mental health

Author’s Note: It has been brought to my attention by an insightful reader that this post could be perceived as presenting psychiatric maxims and advice. I want to be clear for anyone reading this that I have no psychiatric or medical training. This post is written purely from the perspective of a layperson with bipolar disorder and is not intended to diagnose, treat or judge any illness or disorder. I apologize retroactively for any lack of clarity on my part.

In a recent Crasstalk comment thread, I made the mistake of writing the sentence “Catherine Zeta Jones is pretending to be in rehab for bipolar disorder.” Although it was certainly not my intention, my very poor choice of words made it seem that I was flippantly saying that Ms. Jones was faking her illness. Perhaps my comment is even worse considering that I do know much better than to make light (even unintentionally) of serious matters.

In hindsight, I know that I should have clarified my point by writing, “Catherine Zeta Jones’ publicist says that she is in rehab for bipolar disorder.” The point I was trying to make is that for an A-list actor, the stigma of admitting to treatment in a psychiatric facility is far greater than the stigma associated with going to rehab. My theory is that drug addicts – regardless of the severity of their addiction – can always say their behavior was a result of temporary weakness, whereas people with mental illness are often viewed as inherently and irrevocably defective. Chemical imbalances in the brain that must be treated with medication are deemed far worse than chemical imbalances in the body that require medication.

Ms. Jones has been diagnosed with bipolar II disorder, which is markedly different from bipolar I. (Bipolar II is characterized by more lows than highs, and the highs are rarely manic. Bipolar I is characterized by less severe lows and intermittent manic highs.) But I think the media lumps the two together because it’s more “exciting” to potentially have a manic-behaving celebrity, as in the case of Britney Spears’ paparazzi-fueled meltdown and hospitalization. But regardless, I think that arguing over degrees of mental illness is both missing the point and enhancing the stigma. I also think that the media’s tendency to publicly “out” people as being bipolar – even if they are exhibiting clear symptoms of the disorder – is victim-shaming at its worst. (Charlie Sheen comes to mind.)

Not every celebrity can be as open as, say, Carrie Fisher, who publicly talks about taking 8 different meds to manage her bipolar I disorder. I can understand a famous person not wanting to be painted with the mental illness brush. I think Catherine Zeta Jones is to be admired for acknowledging it. Of course, the extenuating circumstances of the personal stress she’s been under have clearly been a factor, but she could have instead chosen to say that she was suffering from exhaustion and face far less public scrutiny.

The brouhaha which my crass comment regarding Ms. Jones created in the comments has made me rethink my own situation. Despite my ebullient friendliness online, in many ways, I am a private person. I didn’t want to offer up as a defense for my remarks the fact that I have bipolar I disorder, because I didn’t want to be perceived as (1) insane, (2) self-hating or (3) unsupportive of other bipolar people, none of which is the case at all. I was merely recognizing the social stigma of the disorder – a stigma so great that it leads to inpatient psychiatric care being euphemistically referred to as rehab, and creates a hierarchy between “good” bipolar (II) and “bad” bipolar (I).

Having dealt with bipolar disorder consistently for eleven years (I was diagnosed a decade earlier) I can tell you that it’s challenging at times, but as long as I’m on top of things, I can consciously forestall circumstances spiraling out of my control. I take only one medication and manage my moods and thoughts quite diligently. Sleep is the best leveler I know of, and I make a concerted effort to keep my body healthy and balanced in all other ways as well. Bipolar disorder does not have to be a dramatic, violent life-interruptor, although mania is often portrayed that way on TV and in movies. It helps to have supportive people in your life; everyone close to me is well aware that I am bipolar, and my family and closest friends don’t judge me for it.

It is my intention to clear up the misunderstanding I created by offering a piece of my personal experience. It is obviously my hope that those reading this will open their minds to the possibility that bipolar disorder – and mental illness in general – is not the death sentence many people have been led to believe. There are varying degrees of the disorder, and I know that I am fortunate to have a milder version of bipolar I. Rather than look at it as a curse, I prefer to look at it the way Jimi Hendrix did: “Manic depression is touching my soul.”

UPDATE: bens made a fantastic — and crucial — comment that deserves to be in the body of this post. He offered some explicit clarification regarding the connection between drug abuse and mental illness that I had completely missed. Here is his comment in its entirety:

Drug addiction is a mental illness. You are mentally ill if you are a drug addict, plain and simple. Not everybody who goes to rehab or goes to a psychiatric facility for “drug addiction” is a drug addict, but for those who are genuine drug addicts there’s no way you can say its not a mental illness.

For CZJ, she probably went to a dual-diagnosis rehab, to get the appropriate level of care. She’s most likely abusing substances, hence the rehab. Just going to a psych facility not tailored to treat her addiction would only be treating part of the problem.