The Stigma Against Mania - Rosemarie Kuenn

            The definition of mania is as follows: mental illness marked by periods of great excitement or euphoria, delusions, and overactivity. Mania is a symptom of multiple mental illnesses, primarily bipolar disorder and borderline personality disorder (BPD). The key component to the definition of mania that I’d like to highlight is euphoria. A sort of MDMA-induced like happiness that occurs naturally from chemical imbalances in the brain. I have bipolar 2, and have experienced manic episodes. There is a difference in mania between people with bipolar 1 and bipolar 2. Bipolar one is characterized by the individual experiencing primarily mania, with some depression. This mania is typically very strong, and can lead to life threatening delusions such as believing you will fly if you jump from the roof of a building in some cases. It is understandable why one would want to prevent this. Bipolar 2 is characterized by the individual experiencing primarily depression, with some mania. This mania is more subdued, sometimes called hypomania. Despite this mania being a lot safer than the mania consistent with bipolar 1, it is equally prevented. I’d like to discuss my experience with this and explain why I think this is. I believe this is relevant to the class because this is a strange phenomenon of doctors going to quite some lengths to attempt to prevent what is essentially a feeling of extreme happiness.

            I’d like to talk about my personal experience that leads me to believe there is an exaggerated stigma against people experiencing mania. I was diagnosed with bipolar disorder in the summer of 2020 and I have had two manic episodes. The first manic episode was a few months before I was diagnosed, and I believe this was the initiation of the disorder setting in. This manic episode was a disaster. I cheated on my wonderful boyfriend of almost five years, I moved back home with my parents, I dropped my music scholarship, and I left my job of two years to go work at a sex shop. I of course accept responsibility for all these things, but I was heavily influenced by my mania. At the time I felt like I was doing everything right, like the universe was guiding me to change my life for the better. This was obviously not the case, and once the mania ended I deeply regretted everything I did. This manic episode completely ruined my life at the time. However, what I believe to be the detrimental part of this experience, was that I didn’t know I was having a manic episode. I wasn’t diagnosed yet and nothing like this had ever happened to me before so I wasn’t on the look out for anything strange. About a year later, while on a lighter dose of mood stabilizers than I am now, I had my second manic episode. For about a week or two, I had a god complex and was saying nasty things to my boyfriend. During this, my boyfriend suggested I may be manic. Once I realized this, I was able to stop my destructive behavior before it went too far. I remained manic for a few more weeks, but no life changing decisions were made, because I knew not to do so. I knew that if there were any major decisions I wanted to make, it would have to wait until my feelings of euphoria went away. I also informed my psychiatrist of my manic episode and my meds were adjusted. This was exponentially less detrimental than my first manic episode, and I believe this is all due to the fact that I knew I was having a manic episode this time, so I was able to watch my behavior. Since this I have been a lot less afraid of having another manic episode and even crave one to some extent, as I am consumed with depression the majority of the time. However, my doctors have done everything they can to prevent this. During this past summer, I was admitted to the psychiatric hospital during a depressive episode during which I was exhibiting suicidal behavior. You know what they decided to do while I was there? Take me off my antidepressants. Apparently, antidepressants can in some cases cause mania to set in. I found this to be an absurd time to take me off of them as I was not exhibiting any manic tendencies, in fact quite the opposite. But when the doctors at the hospital saw that I was on Zoloft, their first instinct wasn’t that this aids me greatly in dealing with my depression and anxiety, but that it may cause a manic episode. In a sense, they were more willing to risk me becoming more suicidal than risk me eventually having a manic episode. I have made numerous requests to numerous doctors to put me back on Zoloft since I was taken off of it, but all my requests have been denied. I have been on several medications since then but none of them have helped me the way Zoloft did.

            So why are doctors more comfortable with bipolar people being depressed ALL of the time rather than being happy and becoming manic SOME of the time? It would seem that mania and depression different sides of the same coin, each holding equal risks that correlate to euphoria and extreme sadness, respectively. In fact, depression manifests in people with bipolar 2 at much more extreme levels than mania does. According to McGovern Medical School, up to 60% of bipolar individuals attempt suicide at least once in their lifetime. So, you would think this would be the primary concern. After all, making potentially poor choices seems preferable to not being alive at all. But, with bipolar individuals, it is mania that is primarily prevented rather than depression. I believe this is because mania makes the general population uncomfortable. 6.7% of adults in America have major depressive disorder, and less than 1% of Americans have bipolar disorder. Depression also manifests in people without major depressive disorder; almost everyone experiences some kind of depressive episode at some point in their life. So, it is my belief that we have become comfortable being around people with depression. It is something that most people can relate to having felt at some point. Mania, however, is not something that people without a corresponding mental illness experience. It makes people uncomfortable that someone can experience such euphoria for such an extended period of time. It probably feels comparable to being around someone who is constantly intoxicated. It doesn’t feel natural to others, and while it is caused by chemical imbalances, it is supremely natural compared to using drugs and creates similar effects with significantly less danger and side effects. People also like to ignore the positive consequences of mania. It is common for people experiencing mania to engage in things like working on big projects, cleaning a house that may not have been cleaned in months due to depression, or develop new relationships with people. Mania can be an extreme motivator. I’m not saying that mania never causes problems; perhaps there are bipolar people who don’t have the ability for self control during mania and would prefer it be prevented by any means necessary. But in my personal experience, having the knowledge that I’m having a manic episode, the supervision of my psychiatrist, and the guidance from my support system, I find it’s fairly easy to regulate. I find it wrong that doctors are willing to make patients more susceptible to depression by refusing them antidepressants in order to prevent mania. I also find it wrong that people will go to great lengths to prevent mania in people with bipolar 2 when those manic episodes may be the only chance they have to experience any prolonged happiness. I believe that with supervision and practice, mania can be a tool to give bipolar people the relief they need from their depressive tendencies.