High Functioning Mentally Ill

DeeDee new“High Functioning” is a term usually reserved for describing autistic people or others with developmental disorders who operate a bit better than expected, which unfortunately isn’t saying much. It’s also occasionally applied to mental illness and other learning disorders. As applies to ADD, which is technically a developmental disorder, I like the following quote that I turned up (I edited bad use of commas because it burns, it burns!)

The twice exceptional individual, intellectually gifted [and] with ADHD, continues to be an enigma… Because they successfully compensate for their hidden difficulties at great emotional, cost their issues rarely come to the fore.

It’s all too true. It’s confusing and frustrating and hard on the self-esteem to know that you’re damn smart, and yet constantly lose things and have trouble with the “stupid” details of schoolwork. The ones that got me were minor but telltale: I constantly misplaced +/- signs in arithmetic, which substantially impacted my GPA in college (I’m not joking), and I could not follow directions because I could not read them. It was as if my eyes could not see a sentence or two, every single time. It completely bewildered me. In primary school, I was simultaneously precocious and a space case. I always spoke at the wrong time and had to work incredibly hard to suppress that because I knew it was wrong but just couldn’t help it.

My Mom loved to relate the story of the incredibly complex lie to my teacher that I concocted in 2nd grade. I was both unable to read the directions and failing to pay attention in class, although no one else ever knew that was why it happened. In a discussion of a reading workbook assignment on barnyard animals and pets, I misread some of the directions, as usual. As we were discussing them in class, I zoned out; I read at the 8th grade level by then, so I rarely paid much attention to reading group. Everyone was talking about their dogs and cats: boring. Then it was my turn. Startled and confused, I said something about a pet duck. It turned out that we were supposed to talk about the pets we actually had, not the ones we wish we had. Oops. Covering for my error, a couple weeks later I told my teacher that the duck got loose and our dog killed and ate it. Phew. Disaster averted. Until the teacher gave her condolences to my Mom at parent-teacher conferences. “What duck?” said my Mom.

That’s the kind of thing that can happen to a high functioning ADDer. It was sorta funny when I was a kid and slipped through because I was smart enough to compensate. It was really damaging when I hit college and couldn’t cope with the unstructured learning environment. It was truly distressing when I literally could not work in a normal office environment due to constant distractedness and poor organizational skills undermining everything I did.

With respect to bipolar disorder, being high functioning can mean really different things. For me, it means that I can succeed in an incredibly demanding intellectual career and I’m wildly creative. But I’m hardly an exception in this respect. Most of us are very high functioning:

The majority of people are very high functioning and I think this is another misconception about bipolar disorder, that it’s an illness, which leads to decline in functioning. In fact, many people with bipolar disorder are higher functioning than most, and achieve a lot in their life, and very creative people, excellent business people, excellent minds.

Few people see the collateral damage, but it’s there. Others in the blogosphere have made some thoughtful posts on this topic.

In my case, there’s a constant negotiation of my self-esteem and self-image based on what I can and can’t realistically achieve. And let’s not forget that I can’t keep up the pace I once did. Unlike my colleagues who work 60-80 hours a week, I can sustain up to 55, which is low enough to threaten my career potential (seriously.) I can only manage 8-10 hours a day, 6 days a week, before things fall apart. I have to make every single work hour pure gold to keep up. Fortunately, I’m wicked smart, so I can usually pull that off and still outperform everyone.

The pros of being high functioning bipolar are relative. I’m able to carry on, work for a living, achieve my goals, and others rarely suspect that I have a serious mental illness. Sure, they notice and remark on my mercurial moods, but no one thinks twice about it because I continue to produce like mad.

The cons are not insubstantial: it is so draining; I’ve fooled the professionals into believing there’s nothing wrong, consequently got the wrong treatment, and suffered unnecessarily for many years; and I’m constantly being invalidated whenever I mention having problems with executive dysfunction or mood swings. I might just intentionally burst into tears the next time someone says, “But you’re so successful, there can’t possibly be anything wrong with you!” That’ll show ’em.

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14 thoughts on “High Functioning Mentally Ill

  1. My therapist has said it’s almost a full-time job living with bipolar because we have to think so much about our moods, thoughts and behaviors! I’ve learned that I can’t keep pace with how I was. I don’t look down on myself anymore. I am trying not to make excuses. I am how I am and it’s ok. I still find myself saying at times “I used to be able to…” but as I become more aware of that, I’m reminding myself that I am perfect just as I am; it’s in those thoughts and words that I am in comparison mode. I don’t have to be different from who I am now. Who’s really keeping track besides me? Plus with learning all the mind/body connections and using mindfulness practices, I as so much calmer and at peace than when I was running around like a chicken with it’s head cut off. Sure, the ideas popped, the possibilities were endless, I accomplished so much but really??? When the depression came and I crashed and burned, then what? I’ll take how I am now, even if at times I think it’s boring, to what used to be. I relish the little things so much more and it’s opened up a curiosity to life instead of missing all of those little things and being frustrated with those around me who were unable to keep up. I AM HIGH FUNCTIONING and very proud of it!

    • I agree with it being a full-time job to just keep myself going within acceptable parameters, and the more I try to do, the worse I do at all of it.

      Overall, I’m pretty happy with myself, though the ADD symptoms get very frustrating. A lot of the reason I’m doing better lately is due to trying to take appropriate care of myself to minimize bipolar symptoms, and trying to embrace simplicity.

  2. My school problems were different. School was hell. Straight from preschool all the way through my senior year. Surrounding me were strangers, eager to get at my throat just so they could climb the social hierarchy. Adults all around, who were supposed to be there to help me. And I was so very sensitive and intelligent.

    I was reading chapter books in preschool. I could count to infinitity if I had the time. But, I could tie my damn shoes! Stupid sight impairment!

    I didn’t want to go to school. It was boring, and all of the other kids hated me for various reasons. I had a teacher yelling at me constantly over nothing. And I was scared.

    I really think that if someone had stopped and taken a hard look, I would have been snatched up out of that class and landed in a gifted program with other kids like myself. Or, the pressure would have been too much and I would have completely cracked. I don’t know.

    That’s why I don’t push at particularly sensitive children. I aid them in trying to work it out appropriately. And I think teachers need special training on how to handle that. Not this, “Buck up soldier” crap.

    • I hated school due to boredom and never fitting in socially. I begged my mom to let me drop out when I was 16 because I was literally bored to tears.

      Being an overachiever is more socially punishable than being an underachiever. Everyone hates the person who knows all the answers, pulls the curves, and corrects the teachers. I was bored in the “gifted” classes until I got to the ones that were taught at college levels. The gifted kids are just as eager to climb the social hierarchy, if not more competitive because they’re already in the top echelons. Their behavior is better, but their insults hurt worse because they’re more perceptive.

  3. Oh, I hated high school as well. I did ok in elementary with friends and academics. I was praised for my grades so that’s what I concentrated on. I started to really stand out academically in high school (gr. 7-12 back then). I always had a book inside my book. I could understand and regurgitate the material without studying. I was a nerd. My class was small…around 70. I was not in the ‘in crowd’. I was picked on. I excelled at academics and music but had a tremendously low self-esteem. The rest of the ‘smart kids’ were also in the ‘in crowd’. ugh. My mental health issues started when I was in 8th grade and I had my first major depression and anxiety when I was a senior in high school. I just chalked it up to upcoming changes. Of course, there was no talk of feelings and I had decided when I was young that I would not share anything with my mom…she was ‘crazy’. (She had bipolar also). College was even more stressful. I started in the gifted honor’s program but had to drop out and be a ‘normal’ college student because I didn’t know how to handle the social part of college very well. Throw an insecure person (me) into a mix where I wanted to fit in so bad…made some wrong choices and I couldn’t keep up academically. Extreme mood swings. Suicidal thoughts. Experimenting with drugs/alcohol/diet pills…Ugh. But of course, you did NOT talk about anything…suck it up and move on. The best thing that came out of college was my husband!
    Grad school 30 years later is wonderful because I know myself and can handle how life is…most of the time 🙂 I don’t fret with the occasional B.

    • Sounds so familiar! Except I only waited 5 years for grad school. I agree, it’s been a much better ride (in most respects) because I have a much better grip on myself and reality-land, at least, to the degree that I can understand any of that.

  4. I went to a high school of nerds, so I liked my high school. I did well in school in general and enjoyed that aspect of it. I *hated* elementary and middle school. I had no friends until high school. (Well, there were a couple, but only someone who used me and, in middle school, the other misfits I talked to at lunch.)

    In elementary and middle school, since I excelled, I was tested for the gifted program several times. I have poor spatial skills, and I’d flunk that part. Even though I did well on everything else, that meant I wasn’t gifted. One of my friends thinks it’s possible I could be a high-functioning individual with Asperger’s, for this and a couple of other traits I have. For instance, I cannot look people in the eye. But if I do have Asperger’s, I’m so high-functioning that most people can’t tell, even professionals. I’ve asked about it and been told nothing conclusive.

    My therapist says I’m a high-functioning person with social anxiety. A lot of people with social anxiety stay home all day, but I force myself to go to a job, where I deal with people every day. Somehow. And though I’m awkward, I’m still effective. In graduate school, I wasn’t that great at teaching; my student evaluations were not up to what was wanted. However, as an adjunct at the community college, I’ve somehow become decent. I teach developmental students, which, in my opinion, is much harder than teaching other levels. I’ve always just sort of instinctively understood grammar, so I was terrified that I wouldn’t know how to explain it to others. While I’m not the world’s best teacher, I can function. I misspeak all the time, accidentally switching words around and stuff. I have to suppress my anxiety as I’m teaching, and sometimes I do it more successfully than others.

    I don’t think people notice my social anxiety and depression at work. They just think I’m someone who likes to keep to myself. They don’t know it’s because I start panicking when I do more.

    I can seem quite stupid in person. I don’t have a lot of common sense, and my mind always gravitates toward the most complicated explanations. I get confused very easily. I’m not a great speaker. Sometimes my family tells me, “For someone so smart, sometimes you’re so dumb.”

    So, anyway, what am I trying to get to here? Lol. For someone with social anxiety, I’m high-functioning. I can get along, but it’s so wearying. Sometimes I get so tired of feeling like I have to hide my anxieties all the time. As you mention, just because I seem to get along doesn’t mean that I’m not experiencing a great deal of anguish.

    • What a weird rubric for “gifted” – I guess they weren’t up on the theory of Multiple Intelligences at that point. I had a harder time with math than anything else, and yet went on to major in it. Go figure.

      I have been literally blown away by the seeming majority of bipolar people who are on SSDI or unemployed. But that comes from interactions on forums where people who are just getting on with life probably don’t have time to linger. Heck, I hardly have time to check in there these days.

      I used to always get criticized for having “book smarts” but no “street smarts” and I think a lot of that was being out of touch due to ADD. I’m much better in both categories now. But I totally get what you mean for being smart/dumb at the same time. The truth is that we all excel at different things. I think that finding your own sweet spot – and sticking with it – is the real trick to functioning well.

  5. I find this a very engaging post for so many reasons. It gives more insight into what it’s like to grow up with ADD, a world foreign to me personally (though not to someone I love dearly). It also throws some interesting things out there on a personal level.

    For instance, the struggles I had in school (before the crazies kicked it into high gear) were mostly due to too much structure. I cannot function in an environment that is rigid and doesn’t leave a tremendous amount of latitude for me to make my own decisions. I would always write my papers in their entirety the night before they were due, because they needed to ‘cook’ that long in my head. In a few cases I even chose to turn papers in late. I could have written a paper that was merely good and turned it in on time, but I chose to write a paper that was exceptional and a few days late. I actually had a lovely teacher my first year of college who saw this and didn’t grade me down.

    I also find the part about individuals with BD being, by and large, high-functioning extremely thought provoking. I have been a very high-functioning individual, caring nearly full time for an infant and a toddler while going to school and making excellent grades, maintaining social interaction, and (of course!) making all of it look effortless. I also have been a straight up non-functioning individual. Unable to prepare my own meals (forget shopping for food), pick up medication refills, dress myself, shower, barely able to get out of my bed to relieve myself. That was pretty much the last frontier I never crossed, in all other respects I would have been classed as catatonic by a trained healthcare professional.

    Where I am right now, by society and modern psychology’s definition, is probably low-moderate-functioning. But by my own definition, I am happy and healthy as I never have been. Society and modern psychology can go jump in a lake. 😉

    • I’d say 85% of the people I’ve come into contact with who are bipolar are exceptionally smart. Functional is another thing entirely, and some of that depends on context – online forums are not the place to find the high functioning people, because those folks are off living their lives (or blogging, perhaps? ;)), not hanging out in patient communities.

      But we all operate differently. I often need to allow things to simmer in the back of my head for a long time, too, but I’ve also learned that getting it out in words a little sooner helps me craft a finer product because it forces and externalizes an important part of the process that would otherwise get rushed.

      I’ve been pretty non-functional at times, but I shower, I get dressed, and do most of those basic things. It’s been a long time since I was so messed up I couldn’t do those things, and I have to credit the meds for that. I just hope it keeps working that way!

  6. I found this post – and the comments afterwards – to be really interesting. As someone with ADHD and, supposedly “twice exceptional” I can relate to a lot of what you’ve written – especially the experiences of school. I would wish that schools had changed but, in my experience, they haven’t much (and I am a teacher myself). As a result, my son – who is also ADHD – is having similar problems to the ones you’ve described here. The only difference is that at least his family and the society around him understand more about these things now instead of judgement just being heaped on those who find they cannot ‘fit the box’.

  7. “But you’re so successful, there can’t possibly be anything wrong with you!” ==> or its counter-part “But you look so good, there can’t possibly be anything wrong with you!”

    Yep, that means nothing because no one can see the struggles that go on in the inside. La procesión va por dentro (Still waters run deep).

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