By Mylika Scatliffe,
AFRO Women’s Health Writer

Noah Dyson is 23 years old, Black, and living with bipolar disorder.

Attitudes about mood disorders and mental illness are slowly improving, but even today there is still stigma. 

“I hate the word ‘crazy,’” said Dyson. “It’s dismissive of a person’s experience. You don’t know what trauma has contributed to that behavior. There is so much that has led this person to this moment in time and they’re not always in control of their actions.”

He’s noticed the Black community often puts the responsibility of mental illness on the patient in a way that is not seen with other illnesses that are beyond our control. “We often see Black people suffering and see them as the problem. We don’t look at them as suffering and having an illness that causes them to behave that way. We have to normalize mental illness as we do physical ones,” said Dyson.

Being Black and bipolar comes with many challenges. Black psychiatrists and therapists can be hard to come by, depending on where you live and your insurance options, making culturally competent care difficult to attain for some Black patients. 

Dr. Beshaun Davis, psychologist with the University of Maryland Medical Center in Baltimore, specializes in the treatment of psychosis in youth and young adults for this reason.  

“I chose this area of treatment because there are not many available psychologists to treat psychosis and because society marginalizes people suffering from psychosis—Black people even more so,” said Davis.

Attitudes have improved, but stigma around mental illness remains in the Black community. 

“The risk of suicide is higher among those who suffer from bipolar disorder and other mental illnesses. The stigma of mental illness, and already being members of a marginalized community, can lead to feelings of hopelessness,” said Davis.

Bipolar disorder (formerly called manic depression), as defined by the American Psychiatric Association (APA), is a brain disorder that causes changes in a person’s mood, energy and ability to function. 

According to the APA all bipolar diagnoses are not the same, as there is bipolar I, bipolar II and “cyclothymic disorder,” which is “a milder form of bipolar disorder involving many ‘mood swings,’ with hypomania and depressive symptoms that occur frequently.” 

Though cyclothymia may present with the same symptoms, the APA reports that it appears with “less severe symptoms than bipolar I or II disorder.”

APA experts say that “bipolar I disorder is diagnosed when a person experiences a manic episode.” While in the throes of a manic episode, “people with bipolar I disorder experience an extreme increase in energy and may feel on top of the world or uncomfortably irritable in mood. Some people with bipolar I disorder also experience depressive or hypomanic episodes, and most people with bipolar I disorder also have periods of neutral mood.” 

This is different from those living with bipolar II who, according to the APA,“often first seek treatment as a result of their first depressive episode, since hypomanic episodes often feel pleasurable and can even increase performance at work or school.”

APA Researchers have found that “people with bipolar II disorder frequently have other mental illnesses such as an anxiety disorder or substance use disorder, the latter of which can exacerbate symptoms of depression or hypomania,” according to information released by the organization.

“People are generally more familiar  with bipolar I which is associated with mania and psychosis.  However, there is also bipolar II, which is marked with more episodes of severe, long-standing depression, as well as hypomanic episodes,” said Davis.

Dyson was diagnosed with bipolar disorder in 2018 after experiencing a manic episode over the course of a weekend of homecoming activities his sophomore year of college. He was 18 years old at the time.

Hyper fixation and grandiosity are common when someone is having a manic episode, which is what Dyson’s friends noticed about him that weekend in autumn 2018. 

“In the days leading up to my diagnosis, I was doing and saying things that were uncharacteristic for me,” said Dyson.  “I was telling everyone that I was going to be a millionaire within a week, and spending a lot of money on myself, buying things for my friends, paying for rideshares all the way to a different city.”

Dyson recalled being fixated on the idea of becoming a millionaire. “I was just walking around telling everyone, ‘I’m gonna be a millionaire. I’m gonna save my family. I’m gonna change the world.’”

For Dyson, the delusions were centered around a familiar need: to take care of his loved ones.

“In my head, my becoming a millionaire meant I’d be able to take care of any and all my family’s problems. I’d create an impactful change in our society. In my manic state, I knew that if I could just make enough money, I would get my family and myself the mental support that we need,” said Dyson.

Dyson suffers from bipolar I, where markers include decreased need for sleep, increased or faster speech,  racing thoughts that cannot be turned off, quickly changing topics or ideas when speaking, increased activity (e.g., restlessness or working on several projects at once) and an increase in risky behavior (e.g., reckless driving or spending sprees).  

Once he learned that bipolar I is associated with episodes of mania and psychosis, Dyson began to take a look at his past. He soon realized that he had experienced symptoms as far back as his sophomore year of high school.

“I  had the opportunity to take part in a student exchange program where I would get to spend time in Japan. While preparing to go to Japan, I felt like I was representing America and the entire fate of the country was in my hands,” said Dyson.  

These thoughts developed into Dyson’s paralyzing fear of messing up and not living up to people’s expectations.  He was dealing with a lot of change in different aspects of his life, including a romantic relationship that was not going well.  “Then there was academic pressure,” he added. 

“I went to the School Without Walls in D.C., and it was very academically rigorous, much different from middle school, so I was having some trouble keeping up.” His situation only intensified as academic stressors combined with turmoil at home, where his father struggled with substance abuse.

“All this just caused me to have an implosion, what was really a psychotic and depressive episode,” said Dyson. This led to him being hospitalized, but he still would not be diagnosed until that college homecoming weekend.

Over the years, Dyson has tried different solutions to manage his mental health. It is not uncommon for it to take a while to find the right treatment for bipolar disorder or any mental illness. 

“In addition to medication and therapy, it is important for people who are bipolar to  recognize what triggers their manic episodes and take steps to mitigate them,” said Davis.

“Fostering a good relationship with your medical provider is crucial– [find] one who will work with you and listen to your concerns when trying to find the medication that will work best for you. Bipolar disorder is typically treated with mood stabilizers, but there is no ‘one size fits all’ for medication. It can be trial and error to find the combination of medications,” said Davis. “It’s possible to even be diagnosed with another disorder before finding what works best for you.”

When talking about the day to day living with bipolar disorder or any severe mental illness, Dyson stressed having a reliable support system. It’s ideal if that village is made up of family and friends.  Dyson talks about this on his podcast, called The TLC Zone.

“You really should surround yourself with people you are willing to allow to get to know you intimately, who will know what medications you take, what hospital you want to be taken to, and what medication you want to be given if the need arises, and to have a psychiatric directive.  Most people know about an advanced directive, but don’t know there is something similar for people suffering a psychiatric emergency,” said Dyson.

Though Dyson does have a strong support team, he has lost a friend or two in the battle for his mental health. 

“It’s hard to separate the person from the illness. Friends and family will intellectually understand ‘Oh he has a mental illness,’ but also [remember that] this person did [wrong] and it hurt me,” said Dyson. “For someone like me, who is very empathetic and mindful of my actions, I will say, ‘Hey I know I’ve done something to hurt you. I want to make amends. Can you please forgive me?,’ and I pray that person is willing to listen to what I have to say. It doesn’t mean we’ll be best friends again, but at least they will hear me.”

Today Dyson is doing well. He still suffers from some depression but is intentional about what he does to manage it. He meditates, reads the Bible, exercises, and gets out into nature. “When you’re sad and having anxiety your brain lies to you. I like to really get out, talk to people and be with my support system to drown out those lies.”