Ask Julie Fast: Come on! Can you really tell you are manic by looking in your eyes?

A friend recently wrote me and asked if my mania in the eyes hypothesis was about the size of the pupil. Here is my reply.

Some background: If you are not familiar with my work, I wrote an article based off of personal and professional experience that hypothesizes we can see signs of mania in the eyes.In my opinion, this could revolutionize how we think about bipolar disorder. If mania is clearly seen in the eyes, it means this is a physical illness. If we can recognize mania in the eyes, it means we can override a manic brain that is telling us we are just fine. I’m currently part of a Southern Methodist University study to test my ideas. Here is link to the webpage if you would like to read more. My  Psychology Today blog: Three Clues to Recognize Bipolar Mania in the Eyes explains my ideas in full.

Julie, are you saying that we need to look for changes in the pupil to see if we are manic? 

MY ANSWER: I am not only talking about pupils here. Instead, I look at the entire eye including the skin around the eye in my hypothesis. The pupil is only one aspect.


Here are examples of what I am talking about.


I always notice a dullness- whether there is flash or not. Also, my lid cover the top of my iris.


Lots of wrings around the eye and pretty closed lids when I smile.


Dysphoric manic


I have a super piercing gaze. No wrinkles under eye. This is where people report the most change in the pupil.

Euphoric manic

When I have euphoric mania- my eyes leap off the photo. No matter if there is flash or not. The whites of my eyes are very white and the color of my eyes is more complicated. I have no wrinkles around the eye and my lid is higher on the iris.

Another common feature is a liquid that covers the eyes when I am manic. It shimmers. I think that one reason we meet sexual partners SO easily when manic is that our eyes light up a room!


The study is ongoing. Please post your pictures. You can help change our bipolar disorder world!

Get it Done When You’re Depressed


How time flies. I had my first bipolar disorder depression downswing at age 19. I had no idea what was happening. I was also psychotic, so you can imagine how few tools I had to take care of myself.  I was finally diagnosed with bipolar disorder at age 31, but no one taught me how to manage this illness outside of medications. For many of us, medications are not enough and the depression remains. I was very, very sick for a long time. I spent days and often weeks in bed, unable to get on with my life.  

This is one of the few pictures I have of myself during my most depressed years. I was 31.  I had my diagnosis and a big ole bag of pills, but I wasn’t getting better. One day, I was standing on a street corner in Seattle and I couldn’t decide what direction to walk. I thought to myself, “This is my life! This is what I’ve come to! I can’t even decide what direction I should take literally?”  And in that moment, my life changed. I realized that depression was never going to let me do anything. If I listened to depression, I would be stuck for the rest of my life. On that day, I decided I would get things done even if I were still depressed. I was waiting for the depression to end before moving on in life. The depression didn’t end and I was stuck, so I changed my plan.

For the next ten years, I taught myself to work, have a relationship and get on with life even though I was often severely depressed. I created strategies, such as never getting in bed unless it was for sleep or the other great thing we do in beds, and made sure I was up and putting on my shoes even if putting on my shoes was all I could do.



I still live with depression and I still use the same strategies I created all of those years ago to get things done when I was depressed.  I love my book Get it Done When You’re Depressed. I used the just last week when a vicious mood swing hit me after a business deal went south.  I hope you can use them as well.  I still believe I can end my depression, but until that happens, I am going to get things done! I want the same for you!


Ask Julie Fast: Will I ever stop being scared of my psychosis delusions and voices?


ANSWER:  Yes, can learn to understand and respect your hallucinations and delusions. For example, I used to get VERY scared that I had a demon following me to harm me. Eventually I saw this psychotic experience for what it was- an anxiety response to a trigger. I still see myself get killed when I have anxious psychosis, but I just watch now. I am no longer scared. I used to see a lot of dead bodies – such as seeing a bag of leaves and just KNOWING there is a dead body in the bag. Now, I have the idea there is a dead body and I say, “Well, I’ve been triggered. I’m psychotic and have to make some changes.”

PARANOIA….The unfounded fear and worry that someone or something is behaving towards you in a harmful way.

My paranoia is still a problem. I think others are out to harm me or steal my ideas. One problem is that I do get a lot of my ideas taken without credit, so this can get complicated. Psychosis is a SYMPTOM. I find it fascinating. My Health Cards changed how I manage this illness. Now, I have ALL of my psychotic symptoms listed and they are familiar. It’s never pleasant, but I have learned to live with my psychosis. I also NEVER go near high THC pot. That made me so psychotic I almost had to go to the hospital!

Also, we can’t talk about psychosis in bipolar disorder without mentioning schizoaffective disorder. If you, like MYSELF have psychosis that is separate from your mania and depression the correct diagnosis is schizoaffective disorder. Here is an article on the topic that can help you decide if you have regular ole bipolar or if you actually have schizo (psychosis) affective (mood) disorder. 


Ask Julie Fast: Why do many with bipolar disorder NOT try to help themselves?


Julie,  I see so many posts of where they self sabotage themselves and sabotage their family.


MY ANSWER:  Helplessness and lack of insight are natural symptoms of the illness. Self help is a luxury of the stable people of the world. Many of us with bipolar experience such intense mood swings, we are simply gasping for air and trying to survive. Even when we DO get a diagnosis, the treatment required for us to stay stable feels monumental and insurmountable when we are sick.

For example, we KNOW that depression responds very, very well to taking action such as going on a walk, going to a good health care professional, taking meds or being around people. I have it written down in a book that people can read and use for less than the cost of a meal. People on the outside looking in often think, “There is help out there dude! Read Julie’s book! What is wrong with you!”

But this is not how it works. People with bipolar are often caught in a selfish trap that comes from being sick. The illness tells us we don’t need help when we are manic and then when we are depressed, we often isolate and refuse help. NONE of it makes sense. It catches me out regularly. I wrote the darn book and on some days it’s hard for me to remember what to do.

 This is why I stress having a management plan in place for when we get sick. I work on my bipolar intensively when I am WELL. Most wait until a crisis hits. This is normal human behavior.

I see this a lot online. People will post about how sick they are and how they need help and yet there is NO sign they are actually doing something about it. Of course this is frustrating. Many who are talking more than doing when it comes to mental health often have more than bipolar disorder to deal with. When you see someone falling apart regularly online or see someone who is self sabotaging, lashing out at others, complaining, acting paranoid or simply being mean, there is usually something more than bipolar involved such as another illness, substance abuse or an external trigger.

Please know that bipolar disorder is episodic. If you see someone having regular posts that are kind and informative and suddenly there is a flurry of out of character posts where the person is ranting and raving and then… the posts are suddenly gone and the person says he went to the hospital.  That is a typical bipolar pattern. If you see someone complain consistently- or throw their loved ones under the bus consistently- and the posts stay up and the person is consistent over time with this complaining and lack of self awareness, this is usually not bipolar disorder.

I like the book High Tide Low Tide: A Caring Friend’s Guide to Bipolar Disorder for friends and siblings who want to better understand the illness and why it is hard for some of us to ask for help.

My book Loving Someone with Bipolar Disorder is for partners who want to better understand why someone would self sabotage and not get help when help is so readily available.

Take Charge of Bipolar Disorder explains bipolar in general and has a chapter on how to get help for a loved one.

For those who want to understand more of the brain workings behind bipolar, I love the book The Complete Idiot’s Guide to Bipolar Disorder by Dr. Jay Carter.


Can We Diagnose Bipolar Disorder Using Eye Images?

This is the question a new study from Souther Methodist University poses based off of my work on recognizing signs of mania in the eyes.  Please visit the website and read more about this potently life changing study. What if we could see that we are manic through a physical sign even when our brain is telling us we are just fine? Think of the possibilities.

Click here to read more about the SMU Mania in the Eyes Research Study.

If you love my work, I would love your support of this project. Even one picture helps!




Positive News for People with Bipolar Disorder


Oh my goodness!  Our blogs and writings can be so depressing sometimes. It’s easy to write about what is wrong with bipolar disorder and lose focus on the many things that people are doing to positively change their lives for the better!

It’s natural that we want to know our symptoms and what we need to do in order to stay stable, but we also need to focus on what is going well in our lives in order to stay happy!

I love making jewelry. Others are artists, karaoke singers, love working on old cars and are sports fanatics. It’s important that I remember that even though I deal with bipolar disorder daily, it is not the majority of my life. I have a great life outside of this illness and the more stable I become, the more I get to lead that great life!

What do you like to do that creates something wonderful? Can you do it even when you are not feeling well?

I believe in you!



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