the dogs, and the meds don’t care if you’re having a depressive episode. So you learn to push through, to silence the parts of you that need rest, because taking a break feels like failing. 

In a different world, one that wasn’t built around the relentless pursuit of productivity, there would be more space for rest, for ebb and flow. But in this world, where everything is tied to work and output, managing a condition like bipolar disorder means constantly negotiating between what you need to be well and what society demands of you. The shame doesn’t come from being “unproductive” in those low-energy phases—it comes from living in a system that treats rest as a privilege rather than a necessity. 

Routine is not the bad guy 

For a long time, I saw routine as something confining, something that would choke the creativity or productivity out of me. In my mind, routine was for people who wanted to live robotic lives, checking boxes and following the same schedule day in and day out.

Here’s the thing about bipolar, though: routine is not a luxury—it’s a lifeline. Without some kind of structure, the pendulum swings too far, and I can get swept up in whatever mood I’m in that day. I’ll convince myself that routine is holding me back from some great creative breakthrough. But the reality is, when I’m not grounded by some kind of order, I start losing control. The ideas come too fast, too furious, and what feels like creativity quickly turns into chaos.

On the flip side, when I’m in a depressive phase, routine can pull me out of the fog. Having something—anything—on the calendar that I have to show up for, whether it’s a trip to the dog park or a meeting, can be the one thing that reminds me I’m still in the world, still tethered to something outside my own mind. Structure becomes a kind of quiet promise that tomorrow I might feel a little bit better.

But here’s the key: my routine can’t be rigid. It has to bend when I need it to. That might mean moving meetings around on a low-energy day or shifting a deadline when I’m feeling the strain. It might mean blocking off time for rest in the middle of a workday, or working in bursts when I feel a creative surge, instead of trying to force it when I’m running on fumes. Routine gives me a baseline—a place to return to when the ground feels shaky. It’s not about sticking to a strict schedule no matter what. It’s about creating a rhythm that can flex with me, a safety net that catches me when I start to spiral.

I’ve learned to embrace routines that work for me. I take my dog to the dog park between 9-10. I work out between 10 and 11. Does this mean I don’t get “to work” until lunchtime? Sure. But the work I get done with these two grounding tasks behind me is worth the work of 20 stressed-out, over-stimulated, over-scheduled versions of me. 

It’s like this for me–is it like this for you? 

A few times now in my working life, I’ve encountered coworkers who maintain “user manuals”—basically Google Docs or Notion pages laying out the details of their workday, their preferred communication stylle, and “how best to get the most out of our work together.” That probably sounds sarcastic, but I’m not against the idea in theory—although I do find it funny that a few people I’ve known who do that profess to be neurotypical. 

In fact, you could argue that this whole essay is an entry in my “user’s manual.” My whole purpose in writing this is basically to teach the world—including me—something about how to work with me. 

There’s a quote that I really love, although I can’t remember where it’s from: It’s like this for me; is it like this for you? That, in reality, is all writing is, at least this kind fo writing: it’s a bunch of people with open wounds wandering around asking “is it like this for you?” 

So that’s what this essay—this attempt—has been: an effort at offering one articulation of what it is like to work as a person with bipolar disorder, or to have bipolar as a person who works. This is what it’s like for me—how is it for you?