Yes, You Can Be High-Functioning With A Severe Mental Illness

We are all around you. We are the walking wounded, the invisibly battle-scarred. You see us every day — in the grocery store, at carpool, at school pickup and dropoff, at PTA meetings, at the gym and at work and at the playground. You probably don’t know that we have a severe mental illness.

We don’t plaster it on our foreheads, or go around announcing it. But it’s there. It’s always there. And even as we smile, even as we make small talk, even as we nod along with you; as we raise our kids and do our jobs and have our fun, it’s always there. Always looming. Always dominating everything.

Related: How To Identify The Signs Of Potential Mental Illness In Your Child, According To An Expert

I have moderate ADHD, an anxiety disorder, and bipolar II. It’s the last one that punches you in the gut, that pushes me beyond the pale of “acceptable mental illness” and into “shouldn’t you be in the hospital?” territory. Because when people hear “bipolar,” they think wild things. They think thousands of dollars wracked up on credit cards and erratic behavior. They do not think of what it is: a mom, terrified and rocking in the dark, teetering on the verge of suicide and only sticking it out because of her kids.

But that’s how things were before I found the right medication. The dark periods still happen: times when I think everyone hates me, when I sleep all the time. But I spend most of my time in a hypomanic state now. That means I just get very obsessed with something (like sewing or my garden), that I talk too much, that I’m hyperproductive. When I start to spiral down, I adjust my meds per my psychiatrist’s recommendations. I don’t fall down much anymore, not as far as I used to, or at least I haven’t recently.

And I am not alone. According to the NIMH, 4.4% of adults will experience bipolar disorder at some point in their lives. Generalized anxiety disorder affects 3.1% of the US population, reports the Anxiety and Depression Association of America; 2.7% of Americans have panic disorder, and 3.5% have PTSD. Major depressive disorder, the leading cause of disability for Americans 15-44.3 years of age, hits a full 6.7% of the population per year.

Half of people with depression also have an anxiety disorder, as do half of people with adult ADHD. Mental Health America reports that 3.99% of Americans have serious suicidal ideation. In fact, the National Association of Mental Illness says that 1 in 25 Americans live with a serious mental illness. They call “serious” an illness that “substantially interferes with or limits one or more major life activities.”

If you met me, you would never know I had bipolar disorder or anxiety issues. That I am one of the folks living with a “serious mental illness.” The ADHD is obvious — I forget things, and I’m spacey. But the other two can remain undetected.

I hold down a job that’s more than part-time, less than full-time. I have several bosses, and most of them don’t know about the bipolar disorder or anxiety. They don’t know about the half-drafted emails I don’t send saying I can’t do assignments, about the terror that jolts me awake when I realize I’ve overbooked myself and I can’t breathe. They don’t need to know. They know I work, and work well, and only took time off at the worst of my bipolar downs. It can be hard. I consider quitting sometimes, when it gets overwhelming. But I never do, because I hold hard to hope it will get better. And when I can’t manage it, my husband does it for me.

With most of the other moms I know, I don’t bother opening up. I know I should, in the name of awareness, but I don’t want to make myself the target of their whispers. I’ve spent time in a treatment center.I know how stigmatizing severe mental illness can be. But I am right beside them, dragging my three kids to the lake. I am right there, schlepping those same three kids and all their junk to a playdate at the park. I know there must be other moms in the same boat — moms with depression, moms with severe anxiety disorders. But we drift past each other with glib smiles, glib answers that we’re fine, everything’s fine, kids are great. The stigma is hard.

Because my illnesses are always there. They are exhausting. The medication I take to control them — the medication that saves my life — makes me tired. I drink a lot of Red Bull and coffee. I take a nap when my husband comes home. We’ve worked this into our marriage, and though I had mental health issues when we met, they’ve escalated since. We love each other, so we worked it out. We have an excellent marriage. Having a serious mental illness doesn’t mean you’re condemned to celibacy or lovelessness or divorce.

But it’s lonely. I know two people in real life with bipolar disorder. One I just met, and when she dropped the mental health truth bomb, I wanted to stand up and hug her and possibly cry. Because she understood all of it. The exhaustion. The mental teeter-totter. The fear, the anxiety, that comes even when I’m in a good place. Because it’s lonely to live with a serious mental illness. It’s hard work, lonely work, heavy lifting done only in the mind, only by yourself. No one can understand except someone who has been there.

And you do not know, as you look around at your friends and acquaintances, who is struggling. You have no idea. Many people reading this had no idea I was bipolar. You do not know because we hide. We’re afraid of what you’ll think of us. We’re afraid of what you’ll say about us. I’m afraid now, as I write this. Severe mental illness comes with so much stigma. But we are all around you. We live, we move, we have our being. Invisibly. Painfully. Oh-so-lonely. But we keep going. You don’t know how much we struggle. And chances are, unless we open up to you, you never will.