Is It Possible to Exhibit BP Behaviors & Other Behaviors Only Because...
[Home] [Bipolar News] [Bipolar Disorder] [Medications] [Treatments] [Bipolar Disorder/Job/School] [Disabilities] [Ask the Doctor] [Ask David] [Self-Injury] [Personal Stories] [Graham's Column] [Steven's Column] [Storm's Column] [Columnist Archives] [Suicide] [Community Support] [Family Members] [Expressions] [Greeting Cards] [Books] [Awards] [Links & Rings] [About Us] [Contact Us]


Q:  Is it possible to exhibit bipolar (and other) behaviors only because I think about psychological disorders too much and unintentionally "fake it" to qualify for a diagnosis?

Sorry to bother you, but this is one question I didn't see covered in your archive:

History: I'm 22, and for the past 6 years ago I've had alternating diagnoses of being bipolar, borderline, or just brilliant and bored with life (and therefore prone to create needless drama). 

During high school I definitely felt like my moods controlled me, and I was certainly depressed and maybe hypomanic (i.e. cutting, being bulimic, overextending etc), and since everything happened naturally my "sickness" seemed kosher. 

I didn't receive help until college, however (my parents were pretty oblivious, but the college officials weren't).  By that point, I was (knowingly) delusional at times, taking handfuls of over-the-counter pills, etc, and acting so 'off' that my roommate seriously thought I was a cocaine addict (  Through it all, though, I knew how weird I was acting, and what made me MOST agitated was the constant question, "Am I faking all of this, or is it real?  But how could I be faking this--but would I be having these thoughts if I WEREN'T faking it?" 

I would obsessively pore over psychological journals trying to diagnose myself, and I never knew whether I exhibited a behavior because it was authentic or because I knew I needed to exhibit it in order to qualify for the pet diagnosis I wanted to convince my psychiatrist of.  This is especially true because if I take enough "time out" I can typically "talk myself down" and avoid acting out (though I can't change my mood).

Now that college is over, I'm more stable day-to-day, but my life is still a mess, even though I've received "the psychological seal of approval."  Among other things, I'm about $20k in debt from spending lavishly during "up" times, I convinced my (now ex) boyfriend to propose to me (and became depressed/claustrophobic and broke off  the engagement a couple weeks later, moving 1000 miles away), impulsively joined the Marines (and was kicked out within 2 weeks), and in general make grandiose/regimented plans for my future/eating habits one week (only to be so depressed that it's hard for me to get out of bed and do anything but gorge for the next week).  

To outsiders I somehow look okay, but in reality?  Obviously something is wrong, but maybe I'm not bipolar or bpd at all, and I'm just using those disorders as excuses so that I don't have to grow up?  But is that even POSSIBLE?  Should "trying to be normal" really be that difficult?  If you have any thoughts, Dr. Phelps, I'd love to hear them, because seriously, this question drives me even crazier than my behaviors!  Thanks!

Dear Carolyn --

A couple of thoughts. One way to approach this would be to connect with a good psychotherapist and ask this question there, expecting that the "answer" would emerge slowly in your work there, as you kept examining the kinds of examples you present in your summary here and those which occur as you go along. In other words, it may be much easier to let an outside observer try to answer this question for you than to figure it out yourself.

Which leads to the second thought: "overthinking" is a recognized symptom of the bipolar thought process. Many times it can look like "obsessive-compulsive disorder", except that the usual themes in OCD are about harm, or completing things correctly, whereas yours is sounding rather different in what you have written here. So it could be that the instrument you are using to try to solve the problem is part of the problem itself. When my colleagues put it thus: if we threw you a ladder to get out of the hole that you are digging, you would probably use it to dig with.

Thirdly, you describe numerous outside observers who have already, and rather consistently, come to the conclusion that there is something wrong with your behaviors that warrants mental health treatment. So simply on the basis of what you have written here, it seems more likely that they are correct then that you are "faking it". However, except for the distress that it is causing you, questioning whether there really is a underlying mood problem to explain your struggles, or whether you might simply be able to overcome those struggles by changing your behavior, is a worthy question. On the other hand, asking questions like that is supposed to lead to improved outcomes, not worse ones, and thus it appears that you may have exhausted the utility of this question and are ready to move on to other strategies.

Interestingly, in this respect, I just came back from a bipolar-specialty meeting in which a research team described their project, just getting under way, testing a psychotherapy approach with no medications at all, for Bipolar II. In other words, the psychotherapy approaches for bipolar disorder are just getting better and better and may decrease the need for medications at least somewhat, if not completely. Again, this suggests that a good psychotherapist might be an important component of whatever treatment approaches you put together at this point. If you invite your providers to point out to you if they ever think that you are "just faking it", and to keep a rigorous examination of that potential in mind as your treatment proceeds, you can potentially "offload" that concern onto their shoulders and focus on carrying out their treatment recommendations. From what you have written, I think that is an exciting prospect and I hope you might be able to engineer something like that soon.

Dr. Phelps

Published September, 2007

Bipolar World   1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014
Allie Bloom, David Schafer, M.Ed. (Blackdog)
Partners:  John Haeckel, Judith (Duff) 
Founder:  Colleen Sullivan

Email Us at Bipolar World


About Us  Add a Link  Advance Directives  Alternative Treatments  Ask the Doctor   Ask Dr. Plyler about Bipolar Disorder   Ask The Doctor/ Topic Archives  Awards  Benny the Bipolar Puppy  Bipolar Chat  Bipolar Children  Bipolar Disorder News  Bipolar Help Contract  Bipolar World Forums  Book Reviews  Bookstore  BP & Other mental Illness   Clinical Research Trials & FDA Drug Approval   Community Support   Contact Us  The Continuum of Mania and Depression   Coping   Criteria    Criteria and Diagnosis  Criteria-World Health Disabilities,  DSMV-IV   Dual Diagnosis  eGroups  Expressions (Poetry, Inspiration, Humor, Art Gallery, Memorials  Family Members   Getting Help for a Loved One who Refuses Treatment  Greeting Cards  History of Mental Illness  Indigo  Job and School  Links  Manage Your Medications  Medications   Medication and Weight Gain    News of the Day  Parent Chat  Pay for Meds  Personal Stories  Self Help  Self Injury  Significant Others  Stigma and Mental Health Law  Storm's Column  Suicide!!!  The Suicide Wall  Table of Contents   Treatments  Treatment Compliance  US Disability  Veteran's Chat  What's New?