Remaining grounded through changes

There are changes you make and changes that happen. Changes that you can see coming and changes that catch you off guard.

For me, bipolar disorder is easier to manage if I have stability, routine, and predictability. It’s easy for some things to throw me off balance, so I have to be especially careful not to let that happen when drastic changes occur or when emotionally charged situations arise.

The changes I make, I make carefully. I know both depression and hypomania can lead me to impulsively do things I will later regret. So even though I am stable and have been for months, I do remain mindful that I still have an illness.

I enrolled in university this year, something I also did a couple years ago while hypomanic only to drop out by the time classes started when the depression hit. I later realised I didn’t even have a real interest in that career; not one that would justify the cost of the degree anyway. This time I gave it some actual thought, it wasn’t a ‘hell, why not’ decision. I’m doing a different degree than what I started back then, and I gave this a lot of consideration. I know I’m doing this for the right reasons.

I plan on also leaving the job I’ve had since I moved here. That’s something I’ve considered doing many times in the past couple of years, either because the depression made me feel like I couldn’t hold a job at all, or because the hypomania made me so angry at everything going on that I just felt I needed to leave or otherwise I’d snap and get myself fired.

I’m leaving for the right reasons. I’m unhappy there. For the most part it brings me nothing but frustration and unnecessary stress. I’m not leaving to escape for the sake of escaping, I’m leaving to give myself the chance to find somewhere better. And I’m not applying to any and every job I find, I’m making choices with the future in mind.

This career change is one I had seriously contemplated pretty much since I was discharged from the hospital. I wasn’t ready for change then, but it’s something I can cope with now. Actually, it’s something I need now. Uncertainty is scary, but I’m confident I can cope. After all, if I could move to a different country with my mental illness untreated, I’m sure I can move to a different job in the same town while being healthy and stable. I’m in a place where I know this won’t make me unsteady and send me into an episode.

Changes I’m responsible for are easy to cope with. My reality changes, but I’m in control of that change to a good extent, and that gives me some sense of security. It’s only when they happen as a result of an episode that I start feeling detached from reality, as I am actively making choices but it doesn’t feel like they’re my own choices at all.

For changes outside my control that I can see coming, I may or may not like them, but I can prepare for them. I haven’t had many of these happen lately. The anticipation can be anxiety-inducing, but I am able to go through them and reassure myself that anxiety is rarely rational.

All the above are changes I can manage without questioning reality. I still feel grounded, life doesn’t feel unreal. It feels different and strange as they take place, but ultimately, I experience them in a way that feels very normal and not unsettling or upsetting.

As for changes I can’t see coming… well, they happen. Some more unexpected than others. These do affect me because I still sometimes struggle with lacking control, and with some of them like a pandemic or someone’s sudden death in the past, I just wasn’t prepared at all. But the more unexpected experiences I face, the better equipped I am to deal with whatever comes next.

My perception of reality was recently challenged as something I took for granted ceased to be real, and this led to brief (but concerning) feelings of questioning both reality and my place in it. I felt disoriented, confused. The fact that something significant happened in a way that forced me to step back and re-evaluate where I stand did shake me up. However, I don’t think it’s at all like the derealisation that used to hit me whenever anything around me changed in the slightest.

I know I am experiencing reality, I’m not in that delusional state I have experienced in the past where I was certain I was dreaming or in a coma, or the derealisation state where I felt entirely detached from everything and everyone around me.

It’s not so much that I feel detached from reality as much as it is that I’ve consciously decided to step back from some of it. The people are still real, they’re not slipping away from my reality, but I am intentionally stepping away from them.

I am very aware of impermanence, I accept it and I remind myself on a daily basis that everything is subject to change. But it’s very likely I unconsciously take some things for granted simply because at first glance they don’t appear to be things that would easily change.

People change, as does our perception of them the longer we know them. Sometimes they surprise you for better or worse. In this particular situation, what I assumed to be derealisation at first was just the struggle to accept that people do in fact do things that completely change the way you see them, sometimes for worse. I don’t feel detached from people around me as I would with derealisation, I am just disappointed.

A difference I have noticed compared with past experiences is that I’m not necessarily angry. I’m just done.

I used to be very shaken up by change. I must admit, completely having to change how I view someone in the way I have now is new to me, and for a minute there I felt like I might just lose my grip. I was ready to deploy all my grounding coping skills. But as it turns out, I was underestimating my ability to cope with changes outside of my control these days.

In this particular situation, I could have easily overlooked certain issues in order to keep things as they were and to avoid stepping out of that comfort zone of stability and uneventfulness. Instead, I chose to embrace change in a way that, as uncomfortable as it might be, is in line with my values.

I think this is what has finally pushed me to realise that change is nothing to be afraid of. It really is inevitable. The things I cannot control, I accept. For the things I have a choice in, I make choices being true to myself. I no longer have a sense of blind loyalty to anyone. If I have to let go, I let go.

I definitely benefit from stability. But complete, absolute stability will only hold me back. I want to be stable, not stagnant. I need some room for variability. I have slowly reached a point where I crave a healthy amount of change, and I’m excited to see where I go next.

Life before diagnosis

Once I had a diagnosis of bipolar disorder and I achieved some mood stability, I went through a short period of mourning the past and the perceived loss of possibilities (the latter will be for a different post). It was short because I had already gone through that kind of process twice: first coming to terms with my estranged father’s suicide, and then coming to terms with being transgender.

I cannot compartmentalise my existence. There are things I did and didn’t experience because of being trans alone, or because of having bipolar disorder alone. However, most of my experiences are a muddy intersection of the two, with both also being influenced by the wider family and societal context.

Having said that, the years-long process of accepting the implications of being transgender was very much focused on that one aspect of my life. Similarly, coming to terms with my father’s suicide and my overall family situation is something I did in a very focused and also detached way. I was examining it the way one examines the plot of a movie. I was the viewer, somehow living through the storyline but not in it.

In retrospect and with the clarity of a diagnosis, I can see now that many of the things I went through internally were driven by my illness and not just life events or gender dysphoria on their own.


I got diagnosed with bipolar disorder last year at age 26 after hitting rock bottom. This will make up more than a quarter of my life if I make it to my 80s. At times it feels like wasted years.

My life before being diagnosed was characterised by long episodes of depression, hypomanic and mixed episodes, and short periods of euthymia.

During these short but stable periods, as an adult, I’d get a false sense of security thinking I wasn’t mentally ill at all. I’d convince myself things were fine and would only continue to improve. I told myself maybe things were never that bad to begin with.

It was only when a hypomanic episode arrived that I knew for sure I’d crash into depression again. When these episodes peaked, I can only describe the experience as descending into madness.

The peaceful periods in between episodes were filled with fear that they would never last. I was told this was pessimism. Some said my depression was my own fault because of this kind of thinking. I see now that it was a very realistic and accurate view, considering the very nature of this illness when untreated.

Of course, I didn’t have this bipolar-specific vocabulary of depressive and hypomanic episodes at the time. The fact that no one was diagnosing me with bipolar disorder despite my suspicions made me feel like I was just losing my mind. I eventually forgot about these suspicions.


I was never happy as a child. Gender dysphoria and a complicated family situation got in the way. I was rejected by peers, ignored or misunderstood by teachers, emotionally neglected by family.

I had my first suicidal thoughts when I was around 10, if not earlier.


As a teenager, the stable neutral periods were always obscured by life circumstances. They were different than the depressive episodes in that I didn’t feel such an overwhelming emptiness and despair, but I wasn’t happy either. I was unhappy in a ‘my life sucks’ kind of way.

For most of my teenage years I had suppressed all the gender-related feelings and thoughts I had as a child, so I was experiencing all the dysphoria without the conscious knowledge of what it was or where it was coming from. My body was uncomfortable to live in, to say the least. I started reading about astral projection; the idea of existing as a being with no physical form was freeing.

Family life was difficult for a variety of reasons since I was a child. Outside of home, most of my peers’ reactions to me ranged from harmless but clear disinterest to straight up bullying. This left me having only a couple of friends who, despite also being outcasts to an extent, weren’t as ostracized as me and eventually drifted away into broader groups of friends.

Ultimately, no one around me seemed to be going through the same turmoil I was going through, and no one showed any meaningful understanding. I found community online instead.

I spent most of my teenage years muddling my way through long depressive episodes on my own. I didn’t understand the odd periods where I felt confident, full of energy and on top of the world. I didn’t understand them because they never lasted, and because it wasn’t actual happiness given the everpresent gender dysphoria.

I continued to have passive suicidal thoughts and eventually started making plans at the age of 14, when my father completed suicide. I started self-harming soon after.

I dropped out of high school at 16. I was a good student, but my depression made it impossible to study anymore and I didn’t see the point in it regardless. My mother agreed this was best for my mental health, but offered me no help or support. In fact, she later confessed that when I was 15 she seriously considered offering to kill me to put me out of my misery.

From that age I had no friends until I started finding some community online. The few in-person friendships I had ended in part because of my mental health issues. I isolated myself. I had no idea what was wrong with me.


In the next couple of years I realised and accepted I was transgender and needed to medically transition. The perception I had of myself as a child and the relationship I had with my own body finally made sense. I began my social transition when I told my family at 18. This gave me a glimpse of hope that at least that part of my pain could get better. Despite the hope, I felt deeply ashamed of being transgender.

I returned to school when I was 20, this time in a different city only being seen and known as male. This made things easier, but I lacked all social skills and suffered through social anxiety. I hadn’t really interacted with anyone in person outside my family or doctors for four years at this point.

That first year of school went smoothly, but on the second and last year of the programme the depression hit again and I nearly ruined my chances at a scholarship abroad. I managed to make that happen.

I had an apparently bright future ahead of me, my life was only getting better as my dysphoria diminished and my living situation improved by moving to a different country. And yet, my mental health was only deteriorating more and more. This made me very frustrated. Why couldn’t I be happy when things were seemingly only getting better?

I felt lost, disoriented, helpless.


Sometimes the break in between depressive episodes would allow me to recover, but in the last few years I was so worn down it was impossible to recover. Each episode was harder than the last.

On the other hand, the hypomanic episodes made me look happy and full of energy and optimism on the outside. Inside, it was a very different experience. As an episode progressed I had less and less control. The restlessness was endless. I channelled some of that energy into my work, but sooner or later the racing thoughts and irritability would take over.

I was impulsive, talkative, oversharing. I started dating soon after moving to a new country and engaged in risky behaviours. I decided I’d start running again, setting unrealistic goals and injuring myself. I planned a holiday I didn’t have the money for, which I cancelled as the depression returned. I spent money very irresponsibly. I enrolled in university, which I gave up on within a month of starting as depression hit again.

In these episodes I didn’t feel as happy as I appeared. I felt restless, irritable, out of control.


The last mood episode I had was a mixed one. Miserable, empty, numb, restless, racing thoughts I couldn’t keep up with, anxious, angry. I felt like I was losing my mind.

At one point I truly believed my real body was in a coma from my previous suicide attempt and this was all a dream. I thought dying would wake me up. I then realised this wasn’t rational. But my mind was in such a perturbed, disturbing, incomprehensible state that I saw death as the only end to it. I did think this was rational.

I went through with it and that’s when I ended up in a psychiatric hospital, where I finally got the right diagnosis.


I could’ve had a very different life. Not even going as far as the ideal scenario where I’m born cisgender and with no mental illness; just with things as they are but having had the appropriate help and support early enough. That would’ve made a massive difference. I could’ve lived and thrived rather than just barely surviving at all times.

At the end of the day, no amount of dwelling will change what my life has been. No amount of resenting those who could’ve but didn’t help me will change things.

I am now able to see my very young past self through the lens of compassion, rather than blaming him for what he went through and thinking he deserved it. This has played an important part in finding self-acceptance. Not only did I stop resenting those who didn’t help me or even made things worse long ago, I also stopped resenting myself for not being stronger.

It could’ve been better, could’ve been worse. But it was what was.