Gabe Howard on What Mental Illness Really Feels Like and Why You Can't Beat Bipolar Disorder
Gabe Howard thought about suicide every day for years. He didn't tell anyone. He didn't reach out for help. He didn't even recognize it as a problem — because as far as he knew, that was just how everyone's mind worked.
"I truly believed this was just part of the human condition," Howard says. "Nobody said this to me. Nobody taught me this. This is an example of something horribly going wrong internally that nobody had the wherewithal to correct, because I never articulated it."
Howard, a sought-after mental health speaker, author of Mental Illness Is an Asshole and Other Observations, and host of the Webby Award-winning Inside Bipolar podcast, joined Emily LoMenzo Washcovick on Success, Rewritten for one of the show's most candid conversations to date. They both live with bipolar disorder, and each have very different experiences with it — which made for a in interesting conversation that was honest and full of mental health language examples.
Born With It, But Never Told
Howard grew up in the 1980s and 90s, in a blue-collar household where men were expected to be stoic and emotionless. Mental health education, already limited now, was virtually nonexistent then. So when Howard's mind moved in ways that would later be recognized as symptoms of bipolar disorder, he had no framework for understanding what was happening.
"I was born this way, so I didn't realize there was a problem," he says. "This is how my mind always worked."
The suicidal ideation that began as far back as he can remember was never something he named or questioned. It was simply there — a presence he accepted as normal, cycling with his moods, quieter on good days and louder on bad ones.
Everything changed when he was admitted to a psychiatric hospital.
"I woke up one day in a psychiatric ward where I was diagnosed with bipolar disorder. I was put on my first psychiatric medications, released to a step-down program, got hooked up with therapies. And I like to say that began my four-year epic battle against bipolar disorder."
What Bipolar Disorder Actually Feels Like
Howard describes bipolar disorder not as a binary of highs and lows, but as a full spectrum — and the middle, the stable zone, is just as much a part of it as the extremes.
"Everybody conceptualizes bipolar disorder as highs and lows. You've got your mania, and you've got your depression. People for some reason think that you're one of those. No — those are just the two extremes. You can be everything in between."
The mania, for Howard, came with grandiosity — an "I'm God" feeling where everything seems consequence-free. It also came with hypersexuality, anxiety, and at times, psychosis. He describes believing there were demons under his bed and interacting with the people around him, not visible or audible, but present in a way that felt completely real.
The depression was something else entirely. Howard has a specific problem with the common description of depression as "walking through sludge."
"But you're walking," he says. "Like, where'd you get the energy for that?"
For him, depression isn't heavy movement. It's nothing. You don't have the energy to move. You can't form thoughts. You don't care what happens to you. He uses the example of a tennis ball being thrown at you out of nowhere — the body's instinct is to move, instantly and without thinking. Depression, he says, overrules even that. "Depression is like, 'Whatever.'"
The "sludge" description isn't wrong, he's careful to clarify. It may be accurate for the person using it. But its incompleteness creates a specific danger: it suggests effort, and effort suggests choice, and suddenly the message people receive is that depressed people are just lazy and need to try harder.
The Truth About Suicidal Ideation Most People Get Wrong
The part of Howard's story that tends to land hardest is his description of what chronic suicidal ideation actually feels like from the inside — because it doesn't match what most people imagine.
"People think suicidality is just, 'Oh, I wanna die, I wanna die, I wanna die.' But it's not. That is the most serious part of it, where intervention needs to happen very quickly. But there are so many other things surrounding it that don't get enough attention."
On his worst days, the thoughts were active — planning, considering, a mind occupied by the details of ending things. On his better days, the thought was quieter: "Today is not the day that I'm gonna do it."
"I'm gonna give myself a break today. I'm glad I didn't do it last week. I'm glad I made it here. This was worth waiting on."
What he wants people to understand is that suicidality isn't a switch. It's a spectrum, ever-present in different intensities, shaping how you plan for the future, how you maintain relationships, how you invest in anything beyond the next day or week. "Always in my mind I was a day, a week, a month from it all being over. So it just became this very here-and-now kind of thought process."
Why You Need to Ask About Suicide Directly
Howard is direct about something that makes a lot of people uncomfortable: if you're worried someone is suicidal, you need to ask them directly. Not "are you thinking about hurting yourself." Are you thinking about killing yourself.
"Hurting yourself and killing yourself are two unique, separate experiences. Nobody ever says, 'Oh my God, I'm sorry, did your child get hurt?' and mean dead."
The reason this matters goes to the psychology of suicidality itself. One of its hallmarks, Howard explains, is the belief that nobody cares — that if you died, the people in your life would feel nothing, or relief. That belief is part of what keeps people from reaching out. When someone approaches a person who is in the depths of that feeling and asks directly, clearly, and by name what they're thinking, that act of directness is evidence to the contrary.
"Somebody walking up to you and saying, 'Hey, are you thinking of killing yourself?' is proof positive somebody cares. If they're tiptoeing around it, if they're not being serious, if you can't recognize it — that's the thing people don't understand."
The fear of asking (of somehow planting the idea, of making things worse is,) Howard says, exactly the kind of barrier that costs lives. He compares it to firefighters being so afraid of fire that they stand back and arc water at it from a distance instead of going inside.
The Person-First Language Debate
Howard has been vocal on a topic that divides the mental health advocacy world: person-first language. The push to say "person living with bipolar disorder" rather than "I'm bipolar" is well-intentioned, he acknowledges — and in clinical settings, he thinks it has a place. But as a broad mandate applied to everyone, he believes it's doing harm.
"Nobody in the history of ever has lied awake at night and wondered if they're having a mental health crisis. They wonder if they're going crazy. They're crying, they're rocking. They're not using the correct language. And what worries me about that is one of the hallmarks of mental health advocacy was meet people where they are — and then we suddenly tried to tell them how to speak."
His sharper critique is directed at what this language initiative inadvertently teaches the people it's meant to help. When someone who is newly sick, newly seeking care, newly trying to find their footing is told that people who call them "bipolar" are insulting them — that correction can turn potential connection into rejection.
"So often people are like, 'Oh, Emily, you're bipolar?' They're trying to connect with you. They're trying to have honest, robust conversations. But we have a whole industry that has trained you to say, 'I am not. I am more than...' And now you're attacking them, and this person's like, 'I ain't talking to you.'"
Howard is clear that if someone requests a specific form of language, he'll use it immediately and without pushback. His concern isn't with the preference. It's with the promotion of one approach as universally correct — particularly when, he notes, there are no studies backing the language initiative as fact.
The Mental Health System Isn't Broken. It's Working as Designed.
Perhaps Howard's most pointed argument is about the system itself. The framing we reach for — "the system is broken" — lets everyone off the hook, he says. Broken implies a design that failed. What we have is a system that was built this way.
"We have instituted a system that frankly does more harm than good, and we're all just okay with it. And then we blame the people in the system for the bad outcomes, so we don't have to hold the people who work in the system or who created the system or who are upholding the system accountable."
The specific frustration: when outcomes are bad, the blame lands on patients. Not on the doctors, politicians, hospitals, or architects of the system that failed them. Howard calls this American advocacy "all wrapped up in a nice little bow" — a willingness to tell sick people sleeping in cars or under bridges that they have the power and the responsibility to change a system that was never designed to serve them.
Management, Not a Cure
The shift that defines Howard's present-day relationship with bipolar disorder wasn't a breakthrough. It wasn't recovery in the way the word is usually meant. It was a change in frame.
"I don't want anybody to hear, 'Oh, Gabe beat bipolar.' People introduce it like, 'Gabe Howard, who beat bipolar, is coming on stage.' I didn't beat anything. It's a reluctant roommate that I can't get rid of."
The pink eye comparison he returns to throughout the episode captures the fundamental misunderstanding he wants to dismantle. People treat bipolar disorder like an acute illness — something serious that requires real effort, but something that ends. Something you get over. The drops, the avoidance, the careful management — and then you never have to think about it again.
That is, he says, exactly the wrong model.
"You should look at bipolar disorder as, 'I need to think about this for a little bit every day or at least every other day. I need to make sure I continue to put the drops in for the rest of my life. And if I do all the right things, I will spend very little time on bipolar disorder.' But very little time is not no time."
The practical management looks like tracking moods, taking medication as prescribed, monitoring sleep and exercise, knowing when to reach out to a spouse or friend versus when to call a doctor, and training the people around him to ask the right questions — and to mean them.
"I spend more of my life living my life than I do managing bipolar disorder."
Not I spend my life. He is deliberate about that distinction. Some portion of his life will always be dedicated to management. That isn't failure. That is what it looks like to take a serious chronic illness seriously — and still build something.
