By Kyle Kawahara, Nomin Ulziisaikhan, Netanel Younker, Hanson Tran and Nik Gorbs, UW Bothell School of Business

“I think it’s important to know that Bipolar Disorder is physical.  It’s not a weakness and you can’t just pull yourself out of a depression. Patience is important,” Emma Sanyal, one of NAMI Seattle’s board members, told us when she described her illness to us.

“It [bipolar] feels like having the flu. There’s no fever or puking, but you just feel too sick to move. And it lasts for months.”

Emma, like many individuals who are eventually diagnosed with bipolar, was not initially diagnosed with bipolar because her symptoms overlapped with those of other mental illnesses. At age 12, she began experiencing symptoms consistent with depression, but she wasn’t aware that it was actually symptoms of bipolar. She noticed that the symptoms began to interfere more with her life when she was 15. Later in college, a doctor prescribed Emma antidepressants without realizing she had bipolar as well Emma remembers, “I was really depressed and a doctor prescribed an antidepressant, which 3 weeks later caused me to have a manic episode. The doctor didn’t ask the necessary questions to make sure I didn’t have bipolar disorder before he prescribed it.”

Emma’s negative experience soured her towards medications, which may have hindered her eventual recovery. “It was the first time I had ever been prescribed anything and I was scared to take anything else for several years after that,” she said when remembering the long-term consequences of the doctor’s misdiagnosis. “It derailed everything for me for a while but I am frequently reminded that not everyone would have survived that, an encounter with the police for trespassing while manic.”

Emma later experienced a 6 year period where everything was looking promising. She finished her undergrad and grad school without medication. She later had a bad year and moved in with her parents again. Emma now says that finding the appropriate medication has been key to staying in recovery.

Emma, like many individuals with Bipolar, was once hesitant about sharing her diagnosis, due to the possibility of discrimination. Thanks to affirmation and support from family and peers, she now is much more open about her diagnosis than she used to be. Many people with bipolar experience discrimination. A recent study by BMC Psychiatry showed 93% of the individuals living with a mental illness sampled experienced discrimination, of which 20% have bipolar. Women with higher education levels tend to report more discrimination than other categories of individuals living with bipolar. Emma is aware of the discrimination that many women with bipolar go through, and now regrets not being more open about her diagnosis in the past. She is aware of the power of having destigmatizing conversations about mental health to battle the culture of discrimination and is now very open about her diagnosis with others.

“I’ve answered a few calls from people asking how to help someone realize that they are sick and need help; I never have a good answer for that one.”

Emma told us that when she worked for two years as a volunteer for NAMI Seattle’s helpline, she assisted others affected by mental illnesses looking for help, and sometimes struggled to find a good answer for those who were seeking help on behalf of others. The vast majority of her callers were mothers looking for ways to help their children, such as housing difficulties. It is extremely difficult to suggest one size fits all help for individuals with bipolar disorder because of the complexity of the illness.

Emma told us that many people tend to not understand these hardships and assume that this isn’t a severe disorder and that it is easily manageable. She also shared that she has had a hard time making and maintaining relationships. The friends she keeps are the ones that are understanding of her needing to drop “off the map months at a time”. In order for an individual without bipolar to have a healthy interaction and relationship with someone who does have, they need to be fully aware of their friends’ unique needs. Emma also emphasizes the importance of peer groups like those provided by NAMI Seattle as families and individuals affected by bipolar rely on the support services they provide. She describes volunteering at NAMI Seattle as being very “healing” because of the positive impact she knows she’s having on others’ lives.

“The friendships I keep are with people who are ok with me dropping off the map for months at a time.”

Emma told us about how she keeps her relationships healthy at home and in general. She is a very empathetic person who cares deeply for others, as evidenced by her NAMI Seattle helpline volunteer background. When it came to talking about her family, she explained that she and her husband work together. When she is getting worked up in a manic phase, she says that it helps her to talk about the things that are going on and work together to reach peace.

Emma explained to us that to keep her household happy and healthy during manic phases, Emma and her partner became proficient at self-care and communication. “Nowadays if I’m experiencing symptoms I double-check to see if I remembered to take my lithium, and then try some of the stuff I’ve learned in online kindergarten this year: push on a wall, count my angry spots, etc”, Emma says.

Furthermore, Emma shared with us that she and her partner have systems for working together when an episode is occurring. As the partner of someone with bipolar, just as with any kind of relationship, she says it’s sometimes easy to forget about yourself when attending to your partner’s needs.

Meeting Emma made us wonder if her experiences were like that of a friend of ours, “Chris”. “Chris” has Bipolar, and she informed us that it’s just as important to care for your partner as it is to care about yourself. “Chris” also says that it’s important for those who have a partner with a mental health condition to also focus on themselves and practice self-care. Emma agrees with Chris’s point of view and also said that self-care helps keep the household healthy. 

The same goes for friendships. Emma explained that the friendships she kept were due to open communication with those people as well as patience. The ones who stick around are the ones who understand her and don’t take things personally when her depressive phases hit.

Emma looks forward to continuing to work with the other NAMI Seattle board members to create more opportunities for support for those affected by mental illness. She also looks forward to continuing to share her experiences with those she meets in order to continue her work in reducing stigma. Be sure to say hello to her if you see her around at NAMI Seattle virtual events!

About the authors: Kyle Kawahara, Nomin Ulziisaikhan, Netanel Younker, Hanson Tran, and Nik Gorbs are students in Professor Laura Umetsu’s business writing and ethics class at the UW Bothell School of Business. They wrote this feature on Emma as part of a class project to destigmatize conversations about mental health with their peers.