Do you have bipolar I or bipolar II? What are the differences and does it matter? Does debating which one is worse actually distract all of us from getting better? In this episode, Dr. Nicole Washington and Gabe Howard, who lives with bipolar I disorder, discuss.

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 also hosts Healthline Media’s Inside Mental Health podcast available on your favorite podcast player.

To learn more about Gabe, please visit his website,

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

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 Howard: My name is Gabe Howard and I live with bipolar disorder.

Dr. Nicole Washington: And I’m Dr. Nicole Washington, a board-certified psychiatrist.

Gabe Howard: All right, Dr. Nicole, I have been wondering, are you a board-certified psychiatrist I or a board certified psychiatrist II?

Dr. Nicole Washington: Gabe, you know there’s no such thing, you know? You know there’s no such thing.

Gabe Howard: But but you also mentioned that you are a mom. So are you a mom I or a mom II.

Dr. Nicole Washington: Gabe.

Gabe Howard: I know I can just do this. Are you a podcaster I or a podcaster II?

Dr. Nicole Washington: [Laughter] You could do this all day.

Gabe Howard: I only bring this up because like board certified psychiatrists is a thing. Right? It’s a thing all by itself,

Dr. Nicole Washington: Yes.

Gabe Howard: Right? So bipolar disorder is a thing. It’s a thing all by itself. Why do we have sequels?

Dr. Nicole Washington: Well, it’s not a sequel. They’re very different.

Gabe Howard: Have we spawned a franchise?

Dr. Nicole Washington: It’s not going to be a sequel.

Gabe Howard: Is there going to be a bipolar III, a bipolar IV? Are we going to wait 20 years and get a bipolar V? Like where the bipolar is aging, but

Dr. Nicole Washington: Oh, my gosh.

Gabe Howard: Still somehow relevant to a specific generation?

Dr. Nicole Washington: I hope not. And we don’t think of bipolar II as bipolar the sequel. It’s very different. Well, I can’t say very different, but there are differences.

Gabe Howard: I know that there are differences, but if it’s very different, why does it have the same name? Like, for example, let’s take it. You know how they say you’re comparing apples to oranges?

Dr. Nicole Washington: Mm-hmm.

Gabe Howard: Why isn’t it apple I and apple II? They’re very different. So instead of calling it an orange, a completely different name to set it apart so that nobody gets confused, we’ll call it apple II. Right? It makes no sense. Why? Why?

Dr. Nicole Washington: Well, I couldn’t tell you why we chose in the beginning when we decided to name.

Gabe Howard: Wait, you weren’t there?

Dr. Nicole Washington: I wasn’t there.

Gabe Howard: You weren’t in the room where it happened?

Dr. Nicole Washington: Nope. I was not there. I may not have even been alive. I don’t know.

Gabe Howard: [Laughter]

Dr. Nicole Washington: I may not have even been alive.

Gabe Howard: Dr. Nicole, I have so many questions about the existential crisis of the bipolar name. But the first thing that I want to know is, was there a manic depressive I and a manic depressive II? Bipolar disorder hasn’t even been able to keep the same name. Forget about the franchising and the sequels and the numbers. We we used to be manic depressive. So was there a manic depressive I and a manic depressive II?

Dr. Nicole Washington: No. And actually, when it was changed to bipolar disorder, there was no one and two. Initially, there was just bipolar disorder. But, you know, when you know better, you do better.

Gabe Howard: So. Okay. So, hang on. So. So first we have to change our name,

Dr. Nicole Washington: Yes.

Gabe Howard: Right? Because manic depressive is a bad name. And it was just changed to bipolar disorder.

Dr. Nicole Washington: Yes.

Gabe Howard: Right? Straight up. That’s the end of it. Okay,

Dr. Nicole Washington: Yes.

Gabe Howard: So what year was that?

Dr. Nicole Washington: So in the DSM III, which was released in 1980, it was just bipolar disorder.

Gabe Howard: Okay, so in, before 1980 or before the DSM III, it was manic depressive. And then 1980, we got the switch to bipolar. Yay, we got a new name. Dun dun dun.

Dr. Nicole Washington: New name.

Gabe Howard: The eighties. Just wild, wild times. And then with the DSM IV which was what like?

Dr. Nicole Washington: 94.

Gabe Howard: 94. So then in 1994, somebody was like, Hey, we’re not done messing with bipolar just yet. First we took their name.

Dr. Nicole Washington: Uh.

Gabe Howard: And so now we’re going to give them numbers. We’re just going to give them numbers.

Dr. Nicole Washington: You describe this, you’re describing like this scene from Austin Powers where there’s a bunch of psychiatrists sitting around going, how do we really mess with people? How about we split up bipolar disorder into I and II? That is not how this goes.

Gabe Howard: Listen in Austin Powers, he was Doctor Evil.

Dr. Nicole Washington: He was.

Gabe Howard: We don’t know what kind of doctor he was.

Dr. Nicole Washington: I feel pretty confident he was not a psychiatrist. Let’s just go ahead.

Gabe Howard: I’m not even sure he was a doctor.

Dr. Nicole Washington: [Laughter]

Gabe Howard: I’m not going to lie. I don’t know that he was a doctor, but if he was, I can see a lot of people thinking that psychiatry would fit.

Dr. Nicole Washington: No. Why would you think that?

Gabe Howard: [Laughter] No?

Dr. Nicole Washington: No.

Gabe Howard: All right, Dr. Nicole, so from the patient perspective, you can see where these are confusing times, right? Many of us, unfortunately, have never heard of many of these mental illnesses. And until we or somebody we love gets diagnosed from them, which is a whole other problem and a whole other episode, but one day we’re told, hey, you have bipolar disorder. We’re like, okay, I vaguely heard of that. I’m now scared. And then we start Googling and find out that it has a whole bunch of different names, a whole bunch of different numbers. So it erodes our confidence in the process, and that’s neither here nor there. I understand why it happens, but sort of walk us through why the evolution in name.

Dr. Nicole Washington: With most diagnoses in the DSM, and in most of science, right? You start off with a thought. And as you learn more information along the way, you change that thought. Like that is at the heart of what science does. Right? You have a hypothesis. You have a way of thinking. You think a certain way, and then you realize, oh, maybe I haven’t been quite 100% correct. Maybe I haven’t been quite accurate in in what we’ve thought so far. So we’re going to change it based on what we’ve seen.

Gabe Howard: So we’ve learned new information. So we’ve categorized it different?

Dr. Nicole Washington: Yes, like we we learn things, right? We change language to be more sensitive to people who have an illness. Right. We we change these things.

Gabe Howard: And it also helps people understand what they have. So, for example, I have a mini schnauzer and there are schnauzers, so we could call them all Schnauzers. And then you wouldn’t know if I had a 20-pound little cute, adorable little schnauzer or if I had a 50-pound big stately schnauzer because they both have the same name. So

Dr. Nicole Washington: Right.

Gabe Howard: So essentially Mini Schnauzer and Schnauzer, while they’re both in the Schnauzer family, you now know more about my dog based on the name change, because, you know, in the beginning they were just all schnauzers. They were just all cuddly little puppies.

Dr. Nicole Washington: There you go.

Gabe Howard: So mini Schnauzer is bipolar I and Schnauzer is bipolar II.

Dr. Nicole Washington: Perfect, perfect example.

Gabe Howard: So, Dr. Nicole, let’s make sure that the schnauzer analogy holds. We know that my mini schnauzer and a regular schnauzer both have a lot of stuff in common. You know, they tend to look alike. They have the same general physical features. They are members of the same, you know, doggie family. But then some differences show up. A big one in the Schnauzer family is that my dog gets to be a maximum of about 25, 30 pounds, and a regular schnauzer gets to be in the 50 to 60 pound range at their max out. And then there’s some other things. Is that how bipolar I and II are?

Dr. Nicole Washington: Kinda. They both will have this elevated mood state. Right. So for bipolar I, that’s a manic episode. For bipolar II, that’s a hypomanic episode. They share a lot of the same symptoms. But the bipolar I manic episode is a little more intense maybe then the hypomanic episode. And I don’t. You get into wording of, you know, saying more severe or more intense or more impairing. People with bipolar II disorder will say, well, my episodes feel pretty intense and they feel pretty impairing. So it, it comes down to wording and education. But by and large, hypomanic episodes are just not as they’re not as impairing. Right? So that’s kind of the big difference is the level of impairment of the episode.

Gabe Howard: It all surrounds mania, if I understand correctly. So hypomania is this elevated mood state, but it sort of stops like here. And everybody who’s listening, I’m holding up my hand, to here.

Dr. Nicole Washington: [Laughter]

Gabe Howard: And now I’m about to raise my hand above the original level of my hand to say that full-blown mania is here. So it’s it’s more intense. It’s more debilitating. It’s

Dr. Nicole Washington: Right.

Gabe Howard: These are the levels where people describe losing time, blacking out. I don’t know what happened. I lost 2 hours and all my friends told me that I did X, Y and z that I have no memory of.

Dr. Nicole Washington: Right.

Gabe Howard: But I know that my friends aren’t lying. So.

Dr. Nicole Washington: Right.

Gabe Howard: So hypomania. Here,

Dr. Nicole Washington: Mm-hmm.

Gabe Howard: Raise your hand a little above. Mania here. So bipolar II stops at the hypomania level.

Dr. Nicole Washington: Yeah. So the time frame is different for those two things. At least a week or having hallucinations, delusions with it for bipolar I. So it has to be severe and then hypomania at least four days. Right. So the time frame is different. And so when you think about like why change, right? Like why a change? Why split them up? You split them up because if you lump them all together, you run the risk of missing the bipolar II people. Because if you’re if your picture of what mania looks like is bipolar I, then what about these II people who may not ever get to the hospital, who may not ever get on your radar? Right. Because they’re functioning through their hypomania. They’re going to work. They’re living life. Now, they’re a little different. They’re a little more elevated than they usually are. But they’re still functioning. They’re still doing things. Whereas a lot of times when someone is in a manic episode, they’re not functioning well. Like they’re not able to function at work and at school and get things done and, you know, avoid the hospital. So when you don’t separate them out, you miss the bipolar II people, which doesn’t serve those people well to get better.

Gabe Howard: And hypomania. It’s it’s impairing. Look, let’s make no mistake about that. It is problematic. I look at it as if if somebody tied both of their arms next to their side and had to complete basic tasks, that would be extraordinarily difficult. But if somebody had to tie one arm behind their back and complete tasks, that would be easier. So it’s easy to see where if all you were looking for was the people with two arms tied behind their backs, you would ignore all of the people with one arm tied behind their back, but those people with one arm tied behind their back, they want help. They want somebody to untie that arm. They are debilitated. They’re having issues. The goal is full use of both arms, no arms tied behind your back. Is that sort of what you’re describing? Because mania is always portrayed in the movies as wild, if that is your idea of what mania is? Literally, Wolf of Wall Street, every movie that we’ve ever seen where the person’s leaping off buildings, just jumping into pools from hotel balconies, if that is your mindset of what mania is, yeah, hypomanic people are not going to trigger that. The medical staff, the doctors or even the people around them, might think that they’re just fine.

Dr. Nicole Washington: Right. Oh, we never see them. They never hit us. We never get to those people. So having the ability to separate them allows you to conceptualize in your mind that, Oh, there are people who have this illness, they may not end up in the hospital or in jail or lose their jobs or any of those things, but they still have this illness that is still problematic.

Gabe Howard: So we’ve sort of alluded to it a little bit. But let’s touch on this controversy of bipolar I being more serious than bipolar II or bipolar II being a less severe version of bipolar I. I am always in the camp of this is a semantics argument and it’s a distraction from helping people. But I know that I can’t just keep painting these discussions with that. Oh, stop it. They’re just words because words do, in fact, have power. But I do worry about this a little bit because things do have severity levels. Does that make it difficult for you as a doctor because you have these severity levels and then you get this pushback where people believe that what you’re saying is my case isn’t severe because somebody is sicker. That’s not what you’re saying. That’s just what we’re hearing.

Dr. Nicole Washington: No, that is not what I’m saying at all. And actually, I don’t have much of an issue calling it I or II or. For most psychiatrists, I think the issue is catching the II. Right? Being able to accurately diagnose the bipolar II disorder. Right. Bipolar one, because mania tends to be, you know, more severe of an episode. It is usually not difficult if you can rule out substances and medical conditions getting in the way. It’s usually not difficult to tell that someone’s manic. Right? Mania is pretty evident. So you’re like, Oh, okay. Like you can spot it immediately. Bipolar II is a little bit more sneaky. The person has this depression and they’re telling you about these depressive episodes and you can’t get a handle on them. But they don’t usually tell you about the hypomania because it is such a functional state. So they’re still working. They’re still going to school. They’re still with their spouses. They’re doing family stuff at this just a little notch above normal mood for them. And it just it’s confusing. So we may treat them for depression and we’re like, oh, they have this treatment-resistant depression. We just can’t stop it. Oh, my gosh. And then eventually we kind of figure it out along the way. But it is not uncommon for it to just be hard to find because of how functional you can be during a hypomanic episode.

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Dr. Nicole Washington: And we’re back with the difference between bipolar I and bipolar II.

Gabe Howard: Categorizing illness is super important to getting people the help that they need. Right? So as we’re discussing, is it severe or is it not severe? Who’s more severe? Who is sicker? I love to call that the suffering Olympics. Right? This is just nonsense. It really doesn’t matter if somebody is sicker or less sick than you. Reasonably speaking, self-preservation kicks in and you only care about yourself. I’ve never once gone to a doctor who said, Gabe, I had a patient who’s worse off than you. And I got up and said, I’m cured. Right. Thank you. Thank you, doctor, for telling me that somebody is better.

Dr. Nicole Washington: [Laughter]

Gabe Howard: And and sincerely, I’ve never once gone to the doctor and been told, Gabe, you’re a very bad case and immediately thought, okay, I need you to stop seeing your other patients. You’ve just told me that I’m a really severe case, so therefore I need you to fire all of your other. We really do need to look at this individually. And categorization is the way that the medical community is researching us individually in our little clumps. So as difficult as it is for the patient community to hear that we’re being put in these little boxes, these little boxes have real scientific rigor behind them.

Dr. Nicole Washington: Yes.

Gabe Howard: The boxes are constricting and they sound, it does sound a certain way. I mean, I think that that you, Dr. Nicole, as a person, can understand that it probably sounds a certain way, but it doesn’t matter how it sounds, it matters how it is and how it is, is extraordinarily helpful toward people getting to where they want to go, which, as I always say is, you know, Hawaii, like we’re all we’re all trying to get better so we can go to Hawaii and

Dr. Nicole Washington: So

Gabe Howard: Buy our yachts.

Dr. Nicole Washington: I would be 100% honest with you. I’ve never really known this before today that

Gabe Howard: Nice.

Dr. Nicole Washington: That was even an issue. Like, I had no idea.

Gabe Howard: We’re learning.

Dr. Nicole Washington: I had no idea that there are people who have bipolar II disorder who feel some kind of way about being told that their hypomania is not as severe as mania. I haven’t seen that. So I don’t know if my patients are just like not telling me that. Is that one of those things they’re carrying around and just not verbalizing? But I’ve never heard that.

Gabe Howard: So the patient community is a, is a vast space,

Dr. Nicole Washington: Yes.

Gabe Howard: Right? So we never know truly how many people are actually upset about something.

Dr. Nicole Washington: Right.

Gabe Howard: Right. I want to point that out. Right?

Dr. Nicole Washington: Because the most upset are the loudest.

Gabe Howard: Yeah, in many times it’s certainly possible there’s only like ten people that care about this. But these ten people are Gabe level loud, right?

Dr. Nicole Washington: [Laughter]

Gabe Howard: They just they got they got podcasts and megaphones

Dr. Nicole Washington: Oh.

Gabe Howard: And blogs

Dr. Nicole Washington: Oh.

Gabe Howard: It is important that it’s not necessarily about the numbers. It’s about the influence of the people who believe this. And we are seeing a lot of writing in the patient community about this idea that for some reason, because you have bipolar II, you’re not as sick and therefore we don’t need to worry about you as much. I can understand how that would feel if somebody looked at me and said, Oh, Gabe, you only have bipolar. Well, I know about this more severe illness, so we’re more concerned about them. I’d be like, But. But I don’t. You’ve now dismissed me, you’ve pushed me aside. So I want to speak to all of the people with bipolar II who feel that way and say, man, and I get it. I do like like genuinely I get it. But I also want to say, we’ve got to stop playing the suffering Olympics. It doesn’t matter. Look, somebody is always going to be sicker and somebody is always going to be better. That’s just the way it is. Look, in my lifetime, Bill Gates used to be the richest person and now he’s not. I mean, if that kind of money can change hands, then clearly in your lifetime, you’re not always going to be the sickest or the well-est . Is well-est a word, Dr. Nicole?

Dr. Nicole Washington: I’m pretty sure it’s not, Gabe. Pretty sure.

Gabe Howard: I just like making up words.

Dr. Nicole Washington: You do like making up words, but I’m pretty sure.

Gabe Howard: Yeah, the

Dr. Nicole Washington: I’m pretty

Gabe Howard: The med

Dr. Nicole Washington: Sure

Gabe Howard: Reviewers

Dr. Nicole Washington: That’s the big

Gabe Howard: Never

Dr. Nicole Washington: One.

Gabe Howard: Call me out on that. They’re like, You can’t say facts. I can’t say like one in two people have bipolar disorder with red hair. The med reviewers come back immediately. I was like, That is incorrect.

Dr. Nicole Washington: Yes.

Gabe Howard: But if I keep making up words, it just it just passes med review, you know, there’s no grammar review.

Dr. Nicole Washington: You.

Gabe Howard: And for that,

Dr. Nicole Washington: You are thankful.

Gabe Howard: [Laughter]

Dr. Nicole Washington: Oh, my gosh. I think for a person with bipolar II disorder, even though I haven’t seen this clinically, where a person feels slighted somehow by being told that hypomania is less severe. I could see how if I had bipolar II disorder, it would bug me with the way that bipolar disorder tends to be portrayed, like in the media or the way that just the way that we think of bipolar. When you say, oh, they’re bipolar or that person’s got bipolar disorder, the picture that comes up in most people’s minds is not someone with bipolar II disorder at all. So I could see how you would feel misrepresented right in the discussion. And that could be very frustrating because I think that could go a long way to help with the stigma associated with bipolar disorder. So I could definitely see that.

Gabe Howard: And to your point, and this is worth driving home because the picture that people have in their head of bipolar disorder is that bipolar I diagnosis. If they didn’t split it up, none of those people would get help. You wouldn’t see it in yourself. Your friends and family wouldn’t notice. They they think it was your personality or bad decisions, etc. Nobody would stop to think for a moment, hey, maybe Jane needs help. Maybe Johnny needs help. Because after all, you’ve got this one singular view.

Dr. Nicole Washington: Right.

Gabe Howard: So splitting it out into these two and educating the world

Dr. Nicole Washington: Yeah.

Gabe Howard: Gets more people help.

Dr. Nicole Washington: I mean, they say Jane’s still going to work. How could she have bipolar disorder? Jane still runs the PTA fundraiser. Jane is still a part-time college student. You know, they may not see a difference, right? Because those people tend to still function, like we keep saying. And honestly, I’ll be completely honest with you, I have had patients who in their careers have actually done a little bit better during their hypomania, depending on what kind of career they have. People who are in sales, people who are doing multiple things like, you know, running with their kids and working and volunteering and all these things. Sometimes they thrive during that moment, at least in that arena. Now, you know the aftermath, what goes up must come down. And that’s not always pretty. But I have had patients tell me frequently that their hypomania has allowed them to be more productive in ways. So, you know, I could see how you would look at that person and say there is no way that that person has bipolar disorder.

Gabe Howard: It’s important to point out in that example that you just gave that that person is still seeing a doctor. That person is in therapy, treatment, seeing a psychiatrist, a psychologist. They’re in support groups. They’ve been able to harness it because they have the group around them. That helps. This doesn’t retroactively make bipolar disorder a good thing. I just found the silver lining in the cloud. And I think that’s important to point out as well. So often we see somebody that makes the proverbial lemonade out of lemons and then we stop thinking the lemons are sour. I think it’s an excellent point to bring up because I don’t want anybody running around who has hypomania to refuse to go to the doctor because they’re afraid of losing that little good thing. Right.

Dr. Nicole Washington: Yes.

Gabe Howard: Working with a good doctor can help you keep the good things and minimize the bad. And I think that’s a really powerful message to get out there for all the people that are like, well, I’m not calling Dr. Nicole.

Dr. Nicole Washington: Right.

Gabe Howard: She’ll take away my lightning. She’ll extinguish my fire.

Dr. Nicole Washington: Right, well, the one thing I do tend to try to work with people who have bipolar disorder on is the fact that reaching a normal mood for you, right. Like whatever your normal mood level is, reaching a normal mood state and having that be consistent, you’re going to be so much more productive than if you’re dealing with depression and hypomania and you’re dealing with those episodes, you know, frequently that up and down. So you’re much more productive even though you feel like you’re super productive during that hypomania, you’re going to be much more productive in the long run if you can be consistent.

Gabe Howard: I know that we’re running out of time. But before we get out of here, I want to talk about all these different names and this idea that it erodes confidence in anything. First off, let’s talk about depression. Depression is well, I’m not saying that it’s well understood. It’s well-known people people generally have some understanding of depression. It’s less stigmatized. There’s less discrimination surrounding it, surrounding it. People are more willing to admit if they think they have depression. It’s just it as far as mental illnesses go, depression is certainly better understood among the population and less stigmatized than bipolar disorder. And depression has had tons of names. I mean, first, let’s talk about the slang names, you know, down in the dumps, the blues, you know, just just feeling sad. Just these these are all general ways that people describe it, that people understand. And even though there are different names, it doesn’t put a stink on depression that that maybe it’s somehow made up in the majority of the population’s mind. And let’s go all the way back to what most scholars agree is the first writing of psychological depression. It was done by Hippocrates all the way back, somewhere between 370 and 460 B.C. And he originally named it Melancholia. So all the way back then, depression started out as Melancholia, and then it’s gone by various names since and it’s been broken out as well.

Gabe Howard: We have depression, we have major depressive disorder. We have, seasonal affective disorder, which is depression by the seasons and on and on and on. Again. Dr. Nicole, I only point this out because it’s so easy to become siloed and think that for some reason all of the other psychological illnesses are well understood, except ours, and ours is somehow doing something different than all of the other psychological disorders, when in fact it’s exactly the same. We’re learning, we’re growing.

Dr. Nicole Washington: Anyone who is is struggling with with that concept. I think it’s also important to remember that with these changes, as research goes on, as time goes on, as we have more experience treating people who have bipolar disorder we’re able to also provide better treatment. So these name changes aren’t necessarily just name changes because we had nothing better to do. And we’re sitting around our Dr. Evil table coming up with ways to change it. But it also drives treatment and it drives things that really ultimately give you a better quality of life in the long run. So these are actually positives, even though they feel frustrating.

Gabe Howard: I really appreciate you saying that because, one, I think that it’s true. I would not be here if there wasn’t robust research into bipolar disorder. Gabe Howard living 100 years ago would have had a vastly different outcome than Gabe Howard living today because of that scientific research. But I do want to ask you a question. As a practicing psychiatrist, do you understand why people are scared when they hop on the Internet? And Dr. Google tells them that the illness that they’ve been diagnosed with has 17 different names and it’s gone through five iterations in their lifetime? I mean, I was born in 1976, so a lot of this stuff has happened in my lifetime. If a patient expressed this to you, what would you say to them? Would you be understanding or what would you say?

Dr. Nicole Washington: Yeah, I can absolutely see the frustration and why a person would be frustrated. I mean, I share with people all the time that psychiatry is different than a lot of areas of medicine. Right. If you think about it, we don’t have fancy lab tests. You know, I can I can run blood work and see if you’re having a heart attack. I can look at an EKG and see if you’re having a heart attack. I don’t have a blood test or a magic wand to wave over you that tells me, oh, yes, this person is bipolar II, or this person is bipolar I, and they’re going to rapid-cycle this many times a year. I wish I did. The brain is still that that big unknown, I think for us in mental health, like we’re just starting to unlock and come up with decent reasons as to why it is that you can go 18, 19, 20 years and not have this thing. And then all of a sudden there it is. It’s still the area of medicine that has the most room for us to learn more, I think, in the upcoming years. And to me, that’s fascinating. Frustrating as heck for the patient. And I share that with them that I get it. But I think it’s just because the brain is just this very unique, complex thing that we just still don’t know everything about yet.

Gabe Howard: And I’m glad that we are still looking into it. I think that is the thing for patients to keep in mind. That study is good, growth is good, learning new things is good because it all achieves the goal that we want, which is to go to Hawaii. It’s to live our lives, it’s to have a great life.

Dr. Nicole Washington: Yay!

Gabe Howard: Listen up, everybody. Thank you for spending some time with us. My name is Gabe Howard and I am the author of “Mental Illness Is an Asshole and Other Observations,” which is available on Amazon because, well, that’s where everything is. Or you can get a signed copy with free swag by heading over to my website at

Dr. Nicole Washington: And I’m Dr. Nicole Washington. You can find me on all social media platforms @DrNicolePsych to see all the things that I have my hand in at any given moment.

Gabe Howard: Dr. Nicole and I both will travel wherever you will pay us to go. You can find out more information on our respective websites. Wouldn’t it be cool if one of us showed up at your next event? And hey, can you do us a favor? Tell people about this podcast. Sharing the show is the way we grow, and wherever you downloaded this episode, please follow or subscribe. It is absolutely free. We will see everybody next Monday on Inside Bipolar.

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