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Myth#3 Bipolar is more serious than depression and it’s preferable to have anorexia over bulimia

Welcome to part 3 of my mental health myth busting series.

In this one I want to address the unwritten, but most definitely alive and kicking, mental illness hierarchy!

All mental illnesses can be mild or severe, at the severe end, any mental illness can lead to suicide.

It depends how you’re measuring severity so making comparisons is unhelpful.

On a number of occasions I have been in conversation with people who make the distinctions and imply that one illness is ‘worse’ than another. For example, I was in a conversation about recovery and someone said ‘but I’ve got bipolar so, of course, I’ll be on medication for life’, I didn’t want to dismiss her statement about being on medication for life, as it may be true but there’s no ‘of course’ about it.

medication being measured into hand

I’ve known people with schizophrenia and bi-polar come off medication and manage the condition (which has seen them into multiple hospital admissions with life risking behaviour) with diet, exercise and lifestyle choices that benefit their well being.
Equally, I’ve seen people (including myself) try coming of medication (for the perceived ‘lesser’ diagnosis of depression or anxiety) but it’s not been possible. Despite putting every therapy skill and lifestyle technique into action.

Whether a condition is managed with medication for life or by other means, anyone who’s been ill will need to vigilant for symptoms returning or getting worse. Some people will need to manage their symptoms constantly, others may be symptom free; this is independent of diagnosis.

Some illnesses are more common than others, this does not make them less severe.

Some illnesses lead to people behaving more outside the norm e.g. responding to unseen stimuli in psychosis, but that does not mean they are more unwell than someone who experiences symptoms that are more relatable, such as low mood.

An elated, high, manic or psychotic person may or may not put their life at risk. Someone experiencing extreme low mood or generalized anxiety may experience suicidal thoughts daily.

Some people judge mental illnesses by what causes them. This is unhelpful as some are reactive, caused by stress or childhood trauma where others are unrelated to life events – neither is worse than the other, the brain is complicated.

Anorexia is perceived as ‘the one where you’re in control’ and bulimia and binge eating disorder (BED) considered ‘the ones where you’re out of control’. Neither of these statements is true but it doesn’t stop people with bulimia or BED wishing they had anorexia. At times when I’ve binged and purged I’ve worried I’m not ‘doing anorexia right’ and I didn’t think I should be getting treatment.

stethoscope on medical chart

The truth is, all eating disorders are life threatening illnesses, none is more or less severe or concerning than the others. People can die from chemical imbalances caused by binging and/or purging, just as people die from malnutrition caused by restriction.

Holding onto inaccurate beliefs leads people to believe they’re not ‘ill enough’ or deserving of treatment, this is dangerous – early intervention is the most important factor in recovery from any mental illness.

It seems that as awareness is raised about mental illness, some seem to be more ‘acceptable’ than others. For example, someone is more likely to ‘come out’ as having depression, anxiety, bipolar or anorexia than they are about having schizoaffective disorder, emotional unstable personality disorder or binge eating disorder.

The mental health world is indebted to people in the public eye who’ve shared their experiences. We just need a few celebs to speak about their experience of depersonalization, avoidant personality disorder or pre-mensural dysphoric disorder and we’ll start talking about these, no more or less serious but, rarer illnesses.

Our aim must continue to be to make all mental illness understandable and as easy to talk about as any physical illness. It wasn’t long ago that people talked about ‘The Big C” as though saying cancer out loud was taboo and dangerous for some reason. People started to be able to say the word ‘cancer’ and now, there are people making a living out of discussing the most taboo of the all – bowel cancer!

So, there’s hope, we will get there!


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