In April, the singer Mariah Carey revealed to People magazine1 that she had a lifelong battle with bipolar II, the less severe form of bipolar disorder. She was diagnosed in 2001 but was “in denial” until recently, and is now in treatment that includes medication and therapy.
The revelation is one of the few times a celebrity of Carey’s fame has acknowledged her struggles with mental illness. In the interview, Carey explained why she had not previously revealed the diagnosis.
“I didn’t want to carry around the stigma of a lifelong disease that would define me and potentially end my career,” she told PEOPLE. “I was so terrified of losing everything.”
Carey hopes that going public will help eliminate the stigma around mental health issues.
“I’m hopeful we can get to a place where the stigma is lifted from people going through anything alone,” she said. “It can be incredibly isolating. It does not have to define you and I refuse to allow it to define me or control me.”
Carey’s bravery in speaking out and using her stature to help others struggling with mental illness will help people dealing with mental illness by reducing the feeling that they are suffering all by themselves, Michael Thase, MD, professor of psychiatry, Perelman School of Medicine at the University of Pennsylvania, tells PsyCom.
“One of the consequences of having a mental illness that is somewhat common in a population, but not so common in everyday life, is that you feel isolated and alone,” says Dr. Thase, who does not treat the singer.
Knowing that someone as successful as Mariah Carey, who has touched so many lives with her music, deals with bipolar II, “can help reduce stigma and can help people feel there is hope, that at least ‘I am not alone,’” Dr. Thase explains.
What is Bipolar Disorder?
Bipolar disorder, also known as manic-depressive illness, is “a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks,” according to the National Institutes of Health.2
While there are four types of bipolar disorder, all, according to the NIH, are characterized by moods ranging from being extremely “up,” elated, and energized (known as manic episodes) followed by very sad, “down,” or hopeless periods (known as depressive episodes).
Bipolar I, the more severe form of the disorder, is defined by manic episodes that last at least seven days or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least two weeks. Having depression and manic symptoms at the same time is also possible.
Bipolar II is the variety Carey has and is less severe than Bipolar I. While people with Bipolar II do have depressive and manic episodes, they are not as acute and extreme as those with Bipolar I.
Why Do People with Bipolar Delay Getting Help?
In 2001, the year of Carey’s diagnosis, she was hospitalized for what was labeled as “exhaustion.”
“Nobody wants to have a serious mental illness,” says Dr. Thase. “Beyond denial, there is the understandable real wish to not have it be true.”
Those who have bipolar disorder who do not seek treatment may feel a shame about mental illness learned at home.
“You may grow up in a family in which others have had mental illness and part of the family’s way to cope with it is to not to talk about it, let the person with the issue suffer in silence and manage it on their own,” says Dr. Thase.
Dr. Thase continues to explain that another factor contributing to the delay in seeking help and treatment for bipolar disorder is due to the possibility that “lots of folk like the milder mood elevations that go with the high side of the illness and view that as the best time of their lives; [they believe] they are at their best. They can feel smarter and prettier and more energetic and more capable and maybe their mind is moving faster and they can do more things and function as well with four hours of sleep as they do with eight.”
Dr. Thase warns that this “up” mood of hypomania is an illness that one does not have complete control over.
“For people with the type 1 form of the illness, the hypomania can accelerate into a full mania,” he says. “You are so over the top and you are thinking delusions and experiencing hallucinations and sometimes behave in a way that is catastrophic.”
How is Bipolar Disorder Treated?
Bipolar disorder is often times treated with a combination of psychotherapy and medications that may include mood stabilizers, antidepressants, and atypical antipsychotics, according to the NIH.5 The disorder is a lifelong, chronic illness requiring long-term, continuous treatment to control the symptoms of mania and depression, which are likely to recur.
“Once you’ve had two episodes, the chances of a third and the chances of a fourth are so high it’s in your best interest to find a treatment and stick with it,” Dr. Thase says.
Sometimes it takes patients experiencing three or four episodes of mania and depression before they finally adhere to treatment, he says, adding that earlier episodes are easier to treat.
The average age of onset is 25, according to the National Alliance on Mental Illness but it can first occur in one’s teens and, more rarely, in childhood.3
“If this illness starts to disrupt your life and you don’t take it seriously,” says Dr. Thase, “by the time you have your third or fourth episode you are through your 20s and you are knocked off your trajectory.”
Is There a Link Between Creativity and Bipolar Disorder?
Dr. Thase says there “is definitely” a link between bipolar disorder and accomplished composers, artists, and authors. He points to author and psychologist Kay Jamieson, who wrote about this connection in the 1993 book Touched By Fire.
On the flip-side, does medication for bipolar disorder dull creativity?
“It will take away the remarkable periods of staying up all night and doing three times as much as you might have done otherwise, but it will give you back the months you have lost when you had an incapacitating illness and had to be in a hospital or were bed-bound with severe depression,” he says. “The view that you don’t want to take treatment because it will cost you your career is a wrong-headed view.”