Chappell Roan is getting backlash. It shows how little we know about mental health.

Breakout queer pop star Chappell Roan recently canceled two festival appearances and has since been called “unprofessional” and “not built for fame” by fans-turned-trolls.

Yet those same fans likely know that Roan struggles with bipolar II disorder, which she says makes it difficult for her to regulate her emotions and navigate her newfound success. “Things have gotten overwhelming over the past few weeks and I am really feeling it,” she wrote in an Instagram story on Friday.

The lack of empathy for Roan’s decision to prioritize her health demonstrates how little so many people know about mental health issues and specifically bipolar disorder.

“The stress to perform, the stress to deliver, that all worsens your baseline,” explains Judith Joseph, MD, a psychiatrist and media consultant who researches high-functioning mental health conditions. “Being a performer and having a tour is stressful in of itself, let alone having to manage a condition that is vulnerable to stress.”

What is bipolar II disorder?

A fan tweeted on Friday that Roan “literally looked the happiest I’ve ever seen her” at her London shows, and not even a week later has reached a low point. That, however, is often how bipolar disorder works.

According to the National Institute of Mental Health, bipolar disorder (formerly called manic depression) is a mental illness that causes abnormal shifts in a person’s mood, energy and activity levels.

"Its high highs and low lows can impede one's ability to function daily," Rwenshaun Miller, LCMHCS, a mental health professional practicing in North Carolina, previously told USA TODAY.

With bipolar II disorder, a person experiences patterns of depressive episodes and hypomania, which is a less severe form of manic episodes in bipolar I disorder. The depression is more intense and frequent depression, and the “up” episodes are never as extreme as “full-blown mania,” according to WebMD.

While most people will experience a period of sadness in their life, depression can be more challenging with bipolar disorder because there’s fewer treatment options and the lows tend to be very low, Joseph says.

Many Americans have bipolar disorder. Understand the cause, treatment of this condition.

'It affects me daily'

Roan has been outspoken about how her bipolar II symptoms interfere with her career, ability to regulate her emotions and response to success. In 2022, she got candid with her fans on Instagram.

“I’m diagnosed bipolar 2 and it’s been pretty hard to keep together and release these songs. I’ve been on meds and I was in full swing hypomania when ‘Naked in Manhattan’ released, which I’m out of now,” she wrote. “I’ve been in intensive outpatient therapy/ individual therapy 4 days a week and it’s definitely been difficult to balance… I don’t really talk about it much, but it affects me daily and is a pretty big part of my music.”

In May 2023 leading up to the release of her chart-topping album, "The Rise and Fall of a Midwest Princess," she updated her fans on her mental health and relationship with fame.

“This job is very difficult for me to process and maintain a healthy life and mindset,” she said in a TikTok video. “Everything is very exciting right now and I’m realizing that success actually makes me quite uncomfortable and self-conscious, and I’m not sure why yet.”

It seems nothing could have prepared her for the success storm that was on the precipice.

Since her rise to fame this spring, Roan has continued expressing both her gratitude, and hardship, to her fans. At a show in June, she took a moment to address her rapid success.

“I just want to be honest with the crowd. I just feel a little off today because I think that my career is going really fast and it’s really hard to keep up,” she said.

Touring is already hard on musicians, bipolar makes it worse

Being a touring musician takes a toll on the body, and managing a mental health condition on top of that can heavy the load. Bipolar disorder can also cause sensitivity to changes in light, time zones and schedules, according to Joseph.

“It’s different from major depression in that a lot of the physiological cycles can negatively impact your mood,” she says. “You need to protect your body’s physiology.”

“Honestly, being a touring musician managing bipolar disorder is really (expletive) hard,” says Zac Carper, the frontman of FIDLAR, an American punk and garage rock band.

Carper was recently diagnosed with bipolar disorder, which has helped him better understand and meet his needs on the road. He now keeps a “rigorous routine”; no drinking, drugs or smoking, and exercising, eating right, journaling and sleeping well.

“So much of this lifestyle requires interaction with other people at all times, so all of us in the band need to find alone time every day to just take some time for ourselves and recharge,” he says.

Other artists have also been open about their experiences with bipolar I and II, including Halsey, Bebe Rexha, Demi Lovato, Mariah Carey and Selena Gomez. Yet, expectations of celebrities to push through the pain remain high.

Musicians need sick days, too

The pressure to push through lows can worsen depressive episodes, burnout and overall mental wellbeing, Joseph explains.

Carper says that artists face a pressure that “the show must always go on,” but that “shouldn’t be the standard.”

“We want to give everything on the stage,” he explains. “When you cancel, you feel horrible for your fans, your bandmates, and all the people behind the scenes that make it happen.”

Joseph works with musicians, and she says sometimes stepping away from what they love is necessary.

“Stopping is a grieving process for them,” she says. “They’re disappointing fans in the short term, but in the long term, they’re going to disappoint people indefinitely if they don’t slow down and take care of themselves.”

Taking mini breaks can help prevent burnout and severe exhaustion or mental health episodes, according to Joseph.

“We have the right to take sick days for ourselves, because mental wellbeing is your foundation,” Carper says. “And you can’t be a successful touring musician without it."

This article originally appeared on USA TODAY: Chappell Roan, bipolar disorder and how we mistreat artists.