Bipolar Expeditions (33 page)

8.2. A worker is putting the finishing touches on a sand sculpture of Benjamin Franklin at the 2002 American Psychiatric Association meeting in Philadelphia. In addition to Franklin's contribution to Philadelphia's history, he has become a symbol of productive entrepreneurial hyperactivity. The drug Remeron, whose name is sculpted into the statue's base, is a remedy for depression. Photo by Emily Martin, 2002.

So compellingly desirable are the depictions of mania in support groups and conventions that being manic depressive almost parts com pany with pathology. In this sense, which I discussed in
chapter 2
, “mania” could be called “manic style,” a style that draws on the “mania” in manic depression, but ignores a great deal of what people experience when they are manic and when they are depressed. Despite all that it ignores, exemplars of manic style are appearing on all sides, from Robin Williams and Jim Carrey, to
Seinfeld's
Cosmo Kramer and Virgin Inc.'s Richard Branson. Before his suicide, the actor and writer Spalding Gray was featured in a Rockport ad sprawled in a chair, hair standing out electrically, claiming, “I'm comfortable with my madness.” Ted Turner is described in the magazine
GQ
as the “corporealized spirit of the age” and he appears in the
Saturday Evening Post
in a pair of commanding photographs. In one he is a businessman, lecturing soberly behind a podium with a corporate logo and in the other he is a wild-eyed ship's captain, fiercely gripping the wheel at the helm of his yacht. The caption to the photographs notes that Turner's competition should be warned: he has stopped taking his lithium (and so might well be about to launch a manic—and profitable—new venture).
²³

How do people who have the diagnosis of manic depression feel about the manias they experience, in a cultural context in which mania is celebrated in the media? Many people frankly appreciate their manias. In one California support group, I commented that the dampening effect of my medications sometimes made me yearn for the experience of mania. Mike leapt to respond.

Everyone always talks about the bad side of the illness, but now I am experiencing hypomania and it is good, I feel just incredibly good. When I worked at a luxury hotel on the coast, I remember, I was in charge, ordering “hot and cold running” limousines. A concierge, a Japanese American guy, said, “You know, you really have a gift.” I feel it really is a gift, it is productive. I have a shrink who doesn't automatically get out the prescription pad, and that's good.

Sweeping the troubling aspects of his condition under his elation, Mike continued.

I don't need much sleep at night but when I need to sleep it comes over me suddenly and totally. Once [falling asleep at the wheel] I sideswiped seven parked cars in a row, but I was only going around thirty miles per hour so no one was hurt badly. I am passionate about the wonderful way I feel; there is nothing bad about it, and it's just a good, productive thing. I feel good about myself.

Referring specifically to the media, people in support groups frequently told me how important celebrated manics were for their morale. Early in my research, I visited an officer of the California patient advocacy organization whose support groups I was attending regularly. Mary and her husband, Ron, responded eagerly to my question about the number of famous people in entertainment and business who were making their diagnosis of manic depression public.

Mary:
There are a lot of people with the illness who know that mania has some positive aspects. If you could just control it. If you could just keep it a little bit high but not too high. Manics are, when they are just hypomanic, really fun to be around. They are charismatic, they've got this great personality, and they are outgoing, effervescent.…

Ron:
They have creativity, productivity.

Mary:
Some people who have a lot of that in their illness don't like taking their medications. Then they go off their medications because they want to feel that way and they feel the medications are putting a lid on them and they don't like that. For me personally, I don't have a lot of mania in my illness—some but not a lot—I have more hypomania than anything else. And I'm very depressed, so the medication brings me up to feeling really good compared to what I did feel. So I don't have the tendency to not want to take my medication. It's not putting a lid on me.

Ron:
The people that are hypomanic like being hypomanic, and feeling regular to them is drugged down. To people who are depressed, they will do anything to avoid that depth of depression and they are more compliant with their medication.

Mary:
The stars and the people who have come out saying that they are manic depressive: I'm not at all surprised because this illness does seem to be linked to intelligence. People with this illness have a higher IQ on average. People are more creative and they do have more energy, so it makes perfect sense to me that they would be writers and poets and actors and actresses and CEOs. It just makes sense.

Mania or, more accurately, mania in mild hypomanic form, is extremely seductive, not least because it seems to offer capacities that lend themselves to success in the contemporary business and entertainment worlds: continuous wakefulness, boundless energy, high motivation, and productivity. Even for those who have been unable to parlay these experiences into lasting fame and fortune, thinking of others who have done so can be inspiring. There is something enthralling about experiencing life as filled with a dizzying number of possibilities, there for the taking.

However intoxicating hypomanic states are, most people in support groups realize that not everyone will be able to ride mania to fame and fortune. By far the greatest majority of stories I heard about mania, hypomania, or depression were stories of pain, loss, and suffering. Enrico told his California support group,

I fall mostly on the manic side, and I'm seldom depressed—I know that is unusual. I do take my meds. In the past I have gone through a lot of money, you might say it was “a few dollars.” I would just spend whatever I had. Now I know if I have three dollars, I should just save half of it. My wife of seventeen years left me—I guess she couldn't take me anymore. I asked my doctor which was worse, the manic side or the depressed side, and he said, “Both.”

Gender and Manic Depression

Are the desirable characteristics of mania accessible to men and women alike? Up until the nineteenth century, mania was frequently represented as both frightening and masculine: “Mad people, especially those deemed to be suffering from mania, were often portrayed … as wild, raging animals insensitive to normal feelings and experiences such as cold and hunger.” The wild figure of the mad person often had a masculine face.
²⁴
By the early twentieth century, the way manic depression was associated with gender categories had changed, so much so that far more women were diagnosed with manic depression than men, by some estimates twice as many. Elizabeth Lunbeck suggests that gender was encoded in the very category itself: the most salient characteristics doctors saw in the manic patient were those associated in other contexts with an unbounded, out-of-control femininity that was at once frightening and alluring.
²⁵
Men diagnosed with manic depression appeared to their doctors, relatives, and friends much like women: excitable, distractible, and talkative, their conduct governed less by rational considerations than by plays of fancy.
²⁶
More generally, in American mores since the post-Civil War period, a volatile temperament in adult women was a handicap for success in standard social roles and the normative definitions of femininity. For example, in Louisa May Alcott's novel
Moods,
Alcott's father, Amos Bronson Alcott, wrote in his letters that the volatile temperaments of his wife and daughter were “dangerous and unnatural.”
²⁷
In contrast, Lunbeck points out, dementia praecox (later renamed schizophrenia) was coded male. Its “stolidity, stupidness and catatonia … were merely the extreme, pathological manifestations of men's naturally more stable nature, just as the periodicity that characterized the manic mimicked in a more marked form the natural periodicity of women.”
²⁸

Today the gender differences for manic depression and depression have shifted. Statistics show that “manic-depressive illness … is equally prevalent across gender[s],” while major depression, with its immobility and numbness, is more common among women than men.
²⁹
We are beginning to observe the inception of the
male manic,
seen as powerful and effective
despite
or, more exactly,
because of
his instability and “irrationality.” Far from being feminized and denigrated as he was early in the twentieth century, the male manic now seems filled with potency. In Kay Jamison's words, “[M]anic states … seem to be more the provenance of men: restless, fiery, aggressive, volatile, energetic, risk taking, grandiose and visionary, and impatient with the status quo.”
³⁰

This change would leave the female manic no better-off. In the course of her career in psychiatry, Jamison notes that the extremes of mania did not sit easily with being a woman: especially when the passion of mania “tipped over into too much anger[,] [i]t did not seem consistent with being the kind of gentle, well-bred woman I had been brought up to admire and, indeed, continue to admire.”
³¹
The energetic force of mania makes it difficult for a woman to pull off being manic while keeping her female identity. In my fieldwork, Marcy described her experience of the incompatibility between being manic and being a woman.

For me the diagnosis [of manic depression] felt like a disorder because I'm used to moving through the world in this very unhindered kind of way. Suddenly it was like I could not satisfy anyone. Everything I did was somehow less than what they had gotten from me in the past. I could not meet other people's needs at all. If I had been born with an X and a Y [chromosome], maybe none of this would have happened, because my own sensitivity to not meeting other people's needs is what finally got me upset enough to find my way into the doctor's office. Not meeting other people's needs is so unpleasant for me that I had to put a stop to that any way I could. I would have taken any drugs that they gave me if I thought that they would make this go away. The Depakote actually did; the Depakote made me more tolerable for other people and that was fine with me. I did kind of think that the energy was particularly offensive to many people in a woman and they didn't really know why.

When she was manic, Marcy found herself unable to interact with other people like a good daughter, wife, or girlfriend should, aiming to satisfy the other's needs. Mania's kind of social engagement has a specific quality: it is a one-way outpouring of energy (perceived as masculine in style) rather than a two-way exchange (perceived as feminine in style).

Race and Manic Depression

In addition to gender reversals around manic depression, there have also been some shifts in how racial categories are aligned with the condition. Mania has often been negatively associated with the irrational, out-of-control, overly emotional, racially marked, nonwhite person; today it can be positively associated with the electrified, jubilant, hyperenergized, racially unmarked (white) person. As background to this shift, the historian John Corrigan found in his study of nineteenthcentury American business culture that African American emotionality was constructed as outside the range of “acceptable or even human emotionality.”
³²
African Americans were seen as impulsive, volatile, and prone to extreme emotional outbursts, while at the same time (and paradoxically) lacking human emotion and feeling.
³³
In the history of American expressive culture of the early twentieth century, “the primitive” marked an out-of-control and uninhibited energy culturally associated with the female, on the one hand, and the African American, on the other. Aesthetic primitivism in the 1920s could rest on “a stereotype of blackness contrived to erect white subjective potency.”
³⁴
White authors wrote about jazz at that time in the United States as a product of effects “at a level of human experience lower and more fundamental—‘deeper,' in one sense—than culture.”
³⁵
In 1919 a Swiss commentator described the power of jazz as emanating from a kind of ritual possession, placing possession “within a European dichotomy that strictly separates it from reason, allowing the ‘depth' of these musicians to become associated with the power of nature and the thrill of barbarism.”
³⁶
In the early decades of the twentieth century, out-of-control emotional energy was associated with “primitive” racial others on the fringes of the human.

Writing in this time period, Marie Cardinal also portrays jazz as an out-of-control force in her autobiography,
The Words to Say It.
Cardinal was a white French girl who grew up in Algeria. She described how she descended into madness upon hearing an intensely emotional trumpet song played by Louis Armstrong in Paris.