Seventeen years after her diagnosis, Mariah Carey bravely revealed her lifelong battle with bipolar II disorder in an exclusive interview with PEOPLE.
The superstar singer says she was “in denial” when she first received the diagnosis, back in 2001, but she now manages her bipolar II disorder with therapy and medication. Carey hopes that speaking out now will help eliminate the stigma around mental health issues.
“It does not have to define you and I refuse to allow it to define me or control me,” Carey says. “This is just one part that I felt it was time to be able to speak about.”
Here’s what you need to know about bipolar disorder.
Bipolar I vs. Bipolar II
Bipolar I is the most severe case of the disorder, and those afflicted have manic episodes that last for at least a week, Dr. Kevin Gilliland, clinical psychologist and executive director of Innovation360, tells PEOPLE.
“Manic episodes are extremely disruptive to people’s lives,” he explains. “When people have mania, their thoughts are often pressured, their speech is rapid, they may be more talkative. In the most severe cases, their need for sleep dramatically reduces, and they may go for a couple days or nights without much sleep at all, yet feel very rested with a lot of energy — and you shouldn’t feel that way.”
“It’s difficult to be around someone with mania,” he adds. “They’re extremely distractible, and they get hyper-focused on a goal or project that is typically very different from their usual life.”
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Bipolar I also comes with severe depression, a characteristic that bipolar II shares. The difference between the two, however, is that bipolar II sufferers have a lower level of mania, called hypomania.
“The hypomania leads to an unpredictable mood,” Gilliland, who does not treat Carey, says. “They rarely complain about it, because they can get more things done, and sometimes they report a higher level of creativity, but it’s a misassociation. Yes, you might have been a little bit more creative, but it’s because of your hypomania.”
Gilliland says that people with bipolar II often think that they’re only creative because of the hypomania, and fear that if they seek treatment they’ll lose their abilities. But in truth, the hypomania just brings out their creativity, which stands out in contrast to when they’re depressed.
“They get described as moody, or difficult people to work with, because those are the two poles of the mood — depression and manic,” he says.
How Bipolar Disorders Develop
Doctors don’t know for sure how bipolar disorders form, but it is most likely a combination of genetics and environment.
“There does seem to be a genetic vulnerability,” Gilliland says. “And with that genetic vulnerability, that is a piece of bipolar disorder. But our environment also plays a role in it.”
How to Treat Bipolar Disorders
The keys to bipolar disorder treatment are medication and therapy, but Gilliland adds that it is also vital to create regular, daily rhythms.
“Our daily rhythms can impact our mood in a positive way or a negative way,” he says. “What you find treatment-wise, is they need medication and therapy, and then awareness of the little things that move us as humans, like sleep and nutrition.”
He adds that it can be tough to find those rhythms as a performer.
“What I’ve seen with entertainers and some other jobs is that it’s a very disruptive schedule, so you end up changing your sleep schedule, which has a negative impact on mood,” Gilliland says.
And he emphasizes that people with bipolar disorder are at a higher risk of developing additional disorders.
“It’s not unusual for people with bipolar 2 to wrestle with alcoholism and eating disorders,” he says. “What you want to be mindful of is the importance of managing your daily life without substances like alcohol and drugs. It’s a balance. Our moods, for all of us, require some balance. But for the people who have a vulnerability, it’s more important to maintain those little things.”
It’s a Lifelong Disorder
Gilliland says that it’s possible to live a “really great” life, even if you suffer from bipolar disorder. It just takes some work.
“The mood is not something to overcome,” he says. “It’s something you learn to live with.”
For more on Mariah Carey and her battle with bipolar disorder, dealing with fame and raising twins, pick up the latest issue of PEOPLE, on newsstands Friday. For mental health help, find a support group in your area through Depression and Bipolar Support Alliance at dbsalliance.org.