“The point about manic depression or bipolar disorder, as it’s now more commonly called, is that it’s about mood swings. So, you have an elevated mood. When people think of manic depression, they only hear the word depression. They think one’s a depressive. The point is, one’s a manic-depressive” (Fry qtd. in Brainy Quote par. 1).
The issue of manic depression, in my own opinion, has always been neglected in terms of study, or even disregarded. Everyone always seems to focus on one side of the disorder, forgetting that there may be another aspect to depression that contributes to the individual’s mental state, and to the same extent. Patients discussed in Chapter Four, “I Now Pronounce You Manic Depressive,” and diagnosed with bipolar disorder had the signs of elevated mood when they were over-excited and chatty, as well as the signs of a downward spiraling mood, which even led them to attempting suicide.
While the opposite of a suicidal mood might be considered a good thing, on the other hand, the elevated mood is not always beneficial for the patients, since over-excited and “speedy” behavior can also lead to potentially dangerous consequences. Therefore, bipolar disorder is deceptively complex and should not be regarded as a one-sided illness, to be treated with one singular method; rather, bipolar disorder is a system of “social, physical, and emotional conditions” (Martin 106) that can be dealt with in a systematic way.
The “gray” case of Mr. Anderson, an economics professor, is especially worth mentioning, due to the fact that he was on lithium for twenty years until he suffered renal insufficiency as a consequence, and whose behavior became uncontrollable after the medication was discontinued. He was sexually inappropriate with students, and failed to control his anger and irritability, especially in the “upper” pole of his bipolar disorder. In addition, when he was down, he needed a lot more sleep than usual. The “ups” went around the “downs” in circles that could take from one hour to five months.
The newly prescribed medication did not seem to help, since Mr. Anderson claimed he had never felt normal after dropping lithium. It is evident that the initial medication prescribed to the patient two decades previously was not properly evaluated in terms of how it could potentially affect his health over a long term. Because bipolar is treated with medication that can adversely impact one’s physical health, it was not the best decision to prescribe lithium for twenty years. Now, even as lithium has been proven to cause serious physical health damage, its absence has negatively impacted his mental state.
I cannot agree with the concluding diagnosis that Mr. Anderson belongs in the “gray zone” between mental illness and mental health, since his behavior shows that he is eager to recover and to feel normal again, and he is passionate about teaching and academia. Mr. Anderson’s mental illness has been controlled by lithium for years, so now, without the medication, the illness will continue to progress without proper intervention.
Mr. Burton’s case is useful, in my opinion, for learning to differentiate whether a person’s misuse of a substance caused manic depression, or if an underlying illness adversely influenced the patient’s condition (Martin 121). Born into an unstable family, Mr. Burton was heavily exposed to negative influences that caused him to try PSD and marijuana. Without support from the family, the patient had become paranoid and bought a gun to protect himself from imagined danger. The interview with the patient showed that he was dramatic in his speech, worried, and anxious.
The way he spoke about his family implied that Mr. Burton lacked recognition and comfort at home. Because of the lack of recognition, the patient strove to perform excellently at his studies, and this turned into an obsession. Thus, Burton’s state was diagnosed as bipolar; however, in my opinion, such a diagnosis should not have been as unanimous as it came to be. Bipolar disorder does not go well with education, since a patient is often too unstable and unfocused to reach his or her goal. To this extent, Mr. Burton had the dedication to perform well in his academic accomplishment. His state can, indeed, be called repression, because he held in his unconsciousness the desire to perform and become recognized by his parents (Martin 124).
On the other hand, I agree with the “manic” characteristic of Mr. Burton, despite his rationality. One can be both rational and manic at the same time, which is a loose interpretation of manic depression or bipolar disorder. In addition, I agree with the postulated similarity between Mr. Burton’s and Mr. Anderson’s cases, in the sense that they were both exponentially motivated by academic success, and both experienced a decrease in motivation as soon as they doubted themselves. Therefore, both patients were highly sensitive to the mood cycles that they experienced and that impacted their ability to function.
In my opinion, the discussion leading to the white versus black identity did not hold up well, despite the fact that some minor explanations were given. In the same way a white person can experience mania, a black person can deal with identity issues and overconfidence. Providing a rationale in assessing white versus black patients seems counterproductive, and may lead to a potentially inaccurate diagnosis.
It is mentioned that medical categories should work in conjunction with cultural background, which defines race in terms of human capacity (Martin 127). Of course, the cultural background of the patient should be taken into consideration while performing an assessment; however, it should be more about cultural upbringing, the influence of traditions, and the role of religion in person’s life, rather than whether a patient is black or white. It is impossible to predetermine if a white person will struggle with overconfidence, or a black person will become manic at some point in his or her life.
Overall, the fact that the psychological assessment in the chapter included both women and men of different races implies that manic depression can affect anyone. However, the main reason it occurs is, in my opinion, a combination of many factors that distinguish one’s life from others. A system of issues, for example, alcoholic parents and abuse of mild substances, can lead to a person becoming alienated and paranoid. In order to compensate for alienation and paranoia, a patient can become obsessed with a particular goal or idea that will drive his behavior “up.” Such “ups” will be intertwined with “downs,” creating a full circle of bipolar disorder behavior. Since a bipolar person struggles with a system of contradictory problems that do not allow stabilizing and finding “middle ground,” in my opinion, it should also be treated systematically.
Works Cited
Brainy Quote. Stephen Fry Quotes. n.d. Web.
Martin, Emily. Bipolar Expeditions: Mania and Depression in American Culture. Princeton, NJ: Princeton University Press. Print.