“I could go from being excited, really outgoing and animated with rapid speech, to magical or deluded thinking.”

I first began to notice symptoms of what I now know to be bipolar disorder at the age of around 13. The main one was extremes of mood- my moods seemed to be much more extreme than what the people around me experienced, and that went for both ends of the spectrum.

I could go from being excited- uncontainably so- and really outgoing and animated with rapid speech, to magical or deluded thinking, like entertaining ridiculous business and travel ideas. By this, I mean that these ideas were completely disproportionate to the resources I had available to me at the time. However, when I did have the means, I would act on them. This meant that when I had money, I’d be reckless with it. I refer to it as ‘the acquisition of shit’- namely, making big but unnecessary purchases like musical instruments or recording equipment. Usually these big purchases linked to my autistic ‘special interests’, which would become almost like a hyperfixation.

At other times I would experience depression and low mood, which again seemed much more severe to me than how others experienced it. It was very isolating, because I felt like nobody understood. The depression was again completely disproportionate in magnitude in comparison to its trigger. It would last for months on end.

I’d become personally and socially withdrawn, have low energy and mood, experience hypersomnia and would be very pessimistic and neurotic. It wouldn’t take much to either push me into, or exacerbate, a negative mindset. Sometimes the trigger would seem to occur at random, but more commonly at that age, the causes were predominantly bullying at school and a tumultuous home life.

My family commented on the severity of my moods, but had no awareness of the fact I had a disorder. At school, the main issue was manic episodes. I’d struggle to concentrate as my brain would go off on tangents. I’d end up in trouble a lot as I couldn’t focus. I’d be sidetracked by fixating on my favourite things or topics, and was constantly told off for correcting teachers if they got something wrong. I was disrupting not only my own learning but that of everyone around me.

Some teachers knew there were issues at home. One teacher picked up on how I used language and how I carefully phrased things, indicative of how I was treated at home; “I was just…”, “I was only…”. I would over-explain and over-contextualise to justify myself.

Bipolar symptoms also affected my friendships and romantic relationships. Whilst I was experiencing mania, everyone thought I was fun and entertaining to be around, if a little chaotic. Others saw me as ‘too much’, so it could be quite polarising in terms of how people viewed me when I was symptomatic. When I was experiencing depression, it was much harder. People didn’t understand why I wasn’t my ‘normal self’. They took the change in me personally, and I withdrew a lot.

Things eased when I went to university. There was none of the bullying I’d been subjected to at school. I also had no reputation to maintain in higher education, whereas at school I’d been known for being quite an extreme personality. I actually did well at university because of the academic challenges it brought. I wasn’t forced to attend university in the same way I had been with school, and making myself go there of my own volition was a big motivator for me.

Bipolar symptoms also sometimes brought unexpected perks. There were instances of me experiencing elevated mood in a manic phase which would combine with hyperfixation, leading to me going three days straight without food or sleep to complete a project or assignment. Although it definitely wasn’t healthy, the reward was exponential, and in fact once I came to realise I was capable of this, I would intentionally delay work until I could hit those conditions in order to maximise my output.

The flipside of this of course were the depressive episodes, in particular during my second year of my undergraduate degree. I found it difficult to concentrate and engage in class, but managed it as best I could by taking breaks when I needed to and catching up with the work when I could manage it.

Initially, my diagnosis wasn’t bipolar. It was cyclothymia. This was given to me following a suicide attempt at 14 and I was referred to therapy via my GP. However, this was family therapy rather than individual therapy, so it was challenging because everyone was on their best behaviour in the sessions and consequently it didn’t accurately represent the difficulties I faced. Nothing really got resolved, and I was given antidepressants to help me manage my moods.

In January 2018 my diagnosis was changed from cyclothymia to bipolar type 2 by a new psychiatrist who stood in for my regular psychiatrist who was on leave at that time. He suggested a psychiatric re-assessment for bipolar and an ASD assessment. I welcomed the news I had bipolar disorder, to be honest. I felt bipolar better explained my experiences than cyclothymia did.

As far as ASD was concerned, people had been telling me for a long time they thought that I had autism, so it didn’t exactly come as a shock. I struggled socially, and eye contact was a nightmare. I not only found it hard to make eye contact at all, but when I did, I had all kinds of problems with judging how long to hold it for and knowing when to blink. I was also hypersensitive to noise and this affected my social interactions, for example having to default to lip reading in loud environments. I was also averse to strong smells, experiencing sensory issues with clothing and my surroundings, and would hyperfixate on things. I also found empathy tricky. My affective empathy is impaired, but my cognitive empathy is very good, so I rely on this a lot to help me relate to others.

Having both certainly makes life a challenge. Hyperfocus is one of the worst aspects for me as it overlaps with ASD and bipolar. When I’m hyperfixated, I can’t sleep, I’m agitated and I become obsessive. Once I’ve identified a rabbit hole, my brain simply refuses to not let me go down it. It’s all-consuming. My hyperfixations broadly fall into two categories; social, which could be a person or thing that then becomes a borderline obsession for me, or academic, like things I’m studying or personal interests like the monarchy which I become absorbed in and memorise reams and reams of information.

Dealing with both is absolutely exhausting. I am aware that I will crash and burn, but I don’t care because in the moment, it’s worth it. Now I try to pick my battles where I can, since I know how much toll it takes on me and I have to assess if the payoff is worth it.

In romantic relationships, bipolar can be a big obstacle. It’s hard for a partner to keep up if I’m manic. It’s confusing and exhausting for them. If I’m depressed, there is genuinely nothing anyone can do to bring me out of it. I’ve found in the past that this is something they take very personally, even when I explain it’s my mental illness and not a reflection on them.

With ASD, this creates an additional communication barrier. This mostly shows up with a partner making the assumption that I should be a mind reader when it comes to their emotions and interpretations of events. I’d often hear, “You should know that would make me feel a certain way”, but I honestly don’t, because I can’t conceptualise that. For me, mind reading is a normal social cue for someone allistic. For someone with autism, we can’t always pre-empt how you might perceive our intentions or what we say.

What’s really helped with bipolar is a decent psychiatrist and the right meds. A good psychiatrist asks the right kinds of questions to link symptoms. Mine explored different combinations of medication too and I currently take an antidepressant and an antipsychotic. Monotherapy doesn’t work for me.

In terms of managing my autism, getting the diagnosis itself helped with work because it’s enabled me to access reasonable adjustments, especially around triggers (leaving the office if I need to, wearing earphones if it’s noisy environment) and not being expected to go on learning days due to the disruption it causes to my routines and the dysregulation that arises from increased expectations around social participation.

As a man with bipolar, in terms of representation, there isn’t much for us out there. Bipolar is, I think, associated more with women because of the (sexist) view society has that mood swings are a ‘women’s issue’. A woman struggling to regulate emotions isn’t as socially alien as a male doing the same, so it’s harder for men to admit when they’re struggling due to social expectations.

The only high-profile male example I’m aware of who is outwardly open and discusses bipolar disorder is Stephen Fry. In fact, I particularly like a metaphor he once gave of comparing bipolar disorder to the weather- it’s not your fault that it’s raining and you’re getting soaked; you didn’t make it rain, and nor can you control the weather. But it will stop raining, and the sun will come out eventually. To expand on this, it is also the case with constant sunlight- things will eventually calm down, and one can recuperate in the shade. I find it resonates with my own experience of bipolar disorder.

I have found that as I’ve aged, bipolar has become easier to manage. When you’re younger, it’s a lot harder due to the usual life transitions. The older you get, the more time and resources you can invest into managing it. Clinically speaking, it’s a lot of trial and error to find something that works.

As an aside, there are some unexpected practical challenges that bipolar can cause that many people are unaware of. I’ve found a real difficulty with life insurance because a lot of companies don’t draw a distinction between bipolar type 1 and type 2. Due to the suicide risk associated with the former, it’s quite often a ‘computer says no’ situation and I’m automatically refused. I’m still unable to find insurance, which is becoming a concern since I hit middle age. It’s hard to communicate the minutiae- in actuality, there are three types of bipolar which aren’t catered for with these kinds of things. It also impacts travel insurance- I’ve found that declaring bipolar has meant the price of the insurance often costs more than plane tickets, making it either extremely expensive or impossible to get.

My advice to someone with bipolar would be to comply fully with taking medications as prescribed by your clinician, engage with your psychiatrist and your mental health team, and surround yourself with people who understand- or strive to if they don’t already. Make a habit to be open and honest when you’re struggling rather than just managing it alone- bipolar isn’t day to day stress, it’s a serious mental illness. Talk about your experiences and be open if you can.

My biggest challenge by far is paying attention to my limits. I still push myself into doing more than I have the energy for. Regulating my moods can be difficult too. The extremities of mood aren’t as great in magnitude as they used to be due to treatment, but they’re still there.