Beyond the Diagnosis: What Living With Bipolar Disorder Taught Me About Occupational Therapy

In August 2002, at 27 years old, I was hospitalized with severe depression and diagnosed with bipolar disorder.

I felt hopeless, broken, and ashamed.

I felt hopeless because nothing I had tried could pull me out of the despair that led to the hospitalization. I felt broken because I had achieved a master’s degree, yet I felt like I had no idea how to live my life. And I felt ashamed because the stigma of being labeled with a serious mental illness came crashing down upon me.

This was the lowest point of my life, and one I will never forget.

Over the years, my experience of living with bipolar disorder has evolved through four distinct perspectives. Each one changed not only how I understood bipolar disorder, but how I understood myself. Along the way, I also discovered how occupational therapy provided the framework that helped me move from focusing solely on my diagnosis to building a meaningful personal and professional life.

Perspective 1: Coping With the Diagnosis

My first perspective was straightforward: I had been diagnosed with a serious mental illness, and I needed to control its symptoms. Treatment began with medication and talk therapy. I learned about bipolar disorder, worked to find the right combination of medications, and focused on reducing symptoms.

At that point, bipolar disorder was the central organizing principle of my life. I understood myself primarily through a diagnosis, and progress was measured by whether my symptoms were getting better or worse. 

Perspective 2: Managing My Condition While Building My Life

After several years and a few different jobs, I connected with a vocational program where we explored potential opportunities to work while accommodating the needs of my bipolar disorder.

I returned to school, initially studying to become an occupational therapy assistant. In occupational therapy, we help our patients as they try to return to or continue pursuing the everyday activities that give their lives structure, identity, and purpose.

This framework helped me look at bipolar disorder differently, and gave me a perspective that was both practical and transformative: a person is more than a diagnosis, and living with an illness doesn’t mean life has to revolve around that condition. Instead, we can develop techniques to successfully participate in the activities that give our lives meaning.

I began building routines that helped me get moving when depression drained my energy. I learned budgeting strategies to counter impulsive spending. I used scheduling and structure to improve follow-through when my thinking felt foggy. 

These were not abstract ideas—they were practical occupational therapy interventions that helped me translate my goals into daily action.

I began believing I could have a life of value and meaning. I didn’t have to define myself as a lifelong psychiatric patient. I could acknowledge that I was going to experience life differently at times, and develop strategies that allowed me to keep participating in what mattered.

My focus shifted from coping with the symptoms of my illness to managing the needs of a condition. It shifted from managing how I felt to managing what I was doing.

Perspective 3: Personal Growth and Self-Discovery

Eventually, my occupational therapy career brought me back to mental health and introduced me to the peer movement. Once again, my perspective changed.

Among people with similar lived experiences, the things that had made me feel different suddenly didn’t seem so unusual. My journey became less about my diagnosis and more about self-discovery.

I began to realize that many of the skills I had learned weren’t “mental illness skills.” They were life skills.

This realization also deepened my understanding of occupational therapy. The skills we develop to manage symptoms, establish routines, regulate emotions, or navigate physical challenges can support us across many areas of life. 

During depression, my self-talk can become very dark, making strategies for responding to those thoughts especially important. But I’ve needed those same strategies when experiencing anxiety before proposing to my wife, impostor syndrome as a new therapist, and self-doubt as a new supervisor.

The sources were different. The skills were remarkably similar.

I was no longer seeing myself as a sick person trying to become well. I was Steve getting to know Steve. I was honestly assessing my strengths and challenges while developing the skills and support structures I needed to experience success and satisfaction.

My focus shifted from managing the needs of a condition to a journey of personal growth and discovery. It shifted from what I was doing to what I was learning about myself.

Perspective 4: Finding Purpose in Pain

As I began sharing my story, I discovered that my experiences could also help other people. That realization brought me to my fourth perspective: finding purpose in the pain.

Today, I look for ways to combine my lived experience with bipolar disorder and my professional experience in occupational therapy to help demystify and destigmatize mental health. Rather than asking only, “How do I live with bipolar disorder?” I have begun asking, “How can I turn my painful experience into an asset? How can I use my lived experience to help someone?”

That perspective is both empowering and scary. I still experience negative self-talk. I still experience depressive and hypomanic symptoms. I still have times when I get caught in the web of self-stigma around having bipolar disorder. 

But now I have the skills and tools I developed throughout each stage of my journey. I also have a clearer understanding of how my experiences can inform, not define, my professional identity. Bipolar disorder is no longer the defining feature of my story. It is one part of my lived experience, one that has shaped how I understand resilience, participation, identity, and recovery.

Over time, my journey has moved from coping with symptoms of an illness to managing the needs of a condition, to a journey of personal growth and development, to finding purpose in pain.

I didn’t choose bipolar disorder, but I can choose how I live with it, what I learn from it, and how I use those experiences to connect with and help others.

For me, learning to live with bipolar disorder has become about more than living with or recovering from an illness. It is about learning skills, developing support systems, and discovering my strengths to address my challenges and be my best self.

A Call to Occupational Therapy Practitioners

As occupational therapy practitioners, we can help people shift from seeing themselves primarily as someone coping with an injury or illness to seeing themselves as people discovering who they are and building lives that matter to them.

Our profession gives us a powerful lens for doing this. While reducing symptoms is important, occupational therapy asks a different question: How can we help this person successfully participate in the activities, roles, and relationships that bring meaning and fulfillment to their life?

These are two very different perspectives. When our primary focus is symptom reduction, success is defined by the presence and severity of the symptoms of the illness, and the illness remains the focus. When our focus is participation and self-discovery, success becomes defined by what a person is able to do, experience, pursue, and become—even when symptoms are still present.

As occupational therapy practitioners, we can help people move beyond simply coping with an illness or injury. We can help them discover their strengths, develop the skills and support structures they need, and create lives in which they can experience success, satisfaction, meaning, and purpose.