Inside Bipolar Disorder

A personal essay series by Jack Mikkel Revheim for RABAGAS Magazine

Two years ago, I was diagnosed with bipolar disorder and ADHD. I was thirty-eight years old.

That may sound like the beginning of this story. In truth, it was closer to the end of a very long process. The diagnoses didn't suddenly appear that day. They simply gave a name to something that had been there all along.

Because if I do, in fact, have bipolar disorder and ADHD, then I haven't lived with them for two years. I've lived with them my entire life—as a child, as a teenager, and as an adult. They have been there through school, working life, friendships, conflicts, ambitious projects, and periods when everything seemed to be going either remarkably well or remarkably badly.

That raises an obvious question.

How can it take thirty-eight years to discover something that has been there all along?

Were the symptoms invisible? Was I simply good at hiding them? Or are these conditions far more complex than most of us like to believe?

Since receiving my diagnoses, I've realised that almost everyone has some kind of relationship with the words bipolar and ADHD. Most people have heard of them, and many have strong opinions about them. Far fewer seem familiar with the nuances.

When people hear the word bipolar, many immediately think of depression. Others imagine dramatic mood swings or people losing control of their lives. ADHD is often associated with restlessness, poor concentration, and constant activity. Reality, however, is rarely that simple.

People are different. Diagnoses are different. And when more than one condition exists at the same time, the picture quickly becomes more complicated than the simplified explanations we are used to hearing.

This series is an attempt to explore that landscape—not as a doctor, a psychologist, or an expert, but as someone who suddenly found a language for experiences I had been observing for years without fully understanding them.

Throughout the articles that follow, we'll take a closer look at what bipolar disorder actually is, how mania, hypomania, and depression can manifest themselves, why ADHD so often enters the same conversation, and what life can look like when you are trying to navigate all of these realities at once.

Along the way, I'll draw on my own experiences, but this is not intended to be an autobiography. Nor is it an attempt to seek sympathy or excuse past choices and actions.

The goal is understanding.

For some readers, these pages may feel uncomfortably familiar. For others, they may offer a glimpse into how a family member, a friend, a colleague, or perhaps a neighbour experiences the world.

And perhaps that is where the real value lies—not in placing people into ever more boxes, but in understanding a little more of what is happening inside them.

Welcome to the series.

I was thirty-eight years old when I was diagnosed with bipolar disorder and ADHD.

That may sound like the point where this story begins. In reality, it was the moment when something finally received a name.

Because if those diagnoses are accurate, then I haven't lived with them for two years. I've lived with them my entire life. Which means we're really talking about decades of patterns that were always there, but were never recognised as parts of the same picture.

And that is where the question begins to emerge.

How can something that shapes an entire life remain undiscovered for so long?

The short answer may simply be that it wasn't invisible.

It was just difficult to read.

I grew up at a time—and in a school system—where there simply weren't many words for the kinds of behaviours that would later receive formal diagnoses. What today might be recognised as ADHD wasn't necessarily viewed as a medical issue, and bipolar disorder was rarely discussed at all.

Instead, I was given other explanations.

I was different. Creative. Eccentric. A little hyper. Someone who simply did things his own way.

And in many ways, those descriptions were true. They weren't wrong. The problem was that they never explained the whole picture.

School went reasonably well as long as I was interested in what I was doing. The moment that interest disappeared, so did my ability to concentrate. Memorisation and structured work rarely suited me, no matter how much time I invested.

There was another pattern as well.

My energy came in waves.

Periods of intense activity, endless ideas, and powerful momentum were followed by periods when everything slowed down. Not as dramatic shifts, but as subtle changes in tempo that were difficult to recognise while they were happening.

The same was true of projects.

I started many of them. Some were completed, some were abandoned, and others eventually led to consequences that only became obvious much later—financially, socially, or practically. At the time, however, they rarely felt like mistakes.

They felt like initiative.

And perhaps that is one of the central ideas in all of this.

The very same traits can be interpreted in completely different ways depending on the context. Creativity can be seen as a strength. Hyperactivity can look like enthusiasm. Instability can resemble flexibility. Restlessness can be mistaken for curiosity.

From the outside, it is entirely possible to see someone who appears to function well—perhaps a little unconventional, but well within the boundaries of what society considers manageable. It is only when those patterns are viewed over many years, and in relation to one another, that the picture begins to change.

For me, that understanding didn't arrive all at once. It emerged gradually. For a long time, the pieces existed without ever being assembled into a single explanation.

I never thought there was something hidden beneath the surface.

I simply believed I functioned a little differently from everyone else.

It wasn't until many years later, when life eventually came to an abrupt halt, that the individual pieces were finally brought together into something that had a name.

And when that finally happened, the most surprising part wasn't that I received the diagnoses.

The most surprising part was how long they had been there without being recognised for what they actually were—not as one dramatic event, but as an entire life that had, little by little, finally found its explanation.

When people hear the word bipolar, one image often comes to mind: mood swings. Up and down. Happy and sad. Stable and unstable.

But bipolar disorder is not, at its core, a description of mood. It is a description of energy, tempo, and the brain's ability to regulate those states over time. That is where many of the misunderstandings begin.

Clinically, bipolar disorder is generally divided into two main forms: Bipolar I and Bipolar II. Bipolar I is characterised by manic episodes—periods during which energy levels and activity become significantly elevated, often accompanied by a reduced need for sleep, accelerated thinking, and an increased tendency to initiate projects or make decisions that differ markedly from a person's usual judgement.

Bipolar II involves hypomania—a milder form of mania—combined with depressive episodes that are often more pronounced and longer lasting. Depression in bipolar disorder resembles depression in many other contexts: reduced energy, diminished motivation, disrupted sleep, and the feeling that life has somehow lost its direction.

But reducing bipolar disorder to nothing more than highs and lows is about as misleading as describing a landscape simply as beautiful or ugly. What is often lost in that simplification is everything that happens in between.

During manic or hypomanic periods, the defining feature is rarely happiness alone.

It is tempo.

Thoughts begin to move faster. Ideas arrive in rapid succession. Decisions are made sooner than they should be, and sleep gradually becomes less important.

From the outside, this may look like energy, creativity, or enthusiasm—and sometimes it genuinely is. Many people describe these periods as deeply productive or intensely meaningful. The difficulty lies in recognising the moment when healthy momentum quietly becomes something else, because what appears to be drive in one context can become overload in another.

Depression, too, is often misunderstood. It is not always dramatic or immediately visible. It can be quiet, persistent, and defined more by withdrawal than emotional collapse. Some people describe it as losing access to themselves.

There is another important point that often disappears from popular discussions.

Bipolar disorder is not a constant state.

It is a pattern that changes over time, and one that can look very different from one person to another—or even from one stage of life to the next. For some, the episodes are clear and distinct. For others, the transitions are far more gradual, almost like a subtle shift in the background that only becomes obvious in retrospect.

That is one reason diagnosis is often more complicated than many people realise. There is no simple laboratory test that can detect bipolar disorder. Diagnosis is based on patterns, descriptions, and changes observed over time. In other words, a person's story is often just as important as the symptoms visible in the present moment.

It is also here that the boundaries between bipolar disorder and other conditions become both interesting and complicated. Many of the characteristics associated with bipolar disorder can also appear elsewhere. High energy, restlessness, difficulty concentrating, and impulsivity can all be associated with ADHD as well, while low mood can arise in many different circumstances throughout life.

That does not mean the diagnoses are wrong.

It simply means they attempt to describe something that is inherently fluid.

And perhaps that is one of the most important things to understand.

Diagnoses are not exact descriptions of people. They are tools—tools that help us make complex patterns a little easier to understand and a little easier to navigate. They explain something, but they never explain everything.

That is why two people with the same diagnosis can live remarkably different lives, express themselves in very different ways, and face entirely different challenges. It is also why what appears, on the surface, to be nothing more than mood swings may in reality be something far more complex.

Not necessarily more dramatic.

But more structured.

And far more deeply woven into the fabric of everyday life.

There is a particular kind of mental state that is difficult to describe without making it sound appealing.

High energy. An endless stream of ideas. Very little sleep. A powerful sense that everything fits together.

On the surface, it can look like productivity. It can look like creativity. It can even look like one of the best periods of a person's life.

But what separates mania and hypomania from ordinary motivation is not necessarily what happens.

It is the way everything accelerates at once.

Thoughts begin to move faster than usual—not simply in the sense of having a lot on your mind, but in the sense that one thought replaces the next before the previous one has fully formed.

At the same time, a feeling of clarity begins to emerge. It can be difficult to distinguish from genuine insight. Connections seem obvious. Projects feel entirely within reach. Decisions no longer feel like decisions at all; they feel like the only logical next step.

Sleep is often the first thing to change. Not always dramatically, but gradually. One restless night becomes another. Eventually, the body seems to need less rest—or rest simply no longer feels necessary.

From the outside, this can look like abundant energy: someone who reaches out more often than usual, starts new projects, speaks more quickly, and seems unusually present and engaged.

But in many cases, it is also the beginning of a process that becomes increasingly difficult to slow down.

This is where the distinction between enthusiasm and overactivation starts to matter.

A period of healthy enthusiasm usually has its own natural rhythm. It builds. It peaks. It settles again.

Hypomania and mania are less predictable.

Rather than unfolding naturally, they tend to escalate.

Projects offer a good example.

It may begin with a single idea.

Then another appears.

Then another.

Not necessarily bad ideas—often quite the opposite.

The difficulty is that, taken together, they become impossible to pursue all at once. Planning becomes less important than action. And before long, action becomes less important than the next idea.

Sometimes this results in remarkable productivity. Things are written, built, designed, organised. A great deal genuinely gets done.

What is less visible is everything happening alongside it: financial decisions made too quickly, relationships placed under strain, and a gradual weakening of the ability to judge long-term consequences.

None of this necessarily feels dramatic in the moment.

Quite the opposite.

It often feels completely right.

Until, suddenly, it doesn't.

That is usually when the transition becomes impossible to ignore—when speed no longer feels like momentum but like something that has taken control; when lack of sleep no longer feels optional but unavoidable; when ideas stop being inspiring and begin to feel overwhelming.

At the same time, it is important to be precise. This is not a state that can simply be described as negative.

Many people also describe periods of mania or hypomania as deeply meaningful—times of extraordinary presence, intense creativity, and a powerful feeling of being close to something important.

It is precisely that ambiguity that makes these states so difficult to fit into simple categories.

This is not merely too much energy.

It is energy without stable regulation.

And when that regulation begins to fail, it becomes impossible to know how long the episode will last, where it will lead, or what it will leave behind.

What begins as clarity can end in chaos.

Not always.

But often enough to become part of the pattern.

Looking back, the signs are usually much easier to recognise than they ever were while it was happening.

At the time, it simply felt like a good period in life.

If Part 3 was about momentum, this chapter is about its absence.

Depression in bipolar disorder is often not a single emotion. It is a change in access—to energy, to initiative, and to meaning. It is not always a matter of something going wrong in the traditional sense. More often, it feels as though the entire system is gradually turning down the volume.

Things that once felt effortless begin to require real effort. Simple tasks become projects in themselves: getting out of bed, replying to a message, keeping a conversation going.

From the outside, none of this is necessarily visible. Many people living through depressive episodes continue to function on the surface. They go to work. They answer when they have to. They do what needs to be done.

What remains invisible is the cost.

The quiet weight that accompanies every movement.

There is another aspect of depression that is often misunderstood. It is not always stable. In bipolar disorder, depression can arrive in waves, interrupted by brief periods when life feels slightly lighter before the heaviness quietly returns. That makes it difficult to identify clear beginnings and endings. Looking back, it is often hard to say exactly when an episode began—or when it gradually became something different.

That creates its own kind of confusion. Not only about what you are feeling, but about how long you have been feeling that way.

Another change often takes place as well.

Your understanding of yourself begins to shift.

When energy and initiative disappear, it becomes easy to interpret that loss as something personal. Not simply that you are experiencing a condition, but that you have become a certain kind of person.

That is one reason depression can become so difficult to carry over time. It affects more than your day-to-day functioning. It also reshapes the story you tell yourself about who you are.

At the same time, it is important to remember that depression does not look the same for everyone. Some experience distinct episodes that come and go. Others live with a quieter, more persistent form that remains in the background for long periods. What these experiences share is not how they appear from the outside, but how they affect a person's ability to move through everyday life.

In this kind of state, life becomes less about making major decisions and more about making small adjustments: how to get through the day, how to stay connected to the world without becoming overwhelmed by it, and how to accept that things which once felt natural are no longer consistently available.

For many people, this is precisely what makes depression so difficult to explain.

It is not necessarily a dramatic event.

It is a reduction.

A gradual shrinking of everything that once felt accessible.

And because it rarely begins with one clearly defined moment, it can also be difficult for those around you to understand what is happening. That is where many misunderstandings begin—not because people do not care, but because what is happening cannot always be seen.

And what cannot be seen is often explained in other ways: as a lack of willpower, as laziness, or as something a person ought to be able to simply snap out of.

In reality, it is rarely about willpower.

It is about access.

And when that access changes, life itself begins to change with it.

When bipolar disorder and ADHD are discussed together, one of two things usually happens. Either they are treated as entirely separate conditions with no meaningful overlap, or they are merged into one broad explanation for restlessness, high energy, and difficulty concentrating.

Reality is more complicated than either of those views suggests.

ADHD is largely a condition of attention regulation, impulse control, and activity levels. It influences how the brain prioritises information and how easily it can engage with—or disengage from—a task. Bipolar disorder, by contrast, is primarily characterised by changes in mood and energy that unfold over time, in episodes that may last for days, weeks, or even months.

On paper, the distinction seems straightforward.

In practice, it is often far less clear.

Many of the characteristics commonly associated with ADHD—impulsivity, restlessness, difficulty concentrating, and hyperfocus—can also appear during different phases of bipolar disorder. At the same time, traits that are relatively stable in ADHD may fluctuate dramatically in bipolar disorder, changing from one episode to the next. That means the two conditions can sometimes look remarkably similar in everyday life, even when the underlying causes are quite different.

Hyperactivity offers one example. In ADHD, it may be a persistent characteristic—a steady current of energy that does not necessarily come and go. In bipolar disorder, increased energy is more often episodic, appearing in phases and usually accompanied by changes in sleep, mental tempo, and patterns of thought.

Concentration provides another example. Both conditions can make it difficult to focus on tasks that feel uninteresting. At the same time, both can involve periods of intense absorption, when everything else seems to disappear.

This creates a diagnostic landscape that is not always easy to navigate.

Symptoms do not always point to a single condition.

More often, they describe how something appears in practice rather than why it happens.

That is one reason it is not unusual for people to receive both diagnoses. It is also one reason why distinguishing between them can take years.

Looking back, the picture can seem neat enough on paper. Two diagnoses. Two sets of diagnostic criteria. Two explanatory models.

Real life is rarely that tidy.

It is less about fixed categories than about shifting patterns.

Some days, the challenge is getting started.

Other days, it is knowing when to stop.

Some periods are defined by restless energy without direction.

Others by intense direction without pause.

It is within that spectrum that many people struggle to find a single, satisfying explanation.

That does not mean the diagnoses are wrong.

It means they are attempts to describe a system that does not always behave consistently.

In practice, ADHD and bipolar disorder are therefore more than two separate explanations. They become two different lenses through which the same person may be understood—sometimes complementing one another, sometimes overlapping, and sometimes making the picture even more difficult to interpret.

That is precisely why the confusion arises so often.

Not because medicine lacks all the answers.

But because human beings rarely function along a single line.

A diagnosis is often understood as the moment when something comes to an end. An explanation has been found, a name has been given, and a direction has been established.

In reality, it is rarely that straightforward.

A diagnosis does not necessarily change what happens in your life. It changes how your life is understood.

When I was diagnosed with bipolar disorder and ADHD, my challenges did not suddenly disappear. For the most part, they remained exactly the same. What changed was the framework around them: the language, the explanations, and the ability to recognise patterns that had previously appeared to be nothing more than isolated events.

Treatment and ongoing care are largely about stabilising what is unstable and making life a little more predictable. For some people, that means medication. For others, it means structure, routines, and support from healthcare professionals. For many, it is a combination of all three.

There is, however, a common misunderstanding. People often imagine that treatment fixes the condition.

In reality, that is rarely the goal.

The goal is to reduce the fluctuations and make it possible to live a life that might otherwise become difficult to navigate.

Life after a diagnosis is therefore not necessarily a new version of life. More often, it is the same life viewed through a different map.

You begin looking back at experiences that once seemed unrelated and trying to understand them in the light of something new. Periods of unusually high energy take on a different meaning. Periods of exhaustion acquire a different explanation. Many people also begin asking themselves where personality ends and symptoms begin.

There are not always clear answers.

Another aspect that often follows a diagnosis is the way it changes your relationship with work and with other people. Some find that greater understanding and structure make everyday life easier. Others discover that their challenges become more visible once they finally have the language to describe them.

There can also be a delayed emotional response—a period of looking back over your life and trying to make sense of what actually happened. It is not unusual for that process to bring both relief and unease at the same time: relief because things finally begin to make sense, and unease because the past cannot be rewritten.

At the same time, it is important to remember that a diagnosis does not define an entire person. It may explain certain patterns, but it says very little about who someone truly is. There is still room for choice, for growth, and for change, even within circumstances that may be more demanding than those faced by other people.

It simply requires a different kind of awareness: a greater sensitivity to your own limits, a deeper understanding of your own patterns, and sometimes the acceptance that certain things need to be approached differently than they are for those around you.

There is no traditional ending to this story. No point at which the condition is simply finished. No final solution that makes everything permanently stable.

What exists instead is an ongoing process of adjustment—between biology, psychology, and the social world; between the individual and the environment; and between explanation and lived experience.

Perhaps that is the most important insight of all.

A diagnosis is not an answer in itself. It is a starting point for understanding a life that is already in progress—not an explanation that brings the story to an end, but one that allows you to read it again.