When people ask whether or not I’m “disabled” because of my bipolar, I choose my words carefully and answer with confidence. Because language, identity, and empowerment are not only important but also interconnected.
After you receive a diagnosis, it is easy, I’ve found, to start to overidentify with it. This is why it’s important to consider the language we use when we talk about ourselves and about bipolar disorder.
Did you know there is a law that defines what the term “disabled” means in American legal jurisprudence?
As I see it there are several key parts of that definition:
substantial gainful activity, and
length of impairment.
So, for instance, a broken leg is a medical impairment that prevents substantial gainful activity but isn’t expected to last longer than a year or end in death. Not disabled.
Some cancers may not last a year from diagnosis to remission. Not disabled.
Other cancers don’t last long from diagnosis to death but are expected to end in death. Disabled.
Those paralyzed from the waist down are considered disabled until they prove they can engage in substantial gainful activity (defined by Social Security as the ability to earn a certain amount of money per month.)
But these are easily diagnosable, visible medical impairments. What about mental illness?
Physical Impairments vs. Mental Illness
The key here, I think, is the severity of the impairment. So, legally speaking, if a person’s illness produces hallucinations, but she knows they’re hallucinations and is not impaired in working by experiencing them, then these hallucinations are not considered a disabling impairment. If bipolar symptoms cause a person to become clinically paranoid to the point that he cannot leave the house, then those symptoms are considered disabling.
Am I “Impaired” and/or “Disabled”?
When it came to my own disability case, I was allowed because I could not interact with the public “normally,” nor could I last a full day doing unskilled work because of my “severe mental impairment of bipolar disorder.” By definition, I was impaired in those two areas.
They were correct. I was impaired in those two areas. But in many other areas, I am not impaired at all. I can still write with ease; I still have use of all of my appendages; I’ve learned coping methods to deal with strangers and loved ones; and I’ve uncovered in therapy why my interactions with others was impaired in the first place.
The Question of Identity
I’ve written before about how I overly identified myself as bipolar, to the point that I did not know how to react when I was told I was in remission with medication. So now I do not identify with my disorder, nor do I consider myself disabled, either. I am impaired, particularly in carrying out tasks that require a full day’s attention. My impairment is not in my ability to perform, it’s in my consistently being able to perform. So, if someone asks, I refer to myself as “impaired by bipolar disorder” rather than “disabled.”
“The term neurodiversity refers to variation in the human brain regarding sociability, learning, attention, mood and other mental functions.… It emerged as a challenge to prevailing views that certain neurodevelopmental disorders are inherently pathological and instead adopts the social model of disability, in which societal barriers are the main contributing factor that disables people. Neurodiversity advocates … argue for recognition of strengths as well as weaknesses in neurodiverse people, and that a variety of neurological conditions that are currently classified as disorders are better regarded as differences.”
In other words, I’m no longer mentally ill. I’m neurodivergent, instead.
The article goes on to note that the term is controversial, with two opinions basically shaping the debate—one side believes that bipolar disorder, autism, etc., are mental diseases that should be treated as such, and the other believes that people with these conditions are merely variations of normal human behavior and should be protected from those who would force them to behave differently or “conform to a clinical ideal.” On the more extreme end, there is even a part of the latter’s platform that actively advocates what is called an “anti-cure” perspective.
In other words, accept the neurodivergent, accommodate them, but don’t try to cure them!
Don’t work for a cure? What kind of talk is this?
I Know My Own Mind
I’m not a doctor or a disability-law specialist. However, I do know my own mind. I have been manic. I have been depressed. I have, on occasion, been “normal” without psychotropic medications. I will take “normal” any day of the week over manic, mixed, depressed, or any other variation of mood that results from bipolar.
I don’t need the well-intentioned telling me I’m normal when I’m not, and that I should simply learn to embrace my differentness.
I feel this normalizing of mental illness is damaging, just as criminalizing mental illness is damaging. After decades of fighting to get a treatment model instead of a punishment model and for mental health to be treated on the same level as physical health, along comes what is essentially a license to ignore the needs of the mentally ill once again—this time by normalizing their behavior. Some people with bipolar may not be as impaired as others. That’s okay. There’s no shortage of labels out there.
But we should all be able to determine how our situation ought to be categorized. No matter how well-intentioned people are, I correct them if they label me as neurodivergent. I am impaired by bipolar disorder. That’s my decision, and no one else’s.
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