Breaking down the myths of manic depression in Damian Leader’s Strictly Bipolar
Depression, manic depression, mania, mental health, bipolar. These are words that should not be fashionable, but in this day and age, are becoming more and more common. And this is not a criticism, as two decades ago barely anybody is aware of the concept of mental health. And though we are becoming more aware, we really don’t have the collective understanding of what the definition of these words mean.
Words are important, especially in the field of psychology, as how they are defined would entail the method of treatment. I had an idea of what being bipolar means, I suspected that some of my friends have them. Many more have depression, diagnosed or not. But do we have a mutual understanding of what depression means? Would the average person that assumes somebody else has depression would know what some of the symptoms are?
I had to look these up myself after a recent breakup, and though I did suffer from a few of these symptoms, I recovered a couple of months later. So did I really suffer from depression? I still don’t know. But it seems that I’m not the only who struggle with these definitions. Leader’s Strictly Bipolar also demonstrates that even among the experts, there is a rift on how bipolar disorder should be treated.
Leader is a proponent of the long game, for practitioners to think twice before giving medication to the patients, and to deep dive to the historical events which may have caused the triggers. Sure, it sounds Freudian, whose theories have been much refuted. But in an age where there is a solution for every problem in the shape of a pill, to address issues to its roots may be seen less practical and more time-consuming. The gamble, I suppose is that the experts may not even hit the mark on the patient’s issues, and risked the time spent on the consultations.
In any case, here is what I picked up from reading Strictly Bipolar:
- Medication alleviates but does not solve the problem
Leader spoke of a patient who had different medications for different ailments (lithium for mania, olanzapine for psychosis, dexmethylphenidate for attention, etc.), but this method will only subdue the symptoms temporarily without attacking the base of the problem. To add to this dilemma, the side effects of these drugs are under-reported, which adds more ailments to what the patient already has. We must instead ask the patient’s motivations which may give insights to the real problem:
Instead of asking if some medication tempers racing thoughts or desperate agitation, we must ask what those thoughts actually were and how they came to overwhelm the person. If someone spends thousands of pounds in a shopping spree, we must ask what they bought and why.
2. The Other is a crucial factor in a person’s mania
The projects undertaken by a manic person are often related to helping others, the righting of wrongs, or some act of protection.
The reason for a person’s mania may be an all gung-ho approach in satisfying someone else, an Other. To the patient, the Other justifies the actions, no matter how wild those actions may be. A person can spend thousands of dollars on a shopping spree for clothes to make themselves to look attractive to someone he or she is attracted to, or to dedicate their time to learn something for the sake of impressing this Other.
In a consumeristic state, it’s all well and good if they are spending their own money, but money is no consequence and the person may fall in debt. Mania, as we know, does not last. When the person feels that they have disappointed the Other somehow, they will strike the new low. Coupled with their new financial burden, the overall pressure will be doubly stacked on them.
Leader also admitted that there may be some utility to this — that the mania can be used to drag others and do good, to move forward and take others forward with you.
3. There are key differences between schizophrenia and manic depression.
The schizophrenic person would be focused on the self, so that melancholia and their depression is in a bubble of their own. Not so the manic depressive person, who would fall into a state of depression if a bond is broken between him and the Other:
“…if the terror of the schizophrenic is the falling apart of their own self, for the manic-depressive it is the falling apart of their Other.”
4. There is no in-between for the manic depressive
The manic depressive shifts between the two sides of the mood spectrum, because there is only black and white, good or bad. We are also incorrect to assume the up or down mood swings, it is more fast or slow. Any contradictions or any subject matter that falls into this grey area would be reorganised into either of the two extremes.
“When researchers discuss where everyday mood alternations end and bipolarity begins, they miss this crucial point: that manic-depression is precisely about the effort to create extremes, to create a world of opposites.”
5. Language plays a shifting role in between a person’s state of mind
Leader also touched briefly on the role of language during the two states, where someone in mania would use words liberally, not giving them much thought, but when they fall into the depressive state, the gravity of the words would fall hard on them. Oscar Wilde would spin up words as though he was spinning a wheel during his times of mania — he is not held down by the significance of the words. If you read Wilde’s poetry, you know this to be somewhat true.
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It is a difficult subject to cover, and it is not a subject I am familiar with by any means, but Leader covered a lot of ground, using examples from popular figures who had been diagnosed with manic depression such as Stephen Fry and Vivien Leigh. The debate will continue, I suppose, as what Leader proposes is time-consuming whilst there are more patients being diagnosed with bipolar disorder. But isn’t that the role of the psychiatrists right now to find the middle ground? To delve deep into the subject’s mind to organise their thoughts, so that the bug under the bricks can be found, and removed prudently?
In any case, it is important to have these discussions. I don’t think there is an all encompassing fix-all solution for a problem as complex as the human mind. We need to take them in a case by case basis. And for this reason, mental healthcare can be expensive. What normal person can afford to go to a psychiatrist for treatment?
