Each of these remarks contains a hidden assumption, from simple – you can choose your moods; to dismissive – your anxiety is not as severe (or as important) as mine; to possible gaslighting (see https://wp.me/p4e9Hv-pm, https://wp.me/p4e9Hv-C2, https://wp.me/p4e9Hv-Cu).
I’ve gotten all of those and more. Once I revealed my disorder to a coworker and she’d ask me, “How are you?” with a concerned look several times a day, taking my emotional temperature. But the question I hate most is a simple one.
Are you off your meds?
Let’s unpack this, shall we?
First, the underlying message is that, to the speaker, you are acting in a strange, inappropriate, frightening, incomprehensible, or otherwise “off” manner.
The second assumption is that you must be on medication in order to appear “normal” at times.
Third, that since you do not appear “normal” to the speaker, the only explanation is that you must not be medicated at the moment.
Fourth, that the speaker has the right to give you advice on how medicated you need to be in order to appear “normal.”
And, finally, that “meds” are the answer to all your problems. If you want to fit into society you must be on your guard at all times and medicate until you are acceptable to them.
There is a slightly less offensive version of the question: Have you taken your meds today?
This might be marginally acceptable from a loved one, who knows that you take medication for your disorder and also knows that you are sometimes forgetful.
But really. Most psychotropic medications build up in a person’s system over time and leave the body over a long time as well. Missing a single dose is not likely to have an appreciable effect on a person’s moods or actions.
There are some anti-anxiety medications that have short-term effects, and a bipolar person might have forgotten a dose or two.
But unless the speaker is the bipolar person’s caregiver, official or unofficial, it’s still rather parental and demeaning – suggesting that we aren’t competent to handle something as vital as our own medications.
Of course, sometimes it may be necessary to help a loved one remember to take medication, whether that person is bipolar or not. On a vacation, for instance, when one’s normal routine is disrupted, a gentle reminder may not be amiss. When one has just started treatment and the routine is still unfamiliar. Or if the person actually is a child.
You wouldn’t ask an adult with the flu “Have you taken your antibiotics today?” You wouldn’t say to a blind person “Now, don’t go out without your service dog.” Most people, most of the time, are deemed competent to know their needs and take care of those needs themselves.
But bipolar disorder and other psychiatric conditions, being largely “invisible illnesses,” seem to invite meddling. Everyone else knows what’s best for us, from a different drug to herbal medicine to a walk in the park to prayer.
They know a little bit about the disorders, perhaps, largely through television and celebrities. But they don’t know your particular version of the disorder (bipolar 1 or 2, rapid cycling, dysthymia, hypomania, anxiety, etc.)
So if I snap at you, or seem anxious, or don’t want to go out, don’t assume. I have regular “normal” moods too, even when I’m on medication. Sometimes I get annoyed if my husband has lost his cell phone for the third time this month. Sometimes I feel sad if my picnic is rained out. Not every mood is pathological.
So don’t assume you know what’s going on inside my head. Unless I ask for help, refrain from putting in your oar.
And don’t ask me, “Are you off your meds?” It’s an insult, not a question.