In a cover story for the new issue of PEOPLE magazine, Mariah Carey reveals that she has been battling with bipolar II disorder for years. She was initially diagnosed with it in 2001, around the time of her very public breakdown. During that time, the singer was hospitalized for “extreme exhaustion” after the infamous visit to TRL where she delivered ice cream and performed a tame striptease. Years after that experience, Carey blamed it on not “having the right support system around me at the time.”
Following her diagnosis, Carey didn’t want to believe she was bipolar, so she tried to ignore it for years. That is until she found herself going through “the hardest couple of years I’ve been through.” That includes being publicly criticized for performances, career struggles, a very public engagement and then split from billionaire James Packer and a reality show that was canceled by E!.
“Until recently I lived in denial and isolation and in constant fear someone would expose me,” Carey said. “It was too heavy a burden to carry and I simply couldn’t do that anymore. I sought and received treatment, I put positive people around me and I got back to doing what I love — writing songs and making music.”
In terms of treatment, Carey’s diagnosis was bipolar II disorder, so she’s been in therapy and taking medication that as she says, helps her find “proper balance.”
“I’m actually taking medication that seems to be pretty good,” she said. “It’s not making me feel too tired or sluggish or anything like that. Finding the proper balance is what is most important.”
So what exactly is bipolar II disorder and how does it compare to the usual bipolar I? Here are five facts to know:
- Bipolar I is actually the more severe form due to the manic episodes. While it is characterized by episodes and symptoms that can last for days, and in some cases, weeks, for bipolar II disorder the episodes aren’t as lengthy. Still, an individual finds themselves balancing similar depressive episodes as well as hypomania over time. In the latter state, they may not sleep, are irritable and experience hyperactivity.
- Those with bipolar II are more likely to suffer more often from episodes of depression as opposed to hypomania. In fact, in some cases, individuals have dealt with at least one hypomaniac episode in comparison to a number of depressive episodes.
- Episodes of hypomania in bipolar II do not reach the full level of mania associated with bipolar I, or to put it simpler, the episodes are not associated with psychosis. Manic episodes are characterized by an extremely high mood that is followed by risky behaviors, including increased sexual behavior, spending sprees, gambling, substance abuse, driving very fast, etc. Because the highs of bipolar II are less intense and involve more perceived energy than usual, they are classified as “hypo,” which in full means “less than mania” or “under mania.”
- Still, both cases of bipolar disorder come with great struggles, so just because bipolar II isn’t associated with psychosis doesn’t mean it is a “mild” form of anything. In fact, it’s been found that bipolar II has been associated with an increased risk of suicidal thoughts and behavior when compared to bipolar I and clinical depression.
- Bipolar II can be very hard to diagnose. In fact, a great deal of patients with bipolar disorder are initially diagnosed as having clinical depression. And because the episodes of hypomania are not as lengthy or associated with psychosis, they can incorrectly just be attributed to one’s personality.
For Carey, she was lucky to be able to have identified what was going on with her, as well as the ability to do something about it.
“For a long time I thought I had a severe sleep disorder,” she said. “But it wasn’t normal insomnia and I wasn’t lying awake counting sheep. I was working and working and working … I was irritable and in constant fear of letting people down. It turns out that I was experiencing a form of mania. Eventually I would just hit a wall. I guess my depressive episodes were characterized by having very low energy. I would feel so lonely and sad — even guilty that I wasn’t doing what I needed to be doing for my career.”
Now working on a new album that she hopes to release this year and feeling good, Carey is sharing her story in the hopes of helping others going through the same mental health struggles.
“I’m just in a really good place right now, where I’m comfortable discussing my struggles with bipolar II disorder,” she said. “I’m hopeful we can get to a place where the stigma is lifted from people going through anything alone. It can be incredibly isolating. It does not have to define you and I refuse to allow it to define me or control me.”
You can check out PEOPLE’s full story on Carey’s journey with bipolar II in the new issue of the magazine, which hits newsstands on Friday: