If you spend time discussing bipolar disorder, you’ll quickly see there are many complexities and controversies surrounding language and identity. Today’s conversation aims to emphasize respect and personal empowerment while encouraging society to accommodate individual language preferences and focus on broader issues of care for those living with bipolar disorder.

In today’s episode, we explore the tension between person-first language and conscious language initiatives and the way individuals with bipolar disorder choose to describe their own experiences. We question the rigidity of language initiatives and advocate for preference versus hard and fast rules

Gabe Howard

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, “Mental Illness is an Asshole and other Observations,” available from Amazon; signed copies are also available directly from the author.

He is also the host of Healthline Media’s Inside Mental Health podcast available on your favorite podcast player. To learn more about Gabe, or book him for your next event, please visit his website, gabehoward.com.

Dr. Nicole Washington
Dr. Nicole Washington

Dr. Nicole Washington is a native of Baton Rouge, Louisiana, where she attended Southern University and A&M College. After receiving her BS degree, she moved to Tulsa, Oklahoma to enroll in the Oklahoma State University College of Osteopathic Medicine. She completed a residency in psychiatry at the University of Oklahoma in Tulsa. Since completing her residency training, Washington has spent most of her career caring for and being an advocate for those who are not typically consumers of mental health services, namely underserved communities, those with severe mental health conditions, and high performing professionals. Through her private practice, podcast, speaking, and writing, she seeks to provide education to decrease the stigma associated with psychiatric conditions.

Find out more at DrNicolePsych.com.

Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: You’re listening to Inside Bipolar, a Healthline Media Podcast, where we tackle bipolar disorder using real-world examples and the latest research.

Gabe: Welcome to the podcast everyone. My name is Gabe Howard and I’m bipolar.

Dr. Nicole: That that is new. That is that is a that that’s not what I was expecting. That’s not how you normally open the show.

Gabe: Well, I thought that you could mix yours up and say, hello, my name is Dr. Nicole Washington and I live with board certified psychiatry. I thought you could use person first language and I could just speak normal. Didn’t you catch on to that?

Dr. Nicole: I did not, I did not. I’m not going to lie to you. It kind of threw me a little bit when, when I, when I was looking down and heard you say that I was not expecting that.

Gabe: So today we’re going to be talking about bipolar disorder and labels, identity and where bipolar disorder fits into us. And there is so so so so much to say. Now in I don’t want to throw the baby out with the bathwater. Right. Conscientious language initiatives are incredible and they are good. And we need we need to pay attention to how we speak and not be offensive and to be inclusive. So, I don’t want anybody to hear, oh, he just wants to say whatever he wants, whenever he wants. Not what I’m saying. I’m saying that things can go too far, right? Water is wonderful. Drowning is bad. So, there’s nothing that’s 100% good and there’s nothing that’s 100% bad. But when we talk about initiatives like conscientious language, person first language and things like that, we always talk about them as 100% good. And I want to give some pushback on that because it leaves some it leaves some things out.

Dr. Nicole: Does it recommend that you not use that language when referring to other people? Because to me, when I think about the language and the guidelines and the media suggestions and things of that nature, I think you can say about yourself whatever you want to. Right? Like if you want to say I’m bipolar, say it, right. If somebody who you know, fat is a good example, you know, like people say, like, I don’t care saying I’m fat, like I don’t care saying I’m a fat person or, you know, that’s if that’s the language you want to use for yourself, that’s your decision. I should not be walking around going, oh, Gabe is the bipolar guy. Or, you’re bipolar or oh, my bipolar patient or those are things that it hits a little bit different when I say it versus when you say it. I mean, don’t you think there’s a difference there?

Gabe: So yes and no. But let’s talk about this for a moment. You introduced yourself as a board-certified psychiatrist,

Dr. Nicole: Mhm.

Gabe: Right? So, if I said, Dr. Nicole is a board-certified psychiatrist, why does nobody say no? Dr. Nicole is a person who became board certified in psychiatry. Why is there no push to push you first and board-certified psychiatrist second, therefore person first language? I mean, you are more than just a board-certified psychiatrist.

Dr. Nicole: You bet I am.

Gabe: And I’ve asked a lot of people this, and the answer seems to be because board certified psychiatrist is impressive and good, and bipolar is bad.

Dr. Nicole: Well, that’s the way we, that’s that’s the way it’s been packaged for so long, right? I mean, we’re still fighting. We’re definitely fighting all of the stigma of all of the, the bad press that bipolar disorder has gotten over the years. And the media specifically, if we want to talk about the media, has done a horrible job of covering mental illness forever.

Gabe: This is where you and I are going to be perfectly aligned, right? I do like the conscientious language initiatives in the media, you know, saying a bunch of bipolars killed a whole bunch of people, and that’s bad because they’re all mentally ill. It’s like, whoa, whoa, wait a minute. What are you trying to say? Uh, well, a person who was diagnosed with bipolar disorder allegedly attacked some people, and the police are sorting it out, and we’re waiting for more details is much better. I completely agree with that. And I like that. But I would point out that the media has this problem in all areas, not just with bipolar disorder. The media has done a good job of alienating and othering genders, cultures, races, people, uh, pretty much since its inception. So, the fact that people with bipolar disorder or any mental illness got swept up into this is not very surprising. So of course, I want the media to do better, but I just want the media to do better. Hard stop.

Dr. Nicole: Yeah. Period.

Gabe: I want them to practice journalistic integrity that they all claim to learn in school. But that might be a little bit outside of this podcast. What I specifically want to know, and this is where people in my community, where we get a little stressed out. Why, when I tell people I’m bipolar, do they automatically hear the negative? How can we not get around? How can we get around? How can we just have it be a descriptor? I don’t want to move it to the positive, I just want to move it to the neutral. It’s just a descriptor. I am, in fact, bipolar.

Dr. Nicole: Do you think that if you, do you think that if you just continue to do it despite other people’s discomfort? That would help move it to the neutral?

Gabe: Yes and no. I don’t know that I can say that it will work, but I can say that it is how I am most comfortable explaining my life to people. So, I want it to work because I want to be allowed to describe my life and my experiences in a way that is most comfortable to me, not in a way that is comfortable to others.

Dr. Nicole: But if you if you then temper it and you start to introduce yourself as, oh, I’m Gabe Howard and I live with bipolar disorder, as opposed to saying, oh, I’m Gabe and I, I’m bipolar. Like, you’ve tempered it for that person to make them not then turn around and say, okay, you’re so much more than just bipolar. You’re so much more than your illness.

Gabe: People do say that a lot. Gabe, you’re more than just bipolar. You’re so much more. And I’m curious, do people think that we don’t know that? Because why else would they say it? They honestly believe that they’re educating us, right?

Dr. Nicole: Yeah.

Gabe: When I say I’m bipolar, they’re like, no, you’re just so much more, okay, you’re telling me that because you don’t think I know. This is my life 365 days a year, 24/7. And you think that you, not living my life, are going to tell me what I don’t know?

Dr. Nicole: I think that they think they’re doing you a favor right? By reminding you. It’s kind of like when people are uncomfortable when with people with disabilities, you know, oh, don’t say you’re disabled. Say you’re differently abled. Don’t say that. You know, I mean, because I think it makes them uncomfortable. It’s more about them and how they feel versus you and how you feel. It’s not really about you. I mean, it’s more about them, right? So, when people are uncomfortable having somebody say, oh, I’m disabled or oh, I’m handicapped or oh, I’m bipolar or I’m schizophrenic or whatever it is, it’s about them. And is that because, you know, why is that? Is that because it’s been ingrained in them that, oh, we can’t say that because that’s really bad and that’s really negative? You know, why is that? I don’t know, that could be a number of reasons. But I think it’s more about them as opposed to you. And they think they’re doing you some kind of justice by letting you know that it’s okay. You know, you’re not just bipolar.

Gabe: You just said my point. It is more about them, the people who are writing these initiatives and deciding how we talk about living with bipolar disorder are not people living with bipolar disorder. By and large, they’ve come out of social worker groups, they’ve come out of medical associations. They’ve come out of support groups. Person first language was developed by social workers, predominantly social workers decided how people with bipolar disorder should explain their own journey. That just sounds icky. And it’s not that they’re bad. And this is the problem that I have. Immediately, whenever I point something like this out, people are like, well, you don’t like social workers. You think they were bad; you think they were being mean? Nope, I don’t. I think they’re misguided. I think they’re very misguided. I agree with you. They think that they’re helping. But you need to listen to our words. We’ve been very clear that what we need is a safety net, beds, health insurance, access to care. And yet all of this time, energy, money and resources is going into how we discuss the problem. I just want to move that time, energy, money, resources, and favors, your words, Dr. Nicole, into actually solving the problem.

Dr. Nicole: Um, so I will say this, um, I’ve spent a lot of my career working with people who have bipolar disorder and schizophrenia. Uh, and I will say the, the treatment that I have seen, the attitudes that I have seen, the way that in which people have been treated has been abysmal at times. Um, the behind the the behind the scenes attitudes, the things that people say about people when the patients aren’t in the room, the way that people and patients get described in those closed door meetings and decision making meetings. The language is terrible. And so, I could really see how a movement like this could start. Because words matter and language matters. And when you talk about people in a certain way with a certain tone, I think it spills over into how you treat them and how you see them. So, I could see how in leadership and closed door sessions and the things that happened, the room where things happened, where the patients are not typically privy to. I want my leadership to say, this guy who lives with bipolar disorder, it has a totally different connotation when it comes to decision making for that person, as opposed to the bipolar patient who does blah, blah, blah, blah, blah.

Dr. Nicole: And so, I think some of these things come out of people whose hearts are in the right place, who want people to use language that just starts to eke out into the atmosphere that, oh, this person is just living with this thing. There’s more to this person than just their bipolar disorder. So, it may not necessarily be just for you that that it’s being said. It may be being said for those people who we don’t want to say, oh, Gabe’s bipolar. You know, it may be for them. But language is important. I mean, mental health, you know, we are all caught up in language. We’ve gone through patients, consumers, customers. Uh, we don’t I don’t even know what to call people anymore. Uh, so we went through that. That was a that was a wild time when, when people wanted this. But let’s not also pretend like there are not people out there who live with bipolar disorder every day, who are the loud, squeaky wheels who are like, don’t call me bipolar. I am a person living with bipolar disorder. Don’t call me. You can’t say that there aren’t people who live with the illness, who are the ones who are out here screaming with their signs, don’t call me bipolar.

Gabe: They’re, they’re absolutely are. They 100% exist and they are right. You should not call them bipolar. And that’s the problem that I have. You should not, in fact address somebody in a way that they ask you not to address them. But then how come the rule exists for how they want to be described? For me, that’s not right. I mean, was there a vote? I don’t remember getting the ballot. I don’t, I don’t understand how this all shook down. I, I also want to address your, you know, the doctors in the room and they’re using this language that people realize is negative, you know, the context of those conversations. And those are rooms that I am not in. What rules are made for those rooms have nothing to do with me, and it would be horribly inappropriate for me to determine how you speak in those rooms. And yet when I slowly move that around to say, so, this is my room and the way that I talk, I get, I get pushback, I get nope, nope nope nope. We know, we know, we know, we know you. Gabe, you’re just you’re more you’re more, you’re more. And I’m just like, but why are we so rigid on this? Because I also noticed that when I, when I read a little further, when we talk about not using bipolar disorder as an identity and how we talk about it, etc., they also say things like, you need to have open and free discussion.

Gabe: You need to talk about it, you need to not internalize it. And you need to be free to discuss it. Don’t hold it in. Okay, I didn’t. But then you told me I did it wrong. So, I don’t know what to do here. And yes, I know there are people that absolutely, unequivocally know how they want to be talked to and they decide that that is how everybody should be talked to. And I would say that whether this is bipolar disorder, race, sexuality, culture, those people are wrong to declare themselves the spokesperson for an entire group and that they and they alone know the only way to do something correctly and then try to use science to back it up. Oh well, this improves outcomes. I sincerely, Dr. Nicole, if there is ever a study done, and I’d like to point out there hasn’t been one, that conscientious language or person first language improves outcomes for people living with bipolar disorder, I’ll back down immediately. Nobody is even looking into it. Were just positive it works. Now, I would like to point out if somebody with bipolar disorder shows up on TikTok or, or any social media right now and says, hey, I know this thing works and I have absolutely no science to back it up, doctors roll their eyes immediately. But yet, we have this entire initiative backed by nothing, and everybody is super proud of it.

Dr. Nicole: In this particular example, it sounds like what you’re saying is that, we start somewhere, right? And if I start somewhere, it’s the it’s the person first language. That’s fine. It’s appropriate for us to use those words with you. But then we still have to let you decide how you want to refer to you.

Gabe: Yeah.

Dr. Nicole: And we take each person’s. We take each person individually in how they want to be spoken to. Now I will say, for me as the doctor, it is so much easier for me to just always use person first and be done with it. I can’t keep up with who wants to be called what, so it is what it is. Like, this is what you get, right? This is what we’re going to get from me, but I’m not going to be uncomfortable if you decide to refer, I’m not going to stop you in the middle of a sentence and say, okay, don’t say that about yourself. You’re more than just bipolar. Don’t say that about yourself. I won’t do that. And maybe that’s the problem. Maybe we need to get to the space where the people on my end are okay with that’s how we choose to do it, so as not to offend anybody. Because if a person doesn’t mind saying I’m bipolar, they probably also don’t have much of an issue with you using person first language with them. However, if they prefer person first language and you don’t use that, they’re going to be offended. So, the the path of least resistance, the route to go that’s probably going to be okay is for us to continue to use the person first language. That’s fine. But we then have to let you be comfortable referring to yourself and really biting our tongues when it comes to us trying to tell you how you shouldn’t refer to yourself.

Gabe: See, and this is what I’m getting at. I’m not trying to change the rule from person first language to non person first language. I’m trying to say that all are in fact acceptable, and I’m really trying to give a little pushback on why we think any of it is offensive. And now there are examples like you gave if doctors are talking around and you know, the context is insulting and you want to improve that, but see, that’s really looking at the context, which I’m a huge firm believer in. And this is going to lead me to my next point. The words were never the issue. For example, in that meeting that you alluded to earlier, if you said, oh my God, all my patients living with bipolar disorder are so stupid and dumb and they can’t achieve anything. And everybody’s like, oh yes, I agree, people living with bipolar disorder are awful. I hate them all. Everybody listening to that would be like, that’s terrible. Why would you talk about people with bipolar disorder that way? But but why? They use the right language. So, it’s the context that we always had the problem with. Context was always the issue. It was never the words. And I, as an advocate am just terrified. See, I’ve lived through I I’m old. It’s come up on this podcast before. When I started out, I was a consumer right. And consumer was the upgrade from patient. And then I went from consumer to, to customer and client, and then I went from customer client to there was like a brief associate movement that never really caught on. And then I became a peer. Now I’m a peer. But here’s the thing. In my lifetime, access to care has gotten harder. It has gotten more difficult. Homelessness has gone up, the suicide rate has stayed largely the same. And access to care is not improving. But yet I’m a peer now.

Sponsor Break

Dr. Nicole: And we’re back discussing the importance of language in how you describe your bipolar disorder.

Gabe: See, when I started, Dr. Nicole, I was a consumer. And that’s bad because it means I consume. And that was the improvement over patient. Because why is it bad to be a patient? You’re, you’re seeing a doctor. I wasn’t involved in that one. That happened before me. And this is just such a distraction to the actual issue. And that more than anything, I feel that I’m not being heard, and I feel that nobody is actually addressing what I, the person living with bipolar disorder, am concerned about. And that is the ability to get needed, necessary medical care and lead a good life. Where is that discussion?

Dr. Nicole: Yeah. So, my general thought I mean, on that is I’m a doctor, I have patients, I just cannot get lost in the consumer, client, whatever it is that we want to use

Gabe: [Gasp]

Dr. Nicole: I know.

Gabe: You can’t have that opinion, that’s terrible.

Dr. Nicole: Gabe is clutching his imaginary pearls right now.

Gabe: There’s a, there’s a power dynamic.

Dr. Nicole: There is.

Gabe: Yeah, it’s a distraction.

Dr. Nicole: It. This is the deal. I am a doctor, I have patients, and I have yet to have someone be all out just appalled that I refer to them as patients, because I think it’s more about how I treat them than what I call them. And so, the same thing applies to what you’re saying. Um, I, I hear what you’re saying, but I, I, I just don’t think that part’s going to change. I think we just need to get the focus off of that and then put our energy into allowing people to call themselves what they want to be called, and allowing people to take on their identities, and not just making the assumption that because a person says, oh, I’m disabled or I’m handicapped or I’m bipolar or I’m schizophrenic, that they don’t have the sense to know what that could mean in a variety of settings. And it is almost like the, the meaning, just the people who mean, well, those people who mean so much good in their heart by saying, oh, you’re not just bipolar. I could see how it could sound a little condescending, like you’re telling that person that they don’t have enough sense and enough knowledge about their own lived experience to know what they want to call themselves. And I could see how that would be, um, how that would be frustrating.

Gabe: All of that is true and I do agree with you. These people mean well and in my mind that’s the worst part because they’re ready, willing and able to help. We just have to make them productive, right? If we could take that collective energy and that collective desire to help and that collective goodwill and put it on something that would work, like Medicaid expansion in all 50 states, like, like increasing the number of beds that are available, like reducing the wait from 3 to 6 months to see a Dr. Nicole down to a reasonable number, like, like making it so people aren’t stigmatized or discriminated against for asking for reasonable accommodations at work. And I know all of those initiatives are being worked on, but I also can’t help but notice that the biggest initiative for the last several years has been how we discuss it, and it’s time to move on from that. It’s time to move on to the next phase. And that is what I’m really trying to get to. And I also want to take a if we can just take a step back for a moment. I am curious why people are so uncomfortable with bipolar disorder and how we can change that. Because as somebody who lives with bipolar disorder, when I see the microaggression that you’re terrified for me to consider myself bipolar, why? What has led you to believe this? Especially? And this is the part that I want to make sure that you address, Dr. Nicole, especially when I know you’re a good person. I know that people saying to this to me are good, good people, but there’s this little part of them. It does not escape me that they think less of me. And you’ve tipped your hand accidentally.

Dr. Nicole: I think it’s a matter of people becoming more comfortable. And really the reason it’s such a big deal is because we’ve all been conditioned that it’s so bad to say it. And now when we hear it, we’re like, oh my God. Like, don’t say that about yourself. That’s horrible. Don’t talk so negatively about yourself. Basically, the people with the illness are just saying, I’m taking the power back.

Gabe: That’s exactly what we’re saying. And I look at the breast cancer movement, right? People are proud of it. It’s, they’re breast cancer warriors, right? They’re wearing shirts. They’ve got their own color, for Pete’s sake. And I want to see that happen for bipolar disorder. Now, listen, nobody wants breast cancer, right? We can all agree on that. And nobody wants bipolar disorder. But if you are diagnosed with bipolar disorder, don’t you want the community welcoming you to look more like the breast cancer community? Here’s your shirt, here’s your ribbon, here’s your march, here’s your parade. Here’s your day. Here’s your media attention. You are a survivor. Here’s a poster. I mean, they they got all the swag, Dr. Nicole

Dr. Nicole: Yeah. No, you’re right.

Gabe: Just out of all the patient advocates, they have the best swag. I look, if I’ve got to be given an illness, I want to belong to that group. I just, I want no illness. I want to belong to no groups. But I got to tell you, they’re they’re being called a warrior. Sounds so much better than being called a. Oh, you know, you are more than just that. I just I want to hear warrior come out of somebody’s mouth before, you know, the head kind of goes down a little. The eyes kind of rise up to meet mine, and the hand goes out to rub my shoulder. Gabe, you’re more than just bipolar, right? Right, I know. I want the warrior treatment. That’s what I’m saying. I want the warrior treatment.

Dr. Nicole: It’s just condition. We just have to get people more comfortable. And that only comes with time. I mean, it just only comes with time and it only comes with people in your situation being comfortable enough saying, you’re right. I am more than just bipolar disorder, but I’m perfectly comfortable referring to myself as bipolar. You can continue to say whatever you want, but I’m comfortable in this and I think those encounters will start to change. The atmosphere will change. We are so much more comfortable with things once we get used to them. I mean, my gosh, think about just the language that is used on TV. Back in the 70s, there are words that are on primetime TV right now. You wouldn’t even see couples in bed. They were in separate beds in the same room. They were in different rooms back in the 70s on sitcoms. Now people are practically having sex on air. Uh, I mean, we’ve just things that have just become we’ve become more comfortable with, we’ve become okay with because they just happen so much. We have to make them happen. The B word. Oh my God, you women have taken back the B word, right? The B word was never a positive word. But now women are calling each other B’s calling themselves B, nobody’s like, oh you’re you shouldn’t say that. You’re,

Gabe: What’s.

Dr. Nicole: You know, oh my God.

Gabe: What’s the B word, Dr. Nicole?

Dr. Nicole: Gabe.

Gabe: Just just just so our audience can be sure.

Dr. Nicole: This is the problem. Gabe knows that I don’t cuss and he’s trying to make me cuss and I’m not doing it. He knows what the word is. I’m not falling for it.

Gabe: Is it bipolar? Is.

Dr. Nicole: Stop it.

Gabe: Is that it?

Dr. Nicole: Oh, that could be our campaign. Our campaign making by the new B word. We can make

Gabe: The new B word, bipolar

Dr. Nicole: We can make it bipolar. [Laughter] Oh.

Gabe: Dr. Nicole, I want to segue a little bit, and people ask me like, why I’m so concerned about this. And the first reason

Dr. Nicole: Yeah.

Gabe: Is, is because I do want to be the master of my own domain. Right? There is a lot of personal stake for Gabe. I don’t want anybody to think that that’s not true, because at 100% is. And I and we’ve talked about several examples of where I feel it’s important that the power dynamic, the power structure, the people who help us make decisions and the good-hearted people all understand our point of view. But put all that aside for a moment. There’s another thing that I think about. I did not know that I was mentally ill an hour before I was admitted to a psychiatric hospital. I was so sick. I was committed to a psychiatric hospital behind a locked door and diagnosed with bipolar disorder. That’s how sick I was. And yet I thought I was fine, so I. I clearly did not have the words to express what was wrong with me. And this is important because could you imagine if I would have walked up to somebody and said, I think I’m nuts, I think I’m going effing crazy. And somebody said, we don’t use those words. Those are a highly offensive words just to and listen, you know, calling people with mental illness crazy and nuts a f and yeah, I’m not I’m not disagreeing that that. But you missed the context. You

Dr. Nicole: Mhm.

Gabe: Missed it. I just asked you for help. And we were so focused on the words. The reality is, is people with severe and persistent mental illness, people suffering from the symptoms of bipolar disorder, they don’t wonder if they’re having a mental health condition. They don’t wonder if they’re living with bipolar disorder. They don’t wonder if they need to seek psychiatric care to live their best life. No, they think they’re going effing crazy. They think they’re going effing nuts. This is the language that we use when we are in our darkest places. And if we want to start saving lives, we need to be aware that that’s the language. The second thing is, is, is when people start hearing podcasts and seeing these, you know, doctors on TikTok and getting this information, they need to recognize themselves. Remember they’re not diagnosed yet. They just have this inkling that something might be wrong and they’re out there seeking help. This is why influencer culture has become so big, because they’re speaking the language of the desperate. And if doctors don’t start speaking that language, then people who need help are going to continue to find influencers over medical help. And that’s dangerous. That is very, very, very dangerous.

Dr. Nicole: Yeah. And I have people who I mean, realistically, in the beginning they felt like they were just bipolar because they really couldn’t identify with much else. Like when you’re in and out of the hospital, when you’re in that newly diagnosed phase, when you can’t figure you don’t even know what it is, and you everything is framed around your bipolar disorder. Everything, everything. You don’t know what’s my bipolar? What’s something else? What’s this, what’s that? Everything is framed around that. And I do know that the patients I’ve had these kind of conversations with, they bring up the fact that in the beginning they were just bipolar. They were just bipolar and trying to figure it out. And they didn’t know them from the illness, from they didn’t feel like a person who was living with bipolar disorder. They felt like, I’m bipolar and I don’t know how to fix this. And being able to call yourself whatever you want is empowering. And I think we have to see it that way. And we have to give people the space to be comfortable calling themselves whatever they want. Because let’s face it, when you have an illness like bipolar disorder, there are so many people telling you what you need to do. Like so many people telling you what you need to do, what you need to do, you need to do this. You got to take your meds. You got to go to bed on time. You can’t ever stay up late and play video games. You can’t ever have a drink. You can’t do these things like, these are the things you can’t do. And sometimes it’s just about power and giving people the power. And I think power is important.

Gabe: I think it is really good advice to really think about it, especially when we’re in our doctor’s office, right? Because it’s not a fun place and it’s a place where it might be on high alert, etc. so making a little mental note of it and deciding if it’s worth it, I think has a lot a lot of value rather than that knee jerk in the moment. I must fix this now for me and for people who have been listening to this entire episode, I want to make both of them acceptable. I want to make them pretty much equal. Right? So, my bipolar patients or my patients living with bipolar disorder, it’s just a turn of the phrase because, well, the English language is really, really messy. It’s just that’s just how it is. I, I, I remember I used to tell my father I was bad, right? I’m bad, I’m bad, I’m bad, I’m bad. Now, for those who can backtrack my age, when I was saying it, Michael Jackson’s Bad album was huge and I was the right age to be inundated by all of it. This really bothered my father because he thought I was literally saying I was bad.

Gabe: He thought that I thought that I was a bad kid, and he sat me down one day to explain it to me and I was like, oh no, bad means awesome. Like he’s like, oh, well, now you have too much confidence. We should probably do something about that. I. So I would point out that sometimes you just got to let things go to keep your eye on the prize.

Dr. Nicole: I mean, people are entitled to their own opinions. I don’t have to agree with them. Uh, I’m a big fan of the. We can agree to disagree on this topic, uh, stance. There are times that patients will bring something up with me. And I say, you know, I hear what you’re saying. That is not how I feel about it. That’s not how I see it. I don’t agree with that. I don’t know that we’re going to agree on this particular thing, and we figure out a way to move past it if we can. I think it’s healthy for you to ask questions. You’re more than more than capable of having an opinion that falls outside of mine.

Gabe: I think it’s really important to remember that disagreement does not equal disrespect. I I’m married, I’ve been married for 12 years, and my my wife is my person. She’s my partner. She’s my friend. She is a single person who I chose to build an entire life with. And I don’t agree with everything she says. I don’t like all the things that she likes, and I think she makes a lot of mistakes. And the reverse is true. She doesn’t like everything I like. She doesn’t agree with everything I say. We often read news articles and see them very, very differently. But what we do is always respect each other. We always talk to each other with grace and kindness, and when we don’t, we realize it later and apologize for it. Because the world’s not perfect, right? But I only point that out because that’s my wife, right? That’s that’s the person who I chose to build a life with. What are the chances that I’m going to find a doctor who I have a greater level of care, agreement with than I do my own wife? Of course, I’m going to disagree with some of the stuff my doctor says. I think that makes sense.

Dr. Nicole: I agree fully with everything you just said, Gabe. I think it is about respect. I think we can respect your side more and just allowing you to call yourself whatever the heck you want to call yourself. And us being our learning how to become more comfortable with that as we continue to move through this whole labeling situation.

Gabe: As we near the end of this episode, I’m really struck with the idea that what I’m telling people to do is, is almost, in a way, nothing. Don’t don’t be so rigid in the way that we discuss it. Listen to people’s context. Be more accepting of the way people describe their own experiences. Don’t get so bogged down in the idea that there’s a right way and a wrong way to discuss bipolar disorder. Do what feels natural to you and ask people to respect what feels natural to you. And then, of course, for the other side, respect what feels natural to people. I, I, I want to remind people, of course, that there there’s no science behind any of this. There’s no magic words. I would I would shout the magic words from the rooftop. If using specific language universally would lead to better overall care. But all of that said, as you pointed out, Dr. Nicole, and I think it’s very, very important to remind people in specific places, in specific rooms, in specific situations, the right language can make all the difference. Any reasonable person listening to this episode would think to themselves, what the hell are you saying? And that’s really my point.

Gabe: Conversations surrounding bipolar disorder are messy, and they involve many different types of people who are coming at this from so many different places that having one right way to talk about it is simply impossible. I don’t know how you feel about this Dr. Nicole, but you see this very differently from me because you’re over on the doctor side. I’m on the lived with it side, and I know that that carries. I take it much more personal when people correct how I speak about my own life, because I feel that it’s the essence of myself. That said, I have to set that aside, and I’m an advocate. I can’t just demand my way because it feels personal to me that the way Gabe personally feels does not dictate care, discussion, etc. any more than the way anybody else feels. And I think that’s what makes this so complicated, because I would love to wrap this up by saying, do this and not that, and everybody lives happily ever after, but we’re really not going to get there, are we?

Dr. Nicole: I don’t think we’re going to get there. Not without a whole lot of work. And maybe we do need our campaign. We need a we need a campaign of people walking around with signs that say, I’m bipolar and letting people become comfortable with that, but I this is a very tough topic. And like you said earlier, there are not a lot of doctors, a lot of clinicians probably listening to this podcast. But from my end and the group of people that I represent on this matter, I do think we need to work a little bit harder on allowing people to describe themselves in a way that’s comfortable for them, and deal with our own discomfort on the backside. And if we can, if we can figure out a way for both of those things to happen, I think we can move forward.

Gabe: That is a mic drop moment, Dr. Nicole. I want to give a great big thank you to all of our listeners for being here. And I want to remind you that wherever you downloaded this podcast, please follow or subscribe to the show right now. It is absolutely free and you don’t want to miss a thing.

Dr. Nicole: And I’m Dr. Nicole Washington. You can find me on all social media platforms @DrNicolePsych or at my website, DrNicolePsych.com.

Gabe: And my name is Gabe Howard, and I’m an award-winning public speaker. And I could be available for your next event. And I’ll even bring Dr. Nicole along if you want. I also wrote the book “Mental Illness Is an Asshole and Other Observations,” which you can get on Amazon because, ugh, everything is on Amazon. But listen, you can get a signed copy with free podcast swag or learn more about me just by heading over to my website, gabehoward.com. And hey, can you do us a favor? Before you go recommend the show, share us on social media. Send somebody a text message, bring it up in a support group. Because sharing the show with the people you know is how we grow. We will see everybody next time on Inside Bipolar.

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