I'm a Black bipolar woman. The way we talk about celebrities like Kanye West shows how much we still need to fight stigma around severe mental illnesses.

• Nylah Burton is a Denver-based writer with bylines in New York Magazine, ESSENCE, and British Vogue.
• Burton writes that rapper Kanye West, who was diagnosed with bipolar disorder at age 39, has recently attracted both intense attention and criticism for his behavior.
• The movement to destigmatize mental health should, in theory, encompass all mental health conditions, but those like West's are still widely misunderstood.
• "Black people like myself and Kanye are rarely given the opportunity to have their mental illnesses viewed with compassion and understanding," she writes.
• Burton says that true destigmatization would mean recognizing more severe illnesses, and how they can sometimes manifest in hurting those around you.

In recent years, iconic rapper Kanye West, who was diagnosed with bipolar disorder at the age of 39, has attracted a lot of attention and fierce criticism for his erratic behavior — particularly his abrupt shift towards conservative politics, including embracing Donald Trump (although he no longer supports the current occupant of the White House).

Some of West's offensive statements — like "slavery was a choice" — were made during what appeared to be severe manic episodes. However, criticism of Kanye has often been fierce and unforgiving, claiming that he is nothing more than a bigot or that his manic episodes are mere marketing ploys.

Kanye's statements and behavior has unquestionably been offensive and hurtful — but cleaving Kanye's behavior from the reality of his condition perpetuates rampant ableism against people with severe mental illness.

As a bipolar woman, this ableism is something I see clearly.

It's distressing to witness, especially in a social environment that claims to be so invested in destigmatizing mental illness.

In theory, combating the stigma against mental illness is supposed to include all mental health conditions.

But in practice, destigmatizing has often focused on more moderate illnesses — and more severe ones like bipolar are still widely misunderstood and mocked.

Destigmatizing mental health too often intersects with the self-care industry, which has become one of the main ways that people seek to destigmatize mental health. Self-care culture usually gets watered down to material things like face masks or bath bombs. Sometimes these are genuinely healthy and helpful practices, like journaling or art or hanging out with friends.

However, as self-care takes up more of the discourse around mental health, people like me are pushed further and further to the margins. Because what we experience definitely can't be cured by a luxurious bath or taking a week off work.

Put simply: It's far easier to accept that people cry at work than it is to accept that sometimes people have hallucinations at work.

This isn't just a quippy line — it's something that actually happened to me during my internship freshman year of college. But I had no roadmap, no way of knowing how to address what was happening to me. People around me discussed depression and anxiety, but no one told me what to do if I started hearing voices.

While experts have stressed the importance of educating the public comprehensively about mental health, most people's knowledge and care remains limited to fairly mild depression, anxiety, and burnout. That's partly why it's so difficult for people to understand what's going on with Kanye West; they simply don't know enough about bipolar disorder or any other severe mental health condition.

While mild to moderate depression and anxiety are painful, severe mental illnesses often cause hallucinations, mania, suicide attempts, delusions, incoherent and rapid speech, and other behaviors that people don't just see as socially unacceptable, but as sometimes dangerous — or even immoral.

When people are introduced to those behaviors, it's usually through mocking or reveling in a celebrity's strange behavior — like Kanye's current struggle, Britney Spears' experience with bipolar, or the continued idolization of deceased bipolar artists like Jimi Hendrix and Sylvia Plath.

And with conditions like schizophrenia or dissociative identity disorder (DID), movies — think Norman Bates from "Psycho" — and discrimination against those experiencing homelessness or addiction teach people to be fearful or disgusted.

Mild depression and anxiety are much less stigmatized than they were before. People talk openly about having bad days or feeling stressed out by tumultuous life events, like losing their job, breakups, and uncertainty about the future. But these are things many people experience.

The symptoms of mild depression and anxiety — which are much different than chronic and severe depression and anxiety — are more socially acceptable than the symptoms of bipolar disorder, major depression, borderline personality disorder, schizophrenia, obsessive compulsive disorder (OCD), and dissociative identity disorder.

For instance, obsessive compulsive disorder can cause things distressing and unwanted thoughts about hurting other people, and dissociative identity disorder is the presence of multiple personality states within one person. These are conditions that people have been taught to fear, erase, and ignore.

This is especially true for Black people like myself and Kanye, who are rarely given the opportunity to have their mental illnesses viewed with compassion and understanding.

In an October 2019 essay I wrote for Zora Magazine, I explored how a white woman with bipolar disorder was depicted on the Amazon series "Modern Love," compared to how Black women with severe mental illness are usually depicted. I wrote, "Black mentally ill women like me are often shown in human cages, in deep poverty, discarded by society. They're not shown as highly intelligent and beautifully manic, as Anne Hathaway's character is depicted. They don't get to dance through grocery store aisles in high fashion, catching the eye of successful Black men who want to marry them because of their joie de vivre. They're not called Rita Hayworths, they're called crackheads."

Not only does race and gender play a role in this stigma, but the type of diagnosis can also be a huge barrier. For some Cluster B illnesses, like narcissistic personality disorder and antisocial personality, symptoms can include manipulation, trouble discerning from right and wrong, or problems feeling empathy, the stigma is so great that many — including other severely mentally ill people — may not include them in our mental health advocacy.

One often overlooked example of this exclusion is the insistence that mental illness doesn't make people exhibit abusive behaviors or say bigoted things, something that was stressed continually on social media after Kanye West's offensive comments.

It's a well-intentioned and mostly true argument, the core of which demands that people understand severe mental illness doesn't make you a bad person. And that's true and incredibly important, given how demonized, criminalized, and pathologized we are in this society.

But true destigmatization of mental illness would mean holding space for the fact that sometimes, mentally ill people can harm those around them as a symptom of their illness.

For instance, if your illness makes it difficult for you to discern right from wrong, you may end up exhibiting behaviors or echoing statements that are hurtful and even rooted in bigotry. But this doesn't necessarily make you a bad person, and it absolutely doesn't mean you don't have a path towards healing and accountability. Even with these behaviors, your illness does not have to define you.

As a bipolar woman, it's also my responsibility to continuously challenge my own internalized ableism when it comes to these conditions. And it's hard, because I've been hurt and traumatized by people who have symptoms like manipulation, abuse, and violating the rights and privacy of others.

But I have to continue to do the work.

Because all severely mentally ill people need to know that they are not broken things, that they can seek treatment to put them on a healthier path, that they can have more loving and respectful relationships, and that they are worthy of care. How can we show them that if we insist on excluding and erasing them, or flattening their realities because they are complicated and hurtful?

The destigmatization of mental health is crucial, but not if it leaves out the people who suffer most from mental illnesses. It's important to keep in mind — especially when consistently engaging in criticism of public figures like Kanye and Britney Spears, for whom fame seems to be a huge stressor and trigger — that these conditions can be fatal.

For instance, up to 20% of people with bipolar disorder (mostly untreated) end their lives by suicide and 20-60% attempt suicide at least once in their lifetimes. Many of these disorders also have comorbidity — multiple diagnoses — with other conditions like substance misuse or cardiovascular disease. In fact, bipolar people have a shortened life expectancy of 10-25 years, mostly due to cardiovascular disease.

We've made great strides in addressing the stigma against mental illness in our society, but we have so far to go. Until we're able to truly understand and have empathy for people with severe mental illness, we can't stop fighting for freedom and compassion.

Nylah Burton is a Denver-based writer with bylines in New York Magazine, ESSENCE, and British Vogue.