It all starts with Adri who’s enthralled by Carla, a girl who picks him up at a club and takes him out on the night of his life… at the start of a manic episode (but he doesn’t know that yet).
Obsessed with getting her number, Adri gets himself “falsely” admitted into the mental health residency she lives in only for Carla to reject him. Rightfully so because he only loves a part of her that he has no real understanding of. The part in question being her fun, confident, impulsive side... during a manic episode.
This repeatedly shows up in their initial interactions where Adri asks questions like, “Why are you here?” and makes comments like “You look perfectly normal” extending the same comments to her circle of friends who are also receiving treatment at the same residency.
Now, none of this makes Adri a villain, far from it. This movie serves to paint an almost perfect picture of:
One: Trying to live well with mental illness in spite of external misunderstanding (Carla)
Two: Trying to genuinely help from a place of gross misunderstanding (Adri)
I feel this statement by the residency’s director captures this two-sided paradox perfectly:
We help patients to live with themselves as they are and that takes a long time. We encourage them not to pretend to be better for the benefit of others. The most difficult thing about being mentally ill is that others want you to pretend that you’re not.
And those words do indeed paint the picture of life at the residency; no one’s rushed to be “normal” and no one’s confined to a lonely dark room even when they have schizophrenia (and are stable). The residents regularly interact and/or are in a room with people even if not engaging in conversations.
In fact, Adri’s roommate (Saul) is a paranoid schizophrenic who takes him around the residency getting him acquainted with all the available facilities. He goes even further to help Adri gain favour with the other residents in hopes that he’ll get discharged soon.
That’s how it works over there — residents grade each other based on improvement in positive behaviours like building friendships and engaging in group activities etc. NOT curing their illnesses.
This movie does an incredible job of showing that people living with mental illness are people who also laugh, cry, excel professionally, crave love and relationship, get disappointed and work through it etc. People who can and have full human experiences.
“You can do anything you put your mind to”
“Did you swallow a self-help/motivational book as a kid?” Carla asks Adri.
Why? Because Adri’s innocently trying to suggest that she can control her actions during a manic episode. This is after Carla shares how she always blows her father’s credit cards when manic among other things and Adri convinces her she has power over her symptoms— bipolar type 1.
Now, as I’m, listening to him, I find myself almost believing him, believing that maybe with time I too should try to go off my meds at which point I recall a conversation with a well-meaning loved one after my initial diagnosis.
The conversation went something along the lines that we could look into natural treatments for my bipolar 2 and a part of me wanted to believe this and stop at that. But in my heart, I knew I wanted to try medication after so many years of struggle with no reprieve and years of battling an invisible illness that’s shrouded in a lot of stigma and misinformation.
Misinformation, in this case, would be a common notion that mental illness medications are automatically addictive. This is usually the case when people abuse the drugs as well as the fact that anti-depressants, antipsychotics and mood stabilisers target the neurotransmitters involved with addiction such as dopamine.
However, for someone who has these illnesses, the medications work to not only treat the conditions but help patients stay in remission because there’s currently no known cure for any mental illness.
Once a patient finds the right type and combination of medications, more often than not many report life-changing effects such as better relationships, being able to hold a job, finishing school and quality sleep among others.
The journey to finding the right medication can be long and arduous but is completely worth it as Bipolar Barbie shares but please let’s not mistake this for addiction to the medications or that the medications are exclusively worsening our conditions. This type of misinformation reinforces the stigma that prevents patients from seeking treatment and adhering to their treatments.
Well-meaning assistance
“Most visitors (family/friends/lovers) want to help their loved ones and believe they know how” — The residency’s director
Remember the director’s earlier statement? That the most difficult part about being mentally ill is that people want you to pretend you’re not. Well, truth is, you listen because a part of you wishes you didn’t have a mental illness not so much because of the insurmountable pain but because of the stigma/shame and the idea of being a burden. This is a pity because people often offer more understanding towards cancer patients, for instance, without shaming them for being terminally ill or “not fighting hard enough”.
Granted we’re not looking for sympathy. We know living well with mental illness calls for plenty of intentional gentle sustained efforts on our part. We just need the room to exist as who we are; mentally ill… and that goes for whether we’re in remission or deep in the throes of an episode.
When I come to you and say, “I’m not sleeping very well and/or losing my appetite and I’m concerned I may be headed into a depressive episode (for bipolar and major depression disorders)” that’s me “fighting” for myself — not by denying or hiding my symptoms. That’s me welcoming you to collaborate with me on the next course of action be it calling my psychiatrist/therapist and accountability friends or reviewing my list of symptoms and mood journal etc.
Back to Adri and Carla, Carla went off her medication believing she could beat her symptoms with sheer willpower. Next thing you know she’s on the edge of a building trying to walk towards the sunrise and it takes Adri pulling her back to save her life.
It also takes that singular moment for Adri to realise how little control Carla has over the severity of her symptoms once she’s going through an episode. Much so that he’s the one who ends up telling the director that Carla had been off her medication for a couple of weeks leading up to her manic episode.
While there are some people who choose to and successfully treat their symptoms without medication, they usually have a plan of action made up of lifestyle changes like regular exercise, diet changes, strict sleep hygiene, meditation, mood tracker journals etc and even still attend support groups and therapy using modalities like Cognitive Behavioural Therapy (CBT).
We don’t see Carla consulting with and developing a non-medication symptom management plan with her doctors prior to going off her meds.
Before Carla’s close brush with death, while manic, you notice her energy levels begin to elevate in an uncharacteristic way from her usual demeanour. She’s a bit more impulsive and even aggressive when she doesn’t get her way — she wakes Adri super early and while she’d usually be okay with him asking for an extra minute, this time she bangs the table beside her in an almost threatening way.
Now, obviously, her symptoms need to last for about five days to qualify as mania but this is where having a symptom checklist comes in handy. And this can only be possible if we allow patients to be unwell, to live with not “free of” or “cured of” prolonged sadness, from hypomania/mania, psychosis, intrusive thoughts, anxiety/ADHD/OCD flare-ups, Tourette’s tics etc.
Allowing patients to acknowledge their symptoms are real and have the potential to worsen if left unchecked helps us understand the anatomy of our individual presentations for the various conditions we have.
Allowing us to accept ourselves with our mental illness(es) means we can begin the work of building structures that will enable us to live well. This could be but isn’t limited to:
linking with a therapist/psychiatrist
engaging in psychoeducation — reading on our specific illnesses, how comorbidities work (e.g. having ADHD co-occurring with Bipolar), symptoms, treatment options (medication and non-medication), side effects of medications etc
building routines that support our day-to-day symptom management using modalities like social rhythm therapy
monitoring our moods regularly
building a support system in friends, joining a support group etc.
Living well in action
Lauren has schizoaffective disorder (a spectrum between schizophrenia and a mood disorder). In this video, she shares how she immediately called her psychiatrist after she found out she was pregnant letting them know her desire to reduce the number of medications she was taking and certain dosages. She also recounts the different challenges she faced and compromises she had to make along the way for her own wellness and consequently the baby.
Her therapist and partner walked alongside her throughout her pregnancy and she even felt safe enough to let her partner know when she was experiencing a few hallucinations while giving birth. This is what it looks like when your mental illness isn’t an inconvenience, an after-thought or “not that serious”. This is also what self-advocacy and taking personal responsibility for your wellness looks like for a patient.
And now you’re thinking, “but she’s hallucinating, how can she be so self-aware and even clearly communicate her symptoms?” Well, no one’s denying the existence of her illness so she can proactively get help, whether medical (dose adjustment) or social support (taking a walk with her partner).
She doesn’t need to get to the deep end in order to prove her illness is real.
This intentional consistent management means she can do amazing things like have a baby and make educational videos on YouTube on mental illness while creating an online community for patients across the globe, myself included.