Bipolar Expeditions (41 page)

Jim used the language of emotional depression to describe his suffering in the wake of national and global economic depression and its effects on him and his family. He “beat them to it” in the sense that he became physically and emotionally “frozen” before his job and his earnings were frozen.

On the other end of the mood scale, which Jim has not experienced lately, there can be equally devastating relationships between moods and economics. When people described these relationships in support groups, their tone could sometimes be humorously bittersweet, as expressed in these three statements, from three different West Coast support groups.

[Michelle said that her $5,000 SSI (Supplemental Security Income) check had just arrived.] There is something about an SSI check that brings on a mania. One time I spent $2,000 of it on a fancy pager with a five-year contract, Chanel makeup, shoes, gifts, etcetera. Those people at the mall know it when they see a manic depressive coming.

Mike:
I like women and falling in love is a lot like mania. You feel upbeat, optimistic, elated, and excited, but then I eventually go into a depression, and the relationships don't last. I can go through a lot of money when hypomanic, especially in relation to women, going out, buying dinner, giving the ice cream girl $100. I bought a $35,000 boat last year, which sank. But I lived on it for a while before it sank.

Richard:
My psychiatry residency was interrupted by this illness. I went on a cross-country trip, spending money like crazy, with my wife and children in the car. I went up to a house, and, as I remember it, I just touched the door and the chain broke. I went in and said, “Sorry I broke your chain.” I was arrested for breaking and entering and did jail time.

But more often, the experience of manic behavior is no joking matter because it is economically devastating. The market's immense capacity to absorb investment acts as a lure to a person in a manic frame of mind. As Kay Jamison comments, “Unfortunately for manics anyway, mania is a natural extension of the economy.”
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Gert was a successful businessman I met at a DMDA conference who worked in the family business before being “felled by manic depression.” His father encouraged his mania, his energy, and his enthusiasm. Gert speculated in gold. He would read an investor's report and just get an intuition that gold was going up. He would spend a lot of money: once he bought five gold funds for a total of $100,000, but “the pattern was I would make $5,000 and then lose $25,000.”

Peter was a successful businessman, in development, public relations, and marketing. He was taking lithium, but when he was about to move to California his doctor said he could stop taking it. In California he had a five-year contract with a Japanese company to develop a golf course. Even though he didn't know a thing about golf, he did it successfully, and in only four years. This enabled him to go for a year without pay and no need to work. Then things started to fall apart. He was footloose with money, and he bought and sold a couple of houses. Now he has only the big office with a gorgeous view of the ocean, and no business. His wife is filing for divorce and his son says he cannot work with him. He wishes the doctor in Texas had not allowed him to go off lithium. One of his former business associates agreed to help him run an antique sale to raise funds from items in his house: “The guy put signs all over the area saying, ‘Antique Sale to benefit the mentally ill.' Now my son is mortified at school—there is such stigma that now none of my former business associates will even return my phone calls.”

Wendy can't tolerate any of the mood stabilizers. She has tried them all and either they do nothing or they have terrible side effects like making her hair fall out. She has to take an antipsychotic because otherwise she thinks people will think she comes from another planet. Until her diagnosis several years ago, she was a high-functioning real estate broker. Her cycle fit the real estate cycle very well because it enabled her to work like a maniac in spring and summer and then slow way down in fall and winter. She was very successful. There was a saying in the office: “If Wendy can't sell something, she will buy it.” She described her fall.

When I fell apart, I had built up my assets and I owned a large apartment building. I lost it all in the hospital. Now my goal is only to own a modest house. I am worried because I am so good at convincing others to go along with my wild, grandiose schemes. I can sweep you up with enthusiasm because I really believe in the scheme and that it is good for you. I am a professional salesperson after all, and positive thinking is a large part of that. My boyfriend has gone along in the past, and now I have pleaded with him to resist. He objects that “it is
so
hard!” What I do is pile one financial obligation up on another until the weight sends me into crisis. I have to keep all the tenants in order, deal with loans, mortgages, all of them so precarious and delicately balanced they threaten to collapse. The growing debt eventually causes
me
to collapse.

The Edge

Accounts like these could help us understand the pain people feel as a result of mania or depression, especially when they are economically disadvantaged. It is equally important to understand how those who cause suffering in others, directly or indirectly, experience inflicting pain on others. Recently, some anthropological researchers have begun to ask how people in positions of power tolerate knowing that their actions may cause others to suffer. For example, in her Wall Street fieldwork, Karen Ho focuses on investment bankers, who, as a condition of their jobs today, not only bring about much suffering for employees of other firms by requiring them to downsize frequently, but also feel the pain of downsizing themselves. One question in her research is how the bankers tolerate knowledge of this double-edged sword, or how they remain to some degree unconscious of it.
⁸⁵

In his research in a nuclear weapons facility, Hugh Gusterson inquired how the scientists there tolerated the knowledge that they were making weapons with the capacity to maim and destroy untold numbers of people. Gusterson argued that widespread use of numeric measures of human pain and suffering blunts visceral knowledge by means of the clean coldness of abstraction. Numeric measures can serve to “drive another person's pain from awareness so that the doctor can get on with his or her task of applying scientific rules and logic to the objectified signs of another person's pain without the pain itself getting in the way.”
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Might there be a connection between the hyperenergized, manic state cultivated by traders, bankers, and other executives, and their awareness of suffering? Is there something about being manic that allows you to ignore your own suffering or the suffering you cause others?

In his
100 Years of Psychiatry,
Kraepelin speaks of the use of painful cures for mania in earlier centuries.
⁸⁷
Since manias would drive a patient to a “higher plane,” deliberately inflicting pain on a patient would force him to “descend from his ethereal perch” and “re-enter the husk.” Part of what is appealing about the state of mania today is a numbness to pain, something that has been a part of the social life of its “disease picture” for a long time.
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Why would this be? As I have pointed out before, manic depression is a condition in which mania and depression are mutually entailed. If, on the psychodynamic view, mania is produced as a defense against the suffering of depression, then the very point of mania is to avoid the experience of one's own suffering. Perhaps it is not too great a leap to suggest that experiencing mania can inure a person to the pain of others as well as one's own. Being inured to pain in the present or oblivious to the inevitability of future pain might be as necessary for consumers on a manic buying spree as for CEOs manically generating profitable ideas. Being on a manic “higher plane” may work well to blind one to the kind of painful consequences caused by corporate CEO decisions to merge, downsize, relocate, or subcontract at the expense of their employees.

On the opposite end of the mood scale, in depression, people feel pain so intensely that they sometimes try to escape through suicide. As mania becomes more and more a separate “thing” that can be managed by drugs, what happens to its dark twin, depression? One marketing campaign for a manic depression drug, a form of sustained-release lithium, placed depression over an “edge.” “Dancing on the Edge: An Intimate Look at a Bipolar Life,” was a display from the 2000 APA exhibit for Scios. Scios's theme for the drug, “Dancing on the Edge,” featured large photos on displays that led viewers through the story. This was what happened to a college guy who was wild but in the top 10 percent of his class and got a dream job. In the corporation, he was both terrific Tim, the wonder boy, and terrible Tim, who was fired, jumped from job to job, and got a divorce. He had a catastrophic manic episode, which really scared him. Upon treatment, he got a new small apartment and a new job. Then came the “end game”: the display showed a picture of a pistol, pills, a razor, and rope. He felt the “tedious grasp of normalcy” and experienced agitation and anger that he had lost his edge, then became full of ecstatic plans about his return to the good old days. Confronted about his compliance in taking his medication, he took off, attempted suicide, but failed. The last display read:

I'm so brilliant.

I'm so confident.

I'm so successful.

I'm so attractive.

I'm so rich.

I wish I was dead.

It may seem impossible for such opposites to coexist in the same person, but they do. They coexist in the two photographs of Ted Turner in the
Saturday Evening Post,
which show him vibrant with power. The caption under the photographs ends on a fearful note: “Turner's father, like Hemingway's, committed suicide.” This raises the implied question: will Turner end his life by suicide as Hemingway did? Poised between the mania that enabled his financial success and the depression that threatens him, Turner is often depicted as a tragic figure.
Time
reported that he prevailed over the “dark legacy of his father” in a life that has been a struggle to master his intense fear of dying in midlife, as his father did. He was convinced that through some “cyclical inevitability” he was doomed to lose whatever he had.
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A long essay appeared in
The New Yorker
shortly after Turner lost his position at AOL Time Warner, describing his fall from invincibility. The essay ended with Turner in a restaurant quoting Thomas Macaulay's “Horatius” from memory: “And how can man die better / Than facing fearful odds, / For the ashes of his fathers, / And the temples of his gods.”
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The excesses in Turner as capitalist and as yacht captain seem necessary for his success, but his excesses are inextricably connected to the possibility of his suicide. His exuberance burns brighter under the shadow of apprehension. (As the Ted Turner caption hints, the risk of dying by suicide among those diagnosed with manic depression is high.
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) “Dancing on the Edge” is gripping because it brings together the dancer's lively beauty with his position on the edge of death. To live under the description of manic depression is to live and die simultaneously, as if the condition foretells one's possible (even likely) suicide. This is a kind of living death, and it is surrounded by an aura of fear and intense fascination.
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9.5. “Dancing on the Edge,” an exhibit at the 2000 American Psychiatric Association meeting. The exhibit advertises Scios Inc., maker of Eskalith, CR, a sustained-release form of lithium used to treat manic depression. Through a number of displays like this one, it tells the story of a young man who plunges from success to despair because of his manic depression. He is helped by medication but becomes suicidal when he refuses to take it. Photo by Emily Martin, 2000.

• • •

In part 2 we have taken a route through mania in manic depression and mania in the market, and we have seen that both forms are infused with fear and desire. Although the mania of manic depression and the mania of manic markets are certainly not the same thing, they do both operate on an edge. We might think of the “edge” as a “break” in the smooth public presentation of manic depression, a break that points to things that are either suppressed or beyond expression in language.
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For the manic male entrepreneur or CEO, the edge might lie near the specter of terrible loss. As the imperative to become the kind of person who can succeed in extremely competitive and unpredictable circumstances has intensified, the prospect of failure has become more frightening. The times are bringing greater knowledge of what capitalism entails and greater fear of what it may require of people. Business entrepreneurs are often called upon to ignore such fear, to continue taking risks even at the risk of social or even physical death. A recent issue of the
Economist.com
quizzes its readers: John Maynard Keynes referred to “animal spirits” when describing what? Answer: The naïve optimism that inspires entrepreneurs. Explanation: Keynes said that for entrepreneurs, thanks to animal spirits, “the thought of ultimate loss which often overtakes pioneers, as experience undoubtedly tells us and them, is put aside as a healthy man puts aside the expectation of death.”
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But can fears continue to be put aside no matter how great they are?