Most encounters with health workers put me in some sort of vulnerable position. That vulnerability drives my anxiety through the roof. I try to be upfront with medical professionals about my Bipolar and anxiety. It’s too easy for others to accidentally rub against my dis-ease. With procedurally necessary invasion of my personal space, having things done “to” me, tools and protocols that I don’t know enough about to understand, having a stranger put their hands on me and sometimes in me, fear and concern about the results, physical discomfort and occasionally pain (to a greater or lesser extent), I think it best to give them a heads up. That disclosure helps keep me safe while allowing them space to complete their work. My neurodivergence usually comes up early in the visit. “Hi Mr. Images. My name is Dr. Brand. How are you? Are your prescriptions up to date and has anything changed since your last visit?”
“I’m well, thanks. I want to let you know that I have Bipolar II with an anxiety chaser. I want you know that, in case I do or say anything that seems (to you) disproportionate to the situation. Sometimes I may need an accommodation. When I need something, I may say STOP so I can let you know what it is. I may ask you to repeat something before continuing.”
I wasn’t always blunt. Younger me would have sucked it up & dealt with the mental fallout later. If I deliver a preamble, most people understand & work with me. Most.
There Aren’t Too Many of Us (relatively speaking)
We don’t learn about neurodivergence and how to treat folks who live with it. According to statistics from the Depression and Bipolar Support Alliance, It’s possible that some people never met one of us in the wild. Even more likely, those of us who have met you, were masking, giving no clue about our Bipolar. We are underexposed. Some people have no knowledge of what it is, or how to speak about it.
Bipolar disorder affects approximately 5.7 million adult Americans, or about 2.6% of the U.S. population age 18 and older every year.
-National Institute of Mental Health-
Most people aren’t mean, they just lack exposure and knowledge so they kind of fly blind when interacting with us. They don’t have the tools they need to feel comfortable knowing know what to say or do.
PRO TIP: ask us. we will be happy to share with you.
anxiety vs. Anxiety
Words lose their meaning when overused. The weight of a word will become dilute after years of misuse.
Language dilution can be defined by using a word with a strong meaning to express a much less strong idea. For example, one can use the word ‘literally’ even when something is not literally true, just to emphasize it.
It happens because people use the words ‘awesome’, ‘wonderful’ and ‘amazing’ even when they do not really mean them. They do so because they want to make their statements as effective as possible without using too much effort.
Doing so, people waste the meaning of words, which are one of our most precious resources. If you use ‘literally’ when you don’t mean ‘literally’, you are not only adding a useless word to your sentence, you are also devaluing the word, so that when it is to be used in its proper meaning, it no longer means anything. We only have one word for ‘literally’, and if ‘literally’ no longer means ‘literally’ then we’ve lost a word.
-Lingo Star Language Services-
Literally, OCD, Satanism, Bipolar, exhausted, hate, God bless you, depressed, forever, awesome, trauma, passed out, legendary, secret sauce, epic, sin, PTSD, 100%, honest. All diluted by overuse, diminished by using them to describe something lesser in intensity lowering the severity or importance of the word.
I am literally starving.
That photograph is legendary.
This is going take forever.
Mental health words fall into these piles of diluted words They are often used as punchlines or as generic descriptors for common human traits. EVERYBODY has anxiety, EVERYBODY has PTSD, EVERYBODY has been traumatized, EVERYBODY has OCD. Their dilution makes their meanings sort of trivial. If I tell someone that I am Bipolar, they may interpret that as “I am moody”, like their cousin Tina. Tina often says she is bipolar. What she means is that she is moody. This makes communicating something very important, much more complicated.
The dental hygienist
Dental exams have the potential to really jam me up and magnify my anxiety disorder. On some occasions that has led to a depression that could last for days or weeks. It is an environment where I need to be prepared and proactive to keep myself safe.
I sit in the chair and the Hygienist comes enters the room. She introduces herself and asks me questions about the daily medications I take.
“is that all of them?” she asks.
“Yes. Also, I live with Bipolar and Anxiety disorders. Dental work is really difficult for me.” So far so good. “I really can’t do the chit-chat thing so please just do what you need to on my teeth and, seriously, we don’t need to talk while we are in the middle of it.”
She starts her work. Sharp pokey things are in my mouth now. I flinch. “Why are you flinching, It can’t hurt. I’m barely touching you.”
“I have Anxiety disorder and you have sharp things in my mouth. It makes me really uncomfortable. So I flinch.”
She continues digging in my mouth. “So, you keeping busy at work?”
“Ma’am, I asked you to not make small talk while you are in my mouth.” I was probably sounding stern (at least). I managed to get the words out through the hands and metal scrapers in my mouth. I was emphatic as my panic was increasing.
She thought responding with “Oh Jesus” was a good response. It wasn’t.
“Ma’am, this isn’t an “Oh Jesus’ thing, it’s me trying to ask for accommodations that I need to get through this.” Breath is filling my chest in an almost painful way: I am starting to sweat. I lean back into the chair expecting to finish the procedure. The next word I hear is “Whatever.”
“WHATEVER? That’s it, we’re done. I’m leaving” I stand up an pull my stupid paper bib off.
”What did I do? What’s the problem?” I felt a need to answer her. “I asked you not to talk to me. You ignored it. I was telling you again about my anxiety and you gave me an “oh Jesus” and then. “Whatever”
“We’re done.” I said. As I was going through the doorway, I hear “I’m just doing my job!”
AND SCENE
This happened/happens. I have learned to set and keep boundaries in order to keep myself emotionally safe, everywhere. Sometimes I’m good at it, sometimes not so much.
Let’s look at another exchange. ( I will condense it as I have been way too wordy lol tonight)
“Hi, I’m Mark. I live with Anxiety disorder.”
“Thank you for letting me know. “Tell me what you need. I got you”
Do you hear and feel the difference? Support not judgement. Treating me with respect and dignity not say things that are dismissive.
Have I prattled on too long? Feels that way to me. LOL.
Do you remember the subtitle of this article? “Mental Health Accommodations Start With Human Decency” Yeah, about that…
Let me try to keep this as broad and simple as possible. Human Decency. Interact with everyone with politeness and decency. If someone tells you they have anxiety, give them the benefit of the doubt. Assume it is clinical and not colloquial. “Thank you for letting me know. Can I be helpful?” If someone tells you they are Neurodivergent, believe them. Magic words, remember? “Thank you for letting me know. Please feel free to speak up, we can adjust.”
Human Decency. Exclaiming “oh Jesus” and “whatever” or anything else sarcastic and dismissive is just fucking rude. Be decent with everyone, no matter the situation. You won’t have to remember to do it, it will become like muscle memory for the mouth. If you live neurotypical (god I hate that word) you would be amazed at the level of “thrown off” we can get over word choice or tone. The concern, for me, is always how fast can I hit the brakes on this train before it totally derails.
It doesn’t have to be that way.
Human Decency.
Stay focused and take your best shot.
All photos are mine unless noted.
If you got anything out of this article, check out one of my most popular.
Great explanation, Mark. I learned a lot about taking a beat and listening when people tell you something when I was teaching. Kids, instinctively tell you their truths. They just want to be believed and supported. Too often, as adults, we get caught up in our own stories and forget/dismiss others’ needs even when they state them clearly as you have done. Thanks so much for sharing your truths!