Can Bipolar Get Worse Over Time?

Can Bipolar Get Worse Over Time?

One of the questions Jonny asked me during a recent podcast interview caught me off guard.

He asked whether bipolar just... appears?

It's such a simple question, but it touches on one of the biggest misconceptions I see.

Most people imagine bipolar disorder like a light switch. One day you're fine, and the next day you're either wildly manic or deeply depressed. (That's certainly how Hollywood likes to portray it.)

But for most of us, that's not how it unfolds.

When I sat down to write Tainted Love, I didn't mean to write a book about my 4 exes (whoops!) Somewhere along the way, though, I realized those relationships weren't actually the story.

They were simply the lens through which my illness had unfolded.

Each man represented a different chapter of my life, but more importantly, a different stage of my bipolar disorder.

Looking back now, I can see symptoms that I completely missed at the time. They started in 1999. The racing thoughts. The impulsive decisions. The emotional intensity. The periods when I barely needed sleep but somehow had endless energy. The crashes that the doctors simply called depression.

None of those experiences felt unusual because I had never lived inside anyone else's brain. I assumed everyone felt this way.

By the time I reached the final relationship in the memoir and ultimate diagnosis (2015), my bipolar disorder looked completely different. Fifteen years had passed without the right diagnosis. I'd been treated for depression, anxiety, borderline personality disorder, eating disorders... everything except the condition I actually had. During those years I was also drinking heavily, trying desperately to quiet a brain I didn't understand.

Looking back now, it's obvious that my illness progressed over time.

Untreated bipolar rarely stays the same.

One statistic has always stayed with me. On average, people with bipolar disorder wait close to ten years before receiving the correct diagnosis. Think about what can happen during a decade of untreated illness. Careers are built and lost. Relationships begin and end. Families are started. Financial decisions are made. Entire identities are formed.

We don't expect diabetes or high blood pressure to remain unchanged if someone goes untreated for ten years. Bipolar isn't any different.

The encouraging part of that story is that progression isn't inevitable forever.

Today, I am still bipolar. I still experience mania. I still experience depression. The difference is that those experiences no longer dictate the course of my life because I finally understand what my brain needs.

Medication is crucial.

Therapy is a must.

Sobriety needs to happen.

Lifestyle is critical.

Learning emotional regulation is key

Protecting my nervous system changes everything.

Every one of those Pillars has helped me build stability.

Ask Louise:

"If bipolar develops over time, how do I know whether what I'm experiencing is just life... or part of my bipolar?"

It's one of the hardest questions I get.

The answer is this:

Stop looking at days.

Start looking at weeks, months, years.

When we're living our lives, everything feels disconnected. We think I was just stressed. I was just excited. I was just burned out.

But when you zoom out, you often discover those "random" experiences weren't random at all.

They were part of a pattern.

That's why psychiatrists don't diagnose bipolar based on one appointment or one symptom.

They're looking for a pattern that's repeated itself over time.

And you can begin noticing those patterns too.

It was learning to stop judging isolated moments and start paying attention to patterns.

One impulsive purchase doesn't tell you much.

Neither does one sleepless night.

Or one really productive week.

Or one bad day.

Surprisingly, the biggest shift for me wasn't medication.

Bipolar isn't understood through isolated moments.

It's understood through recurring patterns over time.

That realization changed everything for me.

This Week's Skill: Become a Detective, Not a Judge

One of the most valuable exercises I've ever done wasn't in therapy.

It happened while writing my memoir.

As I laid out fifteen years of my life chronologically, I stopped seeing isolated events and started seeing patterns.

I'd encourage you to try something similar.

Grab a notebook or a blank sheet of paper and draw a simple timeline.

Start with the year you first remember struggling with your mental health and work your way to today.

Now begin adding the major events.

Include depressive episodes.

Periods where you barely needed sleep.

Times you felt unusually energized, productive, or confident.

Medication changes.

Relationship beginnings and endings.

Job changes.

Alcohol or substance use.

Hospitalizations.

Major life stressors.

Don't try to explain anything. Don't judge yourself. Just observe.

When you've finished, ask yourself these three questions:

• What patterns do I notice?

• What usually happens before I become unwell?

• What seems to help me recover?

You might not discover anything life-changing today.

But over time, this timeline becomes incredibly valuable. It can help you recognize your own warning signs sooner, have more productive conversations with your psychiatrist or therapist, and understand your illness with far more clarity than trying to remember everything in your head.

One of the greatest gifts we can give ourselves isn't perfect mental health.

It's learning to recognize our own patterns before they become our next episode.

Until next week,

Louise 🤍

Have a question for a future newsletter?

Ask me anything about living with bipolar disorder. I read every single email myself, and only I will see your question, and if it's selected, I'll answer it anonymously.

While I can't guarantee I'll be able to answer every question, I'll do my best to get to as many as I can over time.

Thank you for trusting me with your question.

​SUBMIT QUESTION HERE​

Learn more about my memoir: TAINTED LOVE​

​I'm Bipolar. Now What? LIVE!​

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