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Bipolar Nation

Today we are excited to bring you Emily Martin a professor of anthropology at New York University. In her most recent book, Bipolar Expeditions: Mania and Depression in American Culture, (published by Princeton University Press), Martin guides us into the fascinating and sometimes disturbing worlds of mental-health support groups, mood charts, psychiatric rounds, the pharmaceutical industry, and psychotropic drugs. Charting how these worlds intersect with the wider popular culture, she reveals how people living with bipolar disorder are often denied the status of being fully human, even while contemporary America exhibits a powerful affinity for manic behavior. In the post below Martin look at how this is affecting American’s perception of mood disorders. Thanks to our friends at PUP for letting us know about this fascinating book!

What lies behind the recent explosion in the diagnosis of bipolar disorder among American children? There is much to wonder about, as we know from Time magazine’s 2002 cover, “Young and Bipolar;” and from a recent 60 Minutes segment, “What killed Rebecca Riley?” Four year old Rebecca is said to have died from an overdose of psychiatric medications given to her for her bipolar disorder. The New York Times had already reported the month before that the number of American children and adolescents treated for bipolar disorder increased 40-fold from 1994 to 2003. Not long afterward, under the headline “Your Child’s Disorder May be Yours, Too,” The Times reported that parents are struggling with whether to acknowledge aspects of their own behavior that are consistent with mood disorders in order to help their children feel they have “fellow travelers.” Behind these stories lie powerful cultural changes in how Americans regard their moods.

Bipolar disorder is becoming not only a disability but also an asset. Because of the creativity of their manic states, larger than life figures like Robin Williams and Ted Turner are frequently described as “bipolar.” Depression, at the other end of the mood spectrum carries a different load of associations. If mania comes to signal success in the competitive, sped-up global economy, depression signals the opposite: the failure to be productive. What interests me as an anthropologist is that cultural values very specific to our society are carried along with the diagnosis of a mood disorder.

For bipolar disorder, the our cultural fantasy is that as depression can be made to wither away altogether, the high energy of the manic phase can be tamed or optimized, so that individuals can succeed and economies grow. The growing numbers of psychopharmaceutical drugs are what allow contemporary doctors to give a patient a diagnosis of mood disorder and treat it, rather than (as in earlier historical periods) lay the patient’s problems at the feet of his or her temperament or character. At a meeting of the American Psychiatric Association, I met a young doctor who practiced in a well-known hospital near Hollywood. When he heard about my research, he became quite interested and offered me this experience.

Where I work, we get a lot of Hollywood comedians coming in. They are manic depressives. There are two important things about this: first, they do not want their condition publicized, and second, their managers always get involved in the details of their treatment. The managers want the mania treated just so. They do not want it floridly out of control, but they also absolutely do not want it damped down too much.

He felt he was being called upon to optimize his patients’ moods (for the theatrical profession and for the particular kinds of creativity it requires) through proper management of their drugs. Listening as an anthropologist, I began to feel uneasy about the prospect of extending the optimization of psychotropic drugs to suit other kinds of employment and people in other age groups. What would happen if optimizing states of mind were extended, as the DOD hopes, to soldiers on combat duty? What are the implications of extending the use of powerful psychotropic drugs to treat children whose behavior causes problems at home or school? A number of factors have been blamed for the rising statistics of bipolar disorder in children: improved treatments or more knowledgeable diagnosis by doctors. But the need for treatment (real as the need may be and helpful as the treatment may be in some cases) cannot be separated from values in our cultural environment that associate some moods with success and others with failure. A broader conversation about the cultural environment in which rates of bipolar disorder are rising would enrich our understanding of what it means to be bipolar – for children and adults alike –today.

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