Being bipolar in Pakistan

First published in Dawn blog.

I suffer from a disability called bipolar disorder, something that 2.4 per cent of the global population suffers from. For most of us, it is a genetic disease, but there are others who don’t have a family history of it. It manifests itself by making an individual feel extreme highs and lows in cycles. It is also varied in intensity and has two classifications: bipolar I and bipolar II.

Being bipolar in Pakistan is not easy. Mental health disorders in this country are taboos that lead to discrimination which we face increasingly by the day. And because our disability cannot be seen, it is often dismissed as a lie or an excuse not to work. The very same people who imply that it’s possible for us to “snap out of it” would never dream of telling someone in a wheelchair to stop whining and walk.

Day by day, we hide our pain, the obsessive thoughts in our head and make excuses that are lies just so that we are not judged. Some of us don’t disclose this to our employers until we’ve been hired because we know that if we do, we may not be hired at all. More often than not, we never disclose. We pretend to be what we are not and over the years, it takes a huge toll on our well-being.

Can you imagine being in our shoes? Can you imagine a day when you’re so depressed that you’re unable to move, let alone get out of bed to brush your teeth or eat? Can you imagine being able to convince yourself that killing yourself would be the best thing you could do for your own family so that they don’t have to put up with your wretched existence? Can you imagine being so elated that you actually believe jumping off a roof will not harm you at all? Can you imagine being so manic that your totally irrational and incomprehensible thoughts actually make sense to you – Can you possibly imagine it at all unless you’ve been through it? We live in hell, which is why we mostly don’t fear death, perhaps this is why we have the highest suicide rate.

While I cannot speak on behalf of all females who have bipolar disorder, I do believe that we face similar discrimination and challenges. Bipolar patients necessarily need support from their family and friends, but in our culture, most families are not willing to accept that we have a problem. There is a lot of denial because of the huge stigma associated with mental health disorders. Many times, it is important for families to convince a bipolar person to seek help for the one who is suffering is not willing to acknowledge that he/she has a problem.

Because we live in a very superstitious culture where religion is given greater value than medical interventions, too many bipolar people are only diagnosed much later than they should be. People who are mentally unwell are usually taken to shrines. Since there is no visible “illness”, it is also considered a “curse” due to black magic. If someone is suffering from a mental health illness, it is assumed that they are possessed by a jinn.

Psychiatrist Dr Nusrat Rana, who runs the Punjab Institute of Mental Health, has had patients whose arms have been cut off by pirs who were trying to exorcise jinns out of them. She treated a woman whose face was scared by a faith healer with hot tongs when she was hysterical. By going through so much trauma, both physical and emotional, most develop Post Traumatic Stress Disorder which further exacerbates their ordeal.

Others marry off their daughters thinking that marriage will “cure” her, only to see that her bipolar disorder has been exacerbated by childbirth and postpartum depression or mania. If her condition results in a divorce, which is mostly the case, she is further shunned and mistreated. This “shaadi kaara doh” advice is also given by doctors, linking it to conversion disorder, which according to Dr Nusrat Rana, is a new version of hysteria, the archaic “wandering womb” syndrome.

As a teenager, I used to hallucinate and see black giants. Even though my mother belongs to a family that manufactures and sells pharmaceuticals, she was convinced I was seeing jinns. She really thought prayer and rituals would solve my problem but they never did. I know I was hallucinating because all the giants went away once I started taking medications that stabilised my brain chemistry. I no longer see things that are not there, nor do I hear voices like I used to. It’s not my mother’s fault that she believed religion could solve my problem and I do not judge her for it. She is, after all, a product of the society she comes from and has been incredibly supportive over the past few years.

This misconceptions regarding bipolar disorder and horrific stereotypes perpetuated by the media, as well as, people in general make having an unseen disability worse than it should have to be. Nor should it necessarily be seen as a “curse” for it can be a gift. Some of the most creative geniuses had bipolar disorder such as Virginia Woolf.

Stephen Fry openly talks about it and has even made a documentary about what it is like to be bipolar. Studies show connections between bipolar disorder and creativity and many lists of famous bipolar artists, writers etc have been compiled which shows just how much those of us with this “disease” have contributed to the world.

Had it not been for bipolar people, the world would have been a duller place and I keep thinking, perhaps just to console myself, that it surely must have evolved for a good reason.