A maniac is a madman, right? And not just any madman, but an escaped-from-the-asylum, Hammer-horror, axe-wielding madman. Tell me that’s not what you imagine when you read the word. The early Greeks, who gave us the term, believed that madness was a divine punishment for former sins.
Many psychiatric and psychological conditions include the word mania. And one of them is manic depression. Nowadays, it goes by a more politically correct name – bipolar disorder.
Bipolar disorder, also known as manic depressive disorder or bipolar affective disorder, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated mood clinically referred to as mania or, if milder, hypomania. Individuals who experience manic episodes also commonly experience depressive episodes or symptoms, or mixed episodes in which features of both mania and depression are present at the same time. These episodes are usually separated by periods of “normal” mood, but in some individuals, depression and mania may rapidly alternate, known as rapid cycling. Extreme manic episodes can sometimes lead to psychotic symptoms such as delusions and hallucinations. The disorder has been subdivided into bipolar I, bipolar II, cyclothymia and other types, based on the nature and severity of mood episodes experienced; the range is often described as the bipolar spectrum.
You can take that definition and run with it if you like. You can tell yourself that such familiar names as Einstein, Van Gogh and Beethoven were all bipolar, that you’re in good company. But how bipolar disorder works in the life of an ordinary human being is something else.
You may be called over-dramatic from an early age. Over-emotional, too prone to wearing your heart on your sleeve. Over-sensitive and cursed/blessed with an over-vivid imagination.
But as an adult, when the switch in your brain (set permanently on a random fluctuating pattern) is on Up, people will describe you as charming, vivacious and charismatic. They applaud your talent. You are a high functioning member of society with great communication skills. You possess a brain that’s sharp as a tack and that’s simply stuffed with creative ideas. You’re a risk taker, courageous and bold. Although some will find you a little intimidating or fast-paced, you’re generally well-liked and people see nothing abnormal in your behaviour.
Perceptive people, however, may notice that you have an edge of desperation. And they’d be right, for underneath, there is indeed a desperation to hang onto the Up, to keep the creativity, the sharpness. A desperation to finish projects that you started with such immense enthusiasm before the switch moves to Down. A desperation not to let people down who you care about. And a desperation not to let people see how your inner life really is.
Being Up is, quite literally, an intoxicating experience. Passions and ideas flood into your brain and you live in a brightly coloured world where every new idea is the one. Sometimes you can’t keep up with what your brain’s throwing at you and even your speech centre becomes garbled. It’s a runaway train but it’s damned exhilarating. Up’s darker side though is Signore Agitato, when the train’s come off the tracks and you’re trying to control those racing thoughts by sheer willpower.
In an effort to become more balanced, you try every medical treatment the world of psychiatry knows. None makes a significant difference, although the side effects increasingly debilitate you. You undergo long periods of therapeutic counselling and find a deeper understanding of your condition. Applied to your everyday life, that understanding changes nothing much. Eventually, you give up and go it alone.
You wrestle with the question of disclosure. You know deep down it’s a lose lose situation. If you tell people about your condition, chances are they’ll be sceptical ‘everyone has mood swings, what’s so different about you?’ or downright judgemental (see the opening paragraph). They may argue that you’re not bipolar, you just suffer from ‘a little depression now and then.’ Most of all, they’ll be damned uncomfortable with your disclosure and many may decide to give you a wide berth from now on. Accordingly, you spend your life alternating between telling people and keeping it a dark, deadly secret.
The largely hidden world of Down is a bleak one. Your previously sharp brain has grown a fleece of ewe’s wool and the world of colours has turned to a blurry grey. You’re physically exhausted and your motivation to even get out of bed is minimal. You sometimes remember that you do have meaningful talents and skills but as these completely vanish in Down, you can’t believe in the veracity of this and downgrade them to meaningless.
In an attempt to escape this blackness, you indulge in self-destructive behaviour. Anything all-consuming will do – booze, drugs, compulsive eating, gambling, sex. These incapacitate you in various ways so that you are at least distracted from the black hell of depression. But they will also drive away even more people in your life.
You make excuses for missed deadlines and meetings. Then eventually you simply cut off the phone and don’t reply to your emails. No lie would be convincing enough. And even if you could convince people, there’s no way of telling when you’re going to be Up again and functioning.
Over time, the Ups will be more and more shortlived and perhaps more extreme and the Downs more sustained. The Ups become a desperate race to accomplish things before the Down hits. It’s at this stage that disappointed friends will begin to drift away, unable to cope with the unremitting rollercoaster ride. They’ll go in search of more normal company. Who can blame them?
Now you find it hard to plan a life, because the pattern is so random. If you promise to be somewhere on a certain day three months hence, where will your mood be by then? Your confidence plummets and you stop trusting your own instincts. Was this or that decision made when you were overly manic? Severely depressed?
Anxiety starts to tag alongside Signore Agitato. The normal filters that allow you to function begin to rust up and your world grows smaller and smaller. You fear that you have become less and less socially acceptable and that perhaps it’s best not to inflict yourself on others.
If you’re lucky, you’ll have around you at this stage loving, understanding and supportive family and friends who are in it for the long haul. This can be crucial to how the life of someone with bipolar disorder pans out.
But from everything I’ve told you, you can see just how corrosive a condition it is. It’s hardly surprising then that people who are bipolar will more likely than not lead a solitary life. That they will often be hospitalised at least once. And that they will have a high suicide rate. It doesn’t seem like such a good payoff for a few fleeting moments of high creativity and charisma.