January 14, 2008The World Isn't FlatThere was an essay in the New York Times yesterday, written by Terri Cheney who apparently writes the "Modern Love" column for the paper. Cheney has a book on the way called Manic: A Memoir which means it's time for the interest-building advance essay in the Times. Cheney was a high school valedictorian who graduated from Vassar and went onto to become a big shot entertainment lawyer in LA. Also, she has bipolar disorder and apparently things weren't going so swell for her. "I didn't tell anyone that I was going to Santa Fe to kill myself," she writes in the book, as noted on the publisher's website. Santa Fe? How prosperous, how Los Angeles, how book worthy. OK, my usual snideness aside, Cheney's essay talks about rapid cycling bipolar disorder in terms of trying to have a romantic life--basically writing checks in her hypomanic self that her depressed self wouldn't let her cash. But there's hope. She ought to be on "Oprah" within days of her book's release. "That was five years ago--five long years of ups and downs, of searching for just the right doctor and just the right dose. I’ve finally accepted that there is no cure for the chemical imbalance in my brain, any more than there is a cure for love. But there’s a little yellow pill I’m very fond of, and a pale blue one, and some pretty pink capsules, and a handful of other colors that have turned my life around. Under their influence, I’m a different person yet again, neither Madame Bovary nor Hester Prynne, but someone in between. I have moods, but they don’t send me spinning into an alternate persona." Oh, please. Cure for love being a metaphor for a cure for bipolar disorder? That's nice and meaningless. I'm always a bit concerned when I read these kind of first-person accounts because I think they give a very skewed message of what bipolar disorder is, how it is experienced and how one successfully grapples with it. It's all a big "I am really a fucking mess, look at how messed up I am and all the things I do that are abnormal, look at me, and I'm really, really smart and went to a top school, but I'm really confused about myself and am going nuts all over the place, look at me!, and all I needed to fix things are a whole bunch of pills. Look at me!" I'm exaggerating, of course, but ever since Prozac Nation (or is it Patty Duke?) there has been a long string of these types of memoirs. I know they make for good copy and publishers love publishing them and people like reading them, so on a certain level, whatever. Most of them are written by women (at least the ones I am familiar with mostly are) and that likely skews things in ways I don't care for either and a lot of them are written by Ivy League/Seven Sisters types. Nice and representative of America. The trouble is they and the experiences they describe are not representative of bipolar disorder as a whole. For everyone who is taken apart by the disorder--or allows themselves to be taken apart--and surrenders to the wildness of it ("Let's go spend $100,000 we don't have"), there are many more people who actively work to make their lives better. Their stories never get told. I guess there's not enough sex and elitist preening in these humans for book publishers. So much for a free market of ideas. By there is apparently a whole new set of bipolar and depression books just hitting store shelves. All of them written by women. Pardon me, but are agents and publishers having a hard time understanding that these two disorders affect men as well and that men also buy books? Anyway, here's a rundown on those books in the UK, including an obligatory advance essay by the author of one of the books. Why depression is described as a "new" plague facing women is beyond me. What's new about women and depression, or suicide and men for that matter? The Cheney essay includes the almost-always obligatory bowing to the chemical imbalance theory. I should think that most editors at the Times are well aware by now that that theory is hardly rock solid science (I assume they read their own newspaper), so why don't they call writers on this sort of thing since the writer could never offer proof that their ills are driving by chemical imbalances? Beats the hell out of me. It's opinion and opinion is fine but it should be explained as such. That said, I don't want to throw too many rocks at the author. They are entitled to their own explanations of things and to explain what's worked for them. They are not entitled to assume that what's worked for them will work for everyone else. That would be crazy. In recent weeks, I've really had mental disorders and how widely varied are individual responses to standard treatments shoved into my face. But much of what I have encountered at the shelter has confirmed what I've known for a long time: some people who genuinely have schizophrenia, depression and bipolar disorder (these are fairly clear cut clinical cases) have it to completely different degrees, and for some of them meds are a very good answer while for others meds either don't work at all or are toxic to their bodies. By toxic I mean that the meds cannot be tolerated by the patients' bodies and as a result they cannot take meds consistently. I've spoken with several clients at the shelter who've been on a host of different meds and their response is virtually the same across all meds. That's frustrating as hell for them of course. These things are supposed to work, doctors press them to take them because they will work, the system makes them available to them because they will work, so they take them and they get sick and can't take them anymore. I understood this dynamic before working at the shelter, but working there it is truly a visceral experience in a way that I wish more doctors and researchers would experience. I know they see it on the ER and psych unit end of things, but by then things are very out of control and the texture of what's going on day-to-day is lost. I think that's led to the silly tautology bandied about by Fuller Torrey, his Treatment Advocacy Center and others in mental health circles that goes like this: the patient has a serious mental disorder; the patient must take meds at high doses to cure this disorder or the disorder will get worse; the patient doesn't take their meds because they claim that they make them sick or the patient is in denial about having a disorder; let's give this dynamic a fancy Greek name so it'll sound authoritative and scientific; we'll call it "agnosia"; these patients just don't know how beneficial treatment with meds is; they must be forced into taking meds because we know and they don't. If only it were so simple in the real world. As it is, I was at a small dinner party the other night and met the 70-something mother of a 40-something man with schizophrenia. She very much fit the NAMI parent model, which is fine, and was very happy that her son was on Risperdal Consta (that's the long-acting injectable). But, as we talked, it became apparent that she's quite honest about the state of the art in treating schizophrenia. "I've always heard that the meds work for one-third of them, that for one-third the meds don't work at all, and that for another one-third they don't need the meds at all," she said. Remember she was talking about schizophrenia. I have no idea how accurate those numbers might be, but I think they give a sense of just how wide open things are out there. I also sense that you could apply the same proportions to patients with bipolar disorder and depression. Meaning that fully two-thirds of people with these disorders either have horrible responses to standard treatments or don't need them in the first place. That's a lot of people, the majority of those diagnosed with mental illnesses. That's kind of important and yet the realities around how mental disorders affect people and are treated in various patients and the wild variations in how people respond or are killed by treatments simply are not addressed. And that's why I get so damn frustrated by essays such as Cheney's. They get published in an important place and are assumed to speak for one and all, becoming the public proxies of how we all experience mental disorders and alleged mental disorders. But the world isn't flat like that. It's round. Posted by Philip Dawdy at January 14, 2008 12:05 AM
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The bipolar label is trendy now and she's clearly exploiting it. The essay is about her flirting with an attractive man in a supermarket, proof in her mind that she was in a manic state, though it's really pretty normal behavior. Then when the man comes to get her for their date, she feels awkard and dresses in black with no makeup (depressed mood swing get it)(you get the feeling this entertainment lawyer wants Wynnona Ryder to play her in the movie), and the date doesn't go well. He calls her again once and she gets so excited she puts make up on then he never calls back. MY GOD SHE MUST BE BIPOLAR afterall she's a single woman who finds dating painful. What worthless trype. A perfect example of opportunistic hyperbole and my personal favorite in books like this, pathologizing normal behavior. Maybe she got Patty Duke her book deal. Posted by: Sally at January 14, 2008 04:20 AMfrom an old February 2000 webpage The 269 patients chosen for the Vermont model study, however, were classic back ward cases--those diagnosed with chronic schizophrenia and deemed unable to survive outside. Not only did the rediagnoses of schizophrenia hold to the narrower definitions, Harding's study in The American Journal of Psychiatry (Vol. 144, No. 6, p. 718-735) showed that 62 percent to 68 percent of those former back ward patients showed no signs at all of schizophrenia. "They just didn't have them anymore." Does that mean people with schizophrenia will spontaneously recover at some point? Harding only smiles at the question, but notes that all of those in her Maine and Vermont studies who had fully recovered, had long since stopped taking medications. What they had in common was that they were out of the hospital, she says, "and had someone who believed in them, someone who had told them they had a chance to get better." Harding cites nine other longitudinal studies like hers, conducted in Asia and Europe. Three of those were conducted before her 1987 study, but had been ignored by American researchers. Each of the nine studies reported an average of 50 percent or higher recovery rates. Hers was the only long-term pair of studies to be matched, and, say colleagues, were so expensive and time consuming that few others can afford to attempt a replication. Posted by: mark p.s. at January 14, 2008 04:21 AMTHanks for this post. Prozac Nation had a big influence on my decision to finally try antidepressants, which didn't work so well for me. I don't think my book would be very exciting. When I was horribly depressed I lay in bed for hours every day - how do you turn that into a book? Chapter 1 - lying in bed. Chapter 2- lying in bed. Chapter 3 - yes, still lying in bed. Chapter 4 - get fired for not going to work because I was lying in bed. And so on. Probably be very boring. Posted by: Lisa at January 14, 2008 07:00 AMHey, I'm with you on the Chemical Imbalance bollox. I don't mind people stating it as a hypothesis, however unlikely. But when it gets stated as fact... The BBC still has it down as the cause of depression on its Health Notes, which really fucking winds me up: I've 'mailed it twice about that, already! Matt Posted by: Matthew Holford at January 14, 2008 07:27 AMI was a little worried that you wouldn't be able to turn an essay about Cheney's book into a diatribe against TAC. Thanks for not letting me down. Posted by: Happy Sessions at January 14, 2008 07:42 AMHardly a diatribe, HS. Those are the facts -- TAC uses circular reasoning to further their vile agenda. The "proof" required to be deemed "lacking in insight" is simply not wanting to be treated. Under TAC's recommendations, I would have to be medicated for life, under threat of imprisonment. I have never been violent yet TAC proposes that I should be subject to a separate set of laws, which obliterate my civil rights. That's not medicine. It's fascism. "Living in a developed country is a 'strong predictor' that a person newly diagnosed with schizophrenia will never fully recover." That's from the World Health Organization and that fact has never been satisfactorily addressed by western psychiatry. Posted by: Francesca Allan at January 14, 2008 08:48 AMI love the TAC paragraph - made water come out my nose I was laughing so hard. And I have to go with Lisa on how boring my book would be. Laid in bed. Thought about killing self. Got on some drugs. They helped a little. Drugs stopped working. Laid in bed and thought about killing self. Got on more drugs. can cope enough to come to work but feel out of it all the time. Not what you'd call a page turner :) Posted by: anne at January 14, 2008 11:36 AMThe problem now is that if I'm in the 1/3 I don't need meds, they will make sure to put me in the 1/3 who's on meds for life. That's criminal and that doesn't get fixed, because we are all insane and we should just shut up and listen to the doctor. When it comes to psychiatry, Doctor is God, literally. Which also explains the viciousness with which they obliterate the minds of the poor saps who come into the ER preaching "I'm Jesus/Buddha" talk. Cop is God too, I'm not very good at analogies & not evolved enough to know generalizations are for the birds. Posted by: z0tl at January 14, 2008 12:14 PMWhat's with the ad hominem attacks on the author of the mentioned article? @Sally: Did you even read the essay? Posted by: Masale.Wallah at January 14, 2008 12:47 PMi think my original words speak for themselves, masale, but to be clearer: i've grown weary of people writing about their own experiences/successes/failures with mental illness as if they are everyone else's experiences/successes/failures and getting said thoughts published in important outlets without even a hat tip to the notion that other people make thigns work out just fine by following other treatment regimines. for an editor not to insist upon even the briefest acknowledgment of that dynamic is lazy and ignorant. Posted by: Philip Dawdy at January 14, 2008 12:57 PM
Sounds like something straight out of a sixteen year old girl's diary. Is there a cure for bad poetry? I'm reminded of one of Seaneen's recent posts at Pole to Polar: "...I hate the term “bipolar disorder”. Its existence enables the buzzword “bipolar”, and it is clinical and dispassionate. I will always think of myself as having manic depression, but even that is associated with a kind of attention-starved temprement which, yes, is seen in famous people because they’re famous people. Famous people exist for attention. It’s not a feature of manic depression.Posted by: Jonathan Schnapp at January 14, 2008 01:09 PM Masale, I read the article and the essay in the times to which the article is linked. Thanks for making me look up ad hominem, maybe now it will stick. Posted by: Sally at January 14, 2008 02:48 PMI just wanted to point out that the Modern Love column is written by someone different every week and I think anyone can try to submit something for consideration. Same thing is true for the last page of the magazine entitled Lives. Sure editors choose the final column that actually gets published but it's not like these columns really reflect editorial points of view. The e-mails for both columns are available either on line or in the print editions. Some of us should go for it. Posted by: Sara at January 14, 2008 03:02 PMHmm. Reading memoirs doesn't thrill you........
Thank you to Jonathon for posting excerpts from Seaneen's blog. If anyone deserves to be published she does. Seaneen is an exquisite writer who has not had the benefits that Redfield Jamison & Cheney have grown up with. I'm not trying to slight either of the other women I mention but I simply find Seaneen a better writer. If you want to get into the soul-mind wrenching that Manic depression brings on please read her posts. Perhaps someone will take note of Seaneen's body of work via her blog and hopefully she will come across a good publisher or they will find her. Posted by: orodwen at January 15, 2008 11:29 PMtotal agreement on seaneen's prowess - she's an amazing girl, and a gifted writer. Posted by: anonymous mom at January 16, 2008 12:27 PMThere is only one reality but many ways to misunderstand it. I do not recommend people to stop taking their P-meds. This Teaching This is the cure for schizophrenia. It is not of my origin. And it THE INTRODUCTION The human being as I see it is made of three parts, the physical, the If you think I am talking about psychology or pyscho-babel you are When we are born we all start out in a state that is much more one of I describe consciousness as levels, starting with the lowest, For some unknown reason some people end up in the spiritual state and This state of schizophrenia can be described as a feeling of being It is very important to understand that the Normal state of THE CURE IS THE TEACHING FOUND IN THE BOOKS ,THE KNEE OF LISTENING AND IF NORMAL PEOPLE CAN CHANGE THEIR CONSCIOUSNESS THEN SO CAN What is consciousness? Human consciousness is a lesser intensity of CONSCIOUSNESS EXISTS IN THE PRESENT MOMENT All modifications or contractions of consciousness occur in the WHY DOES THIS SENSE OF SEPARATION EXIST? It is written in the Upanishads that as soon as an other is noticed WHAT IS PERCEPTION? What you consider to be your sense of perception is in fact that WHY DOES THIS SENSE OF SEPARATION CONTINUE? It continues because in every single moment of the day you meditate on HOW DOES THIS SEPARATION STOP AND ONES CONSCIOUSNESS EXPAND AND THUS The natural state of consciousness is oneness, the unnatural state is REAL ENQUIRY All you must do in every moment of the day is to enquire of yourself, THE GREATEST BOOKS ABOUT THE NATURE OF REALITY OR CONSCIOUSNESS EVER They are THE KNEE OF LISTENING and THE METHOD OF THE SIDDHAS by Adi Da MY MOMENT OF FREEDOM I read those two books in 1975 and experienced the most extraordinary OTHERS HAVE BEEN FREED SEE FOR YOURSELF THE FORCE WHAT I KNOW Now it is up to you. Roky THE MEDITATION OF UNDERSTANDING Real meditation doesn't do anything for you. It has no purpose. When a I have bipolar disorder and am also clinically depressed. I have been this way for the past 5 1/2 years or more. I DO want to read this book, just to see what Ms. Cheney has to say about her dealings with the disorder. At times I get aggravated with the quick diagnosis of so many people nowadays with bipolar disorder, but then at the same time I am glad to see it getting the attention that it so much deserves. Post a comment
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