Bipolar Expeditions (34 page)

My first anxiety attack occurred during a Louis Armstrong concert. I was nineteen or twenty. Armstrong was going to improvise with his trumpet, to build a whole composition in which each note would be important and would contain within itself the essence of the whole. I was not disappointed: the atmosphere warmed up very fast…. The sounds of the trumpet sometimes piled up together, fusing a new musical base, a sort of matrix which gave birth to one precise, unique note, tracing a sound whose path was almost painful, so absolutely necessary had its equilibrium and duration become; it tore at the nerves of those who followed it.

My heart began to accelerate, becoming more important than the music, shaking the bars of my rib cage, compressing my lungs so the air could no longer enter them. Gripped by panic at the idea of dying there in the middle of spasms, stomping feet, and the crowd howling, I ran into the street like someone possessed.
³⁷

Toni Morrison writes that she remembers smiling when reading this passage, in part because Cardinal's recollection of the music had such immediacy, and “partly because of what leaped into my mind: what on earth was Louie playing that night? What was there in his music that drove this sensitive young girl hyperventilating into the street,” feeling “like someone possessed”? Morrison muses on the “way black people ignite critical moments of discovery or change or emphasis in literature not written by them” and the “consequences of jazz—its visceral, emotional, and intellectual impact on the listener,” which in this case tipped Cardinal from sanity to madness, from rationality to “irrationality.”
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Illuminating Morrison's points further, Phillip Rack, a psychiatrist who observed and treated West Indian immigrants in England in the 1960s and 1970s, wrote about psychiatric diagnosis for Afro-Caribbeans. Rack described a syndrome called “West Indian Psychosis,” said to be found among people of Afro-Caribbean descent characterized by “excitement and over-activity, with pressure of thought and speech … bizarre behaviour … violence … talk [which is] fragmented or incoherent.”
³⁹
This diagnosis was usually taken to be an attack of an endogenous psychosis, but Rack argues that “when an African, Afro Caribbean, or Asian patient behaves in a manner that would, in a British patient, point to a diagnosis of mania [which was included in West Indian Psychosis], the practitioner should keep in mind the possibility that this is a stress reaction, and not an attack of an endogenous psychosis.”
⁴⁰
Rack suggests it is perhaps hard for clinicians to see a stress reaction instead of an endogenous psychosis because of certain preconceptions. The stereotype of the “wild West Indian” or “the image of the big wild, dangerous black man or woman” is deep in the minds of many white people, partly because some West Indian speech styles sound to English ears “sharp, intense, abrupt, and hard-edged, with sudden changes of pitch, coupled with an ebullience of manner that suggests intense emotion or extraversion. Also there is a great deal of genuine anger, frustration, and bitterness among certain sections of the AfroCaribbean community in Britain, and it causes acts of violence that attract a great deal of media coverage.”
⁴¹
Rack is implying that psychosis (here including mania) fits more comfortably with racialized blackness than it does with racialized whiteness. Hence, clinicians should bear in mind that their preconceptions may lead them to diagnose psychosis where a stress reaction would be more accurate.

In my fieldwork, nonwhite members of support groups expressed outrage similar to Morrison's and Rack's when faced with both the description of manic depression and racist treatment. Enrico explained,

I'm coming to this group for anger management. I get extremely angry at any comments about “the help,” anything like that; maybe I am oversensitive, but in a job interview once, they referred to me as a “green bean.” At first I just thought that meant inexperienced, but later I found out that it is a term for an ignorant Mexican. I don't know what to do with the anger. I play sports, and after that incident, I played racquetball so long and hard the ball broke into pieces. Is this the best way? I think maybe I should take up boxing. I also mistrust those little boxes they want you to fill in on the employment application. Ethnic categories! Who's interested in that? If I put “Mexican,” they will think I don't speak English!

The group took this very seriously and discussed which state agency would be the best place to report a discrimination complaint. The editor of the regional association newsletter,
The Roller Coaster Times,
happened to be present and she promised to publish the address and phone number of the correct state agency in the next issue of the newsletter. But the more telling point is that some people may be less willing to tolerate extreme emotions from a woman or man of color than from a white man in a position of power. As the sociologist Pam Jackson remarked to me, “A white man can act crazy like Ted Turner, but if a black man acted like that he would be arrested.” There are celebrated African American comedians who are described as “manic”—Eddie Murphy, for one—but unlike white comedians, they are not found on popular lists of famous manic depressives.
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Not surprisingly, African American CEOs celebrated for their manic style are nonexistent.

Manic Depression as an “Asset”

With her memoir,
An Unquiet Mind,
Jamison reveals her own diagnosis of manic depression and gives us a powerful phenomenological description of the condition. Here is her eloquent account of the exhilaration and despair that can be part of mood disorders: “I now move more easily with the fluctuating tides of energy, ideas, and enthusiasms that I remain so subject to…. My high moods and hopes having ridden briefly in the top car of the Ferris wheel will, as suddenly as they came, plummet into a black and gray and tired heap … then at some unknown time, the electrifying carnival will come back into my mind.”
⁴³
Just as Jamison conveys the pain of depression, the disastrous consequences of mania, and the danger of suicide associated with manic depression, she also describes appealingly the thought processes of mania: “Fluency, rapidity, and flexibility of thought, on the one hand, and the ability to combine ideas or categories of thought in order to form new and original connections on the other … rapid, fluid, and divergent thought.”
⁴⁴
Thought is rapid and flighty, jumping blithely from one thing to another.
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For Jamison, manic depression entails a “distorted” sense of time and space: “delusions” abound in the manic phase. Objects seem to merge, to flow into each other. Shapes shift. Any ordinary thing can change into something else and then something else again.
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As rapidly as they are described, however, these distortions are becoming assets in accordance with new realities instead of irrational delusions. In general, the qualities praised seem to fit perfectly with the kind of person I described in
chapter 1
as highly desirable in corporate America: adaptive, scanning the environment, continuously changing in innovative ways, a creative chameleon. If there is an increasing demand for restless change and continuous development of the person at all times, in many realms, then manic depression might readily come to be regarded as normal—even ideal—for the human condition under these historically specific circumstances.

How does inhabiting such a space of flux come to seem desirable? Many people I spoke with struggled with this question. In an interview, Peter Whybrow, UCLA psychiatrist and author of accessible and influential books on bipolar disorder,
A Mood Apart
and
Mania in America,
explained to me his view of how manic traits come to seem desirable.

Peter Whybrow:
I'm convinced that we have tended to deny the social value of [manic and depressive] behaviors. It's only when they go over the top and create a sort of idle self or a socially destructive self that everybody throws up their arms and says, “Ah, this is terrible,” and then stigmatizes [mania or depression]. In a peculiar way, this distinguishes manic depression from exactly the same behavior that doesn't reach quite these heights for some reason. My own sense is that there's a part of American culture that feeds that.

Emily Martin:
Feeds the stigmatization?

Peter Whybrow:
No, feeds the escalation. In fact, in the book
[Mania in America],
although I don't make it explicit, the implication is that there's something in “immigrant hubris” that's close to manic hubris. [Early immigrants to the United States were gripped by the conviction they could rise up the social and economic ladder if they poured energy into their work.] For manics today, if you're sleeping four hours a night, having rapid, somewhat bizarre thoughts, on-the-edge ideas and a few other things, you are considered to be helpful in moving an Internet company into the stratosphere … and conning a lot of people into giving you a lot of money. That is becoming very advantageous. On the other hand, if I end up saying not “I can build this Internet company and you should give me money because I'm going to make you a millionaire” but just “what I say is significant enough that it's going to change the world” (there is a subtle difference of meaning here!), you immediately are seen as a madman as opposed to an entrepreneur.

“I'm going to change the world with my little company I'm making.” Look at Steve Case, CEO of America Online or Jeffrey Bezos, CEO of
Amazon.com
. When they're asked what they're doing, they say, “We want to change the world.”

Well, you get somebody who's in the early stages of mania who says they want to change the world, there's no difference except the context within which they say that. One of them says, “I'm going to change the world through building this new marketing thing, which we call e-commerce,” and the other says, “I'm going to change the world because I'm chosen, and I have a better vision than everybody else.” The second person goes into the asylum and the first person goes into the Fortune 500. Yet there is no real difference in the early stages of what they're saying.

The perception that mania has market value was expressed even by people I met who have not reaped fame and fortune in their manic depressive lives. John, a Vietnam veteran who has been a California support group leader for some years, thought deeply about this issue. He summarized his dynamic philosophy of life.

Adapt, adapt, change, change, change. You can't catch a firefly: you might catch its corpse, but not the firefly itself. Human beings always have to make decisions based on incomplete information. The idea, though, is to remain practical, remain open, [to have] the ability to accept something new and conditions that are new, because the world is always changing. Many times having a spike [of manic energy] gives you a new perspective, an impetus to creativity. You can see ahead even if you have to go sideways. It is an environment for creativity. If you totally eliminated the spikes, you would diminish creativity over time. The experience of having spikes is a plus and a minus. The perspective is that having gone through a battle, you are a veteran. Just like the shamans of old, you should be praised for having survived it. There is value in it, like going through battle; we exalt our veterans and at the same time we have to go on to peacetime. Manic depression is the same as war in a way because it's the war of all sides seeing something different. Even going psychotic is like being a casualty. [You might be wounded, but not fatally.] You can recover and have a good life, but it is still a battle. The value of it is you have seen some vistas, you've been there and you've survived. You've seen something, and that experience should be neither exalted nor put down.

Having spikes is busting through boxes. I don't have a word for it; we would need to find an image or a metaphor. It's not linear at all.

John is elaborating on ideals of energy and creativity that are held out for our enticement in the culture in a general way, not on his own lifethreatening experiences while he has been manic or depressed. In John's case, as for many others living under the description of manic depression, the condition can often be a source of profound suffering. However, John believes that there is social value in being able to shift his manic energy sideways, like a firefly, and to dart in new directions through its glow.

Marcy saw social value in the way her manic states allowed her to experience life as if it were an episode of
Sex and the City,
experiences she thought many women would envy. She began by describing what happened when she was “racing.”

I was getting a lot of response from men, too much. I mean I was not answering my phone after a while. Whatever kind of energy I was giving off, I had men making passes at me. It really shocked me because I felt that they were making passes at me which were completely uninvited and how dare they extend into my personal space.
They
were irritating me. I was single for the first time in four years, but this was beyond anything that any of my friends who were single appeared to be experiencing and beyond anything I've ever experienced in my entire life. These men would approach me who seemed like perfectly normal people. They were convinced that I had sent them a signal and I am looking at them going, “Well, you're very mistaken because there was no signal.”

Although she noted her women friends admiration, and could not help being amazed at her ability to attract men, Marcy expressed ambivalence about not being able to control the pace of either her thoughts or her social interactions.

John and Marcy are feeling the effect of powerful forces that are turning mania into a social asset. Depictions of Robin Williams as a stand-up comedian or Ted Turner as a CEO—both paired with the label “manic depressive”—are part of the movement of the category mania from an impediment to something that gives pleasure, brings rewards, and, in its inventiveness, produces forms of value.
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John's creative spikes and Marcy's racing states have their dangers, but they also hold the promise of a precious vitality.