Everybody around Lauren Thompson understood that she was different when she was just a toddler, and would erupt into tantrums at the slightest provocation. First she’d bang her head against the wall, then weep inconsolably for several minutes, and end the cycle with uncontrollable giggling. Her mother Gen was at a loss. “She’d be crying, crying, crying, and then stop abruptly and burst out laughing.” Gen never understood what triggered her little daughter, and never knew how to help stop it once it started.

Lauren’s first years at school were no easier. When she started kindergarten, she felt so afraid to separate from Gen that she’d cling to her legs in the doorway, sobbing. The morning routine was so disruptive for other students, the teachers asked Gen to volunteer in Lauren’s classroom. (She did.)  As Lauren, now 21, progressed through early grades, teachers reported that she often zoned out in class, daydreaming or drawing while she should have been paying attention. She was also painfully timid, so afraid to speak that she often only wrote notes to ask questions, or to be excused for the washroom. By grade three, her anxiety about school became so extreme she often stayed home with stomachaches and migraines. “Just the thought of the classroom freaked me out,” she says. Ordinary play was scarcely easier. If her Barbie dolls’ clothes didn’t slip on just right, or if she couldn’t locate one of their tiny shoes, she’d pop their heads off in frustration. 

She recognized that her reactions were extreme, and often hid her outbursts from her mother. “I thought she’d think I was crazy,” she says.

She collected items that made her feel secure, regardless of their seeming importance: gum wrappers, used packaging, shoe boxes, broken headphones. She counted steps, and made sure the decibel on her iPod was set at an even number. She never, ever stepped on cracks, fearing disasters beyond even breaking her mother’s back.

The one thing that helped calm her down was art. She drew, painted and took stunning photographs of buildings and nature scenes around Toronto.

But her anxiety persisted into her teen year. She experienced panic attacks so severe she couldn’t go to school or the mall. Lauren also lost her appetite, and pounds melted off her slender frame. She’d stay up at night for hours making dark, aggressive artwork and listening to grunge alternative rock music. One time, she painted a woman who had thorns poking out of her eyes and mouth.

Those years had other stressors. Lauren’s father Daniel suffered from anxiety and depression, conditions he medicated with copious amounts of alcohol. In 2008, he went to rehab. Then Lauren’s brother James was diagnosed with bipolar II, a form of bipolar illness that is often marked by profound depression. For the better part of a year, doctors attempted to find a cocktail of medications that could alleviate his suicidal despair and bring him some measure of stability. Gen, struggling to keep the family together, began suffering from severe anxiety herself. She sought help from a social worker and her doctor and began taking medication in order to function.

By the summer of 2011, Lauren’s panic attacks had grown so severe, sometimes she couldn’t even leave the house. Gen knew she had to do something, so took Lauren to James’ psychiatrist, who prescribed Sertraline for what she tentatively diagnosed as an anxious depression. But the doctor – and Gen – suspected that she might have bipolar disorder, too. If she did – and the chances weren’t small – the Sertraline might trigger a mania, the doctor warned.   

Researchers aren’t sure what causes bipolar disorder, but know it has several key contributing factors. Genes, as in the Thompson family, are likely to play a role. In addition to James’ bipolar diagnosis and Daniel’s depression and anxiety, Gen’s sister has lived for years with schizophrenia. And Lauren’s paternal grandmother was diagnosed with bipolar disorder late in life.  

A few days after Lauren began taking Sertraline, her depression lifted. But her behaviour became erratic. Just weeks before, she’d been too afraid to go to school. Suddenly, she was telling offensive jokes, and filming her imitations of Jim Carrey’s most outrageous antics, which she posted on YouTube. Thoughts seemed to course through her brain more swiftly than ever. Colours appeared brighter, and the flavours in even ordinary food – the salt on a steak, or the sweetness of Cherry Coke -- seemed extraordinary.

She and Gen returned to the doctor, who diagnosed Lauren with bipolar disorder. She prescribed Quetiapine, a mood stabilizer, in addition to the Sertraline. “I wasn’t that surprised,” says Lauren.  “I was glad to have a name for it.”

But over the next many months, she struggled to find stability, even under the care of a psychiatrist at Sunnybrook Department of Psychiatry’s Centre for Youth Bipolar Disorder. She began dressing provocatively, and dated different guys in quick succession. Her panic returned, and she began hanging out with friends who drank heavily. She even told her mother she planned to marry her 17-year-old boyfriend, and one night broke out of the house through the basement window. There was other strange conduct, too: Lauren would stay up all hours doing abstract artwork, then crumple into bed, exhausted, believing she’d created masterpieces. But in the morning, she’d wake to wonder what she’d been thinking.

She thought she needed shoes in every colour. She became obsessed with germs, washing her hands multiple times a day. And during a family vacation to Florida, Lauren, whose life until then had been shaped by her social anxiety, declared that strangers on the street recognized her as a famous person. “Can’t you see that everyone is staring at me?” she asked her incredulous mother.

Together the two would travel to the Centre for Youth Bipolar Disorder, where Gen would also see her daughter’s psychiatrist. Mother and daughter would fill out questionnaires about Lauren’s behaviours in order to help tweak her treatments. By 2013, her doctor had added an anticonvulsant, Lamotrigine, which also helps prevent the mood swings of bipolar disorder. Finally, she was becoming stable. Her doctor also diagnosed her with ADHD (for which she takes Concerta, a psychostimulant). She has also been diagnosed with OCD, which she approaches with cognitive behavioural techniques designed to help her cope with her uncomfortable thoughts about germs without responding with compulsive handwashing.  

After she was first diagnosed with bipolar disorder, Lauren became fearful when she would feel panic coming on during stressful occasions: crowded subways, or social events with strangers. Her stomach would churn, her breath would grow short, and her mind would leap immediately to catastrophic thoughts about another dark depression. But three years on, she is able to remind herself that her feelings are temporary, that she has a trusted doctor to turn to, and a broad support system of friends and family.

And she is flourishing. Lauren recently graduated from college with a degree in early childhood education, and works at a day care center as an educator. She lives at home in North York with James and her parents, and her purple room is decorated with a bright array of her photographs, portraits and paintings. A large easel stands squarely in the room’s center, upon which rests a striking image of a lighthouse on Georgian Bay, painted in vivid blues, reds, and oranges. Her brown eyes glow with excitement as she points out her brush strokes.

She is engaged to be married to Jesse, her boyfriend of two years, and whom she told about the disorder when they’d been dating only one month.

 “I didn’t want to hide it,” she says. “I’m not ashamed of it – it’s who I am.” 

She also wanted him to be aware of the illness’s power to cause changes in sleeping patterns, energy levels, cognition, and temperament, and to help take note when she became overly irritable or anxious.

On a foggy evening in January 2017, Lauren, Gen and James gathered at their dining room table to discuss the impact of the illness on their family. Gen is highly attuned to the disorder as the mother of two young adults who have it. She gives community talks about the disease, and is not shy about discussing the illness with parents and teachers at the school where she works. She subscribes to a magazine about bipolar disorder, and is abreast on the latest research for treatments. And James, to whom Lauren is very close, offers the support that is borne of experience. “I’m not alone in this, and he shares with me his strategies for dealing with what he has gone through,” she says. James, 24, who has a degree in psychology and works at a group home for people with autism, nods. “When she gets depressed, I remind her that it’s where she is at that moment, and that it’s not a death sentence,” he says.

Lauren is grateful for her family’s early intervention. “No one was in denial about what was happening to me,” she says. She hopes her outspokenness about the illness can help others. “I want people to recognize the signs and symptoms and to get diagnosed early. Nobody should have to suffer.” Indeed, the earlier the symptoms are diagnosed, the more likely a person will remain stable, staving off periods of mania that can result in risk-taking behaviors, or the depressions so severe the person thinks about, or attempts, suicide. Those with bipolar disorder are at increased risk of suicide, but should know that there are many supports available to help. The longer a person with bipolar illness suffers from unmedicated bouts of mania or depression, the more likely it is for subsequent episodes to become more intense.

She has a new group of friends she has cultivated since she was first diagnosed, and she is upfront with them about having bipolar disorder, too. 

When people think of someone with the disorder, Lauren says, they expect someone who has moods that can switch at any moment. “And that’s just not how it is,” she says. “It doesn’t happen like that, at least for me.”

Some are shocked when they sleep over and see amber bottles of pills. (She takes four medications.) "I’m really upfront about it and say ‘I have bipolar disorder and here’s the deal. I need these meds to stay stable.’”

Lauren has also participated enthusiastically in research. Scientists are trying to learn more about the illness by studying the brain functioning of those who have it, and so far Lauren has enrolled in a handful of studies. (The results have not yet been published.)  In one study that measured the effects of exercise on the brains of people with bipolar disorder, Lauren got an MRI before and after pedaling vigorously on a stationary bicycle. Another measured the blood vessels in her eye in an attempt to determine why those with bipolar disorder are at increased risk for cardiovascular disease. Adolescents, who are at comparatively early stages of the illness, may provide clues to the link. And in yet another, researchers took blood samples every four months to look for biomarkers that may track the predictability of a mood shift. 

“We all do what we can, right?” she asks. She points to the singer Demi Lovato’s recent disclosure that she has bipolar disorder as a positive sign, and hopes that her own will have a similar effect on others. “She opened up a lot of youth’s minds about the concept of it, and had a lot of people who were able to get help after her.” Now, a person once so frightened of interacting with others that she couldn’t leave her house is speaking publicly about her condition. “The reason I’m doing it is so people can see, ‘Look, she’s functional, she has a normal life and is like everybody else because she takes her medication.’” She shrugs. “I take the stigma away by talking about it myself.”