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If someone wants to talk about suffering from anxiety disorders or clinical depression, their audience has touchstones by which to understand. Most everyone cannot imagine what it’s like to experience anxiety or depression as illnesses, i.e. to experience an excess of those feelings which may or may not be attached to a rational spur, but we can count on most everyone knowing what the raw emotions of being anxious or depressed for a short amount of time feel like.
In the case of clinical depression specifically, we can imagine that most people have felt, during a time of grief, what it’s like to feel nothing at all. By sharing those raw emotions and experience, we can reasonably assume that a majority of people can at least extrapolate an idea as to what the symptoms of anxiety disorders or clinical depression feel like.
Talking about bipolar disorder, on the other hand, faces a very specific challenge because it’s not an illness defined by an excess or lack of emotion, but an excess of emotional change. And I don’t think most people have any touchstone by which to understand that.
My high school had a ski club. One night a week everyone who paid the club fee would pile into a bus with their skis and poles and goggles and head off to spend an evening on the slopes, and in my junior year I was dating a girl who was part of the ski club.
I asked my parents for the money to join the club. They didn’t have it to give me. I don’t remember how or if we discussed equipment, but that would have been another issue to tackle because I didn’t own any. I’d never skied before, and honestly my desire to join the ski club wasn’t about the skiing. It was about wanting to be with my girlfriend, and not wanting to feel left out.
One night when my girlfriend was out with the club I was despondent. I felt so sad, and so lonely. I asked my parents, yet again, for the money to join the club. I flew into a rage at my mother when she told me yet again that they didn’t have the money.
Then I started crying because I felt so left behind. Then I started screaming at my mother again because I knew she had the ability to fix this by letting me join the ski club but she wouldn’t let me, which made no sense, of course, because my parents really didn’t have the money. Then I started crying again, feeling hopeless, until I got angry again.
This went on for like an hour until, exasperated, my mother called her therapist and asked me to talk to her because my mother needed someone to calm me the fuck down.
Understanding my being sad at feeling left out or my anger at not getting what I want probably aren’t very difficult for you, even if the irrational severity of my emotions that night don’t make any sense. Understanding how privileged my thinking was, and why that was a problem, probably aren’t very difficult for you, either. Can you understand what it was like for me to be locked into that feeling of privilege and shift between those emotional extremes every five minutes or so, for an hour?
I imagine not. In fact, I imagine the idea might be pretty scary for you. And now you understand the other, particular challenge of talking openly and bluntly about bipolar disorder. It’s scary because it’s difficult to understand.
Let’s say that our potential for emotion is represented by a sine wave, with excitement at the top and lethargy at the bottom. To begin to understand what it feels like to suffer from anxiety disorders or clinical depression, one has to imagine the different levels to which someone with one of these mental illnesses feels those emotions, usually for no rational explanation.
Or, to put it another way, anxiety disorders and clinical depression are defined by or “live” where the lines are:
To begin to understand someone with bipolar disorder you not only have to understand where they go on this emotional sine wave relative to the middle, which has the same level of variety you see in different people with anxiety disorders or clinical depression, but you also have to understand how often a person with bipolar disorder is moving between those states.
Feeling awful or crippling anxiety or depression are the common bond that people with anxiety disorders or clinical depression share with one another. Feeling awful and being crippled not only by those emotional states but also by the endless shifting in-between those states is what people with bipolar disorders share with one another.
Or, to put it another way, where anxiety disorders and clinical depression are defined by or “live” on the lines that dictate the extent of the emotions, bipolar disorders are defined by or “live” in the constant flux in-between those lines.
Our ability to talk about mental illness at large comes down to our ability to understand individual mental illnesses, and I think we can thank the relatively accessible nature of understanding anxiety disorders or clinical depression for the current climate of tolerance and understanding we have towards mental illness in general. We also have many more people who are willing to publicly identify as suffering from these illnesses, which helps to break down stigmas.
I think that same climate of tolerance and understanding is responsible for why more people are speaking openly about living with bipolar disorder, but I worry that such open discussion of bipolarity is going to take much longer to break down the stigmas associated with the illness.
Media, particularly television and film, have a lot to do with making mental illness a safe subject to discuss. It is perfectly normal nowadays for us to see characters with anxiety disorders or clinical depression in media. Tony Soprano suffered from anxiety attacks so severe they made him lose consciousness, so he went to see a psychiatrist. Don Draper is depressed and tries to hide it with alcohol.
Media has to heighten the effects of these mental illnesses in order to make sure the audience gets it, and as someone who suffers from both anxiety and depression at different points in his spectrum the depictions of those disorders in media have never bothered me.
The loudest depiction of bipolar disorder in media, however, exemplifies how difficult it is to discuss bipolar disorder because that depiction misses the point entirely.
Claire Danes plays a CIA agent with bipolar disorder in the Showtime series Homeland. Her performance has been praised as a very honest depiction of the illness. If you look at that praise closely, Danes’s performance is mostly praised for its depiction of mania and psychotic breaks, neither of which have anything intrinsically to do with bipolar disorder.
All forms of mania are not the same. Not everyone who has bipolar disorder has a psychotic break. I don’t even know what that means! But it’s much easier to depict extreme mania than it is to depict mood variability — just showing Danes’s character depressed in one episode and manic in another episode doesn’t do a very good job of digging into the heart of what defines bipolar disorder — so mania is what winds up on the screen.
I shudder at the idea of Danes’s performance being a touchstone for how people might begin to understand bipolar disorder. Understanding what mania looks like tells you nothing of what it is to live with this illness. It only shows you one, possible top of an emotional sine wave that a majority of the people with bipolar disorder probably never reach. Yet now I have to face the specter of someone learning that I’m bipolar and then thinking about Claire Danes on Homeland and wondering if that’s how I get sometimes.
I’m glad that people are finally speaking openly about bipolar disorder, but I don’t know if we’re doing an adequate job of explaining what this illness is really about. It’s not about the excess or lack of any emotion. It’s about an excess of change between them. Without treatment, those of us who live with bipolar disorder are held hostage to those cycles of change. It wasn’t until I saw those cycles begin to end in myself that I realized I’d finally taken a major step towards ending the way bipolar disorder had charted the course of my life up until that point.
All sine wave images from Wikimedia Commons under Creative Commons licenses.