A Firsthand Account of What Insight (and Lack of Insight) Means in Bipolar Disorder

Looking back on my experience with bipolar disorder I was never aware that my emotional state and ultimately my behavior sprang from a bio-chemical imbalance in my brain.

How could I? I’d never heard of manic depression before.

I always attributed my emotional and mental state as being part of my personality or my artistic temperament, both of which contributed to a lack of insight during my episodes.

Insight is defined as having the ability to discern truth from falsehood or fact from fiction. It includes the ability to think rationally and exercise sound judgment. A lack of insight is just the opposite.

What a Lack of Insight Feels Like and How It Manifests Itself During a Depressive or Hypo-Manic Episode.

As a general rule my depressive episodes were not triggered by external circumstances, as is the case with most people who experience periods of melancholy or sadness. For me it felt like a dark cloud descending upon me for no apparent reason at all.

Suddenly, I seemed to be looking through negative lenses that distorted my perspective on life in general and myself in particular. I became highly critical of my abilities, setting little value on anything I accomplished. The future seemed shrouded in gloom and I felt like an outsider.

At times it felt like I was living in two dimensions simultaneously - the physical world of time and space, and a world that held me captive with invisible chains that no amount of self-will could set me free.

Hypo-mania, for me, was akin to being submerged in a sea of vibrant colors all swirling around at blinding speed. Racing thoughts and flights of ideas left me confused and hindered my ability to communicate clearly. Errors in judgment prompted me to take dangerous risks with little, if any, concern about the consequences.

One afternoon after observing my mood swings and subsequent behavior, my wife presented me with a book about bipolar disorder and said she thought I was manifesting many of the symptoms. I immediately dismissed that idea by telling her there was nothing wrong with me that a little less stress and some rest and relaxation wouldn’t cure.

Denial, (another one of the signs of a lack of insight) was not only true in my case but seems to be a common among many others who struggle with bipolar disorder, especially before being correctly diagnosed.

It usually surfaces when someone suggests you may have bipolar disorder. Immediately, defenses go up and even the most blatant symptoms are minimized and rationalized away.

Denial does not affect everyone in the same way. For some, it becomes so strong that it will only yield when the consequences become so overwhelming that they collapse emotionally or are hospitalized.

For others it may take loosing everything they hold dear, (spouses, children, family, jobs, etc.) before they will admit the truth about themselves and seek help. And sometimes, in the most extreme cases, it may take waking up in a hospital room after a suicide attempt.

Other Contributing Factors That Lead To An Inability To Discern Fact From Fiction.

First: The way one is raised.

For example, in an attempt to help me achieve my greatest potential, my father inadvertently programmed me into believing that anything Idid was never quite good enough. “That’s good but…” I can still hear him say.

Over time that message became so deeply ingrained in my subconscious that it became part of my belief system. That conviction not only prevented me from discerning truth from error about the things I did, but was eventually translated into the belief that I as a person, was not good enough.

That erroneous reasoning produced in me an inferiority complex that enslaved and drove me to find some sense of personal worth from the approval of others. At the deepest level of my being, I didn’t like myself.

Second: Culture, Technology, and the Media.

Today, more than at any time in the past we are inundated with information, thanks in large part to advances made in advertising, television programs along with their commercials, movies, the internet, social media, etc. Those things not only influence the general public, but also affect the way those of us with bipolar think and act.

What Constitutes Insight, and How to Gain It.

Insight is not a one time epiphany, but an ongoing commitment that begins with an awareness that something is wrong, admitting it, and having the willingness to do whatever it takes to correct it. This will mean;

• Finding a doctor who specializes in mood disorders. This will help you gain insight into what the problem is and how it can be treated. I speak from personal experience as someone who was misdiagnosed many times by “general” psychiatrists who treat a plethora of disorders. It was only after being referred to a mood disorder specialist that I was correctly diagnosed and successfully treated me. Personal references are always best, but your local NAMI affiliate can probably refer you to a doctor who has successfully treated individuals with bipolar disorder.
• Consulting a cognitive/behavioral therapist who has treated patients with bipolar disorder can help clean out the emotional “cobwebs” that have accumulate in your mind over the years. Again, it was a cognitive therapist that helped me gain insight into what my father was trying to do that lead to the erroneous conclusion that I, as a person, was not good enough.
• Attending a good support group, either in person or online, is another effective way to not only gain insight on issues you may be struggling with but can also provide you with immediate constructive feedback. Other benefits a support group provides include;
  1) Helping you deal with stigma or isolating.
  2) They can also teach you coping skills to countermand mood swings.
  3) And being part of a group provides an opportunity to develop relationships with others who understand the battles you face everyday.

What I Did to Keep and Improve the Insights I Acquired

• Reminding myself daily that I am a unique individual created by God with gifts, talents and abilities specifically designed for me to glorify Him and enhance the lives of others.
• Keeping a journal of the insights I’ve gained, and new ones I’ve discovered, serve to reinforce and encourage me whenever I get discouraged.
• Reading books and meditating on the insights others have gained and passed down through the ages is another means of enlightenment. For me that would include the book of “Proverbs” written by a man who many consider to be the wisest man that ever lived. That book in particular has provided me with insight in many areas of my life.
• Developing relationships with people I trust, respect and admire for the insights they’ve acquired over the years has benefited me as well. Being around such people, as the saying goes, “more is caught than taught.”
• Finally, don’t be afraid of stumbling or failing. People learn and obtain insight by making mistakes when trying to achieving their goals. The key is perseverance, which eventually will produce discernment, (insight) and personal growth.

By way of encouragement let me leave you with this;

When I was in the depth of my struggles, after three suicide attempts and four hospitalizations, I never dreamed I’d write two books on bipolar disorder and gain enough insight to help others dealing with their disorder by writing blogs.

The pain was too great. The confusion too deep, and the hopelessness too complete.

But I’ve learned that bipolar is treatable and that through stability one finds insight.

Exercising sound judgment does not happen over night; It requires commitment, but it is absolutely achievable. 

Would you like help? Whether you have questions about your bipolar disorder, or someone you know, I'd love to connect with you.

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