Bipolar Expeditions (45 page)

28. Bateson,
Steps to an Ecology of Mind,
137–38.

29. In her perceptive ethnography of atherosclerosis, Annemarie Mol prefers to speak of enactment rather than performance to capture the ways diagnoses and treatment come into being. For her case, performance would raise too many possibilities: the existence of a stage and a backstage, the question of success or failure, and the issue of effects beyond the performance. For my case, where the attribution of rationality is at stake, these are exactly the possibilities I want to raise. Mol,
The Body Multiple,
32–33.

30. Joyce,
The Rule of Freedom,
41.

31. A perceptive account of the “style of thought” of biological psychiatry in historical context is in Rose, “The Neurochemical Self and Its Anomalies.”

32. On a popular rendition of the neural location of emotions, see Blakeslee, “Humanity? Maybe It's in the Wiring.” For MRIs illustrating a “murderer's brain” and the brain of a depressed person, see Carter,
Mapping the Mind,
92, 99. Joseph Dumit has done an important ethnographic study of how MRIs are understood and function culturally. See his
Picturing Personhood.

33. Tierney, “Using MRI Machines,” A17.

34. Jamison,
An Unquiet Mind,
191.

35. Hinshaw,
The Years of Silence Are Past,
132.

36. Although during my fieldwork there was a major breakthrough in neuroscience, demonstrating for the first time that learning enables the adult mammalian brain to grow new neurons, this experimental finding had not yet had an impact on people's general sense of their mind's capacity. See Gould et al., “Neurogenesis in Adulthood.” For a review of the impact of this work, see Gould and Gross, “Neurogenesis in Adult Mammals.”

37. Some of the best-known books written by doctors to educate the public about mood disorders do not reduce the cause of mood disorders to the physical realm. They manage this by discussing a wide range of contributing factors, from social environment to family history. See Torrey and Knable,
Surviving Manic Depression;
Mondimore,
Bipolar Disorder.

38. For a discussion of how methodological variation between studies makes it difficult to determine the prevalence of mood disorders comparatively, see Waraich et al., “Prevalence and Incidence Studies of Mood Disorders.”

39. A kind interlocutor from the industry allowed me this glimpse. I describe the circumstances in
chapter 9
.

40. Carey, “Use of Antipsychotics by the Young Rose Fivefold.”

41. Light and Lexchin, “The International War on Cheap Drugs.”

42. Landers, “Waiting for Prozac.”

43. See McClay,
The Masterless;
Cushman,
Constructing the Self.

44. Gamwell and Tomes, “The Asylum in Antebellum America.”

45. Burton,
The Anatomy of Melancholy
,9.

46. See MacDonald,
Mystical Bedlam,
9–10. This book provides a detailed discussion about the disjunction in the seventeenth and eighteenth centuries between supernatural accounts of madness preferred by religious believers and secular accounts preferred by physicians who relied on their increasing understanding of physical science.

47. Screech, “Good Madness in Christendom.”

48. Rather, “The Six-Things Non-Natural.”

49. Berrios,
History of Mental Symptoms.

50. Roy Porter gives a lucid overview of this chapter in the history of madness
(Madness,
56–61).

51. See
chapter 9
of Watson,
Basic Writings in the History of Psychology.
which discusses one of the founders of faculty psychology, Christian von Wolff, and his division of the faculties of the mind into “knowing” on the one hand and “feeling and desire” on the other. S. Alexander Rippa traces the influence of faculty psychology on specifically American educational theories
(Education in a Free Society,
217–19).

52. The clinical usefulness of the intellectual view of madness had already been challenged early in the century by Pinel, Prichard, and Heinroth, as described in Berrios,
History of Mental Symptoms,
294. Generally in the nineteenth century, physical explanations of mental illness were dominant, in England at any rate. Andrew Scull's trenchant account makes this plain
(Social Order/Mental Disorder,
24–27). But the details were far from clear. Allan Young explains the debates in the mid-nineteenth century over whether faculties were properly found in the brain, the mind, or were best abandoned
(The Harmony of Illusions).

53. Berrios,
History of Mental Symptoms,
295.

54. Darwin wrote that “the main difficulty in elucidating emotions consists in the fact that the major part is due to historical antecedents registered in the susceptible organisms, but little to individual acquisitions. No experience of the individual can account for the strength or the direction of feeling” (quoted in Berrios,
History of Mental Symptoms,
296). In this Darwin echoed Herbert Spencer, who held that “the doctrine maintained by some philosophers, that all the desires, all the sentiments, are generated by the experiences of the individual, is so glaringly at variance with hosts of facts, that I cannot but wonder how any one [sic] should ever have entertained it.” Quoted in R. Young,
Mind, Brain and Adaptation in the Nineteenth Century,
182–83. See also Browne, “Darwin and the Face of Madness.”

55. Berrios,
History of Mental Symptoms,
298.

56. Ibid., 298–99.

57. Berrios,
History of Mental Symptoms,
298.

58. Berrios has questioned how central Kraepelin's concern with the affective realm was. Kraepelin's distinction between dementia praecox and manic depression “appears to be based on a distinction between thinking and affect, respectively.” But alongside his criteria for the prognosis of manic depression, heredity involved only the “presence of excitement or inhibition.” “As far as this writer has been able to determine, nowhere did Kraepelin say that manic-depressive insanity was a
primary disorder
of affect” (Berrios,
History of Mental Symptoms,
297).

59. Berrios,
History of Mental Symptoms,
297. Contemporaneous with abstract schemes for classifying mental disorders were rich qualitative descriptions of the specifically emotional side of the emerging categories of mental illness. In Karl Jaspers's account, the manic fairly flies off the page: “The massive associations at his disposal come spontaneously and uncalled for. They make him witty and sparkling; they also make it impossible for him to maintain any determining tendency and render him at the same time superficial and confused. Physically and mentally he feels that he is extremely healthy and strong. He thinks his abilities are outstanding. With unfailing optimism the patient will contemplate all things around him, the whole world and his own future in the rosiest of lights. Everything is as bright and happy as can be. His ideas and thoughts all agree on this point most harmoniously; to any other idea he is wholly inaccessible”
(General Psychopathology,
2:596). Kraepelin wrote that the depressed patient “cannot collect his thoughts or pull himself together; his thoughts are as if paralysed, they are immobile. His head feels heavy, quite stupid, as if a board were pushed in front of it, everything is confused. He is no longer able to perceive, or to follow the train of thought of a book or a conversation, he feels weary, enervated, inattentive, inwardly empty; he has no memory, he has no longer command of knowledge formerly familiar to him, he must consider a long time about simple things, he calculates wrongly, makes contradictory statements, does not find words, cannot construct sentences correctly”
(Manic-Depressive Insanity and Paranoia,
75).

60. Goodwin and Jamison,
Manic-Depressive Illness,
61.

61. Freud, “Mourning and Melancholia,” 161. When Freud's ideas took hold in the United States, they were in the guise of the ego psychology developed by his daughter, Anna Freud. With few exceptions, American psychoanalysts were identified with ego psychology from the 1940s to the 1960s. Thereafter, this psychoanalytic approach lost ground to new forms of therapy focused on group dynamics and individual identity, on the one hand, and to new research in the neurological sciences, on the other. Zaretsky,
Secrets of the Soul,
333–35.

62. Freud,
The Ego and the Id,
54–55. Current scholarship has taken Freud's ideas in a number of productive directions. Juliana Schiesari gives a detailed reading of how melancholia is gendered in Renaissance literature (The
Gendering of Melancholia). Loss: The Politics of Mourning, by
Eng and Kazanjian, provides a set of case studies of the role of melancholia and mourning in history and politics.

63. Klein, “A Contribution to the Psychogenesis of Manic-Depressive States.” See also the work D. W. Winnicott did to develop Klein's theories on the depressive position and the manic defense (“The Manic Defense”). Mabel Blake Cohen et al. provide a useful overview of Freud's, Klein's, and other psychoanalysts' work on mania and depression (“An Intensive Study of Twelve Cases of Manic-Depressive Psychosis”).

64. I read all accounts of mania contained in the
New York Times
using ProQuest's Historical Newspapers index, which covers the years 1851–2001.

65. “Mania Kills Man by Push on Elevated.”

66. Staff Correspondent, “Mrs. Fosdick Kills 2 Children and Self.”

67. “Chemistry of Insanity.”

68. Lawrence, “New Vistas Opened for Chemical Approach to the Treatment of Mental Illness”; Lawrence, “Chemical's Cure of Insane Is Seen.”

69. “TV Review: ‘Manhattan' Series in Debut on Channel 2.”

70. “Main Types of Mental Disorder Explained for the Red Cross.”

71. R. Prescott, “Food Consumption, Prices, and Expenditures, 1960–81.”

72. Jayson,
Mania,
214.

73. Jewell, “Ruskin's Life Explains His Works.”

74. Ibid.

75. O. Prescott, “Books of the Times.”

76. “Leonard Woolf Is Dead at 88.”

77. Finkelstein, “Lithium Therapy.”

78. L. Brown, “Lithium Use in ‘Maude,' Medical Issue.”

79. The film is in the History of Medicine collection in the National Library of Medicine. In expressing these views, Fieve tapped into an older clinical tradition in which, writing in technical publications, doctors had for some time been associating manic depression with worldly success. In 1926 Ernst Kretschmer wrote, “In our material there are many excellent examples, where hypomanics, who must certainly be reckoned to the buoyant group, have had astonishing and lasting success in certain walks of life, e.g., merchants, speakers, journalists, etc., and are regarded with great respect by their colleagues. Their positive peculiarities are their tireless energy for, and enjoyment in, their work, their temperament, sharpness, élan, daring, lovableness, adaptability, free unshackled natures, skill in the handling of men, richness of ideas, eloquence, and an astonishingly clear eye for the right moment”
(Physique and Character,
131).

80. Bentley, “Man's Despair, and Hope.”

81. Jamison et al., “Clouds and Silver Linings.”

82. Jamison,
Touched with Fire,
267–70.

83. “Display Ad 52—No Title.”

84. Jamison, “Manic-Depressive Illness and Creativity,” 63.

85. Goodwin and Jamison,
Manic-Depressive Illness.

86. Similar concerts were also organized by Jamison in St. Louis and Washington, DC.

87. There are too many to cite here, but
Bipolar Disorder for Dummies,
published in 2005 by Fink and Kraynak, indicates how far the term had come into everyday use.

88.
http://www.dbsalliance.org/NameChange.html
. See
table 5
in the appendix.

89. Wolfe,
A Man in Full,
195. Wolfe may be alluding to Ted Turner's important role in Atlanta business and his association with bipolar disorder.

90. Jamison,
An Unquiet Mind,
182.

91. Ibid., 181.

92. Ibid., 182.

93. Harry Stack Sullivan's work contributed to this effort. Without minimizing its specific features, Sullivan argued that “schizophrenic phenomenology” required “for its complete exposition nothing different in essential quality from the elements of commonplace human life”
(Schizophrenia as a Human Process,
200). More boldly, he also asserted, “I am convinced that in the schizophrenic processes and in the preliminaries of schizophrenic illness—so common among adolescents who are having trouble in their social adjustments—can be seen, in almost laboratory simplicity, glimpses which will combine as a mosaic that explains many more than half of the adult personalities that one encounters” (201–2). Thanks to Amy Smiley for steering me to this point.

94. “The New Jobs: What They Are, What They Pay.” As one example of these changes, the Sparrows Point plant of Bethlehem Steel had been an important source of economic security for Baltimore's working class since the early 1900s. After World War II, the plant reached its peak employment of 35,000 workers: union wages supported second- or third-generation steelworkers in middle-class lifestyles. Because of steel imports, the plant workforce was reduced to 8,000 by the mid-1980s (Putting Baltimore's People First,
Putting Baltimore's People First).
In October 2001, Bethlehem Steel filed for bankruptcy, by then supporting a workforce of only 4,000 (“U.S. Steel Losing the Game”). In January 2003, with a workforce of 3,200, management approved the sale of the company to International Steel Group and was expected to lay off 1,000 of the remaining workers (“End Arrives for Bethlehem Steel”). Statistics from the Bureau of Labor Statistics of the U.S. Department of Labor show the dramatic fall in manufacturing jobs and rise in service jobs for the Baltimore metropolitan region, a decline that continued into the period 1995–2005 (Bureau of Labor Statistics, “State and Area Employment, Hours, and Earnings”).