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Disappearing Acts: When friends are gone after a diagnosis of bipolar disorder

January 25, 2010 | By | 6 Replies Continue Reading
Someone loses her friends after being diagnosed with bipolar disorder


Dear Dr. Levine,

I am reeling from the awareness that certain friends who meant a great deal to me have abruptly turned their back on me now that I have revealed and declared my struggle with mental illness. I was diagnosed with a form of bipolar disorder after weathering several years of depression alongside “up” periods. When it was just garden-variety depression, I believe the problem had been more acceptable to these individuals, who are mostly male.

Now, having spent almost two weeks in hospital, the tables have turned and folks have run for the hills. I mean nothing: No phone calls, no cards, unreturned e-mails. These relationships, mind you, go back almost 20 years. I’ve spent most of my time being the “counselor” to these folks. Still, for the most part, I gained a lot from the relationships: mentoring, laughter, contacts, learning, etc.

So I’m not sure how to proceed from here. My self-esteem is shot-to-be-damned, and I really haven’t much patience right now for the childish ways of grown people. Over the years, I’ve observed that people who “hide” from others’ adversity find some way to wheedle back in after it seems like the coast is clear. I’m pretty clear about cutting these folks off, since there’s really nothing to be salvaged except my self-worth. I am angry, and I can’t guarantee that I still won’t be angry when they inevitably return to my world. How would you suggest I handle this?

Signed, Alone


Dear Alone:

When someone has a serious medical condition, deciding whether or not to tell others is never straightforward. This is compounded when it comes to disclosing mental or emotional disorders because of the pervasive misunderstanding, stigma and discrimination commonly associated with disorders of the brain. As you found out, there is even a pecking order among mental illnesses. People are generally more understanding and accepting of depression and anxiety disorders than they are of bipolar disorder, schizophrenia, or schizoaffective disorder. This is simply because of the dismal lack of mental health literacy among the general public.

In considering whether or not to tell, it’s important for someone to think through whom to tell (the answer might be different for different family members, friends, employers and acquaintances) and how much information and detail to provide (e.g. the name of the disorder, the nature of the treatment, specific vs. general information, etc.). Decisions like this are deeply personal. Ultimately, individuals need to make decisions that feel comfortable to them! There is no right or wrong.

Getting back to your specific situation: You made the decision to be candid with friends whom you trusted, hoping they would understand and rally around you. This wasn’t the case so I understand your disappointment. But consider the possibility that these friends weren’t ill-intentioned. They may simply have felt uncomfortable and didn’t know exactly how to react or what to say—because they don’t understand bipolar disorder, its course, or its treatment.

Perhaps, you could seize this as a teachable moment, focusing on one or two of the individuals with whom you feel closest, and helping them better understand your experience. After you speak, you could also direct them to online resources for information such as one of the booklets made available from the National Institute of Mental Health  or from the National Alliance on Mental Illness.

Being hospitalized for a mental disorder often feels like a setback to that individual (although it shouldn’t be that way!). Admittedly, it is an unplanned disruption to work, study, and/or friendships. You say your self-confidence is shattered-so give yourself the gift of time and allow yourself to slowly get back into a normal routine. Try to hold back your anger towards your friends, which may turn out to be misplaced. You may find that some of these friendships were tenuous and aren’t worth resurrecting but I sincerely hope that at least a few of them will be recoverable.

You signed your letter “lonely.” Simultaneous with working on your old friendships, you may want to get involved in a support group such as those sponsored by the Depression and Bipolar Support Alliance. This will allow you to meet other people who have struggled with similar issues and who can support you as you get back on your feet. I hope you also have the benefit of a relationship with a mental health professional who can help you get over this trauma.

Remember that lifting the veil of secrecy and shame that shrouds brain disorders can only be accomplished one person at a time. I applaud your honesty as well as your posting this letter.

Warm wishes for your recovery,

P.S. In my book (co-authored with Jerome Levine, MD), Schizophrenia for Dummies (Wiley, 2009), on P. 216-222, there is an extensive section on “Breaking the News,” the pros and cons of disclosing mental disorders. Since it provides far more detailed advice than I could post here, you may want to glance at the book in the library. Although my comments in the book are focused on schizophrenia, they are just as pertinent to bipolar disorder.


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Comments (6)

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  1. Anonymous says:

    Hi Jas,

    Is it realistic to suggest that she look into a bipolar support group?

    One strategy that helps with down-grading the intensity of a friendship – which is your intention – is putting a viable alternative before them by explaining that you feel you can’t be the friend that they need but that you don’t want to abandon them in their need and that you want them to have the best kind of support, which would be someone who’s walked in their shoes. Also, give them the example by you yourself engaging in a support group for people with your anxiety issues since it would help you and also show that you take your own advice.

    Hope that this helps.

  2. Anonymous says:

    I am friends with a woman who shared, after a couple of years into our freindship, her bipolar diagnosis with me. I had always valued our friendship, and her disclosure explained a lot of things to me… our friendship had felt very intense, lots of emotional highs and lows -but very few plateaus. Sometimes I felt very drained after spending time with her. Often she would disappear for months, declining invitations-I never took it personally, but I noticed it. These things, I didn’t mind. But the anxiety I experience when she is in crisis due to her (at least what I judge to be) impulsive decisions has proven to be the hardest thing to handle because of my personal history.
    I often feel deep anxiety when she comes to me for support after making a choice that I feel is going to have drastic consequences. For example, in a couple of days she is leaving the country with a man she just married after only knowing for 8 weeks. I try very hard not to be emotionally invested in her choices, and that is my issue- I was raised by a single parent who made very similar impulsive choices- which had major consequences in my life as a child, and sometimes her behaviour triggers me. I want to go in and fix/prevent/save which isn’t fair to either of us. Yes I’m going to therapy- I know it’s me, a more objective, healthy friend would just wish her well and hope for the best…
    I have decided that I want to take a step back in our friendship, and keep it to mostly public functions. I care for her, but I just find it too difficult to be authentic and support her, be her confidant, when her decisions often trigger my most primitive fears – and I feel that when I have been honest with her and try to broach my reservations she gets defensive and makes light of it- I worry too much. I am also not sure how she would react if I told her why I was taking a step back.
    I am sharing this because I hope maybe some of the readers here can see the other side… it’s not that I want to abandon her, it’s actually because of my personal history, it’s just too hard. I want to be in a place where I can care for her but have a healthy detachment.
    Thanks for listening

  3. Irene says:

    Hi Julie:

    I’m sorry you are feeling so sadly and disconnected. You should talk to your therapist about it and you also might want to find out if there are any peer support programs in your area to help you get over the hump. I know you will feel better over time.





  4. Julie says:

    I could have written the same letter as the original poster. I received a bipolar diagnosis last June. I am so alone with this. So alone. I have never not had friends; right now, I don’t have any at all. I regret trusting them, although I had no reason not to, I thought. It is so painful, that even writing these few sentences makes my throat tight and my eyes well up.

  5. Alone says:

    Thank you for taking the time to respond to my letter, Dr. Levine. I do have a trusted professional with whom I am engaged in therapy. I expect the healing process to continue. Your kindness and candor are greatly appreciated.

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