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In the press, at work, in the company of friends, there is a lot of talk about the phenomenon of bipolarity, about bipolar affective disorder. Until recently known only to specialists, this term is now used everywhere. What is this disease really?
“It’s just unbearable! He is in a great mood, then a minute later he is no longer in the spirit! 17-year-old Polina complains to her sister about a young man she knows. She seriously explains: “Probably he is bipolar…”
Ten years ago, this term was found only in scientific papers and speeches of psychologists and psychiatrists. Today everyone knows about bipolar affective disorder. Heroes with BAD appear in fashion series – CIA agent Carrie Matheson from “Homeland” or the unworthy mother of the family from “Shameless”1.
Movie stars Jean-Claude Van Damme and Catherine Zeta-Jones admit to suffering from this disorder, and Stephen Fry even starred in a documentary where he talks about his relationship with the disease and explains how you can live with it.2.
Never before have disorders enjoyed such interest of the general public, with the possible exception of schizophrenia, sung by Mikhail Bulgakov in the novel The Master and Margarita. However, schizophrenics themselves rarely talk about their illness. “This is quite understandable: the disease takes a lot of strength, it is difficult to combine it with a full-fledged existence,” explains psychiatrist and psychotherapist Olga Kazmina.
But bipolar disorder with long periods of complete recovery between manic and depressive phases does not interfere with living in society.
A disease that fits the modern rhythm
Bipolar affective disorder is a kind of disease of the century, because it fits well into the hectic rhythm of our time and fits in spirit with an atmosphere of constant instability, uncertainty, says psychoanalyst Darian Leader.
There are even dubious publications that advise maintaining euphoria, exaltation, accelerated thinking (that is, manic states) in order to be more effective at work. And top managers are taught to use such states to increase productivity. In Hollywood, agents make sure the drugs stars take during manic episodes keep their euphoria and arousal in check, but not too much.
The desire to communicate that is characteristic of bipolar disorder becomes an advantage in this age when communication is a must.
“The self-confidence, excitement and energy that characterize the initial phases of the manic stage are essential for success in the modern world,” notes Darian Leader. When you have to work after hours, deal with constant stress and burn at work, hyperactivity becomes a definite plus that allows you to survive.
The urge to communicate that is characteristic of bipolar disorder is an asset in this age where communication is essential. Ideas about our own omnipotence, also typical of the manic phase, are quite consistent with modern ideals of personal development, which imply the desire to fulfill our desires.
“Confessions of a normal crazy woman”
Angels, shining light, dazzling love… “I ran inside myself, like on bridges through a swamp, according to the plots of fairy tales.” But reality was visible through them: hands tied to the bed, dirty walls of a psychiatric hospital, rude orderlies. The author, Olga Marinicheva, is reporting from inside her soul, trying to extract from her suffering a meaning that could help others suffering from bipolar disorder (Vremya, 2011).
Side Benefits
The feeling of strength and freedom helps to feel alive. A person with bipolar disorder experiences a heady sense of unity with the vast world, that “oceanic feeling” that the writer Romain Rolland mentioned in a letter to Sigmund Freud3.
“It seemed to me that secrets were revealed to me that were inaccessible to other people,” 29-year-old Evgenia recalls her manic episode in the spring of 2015 with a certain amount of nostalgia. “I saw hidden meanings everywhere.”
“If it were possible, by pressing a button, to be cured of bipolar disorder, I think not everyone who suffers from it would dare to do this,” says the psychoanalyst. “Even if he regularly ends up in a neuropsychiatric dispensary, having spent all his money in a fit of shopaholism, quarreling with all his relatives, or risking his life in a ridiculous fit of heroism.”
“Euphoria can be replaced by irritability, especially if ambitious plans fail, and gloomy hostility towards others,” adds Olga Kazmina. And this is the paradox of the disease – it makes a person unhappy, anxious and leads him to despair, but it also makes him unusually strong, creative and energetic.
That is why they do not hesitate to talk about it, and sometimes it is even considered a virtue. Alexander the Great, Mozart, Napoleon, Newton, Balzac, Nietzsche, Einstein… It is generally accepted that many geniuses suffered from bipolar disorder. Perhaps some of us want to continue this series?
Wrong diagnosis?
There is so much talk about bipolar disorder also because the number of people who have been diagnosed with this disease is constantly growing. “About 3% of Europeans suffer from this disease, while back in the 1990s they were only 1%,” says Darian Leader. “Influenced by the DSM, the bible of the Anglo-Saxon psychiatrists, this diagnosis began to cover a larger list of symptoms.”4.
It now includes affective disorders (such as frequent mood swings), behavioral disorders related to alcohol and drugs, and irritability. These symptoms unite very different people in their behavior and fate.
52-year-old Yegor survived the only episode of hyperactivity at the age of 20. He was treated with lithium and now leads a normal life. 40-year-old Mikhail was diagnosed with bipolar affective disorder after years of treatment for depression, when it turned out that antidepressants did not help.
True, the current regimen of treatment – antidepressants, antipsychotics and lithium – also does not help. 45-year-old Ivan, a real estate agent, fell into the “chasm” on his thirtieth birthday. He went to the casino, lost to the nines, got into huge debts, not realizing the consequences of his actions.
37-year-old Antonina, an artist, had an attack on the opening day of her first exhibition in 2011: “I hardly slept, I painted all day long. Driven by love for all mankind, I settled two homeless people in my workshop. My husband was furious and sent me to the clinic.”
Impulsive people who are prone to frequent mood swings, fans of marijuana or alcohol, those who find it difficult to sit still, keep a job and long-term relationships – all of these people are also diagnosed with such a diagnosis.
Extremes meet?
“Bipolar affective disorder (BAD) is a mental illness that manifests itself as a change in mood and activity level,” says psychiatrist Olga Kazmina. – The expressed form is usually called manic-depressive psychosis (or cyclophrenia). The patient loses control over himself, falls into euphoria, feels vigor, a surge of energy, physical strength, health, and ceases to really perceive painful sensations.
He talks a lot, sometimes dresses ridiculously and colorfully, becomes overly familiar, experiences increased sexual desire. Then suddenly (sometimes within one day) euphoria can be replaced by irritability, especially if ambitious plans fail. Speech becomes not only fast, but also confused. Hallucinations, delusions of persecution, mystical visions, delusional ideas may appear. At such moments, the patient is dangerous to himself and can make decisions that put his life in danger.
The mild form suggests that the disease does not change the personality of the person, long light intervals predominate in him.
A promising market for laboratories
And often wrong. Psychiatrist Allen Francis, a personality disorder specialist and author of the first editions of the DSM in Europe, is convinced that this is happening under the influence of the pharmaceutical lobby: The “epidemic” broke out when antidepressants began to bring in less money and there was a need to come up with new treatments and sell new drugs. .
Patients are prescribed tranquilizers, antidepressants, mood regulators, and antipsychotics—and so bipolar disorder is a big moneymaker for the manufacturers of all these drugs. “The pharmaceutical industry is a gigantic business,” the psychiatrist emphasizes. – In the world market, sales of psychotropic drugs exceed 7 billion a year. The best way to keep making money is to find new diseases. And create cures for them, preferably in the form of easy-to-use tablets.
The peculiarity of mental disorders also plays a role in the spread of this “epidemic”: unlike other diseases, they do not have visible objective causes and manifestations, such as brain damage, changes in blood composition, the action of viruses or bacteria.
“Psychiatrists don’t have the screening criteria that doctors in other specialties work with,” admits Allen Francis, “so nothing prevents a diagnosis of “bipolar disorder” in the presence of symptoms that would previously be called depression, it is only necessary for an authoritative organization to sanction such a change in definitions. …” What disease will become fashionable tomorrow?
1. Homeland (“Homeland”), American action series; premiered on cable channel Showtime in 2011; Shameless (“Shameless”), American comedy-drama series. It premiered on Showtime in 2011.
2. Crazy Depression with Stephen Fry, dir. Ross Wilson, BBC, 2006.
3. R. Rolland “Articles, Letters” (Rainbow, 1985).
4. DSM (Diagnostic and Statistical Manual of Mental Disorders). This guide to the diagnosis and statistics of mental disorders is published by the American Psychiatric Association.