My hands were shaking uncontrollably as I paced down the hallway, praying to God that nobody would see me. I was actually on a loop: five floors, two stairwells, and I had made six complete laps so far. My thoughts raced, my attention being dragged around to everything within eyesight. I knew I was incapable of a comprehensible conversation at that point. And if someone asked me a question with any substance, my cover would be completely blown, and I had no idea what the consequences would be. I was having a full-blown manic attack in the middle of a work day. I’d sent a panicked text to my wife to bring me a Xanax, indicating that it was an emergency. (I couldn’t drive.) I didn’t know how long it had been, but it felt like an eternity. This is the reality I live with, as someone living with bipolar disorder working a professional job.

Thankfully, I’ve been on a good regimen of medicine for almost ten years (and a bad one for three years before that), so this level of incoherence only hits me about once every six months or so. It used to be worse. A lot worse. I’m a smart guy who does good work, but I almost failed out of college. I found myself in a lot of destructive relationships (where I was doing the destroying), although it took me years to realize it. And, month to month, I didn’t know where my personality would take me. I’d go from six months on a manic high to eight months on a depressive low with no clear indicators or forewarning. There were a number of times when my life was seriously in danger. So I’m in a much better spot now than I was thirteen years ago.

But even with medical help and coping strategies, there are still the manic days of fun and laughter and inappropriate outbursts and really bad decisions. There are still the depressive days when it can take me over an hour just to will myself to get out of bed and I’m physically in pain for the entire day. There’s still the uncertainty of not knowing if you’re going to have that manic energy and determination for another six months or if you’re going to suddenly switch into depression mode and have to drop commitments and responsibilities just to cope with the basics of life that everyone else seems to handle just fine. So life is better, but still not easy.

As you can imagine, these complications are at their worst in the workplace. Problems both internal and external can make work harder than any other area of life for a bipolar individual. And, whether you know it or not, you may already be working with one. Bipolar disorder affects about 2.6% of the population of the United States, so if you’re working with at least 50 people, there’s a good chance at least one of them is bipolar. If you work with a lot of creative professionals, there’s an even higher occurrence among that group. I wanted to write this to illustrate some of the challenges we face and shed some light on a commonly misunderstood disorder. If you know or work with someone who is bipolar, simply understanding these things can go a long way in improving your relationship with that person.

Being a bipolar professional means suffering silently, keeping it together even when you’re dying inside. It’s a lot more serious than it looks. According to the EEOC and the ADA, my condition is actually legally classified as a bona fide disability. That comes with it the ability to request accommodations from my employer, similar to how employers have to provide wheelchair-accessible facilities. The website that pointed this out to me actually had a list of proposed accommodations, including things like allowing frequent breaks, providing a part-time work schedule, providing written instructions for everything, and providing sensitivity training to anyone who has to work with me.

Those who actually work with me would probably scoff at this list, as well as classifying me as disabled. I manage to keep it together very well, and my work ethic is excellent. I wasn’t diagnosed or treated until I was 21, and the treatment wasn’t perfect, so I’ve gotten very good at coping with — and hiding — my disorder. Bipolar disorder is an invisible disability. I’m not saying I need, or even want, accommodations. Just like any person with a disability, I don’t want to be thought of as being weak or incapable. If I can make it on my own without help, that’s what I’m going to do. I’m just saying I don’t have it nearly as together as I appear to, and it’s a lot harder than it probably looks.

But the flip side of that is that it’s actually not a great idea to talk about your struggles in this area. When people hear you’re bipolar, many will make assumptions about you: That you’re unstable. That you’re going to snap. And any time you mess up or stumble, people will attribute it to the disorder. I have to work twice as hard to put forth an appearance of competence and stability, and risk throwing it all away when I slip up, whether it’s related to the disorder or not.

Being a bipolar professional means never knowing if the feelings you’re having are real and valid, or just the product of a chemical imbalance in your head. Is that coworker really being ungrateful, or do you just have an unrealistically high opinion of how awesome you are? Did you really just fail everybody, or do you just have an unrealistically low opinion of yourself right now? A normal person is able to trust their feelings as being, for the most part, an accurate representation of what’s going on around them. Or, at the very least, if they have a tendency to misjudge things, they have a consistent tendency to misjudge things.

I just realized yesterday that I’ve been manic for at least a month. Thanks to my own education on the disorder, I know now to be a lot more careful with those little quips and outbursts I think are funny, to be a lot more careful with my assessments of risk — but I didn’t know that a week ago, and my judgement was roughly the same. Similarly, a while back, I was struggling with projects and assumed it was because I didn’t have the necessary skills and temperament to do my job well. I soon realized I was actually just really depressed and doing fine, but in need of some appropriate project support. I reached out to my supervisor and quickly got the support I needed — but I only did so because I realized I was depressed and probably not thinking of myself correctly. These are successful coping stories, but it took me years to get to this level of self-awareness, and these things are still not immediately apparent to me.

Being a bipolar professional means dealing with an absurd amount of misinformation, stigmas, and prejudices. Mental illness is probably the only medical condition that people will judge you for treating. I constantly run into people that feel sorry for me not because I have bipolar disorder, but because I am treating it.

Think back on the movies you’ve seen. Can you name one where a character discovers he or she has a mental disorder, and is able to live a normal life with the help of modern medicine? I can’t. Can you name any where a character discovers he or she has a mental disorder, and rejects the false wisdom of doctors and scientists and learns to control it by strength and willpower alone? Yeah, pretty much every movie featuring a mentally ill main character.

I fully realize that medicine is not necessarily a good option for everybody and that some people are able to control it on their own without medicine. And I fully realize that some medications carry with them bad side effects that can make life hard in their own ways. But the implication is that solving mental illness without medical help is a viable option for everybody, and that this is somehow secret knowledge that doctors don’t want you to know for evil reasons. The implication is that I’m taking medicine either because I lack the strength and willpower to deal with this on my own, or because I lack the intelligence to see through the alleged lies of the pharmaceutical industry pushing these drugs — or both. If I face the disorder without treatment, I am unstable, unsafe, and unreliable; but if I deal with it with effective medical help, I am weak, gutless, and stupid. This is the absurd Kobayashi Maru that we face.

And then there are those who believe the whole mental health field doesn’t exist and is made up by the pharmaceutical industry to increase their profits. These people believe that the mentally ill are paranoid hypochondriacs who have seen one too many informational videos produced by the pharmaceutical companies and convinced themselves that they have made-up disorders, then gone to their doctors and demanded medication.

I’ll be the first to admit that there are doctors who overmedicate (I had one) and patients who misdiagnose themselves (I dated one in college). But mental illness is real, and it can be fatal. The rate of suicide in the general population is .013%. That’s it. The rate of suicide amongst bipolar individuals as between 15 and 17 percent. That means that bipolar people are at least 1153 times more likely to kill themselves than the general population. That also means bipolar disorder is 50% more deadly than breast cancer. And even with its faults, medical treatment of mental illness is real and effective. Success rates of treatment for mental illness are between 60 and 80 percent. Compare this to the treatment success rates of heart disease (40–60%) or breast cancer (around 30%) and it’s easy to see the hypocrisy.

In the workplace, these stigmas often lead to others believing we are frail, weak-willed, unstable, ignorant, or “crazy.” I’ve heard numerous times that I’m using my disorder as a crutch, or that I’m just making excuses for bad behavior and negligence. I’ve had people question my competence, or say I’m not fit to lead. I have to listen to people say things like, “Did you take your pills today?” I even on one occasion, upon telling a doctor I had bipolar disorder, heard the response, “Whoa! You killed any kittens today?”

And it’s crazy. I’m a manager-level web developer at the largest ad agency in Kansas City. I’ve been published multiple times on A List Apart, one of the biggest publications in my industry. Without knowing that I have a major mental disorder, I don’t think anyone at work would suspect it. I’m very good at my job. So these assumptions people make are based entirely on my condition, not my behaviors. I have to be careful not to let people know until I’ve had a chance to prove myself first. With some people, I never feel safe being open about my disorder, as was the case with a supervisor at my last agency. If this is a condition that experts have determined should legally entitle people to make requests for accommodations at work, but that is stigmatised to the point that employees may not be safe if they reveal that they have it, we have a major problem with our society.

Being a bipolar professional is not easy; but neither is it impossible, or improbable. I’m living proof that people can overcome these challenges and be very good in their careers. While sympathy is nice, the last thing we want is pity. And even though I didn’t go into it, there are actually some strengths that come along with bipolar disorder, such as enhanced creativity and adaptability. But hopefully I’ve shed some light on how this disorder affects people and makes our lives harder. A broader level of understanding and awareness will go a long way in making this disorder a little more manageable, not to mention socially acceptable. If you have questions, I urge you to get in contact with me, either through that comments box below or other channels. Thanks for reading, and thanks for caring.