David Letterman And Dr. Phil On Bipolar Disorder

As I mentioned earlier today, last night David Letterman and Dr. Phil had a little chit-chat on "Late Night." The TV psychologist was discussing his Dr. Phil's House, or whatever the hell it's called, wherein reality TV meets mental illness, abnormal psychology and, one supposes, human drama. As it turns out, there is now a man with schizophrenia on the show and Dr. Phil and Dave briefly discussed him and psychosis.

Then, Dave steered the conversation to bipolar disorder. I'd been working at my computer and listening to their exchange, but this short discussion got my full attention, although I was only able to take down part of the conversation (I have been unable to find a transcript). I did much better at capturing Dr. Phil's answers than Dave's questions. It was stunning, one of those weird little watershed moments, at least from where I sit. After all, whenever bipolar disorder is discussed on national TV it's always on a news program and it's about a shooting or the naked guy running down the street or what have you. This was not that.

Dave essentially asked Dr. Phil, What about bipolar disorder?

"Bipolar is kind of way overused," said Dr. Phil. After being asked about bipolars by Dave, Dr. Phil gave a thumbnail description that mostly focused on manic/hypomanic screwiness and impulsiveness. He talked about people who "get really expansive and out of control." He mentioned a former patient of his who once bought seven Mustangs one morning, if I caught that properly. He made no mention of the depressive side of bipolar disorder.

Dave pressed him on whether bipolars needed to be on meds all the time.

"Well, no," said Dr. Phil. "Sometimes meds can help, but you can also do talking therapies with them."

Don't these people "tend not to stay on" meds? asked Dave.

"If they don't, you have a real problem...one of the biggest," said Dr. Phil. "Do you take meds, Dave?"

"Every night before the show, I take a handful of Tylenol PM."

And that was it.

Several thoughts. I wish Dr. Phil could've pressed a bit more on the idea that bipolar disorder is way over-diagnosed--because it is--and a term that has become something of a cultural shorthand for hyper-energized people who are a bit too creative for their own good. But he did essentially say that the disorder is not such a big deal.

It's interesting that Dave twice pushed Dr. Phil on meds and bipolar disorder. Dave's hometown is Indianapolis, where Eli Lilly is headquartered and has been for many years. Perhaps, it's something in the water.

To nitpick, Dr. Phil over-emphasized the manic/hypomanic end of things. Mania and hypomania will always get the headlines. As I am sure he knows, depression is the far gnarlier piece of bipolar disorder, at least for the individual patient. He didn't get into positive aspects of bipolar personalities--let's face it, all that racing energy and creativity is highly desirable both for individuals and society as a whole. Neither did Dr. Phil broach the very thorny issues around medications.

But that's OK. It was an impromptu one-minute exchange on national television. It almost felt like a victory somehow, especially because Dr. Phil had tossed out a subtle bit of doubt in how America views and treats bipolar disorder. It was enough. Of course, it had to come from the mouth of a psychologist.