Mariah Carey just joined the growing list of celebrities opening up about their mental health: The the 48-year-old pop icon told People she was diagnosed with bipolar II disorder back in 2001.
"I didn’t want to believe it," Mariah said of her initial diagnosis, for which she didn't immediately seek treatment. "Until recently I lived in denial and isolation and in constant fear someone would expose me."
WHAT IS BIPOLAR II DISORDER?
There are actually four types of bipolar disorder—but in general, the condition is characterised by intense shifts in mood, energy, and the inability to carry out daily tasks, according to the National Institute of Mental Health (NIMH).
Bipolar I disorder is known for its manic periods that typically last for about a week, and may require hospitalisation due to their severity. "In manic episodes, people may change their appearance and be more sexually suggestive, they may quite a successful career to start a new career in a field they are not qualified in or spend a significant amount of money they don’t have," says Kevin Gilliland, clinical psychologist, author of Struggle Well, Live Well, and executive director of Innovation 360. "They often have very limited insight and judgment into how they are acting and being perceived by others." This mania is followed by bouts of severe depression, Gilliland says.
Mariah has bipolar II disorder, characterised by hypomania, which is a much less severe. "People with hypomania rarely require hospitalisation," says Gilliland. However, the depressive episodes in both bipolar I and bipolar II disorder can look the same, he says.
Mariah told People she initially thought she suffered from a sleep disorder:
"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 characterised 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."
The third type of bipolar disorder is known as cyclothymic disorder (defined as numerous periods of hypomania and depressive periods lasting for at least two years, but not meeting standard diagnostic requirements).
The fourth type: specified and unspecified bipolar and related disorders—or bipolar symptoms that don't match any other categories.
HOW COMMON IS BIPOLAR DISORDER?
The NIMH estimates that roughly 4.4 percent of U.S. adults will have bipolar disorder at some point in their lives. (Demi Lovato has also been vocal about life with bipolar disorder.)
But as Women's Health has previously reported, bipolar disorder is often misdiagnosed because people don't tend to seek treatment during the manic highs; instead, they see a therapist during the low points, making it easy to accidentally diagnose the disorder as depression.
According to People, Mariah only started a therapy and medication course "recently" (she did not specify exactly when), despite being diagnosed in 2001.
"I’m actually taking medication that seems to be pretty good," she told People. "It’s not making me feel too tired or sluggish or anything like that. Finding the proper balance is what is most important."
Although the past few years have been "the hardest couple of years I’ve been through," Mariah said she's faring much better with treatment.
"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."
This article originally appeared on Women's Health US