far as I'm concerned, there is at least a grain of truth in all of these arguments—they're not necessarily mutually exclusive. The pattern we call bipolar seems to have a genetic component and a trauma component and a social component and a cultural component and an environmental component, and—sure, why not?—an astrological component and a yogic component and a Star Wars use-the-force component and who knows what else.
My point in bringing all this up is not to sow unnecessary confusion or to undermine any particular group's point of view. On the contrary: I think the more angles from which you approach your own mental health, the better. If you attribute all your ill-health to brain chemistry and treat it with only medication, you might neglect to address your physical health, your emotional life, your relationships, your beliefs, and other factors that have a very real impact on your overall wellness. If you attribute all your ill-health to social and environmental factors, and treat it with only lifestyle changes and talk therapy, you may have your progress interrupted by a manic episode that could have been easily prevented with a touch of lithium.
Every person is different, and every person diagnosed with bipolar is different. Sometimes I wonder if the thing we call bipolar has different causes for different people: if some people have “classic” bipolar, which is truly genetic, neurochemical, and lifelong, and some people have more of a situational bipolar disorder—a response to chaotic surroundings, housing instability, poor coping skills, or trauma, which is more environmental than genetic in nature. This could account for why some people with bipolar ardently praise medication, and some people also diagnosed with bipolar seem to do better with therapy, meditation and lifestyle changes. Of course, there are also those people who seem to do best with both!
People who have been diagnosed with bipolar always have a certain narrative about how it developed: “I'd just gotten my first job and my first girlfriend, my parents divorced, and I started going crazy.” “I was staying up late, listening to a lot of Marilyn Manson, and shit just started getting weirder and weirder.” For one thing, humans love to tell stories. It makes much more sense to place bipolar disorder in the context of certain events, rather than having it come out of nowhere. Though the environmental triggers of bipolar disorder are not well understood, one thing many accounts have in common is a period of lifestyle change, stress, or major life events (both positive and negative). Real specific, huh? Try naming a time in your teens and twenties when you're not going through a period of stress, lifestyle change, or major life events!
In other cultures, narratives of mental illness sometimes focus on spiritual matters (“he is being haunted by ghosts!”) or family relations rather than biochemistry. Our Western narrative might be scientifically accurate, but it is not necessarily the most useful or compassionate way of imagining mental illness. If “haunted by ghosts” feels more meaningful and accurate to you than “haunted by misbehaving neurotransmitters,” then please, tell your own story!
Otherwise, it's you against the mothership. Lock and load, lock and load. . . .
EIGHT WAYS TO PROVE YOU DON'T HAVE BIPOLAR
1 Keep a straight face and neutral affect at all times. This will demonstrate how completely stable your mood is.
2 Whenever you hear something about bipolar disorder on the news, laugh loudly and say, “Ho, ho, ho, I'm so perfectly twitterpated to not be affected by such a foreign and fearsome affliction as that!”
3 Paint rabbit faces on your meds so they look like recreational drugs. Wear furry clothing and plastic beads so people think you're a raver.
4 When you get hospitalized, tell everyone you know you're an “investigative journalist” doing an exposé of what it's “really like” to be hospitalized.
5 Hire a look-alike to impersonate you at social events when you're too depressed to go out.
6 Surround yourself with people who are more extreme than you (drama students, nonrecovering addicts, circus people). In contrast, you will look totally un-bipolar.
7 Start a fake blog about your completely normal, nonbipolar life. Include entries such as, “Fun day at the mall!” and “New kitty is cute!”
8 Get a high-powered career that could never be held by a person with a mental illness. That will show them!
2
MANIA, DEPRESSION, PSYCHOSIS, OH MY!
A WHIRLWIND TOUR THROUGH THE EPISODES OF BIPOLAR DISORDER
States of human experience are extremely difficult to classify. Where does a mood end and a physical sensation begin? Where does a mental experience end and a spiritual experience begin? What's the difference between a bad mood and a bad day? Are some days just inherently sad or manic, or are “sad” and “manic” things that only happen inside individual people, and not in groups of people or in the wider world? Can a person be “depressed” or “manic” in a vacuum, or are those states in constant interplay with other people in the outside world?
Are you still “manic” if you feel really sad while you rearrange your furniture at three in the morning? Are you still “depressed” if you have two really bad days, then three really great ones, then two bad ones again? Is it still “psychosis” if you perceive your experience to be the result of intense yoga practice? Is it still “depression” if you have lots of energy and will to live, but feel overwhelming grief that they drained your favorite swamp to build a shopping mall?
These are all questions the Diagnostic and Statistical Manual of Mental Disorders (the book psychiatrists use to diagnose mental illnesses) does not get into. The DSM is all about putting human experiences into categories—drawing lines even where it doesn't make sense to draw them.
Think about a tree in the forest. It has bark and leaves and branches, which are obviously part of the tree. But what about the moss growing on the bark, and the ferns growing on the branches, and the mycelium intertwining with the roots, and the insects nesting in the wood? Are they part of the tree? Are they separate? Are they somewhere in between? A claim in either direction is very much up for debate. (The tree would die if you stripped off all the moss, or killed the mycelium—then again, can you really say that moss is part of a tree?)
Mood descriptions are no different. Take depression, for example. There's a feeling of sadness and a physical heaviness which are “obviously” part of being depressed. But your knee hurts from where you tore your meniscus, your job is entering data into a computer all day, and you hear cars and trucks driving past your house all the time, and you feel really, really down about that swamp. Are the cars and the job and the swamp part of your depression? Or is the feeling of sadness and the heaviness in your body the only part of depression that counts?
In this chapter, I am going to go through the DSM definitions of bipolar mania, depression, and psychosis because you are probably going to Google them anyway (don't lie!). But listen to me: even if some aspects of these descriptions sound familiar to you, don't let them overwrite the details of your personal experience. It's easy to read this stuff and say, “Oh yeah, I guess my mood lasted for four to seven days, and come to think of it, I did sleep less that month,” even when that isn't the whole story. There's a strong human impulse to identify with categories (that's why people get so obsessed with their astrological signs). At its worst extreme, the DSM can act as a script for “how to be bipolar” even if that's not how you experienced your moods before getting diagnosed.
So please keep perspective as you read this. Even if the DSM description of bipolar sounds just like you, don't lose sight of the moss and ferns and all the other unique details that make you you.
I'M NOT MANIC, I'M JUST HYPHY
Before we get into all this bipolar stuff, let's talk about hyphy. Hyphy is a Bay Area hip-hop style characterized by people dancing or acting in a hyperactive, ridiculous manner. You put on your stunna shades, get blasted, and “go