You have hit the nail right on the head there, Bishamon, in my humble, untrained-but-experienced-with-a-bipolar-friend opinion.
If any of you see a person in full manic mode, going on about the Bible (and getting it all wrong), then you’ll see it’s not a joke.
Phlosphr:
Thanks for the link.
The thread title: Is manic-depression a disease to be cured?
Isn’t that what we are supposed to be talking about here?
In answer to the OP’s question, the link that Phlosphr provided indicates that genetic illnesses can also be considered diseases.
Although science may not be able to cure this disease yet, research, incuding genetics, may sled some light on solutions. But the symptoms are certainly treatable and maybe some of the newer medications could relieve your symptoms without damaging your creativity.
I am not a physician.
Anecdote – my partner was diagnosed with bipolar last year. He’s a writer, well-published and shortlisted for awards and has received fellowships etc. So he’s not a creative wanna-be, he really was already successful.
Last year things got impossible for him and with him. He trialled depakote with grave misgivings about the (possibly mythical) effects on his creativity. His normal output was 2 books in a good year with lots of time off for depression and inability to deal with life.
In the past year he’s written 6 books, one of them the best he’s ever written. Without the cycling of bipolar, he’s more productive, more happy in himself and a damned sight easier to live with.
I don’t view bipolar as this romantic condition where the price of genius is suffering. Neither does he any more.
That’s exactly my experience with depression. When I was untreated, I thought I was a great writer. Treated, I discovered that I was writing self-indulgent crap, but I was so tortured and dramatic that it seemed somehow laudable.
I do not, of course, claim this is true of everyone. But it seems to be true more often than not.
Julie
And really, what is the rate of successful untreated manics, with the unsuccessful?
For every Van Gogh, you probably have about 100 who aren’t successful.
I am not manic-depressive, but I can share some of the concerns expressed here.
I have always felt cynicism, a grim outlook, and a curmudgeonly demeanor to be a part of my identity, my personality. It is who I am.
When my dissertation coach told me she thought I might be getting depressed, I started wondering what my doctor was going to want to do if that diagnosis panned out. I had a grave concern about the effect of pharmaceuticals. I worried that they wouldn’t just “fix” my dysfunctions, they would also strip away that delightfully bitchy outlook which is the hallmark of who I am.
I would imagine some artists feel something analagous to this–that the more tortured parts of their souls are a font of genius and creativity. It is who they are. They don’t want to lose that.
I think such concerns are valid. However, in my understanding of how medication and other therapies work–and in my own personal experience–it turns out that the fears are unnecessary. The goal of therapy and of drug treatment is not to erase the extremes of human emotion. I’m still a bitch. I’m just a functional bitch. What is gone are the negative thoughts which were irrational, such as assuming my boss loathed me. The general negative thoughts (grumble, grumble; damn, that singing bird is annoying) stay with me.
I presume that an artist who uses strong emotions as a wellspring of material doesn’t have to be clinically and constantly depressed to succeed. You can improve the depressive (and manic) symptoms but the essense of the person will still be the same.
I just met with a group of psychiatric inmates’ liberation / “consumers-survivors-expatients” movement people and we talked about public perception of us and public education and how we wish to be perceived.
Is it a “disease”? Some of us do believe there is a difference and that at least under some circumstances this difference is the reason we have received psychiatric diagnoses, although we don’t tend to attach much credibility to the medical model of mental illness.
But a difference only becomes a disability (let alone a disease) when we, on an individual basis, determine that we find that difference disabling – and not all of us do.
And the bottom line is this: no coercion. No forced treatment. We have the right to be untreated uncured crazy people. (As with noncrazy people, nondiagnosed people, etc., we are subject to laws that govern behavior and if we violate them we can be charged and arrested like anyone else). And it is our right to choose to remain untreated and uncured that we are fighting for.
That’s all well and good-but when “untreated crazy people” become a danger to themselves and others, then their right to remain untreated ends.
AHunter3, I don’t disagree with you, but I would like your view on this sort of situation:
A patient of my acquaintance is bipolar, rapidly cycling (4 or 5 full cycles a year), and completely psychotic during both the severe depression and severe mania (catatonia, hallucinations). When not on medication, these cycles are devastating to the family, especially the young children. The patient is unreliable as a parent during these extremes, yet breaks no laws. Spouse, family and friends are always on high alert to mitigate risk and damage to the children and to the patients, but things do slip thru. The patient agrees the behavior is a problem, but only wants medications during exacerbations. However, during the exacerbations, the patient then refuses medications. Clear and present danger is difficult to demonstrate to the courts, and they have declined to intervene.
What should the family do? What should society do?
even sven, my baby sister just started taking a time-release Lithium which has improved her mental health greatly. She has struggled with bipolar since she was a teenager (she’s now 31). She has gotten worse and worse with time. It’s been a struggle for the family to help her through it all, and medication has been a big stumbling block. She’s had bad experiences with most of the standard medications, including Lithium, depakote, and wellbutrin. You might like the time-release Lithium.
A couple of words about the disorder/disease (I’m not gettin’ in that fight!): It’s awful. Hideous. Here’s a few excerpts from some of the e-mails I’ve gotten from her:
Sorry for the length, but I’m trying to illustrate what a fight it is for her. You would do well to see a mental health professional; it’s not the type thing that I would advise anyone to “self-treat”.
P.S. Upon preview, after reading QtM’s post, I will add that she has a 10 yr old daughter whom she is incapable of parenting due to her bipolar. They have zero relationship. It’s very heart-wrenching to us, as her family.
Let’s see…I’m going off of a few articles…
The first one is “Manic-Depressive Illness and Creativity” by Kay Redfield Jamison". She begins by showing a relationship between creative thinkers (writers, painters, etc.), manic-depression and suicide. She states “First, the common feature of hypomania seem highly conducive to origional thinking” and goes on to say that "sharpend and unusually creative thinking and increased productivity’ is in the diagnostic critera. She then theorizes that manic-depression allows people to understand the moods and contradictions of humanity better than a person with a more consistant outlook on life. She says that while may people seek treatment, “these drugs can dapan a person’s general intellect and limit his or her emotional and perceptual range”. She then pins her hopes on genetic thearapy.
Next, I am looking at a sections of “Touched with Fire” also by Kay Redfield Jamison. In this section, she looks at the effects of lithium on creativity. She finds evidence that lithium not only changes the personality and temperment of the patient, but it can actually lower their intellectual capacity. She points out that manic-depressives are resistant to treatment not because they are too crazy to make decisions (as some of you have posited) but because they miss the power of their everchangeing moods. She then states once again that modern medicine helps, but that individuals must be free to choose their own level of treatment.
Finally, I looked at “Connecting Depression with Anxiety” by Richard A Friedman, in which he relates the very interesting story of a photographer who began treament for mild manic-depression. Her resulting art changed dramatically. It became very commercially sucessful, but fairly mundane. She began taking pictures of cute kids and couples and abandon her more challengeing work. She went off of drugs for a while, but then went back on them.
Anyway, all these articles seem to point to a link between creativity and manic-depression, and clearly explain some of the complications that come with treatment.
AHunter3, you are just the person I was hoping would show up. Can you share some more of your views?
Some more about my personal situation…
I tried the medication thing once, and within twenty minutes of walking into the office I walked out with a prescription for Celexa (they didn’t even ask if there were any manic elements of my depression). I took a couple doses but I realized A: The side effects were too severe for me to be getting used to them during finals week B: School was ending and I had no way to maintain a $70.00 a month perscription over the summer, and it would be dangerous to have to quit cold turkey once I got used to them C: They wern’t evenn putting enough thought into this whole thing to get an accurate diagnosis.
I tried the consuling thing. The guy asked me why I didn’t want to take medication. Then he asked me if I got enough excersize (at the time I’d wander around for four or five miles a day crying). Then he said there wasn’t much he could do for me.
In the meantime, I’ve been having my ups and my downs. Whenever I feel ‘normal’, everything feels so stagnant and dull that I almost wish I felt bad again. I’ve had some pretty increadable lows, but somehow I keep on suceeding in my life. I’ve managed to graduate college with a variety of honors, even though I spent huge chunks of school in hiding under my blankets crying. I don’t really understand it, but it seems to “work” at the price of “normallicy” that never really feels alive to me anyway. I’m a filmmaker, and I know that the super-confidence, endless energy, and heightend competence that comes with my manic states has helped me in so many of my projects. It’s like I’m a superhuman when I am busy, and totally depressive when I’m not. I know it will just get worse if I don’t do something, but right now it is the only way I know how to live. The devil I know and all…
In the meantimes, I decided against the whole having kids thing. I know too well what it is like to be the dependent of someone who is unstable. And I know that it is enough of a struggle just to remain responsible for myself, much less another helples person.
The coercion thing – I’ll freely admit I coerced my partner into treatment. He either sought out treatment of whatever kind, meds, therapy, whatever or he left the family home until he was willing to. I did not see that he had the right to remain untreated when his effect on the children was so negative. This household was a nightmare place to live and for me, I am not so respectful of someone’s disorder/disease that they get to make me and my kids suffer alongside them. He chose meds and yes, I think it was under duress but he could have walked. The door was open.
The creativity thing – maybe we were lucky or a statistical anomaly. I have not seen a decrease in creativity and Mr P certainly doesn’t think he has had one. Prozac was worse in that regard. I don’t value creations bought at the cost of human misery though.
Guinastasia:
Under the same circumstances (and no others) that your right to remain untreated would end were you to become a danger to yourself and/or others, I presume?
If it were you, you’d have to actually do something? Or would the opinion of some people that in their excellent judgment you were likely to do something dangerous suffice?
And if you become dangerous, how shall we “treat” you?
Qadgop the Mercotan
I think if it were me, I’d have an attorney draft me two documents:
a) a Springing Power of Attorney designating someone as my “official take-over decision-making person” should I become incapable of making my own decisions. I would be very explicit about this authority expiring as soon as I was once again able to determine matters for myself, and also about restricting the area of authority to a select few areas, mostly medical/pharmaceutical.
b) a Health Care Proxy and/or Living Will, designating the same person and laying out in explicit details how I’d like to be treated medically (psychiatrically) and for what duration.
I think the combination of the two would be sufficient to “protect myself from myself” if that’s what I wanted. The POA by itself might not do it because questions would be raised about whether or not I were sufficiently incapable of still managing my own affairs, but in conjunction with the HCP which indicated that were I to still be in my right mind I’d be taking pyschiatric pharmaceuticals until I was once again in my right mind, I think it would convey a pretty clear sense of what my (normative) wishes were.
Good question 
Primaflora:
That’s reasonable.
I’ll tell you right now that there are many people in the movement who are not pleasant to deal with.
Ultimately that’s OK. I had a college professor who had a sign in her office that read something like “Gender equality is not when a female genius can go as far as a male genius; it’s when a female schlemiel can get by as easily as a male schlemiel”. In our case, we need the freedom to be as unpleasant to deal with as people who don’t have psychiatric diagnoses, without facing any involuntary treatments they wouldn’t.
But your individual private little household is not an institution and his freedom and interests don’t get to override yours. I think it’s reasonable to say “Fine, don’t take the drugs if you don’t want to. There’s the door. I want to be on the other side of it from you while you’re like this.”
H’uh?
You mean, if I were a danger to people, should I be treated? Hell yes!
I’m a caretaker for a person with mental illness.
There is nothing harder to do than invoke a Medical POA, or one for Mental Healthcare, when you’re dealing with a person indulging in dangerous behavior, doing things that will cause real problems, but still with it enough to ‘pull her act together’ for the cops and EMTs.
Several times, I have had to allow her to get into binds that cost me a fortune to get her out of, in order for an authority figure to stop her. Then I have to get her out of jail and into the psych hospital.
If one has to go to that extent to be able to ‘cope with my illness in my OWN way’, one should expect to lose the trust of friends and family members. Make sure that you choose a POA that isn’t as undependable as me. I keep on having to have cancer treatment and surgery, and when the attention is not on this person full-time, she acts out. I’ve had to have a phone brought to me in the ICU to contact her psychiatrist and psychologist.
As my time is running out, I can’t find someone willing to take the responsibility. What does society do then? Allow her to make the decisions that will end up with her being a corpse or a bag lady? Hospitalize her for the rest of her life? Hire someone to follow her around to turn off burners, close freezers, pull her out of the middle of streets, take away broken bottles and knives, take away drugs, stop her from all the things that she’ll do to hurt herself and others?
If you want to function in society, you have to make certain sacrifices. You have to decide what they are. Society gets to decide if it’s enough.
Option #1 may have to be the way to go, if only because people are damaged more severely and significantly by coercion, no matter how often it may be fueled by good intention, than by a commitment to respecting people’s liberty and self-determination, no matter how often it means letting them die of neglect and failure to intervene.
Some of the best options for improving on that sad set of choices have been user-run alternatives, which have ranged from housing and mutual support groups to out-and-out Safe Freakout Centers. But these are hard to keep going without dependable funding streams and the mental health system’s record for funding user-run alternatives has been spotty at best. And if the individual does not perceive him or herself to be in need of help, we certainly aren’t going to impose it!
So…I suppose some of you are wondering…what [does AHunter3 think] should one do when a person is essentially dangerous, but mainly to themselves and therefore isn’t violating any law for which they could be locked up, and can pull themselves together well enough to “pass” when the cops come? Mostly: respect their right to make stupid decisions and/or be weird and disruptive and/or highly unpleasant company to all in their surround and/or destroy their lives. Because you could be wrong in your assessment of these things, see? And because if they are sufficiently out of it to warrant intervention over their objection, then a court of law should be able to find them so.
Anyone competent enough to “pass” is no different from your dear Aunt Harriet who persists in eating foods that are not good for her and dating men who are not nice to her and who drinks way too much and bar-hops through the more dangerous parts of town very late at night: you’re absolutely convinced she’s gonna kill herself one way or another, but the world is a better place for the fact that there isn’t a damn thing you can do about it unless you can convince her that she should change her ways.