Is there a cure for bipolar disorder? Dr. Richard Besser responded to the question during an interview (April 14, 2011) on ABC’s Good Morning America. Besser replied that the condition is “managed and controlled” by the client, but cannot be cured.
Therapy, counseling, and medication are used to control the disorder and are vital to surviving bipolar disorder. Without interventions, the condition can cause a great deal of damage to the sufferer. As defined in Taber's Medical Encyclopedia 25th edition, bipolar disorder is “a psychological disorder marked by manic and depressive episodes.”
Taber’s distinguishes manic episodes from depressive episodes of bipolar disorder, explaining that a manic state is a mood “characterized by excessive energy, poor impulse control, psychosis, agitation, flight of ideas, frenzied movement, and decreased sleep” while a depressive state is “marked by loss of interest or pleasure in living.”
Manic and Depressive Episodes
Assessment Technologies Institute further describes the symptoms of mania and depression in the textbook of Mental Health Nursing for RNs (registered nurses). Indicators of mania include:
- Persistent elevated or irritable mood
- Impulsivity: spending money, giving away money or possessions
- Racing thoughts
- Increase in talking and activities, grandiose view of self and abilities
- Psychotic behavior
- Impairment in social and occupational functioning
- Poor judgment
- Delusions or paranoia
- Hyperactivity
- Dislike of interference or intolerance of criticism
- Attention-seeking behavior: flashy dress and make-up, inappropriate behavior
The symptoms of depression include:
- Disturbed sleep
- Tearfulness, crying
- Withdrawal, social isolation
- Self-destructive behavior
- Lack of energy
- Risk to self or others
- Loss of pleasure (anhedonia) in formerly pleasant activities and hobbies
The list of symptoms indicate that the client is at risk, whether manic or depressed. Bipolar Disorder, or manic depression, is destructive, regardless of the mood of the sufferer. However, mania and depression have been linked to achievement in some individuals and researchers have studied a possible relationship between mental disorders and creativity.
Creativity, Artists, and Mental Illness
E. Torrey and Michael Knable, the authors of Surviving Bipolar Disorder, observe that “for centuries unique creative talent has been seen as related to mental disturbance.” In explaining the link, as related to manic phase of bipolar disorder, Knable and Torrey write that “certainly many of the symptoms of mania could be considered adaptive or useful qualities for creative pursuits.”
The author of Taming Bipolar Disorder, Lori Oliwenstein, observes that “Nancy Andreason M.D. currently chair of Psychiatry at University of Iowa did some of the very first work into the links between creativity and mental illness, particularly mood disorders…” and in summarizing Andreason’s work, Oliwenstein notes that, “so many of mania’s features in fact seem tailor-made for the creative mind that you might wind up wondering how it is that not every artist or writer, or musician is diagnosed with bipolar at one time or another…” Although depression and mania have been linked to creativity, the effects of bipolar disorder are overall debilitating.
Wanting to be Bipolar
Ironically, the manic state destroys lives but has a certain appeal. Knable and Torrey compare the appeal to the siren song of ancient Greek mythology, tempting but ultimately deadly. The authors entitle one section of their book “The Seduction of Mania,” and they quote Jackie Lynden – the daughter of a woman diagnosed with bipolar disorder – and try to explain how mania seduces a sufferer.
Lynden’s daughter describes the elation of her mother’s manic state and contrasts it with despair that her mother otherwise faces: “In her delusions, my mother fancied above all else that she had dignity and power….She could fly beyond mortal realms, inhabit all the shining positions of influence that she lacked in the real world. However, in the hospital layer upon layer of delusions were peeled back…to be only human caused fear and doubt and mortality and the dead weight of having run out of dreams.”
Medication Controlling Mania, Delusions or Ending Dreams
In her real life, without the influence of mania, Lynden’s mother ran out of dreams; the delusions and fantasy of mania held greater appeal than life devoid of dreams. Such is the appeal of mania; some clients are reluctant to use their medication because in the “real world” they have “run out of dreams.”
But mental illness is not necessary to creativity. Torrey and Knable quote Charles Lamb insisting, “It is impossible for the mind to conceive a mad Shakespeare.” Madness and mental illness lead to tragedy more often than they lead to triumph. Bipolar disorder is a mental illness, and illnesses – of the mind and body – are generally perceived as curses, not blessings.
Controversy, Disagreement about Mental Illness
Taber’s defines mental illness as “any disorder that affects mood or behavior.” Whether the effect is positive or negative is sometimes debated even by those suffering the so-called disorder – how so? Well, homosexuals celebrate their sexuality although homosexuality was once classified as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM). As another example, many individuals with Asperger’s Syndrome do not believe that they are suffering from a disorder and value the abilities consequential to Asperger’s Syndrom. Disagreements and changes in the categorization of such conditions indicate that mental illness is not always well-defined.
The DSM is constantly revised and changed. Defining behavior as “normal” is challenging because culture and beliefs determine the definition of normal. Thomas Szasz, the author of Myths of Mental Illness argues that “mental illness is not something a person has but something he or she does or is.” He adds that, “strictly speaking, disease or illness can affect only the body; hence, there can be no mental illness.”
Sickness of the Mind Based on Human Behavior not Cellular Biology
Szasz highlights the challenges of classifying mental illness as he insists that “mental illness is a metaphor. Minds can be ‘sick’ only in the sense that jokes are sick or economies are sick.” In accordance with his beliefs, Szasz has supported policies that provide autonomy to individuals with mental illness and aids them in avoiding involuntary psychiatric intervention. Szasz calls involuntary psychiatric interventions “crimes against humanity.”
Policies and laws have been enacted to recognize the rights of the mentally ill and, except for certain circumstances, the mentally ill are not mandated to receive treatment for their condition. Some mental disorders, particularly the manic phase of bipolar disorder, have been linked to creativity; however, the negative aspects of mental illness far outweigh any related creativity or artistry.
Is mental illness a different way of thinking? Critics would argue that a sick person would seek out a medication or therapy to ease the suffering. The hesitancy of some individuals to seek out psychiatric intervention underscores the complexity of providing mental healthcare and diagnosing mental disorders. The ill-effects of a mental disorder must be recognized by sufferers before they will make a sincere attempt to control, manage, or eliminate the sickness. For those suffering bipolar disorder, overcoming "the seduction of mania" may be the most important aspect of successful treatment.
Sources
- Assessment Technologies Institute. Mental Health Nursing. ATI. 2006
- Oliwenstein, Lori. Taming Bipolar Disorder. Psychology Today. Penguin. 2004.
- Szasz, Thomas. Myths of Mental Illness. 1974
- Taber’s Medical Cyclopedic Medical Dictionary 20th Edition. Unbound Medicine.
- Torrey, E., Knable, Michael. Surviving Manic Depression. Basic Books. 2002.
- Townsend, M. Psychiatric Mental Health Nursing, Concepts of Care in Evidence-based Practice. F.A. Davis. 2007.
Marian Henderson - I was in the Marine Corps for 12 years, and after completing my last four-year enlistment, I became a Merchant Marine. I worked aboard ...
