A Fish Growing Lungs By Alysia Li Ying Sawchyn

Imagine living through your teen years, experiencing everything that comes with being a teenager. You misbehave, you rebel, you experience a number of emotions each day, all of which you believe are common aspects of your age. But then you are diagnosed with bipolar I and your whole world is changed. That is exactly what happened to Alyssa Li Yan Sawchyn at age eighteen. She then spends the next seven years learning to live with and manage her bipolar disorder while also doubting the diagnosis and navigating love, addiction, and friendships. Sachwyn reflects on those seven years living with what she thought was bipolar I and her subsequent withdrawal from medication after finding out she had been misdiagnosed. She tears open the book of her past and lays the pages out for all to read. In A Fish Growing Lungs she is sorting through the pieces of the past seven years.


“I held my body like other people hold worry stones or rosaries—for reassurance, to remind myself of what exists.”

Sachwyn begins her first essay detailing the events that lead up to her first hospitalization and initial diagnosis. In that moment, the line between reality and fantasy began to blur. She experiences psychosis—an abnormal condition of the mind that results in difficulties determining what is real and what is not real—for the first time. She has to remind herself of her own existence as she is unsure of reality. Even years later she still has trouble accurately remembering what happened that night. Her recollections of that first night and how she behaved in her relationship with her mother shows how her body had begun to betray her.


“Considering how it has misled me in the past, I’m surprised how tightly I still hold on to my body as my means of understanding truth.”

The subject of her body and the way the disorder just takes over as she struggles is something she revisits throughout her essays. Those suffering with bipolar disorder experience a rollercoaster ride of emotions that take over and overwhelm the sufferer. These mood shifts and the accompanying episodes can occur at any given moment. And those suffering through them have no control over how they react or the consequences the episodes have on their lives. For Sachwyn, at times she was unsure of whether she had done something intentionally or if it was a result of her disorder and medication.



There are many instances and factors in our youth that cause us to misbehave in addition to just the simple fact of being teenagers. It is a time when so much in our lives is changing—our friendships, our relationships, our future is just laying out in front of us. We make mistakes and rebel, so how can we separate what is just teenage behavior from a disorder that will continue to affect us for the rest of our lives? As the average age of a bipolar diagnosis is approximately twenty-one years old with most cases of bipolar disorder commencing when individuals are aged fifteen to nineteen years old, Sachwyn’s misdiagnosis begins to make a bit of sense.


“But, goddamn, growing up sure can look like madness.”

In her youth, Sachwyn rebelled like a lot of other teenagers, but she also participated in behavior that would be cause for alarm for any parent such as self harm and addiction. Medically speaking these mental health issues are commonly associated with bipolar disorder, but not everyone who suffers from them is bipolar. Whilst reading this book, I kept coming back to how thin the margin of error must be in diagnosing bipolar disorder especially in teenagers and young adults. How exactly do we know when we have crossed that line from normal behavior to something that needs to be medicated?


When Sachwyn was first diagnosed with bipolar disorder she was locked in a state psychiatric hospital without her consent. She states how once you are committed, especially as a woman, the more you protest the more evidence of your instability you are handing over to your doctors. When an individual is locked away with a psychiatric disorder, they begin to be stripped of their humanity. They are no longer in charge of their lives or have the ability to make any decisions that pertain to them. As Sachwyn states in one of her essays, ”diagnoses become labels that determine futures.” Unfortunately, there is still such a stigma around mental illness even though a diagnosis shouldn’t determine your worth or ability to live your life. This is particularly troubling for women of color who already do not have the same advantages as white women. Once that diagnosis is stamped on you, that is all everyone sees. The person you were prior to the diagnosis no longer exists, making it more difficult to do things like land a job, apply for loans, or just get health insurance.


Sachwyn’s behavior during this time also affected her relationship with her parents. She writes of her at times manipulative treatment of her parents and how she used her breakdown and bipolar disorder as an excuse for her behavior. As I kept reading more about her initial diagnosis and later misdiagnosis, I thought about what it must be like to think that the reason you treated those in your life poorly was because of a disorder only to later find out that it was 100% you and nothing else responsible for that behavior.


The essays in this collection reveal what it feels like to live life under a microscope as you are trying to wade through a bipolar diagnosis. It’s difficult enough being a twenty-something year old woman without adding on a mental disorder. Sachwyn spent her early and mid twenties under the watchful eyes of her parents, friends, and a number of doctors living with the fear that if she said or did the wrong thing she could be institutionalized. She relives that loss of autonomy and the impact this misdiagnosis had on the relationships in her life. And although time passes and wounds are patched, the scars of those memories remain and they are something that she will carry with her. Her essays give the reader insight into what it is like to live with bipolar disorder and what it is like to try to find your way back from a misdiagnosis and in a way, find yourself.


A Fish Growing Lungs

By Alysia Li Ying Sawchyn

170 pages. 2020.


Buy it here.