Welcome to the Jungle, Revised Edition. Hilary T. Smith

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      2

      MANIA, DEPRESSION, PSYCHOSIS, OH MY!

      A WHIRLWIND TOUR THROUGH THE EPISODES OF BIPOLAR DISORDER

      States of human experience are extremely difficult to classify. Where does a mood end and a physical sensation begin? Where does a mental experience end and a spiritual experience begin? What's the difference between a bad mood and a bad day? Are some days just inherently sad or manic, or are “sad” and “manic” things that only happen inside individual people, and not in groups of people or in the wider world? Can a person be “depressed” or “manic” in a vacuum, or are those states in constant interplay with other people in the outside world?

      Are you still “manic” if you feel really sad while you rearrange your furniture at three in the morning? Are you still “depressed” if you have two really bad days, then three really great ones, then two bad ones again? Is it still “psychosis” if you perceive your experience to be the result of intense yoga practice? Is it still “depression” if you have lots of energy and will to live, but feel overwhelming grief that they drained your favorite swamp to build a shopping mall?

      These are all questions the Diagnostic and Statistical Manual of Mental Disorders (the book psychiatrists use to diagnose mental illnesses) does not get into. The DSM is all about putting human experiences into categories—drawing lines even where it doesn't make sense to draw them.

      Think about a tree in the forest. It has bark and leaves and branches, which are obviously part of the tree. But what about the moss growing on the bark, and the ferns growing on the branches, and the mycelium intertwining with the roots, and the insects nesting in the wood? Are they part of the tree? Are they separate? Are they somewhere in between? A claim in either direction is very much up for debate. (The tree would die if you stripped off all the moss, or killed the mycelium—then again, can you really say that moss is part of a tree?)

      Mood descriptions are no different. Take depression, for example. There's a feeling of sadness and a physical heaviness which are “obviously” part of being depressed. But your knee hurts from where you tore your meniscus, your job is entering data into a computer all day, and you hear cars and trucks driving past your house all the time, and you feel really, really down about that swamp. Are the cars and the job and the swamp part of your depression? Or is the feeling of sadness and the heaviness in your body the only part of depression that counts?

      In this chapter, I am going to go through the DSM definitions of bipolar mania, depression, and psychosis because you are probably going to Google them anyway (don't lie!). But listen to me: even if some aspects of these descriptions sound familiar to you, don't let them overwrite the details of your personal experience. It's easy to read this stuff and say, “Oh yeah, I guess my mood lasted for four to seven days, and come to think of it, I did sleep less that month,” even when that isn't the whole story. There's a strong human impulse to identify with categories (that's why people get so obsessed with their astrological signs). At its worst extreme, the DSM can act as a script for “how to be bipolar” even if that's not how you experienced your moods before getting diagnosed.

      So please keep perspective as you read this. Even if the DSM description of bipolar sounds just like you, don't lose sight of the moss and ferns and all the other unique details that make you you.

      I'M NOT MANIC, I'M JUST HYPHY

      Before we get into all this bipolar stuff, let's talk about hyphy. Hyphy is a Bay Area hip-hop style characterized by people dancing or acting in a hyperactive, ridiculous manner. You put on your stunna shades, get blasted, and “go stupid.” One particularly prestigious way of “going stupid” is to put your car in neutral and dance on the hood while it rolls forward without a driver; this is called ghost-riding the whip. E-40 and Mistah F.A.B. wrote entire songs about ghostin'.

      Now, when you think about it, all this going stupid sounds a lot like a manic episode: substance abuse, hyperactive speech and dancing, risky and grandiose activity—feelin' like a star. Yet thousands of otherwise sane, asymptomatic people get hyphy every day, and nobody accuses them of having bipolar disorder. What's the difference between being manic and plain old gettin' hyphy?

      MISTAH F.A.B.'S GUIDE TO THE DSM-V

      As you can see, there's a broad behavioral spectrum to ghost-riding the whip, and in this case, I've categorized behaviors as “manic” or “depressed” based on how far they deviate from the hypothetical Mistah F.A.B.'s normal hyphy or unhyphy mood states. In the following section, I'm going to be discussing the criteria physicians use to identify the different aspects of bipolar disorder as outlined in the DSM-V, that big fat book published by the American Psychiatric Association that contains the diagnostic criteria for all the psychiatric disorders our society currently believes in. Like the songs in a jukebox, the stock of “mental disorders” in the DSM changes all the time—up until 1973, homosexuality was listed as a mental disorder (message to APA pre-1973: you guys aren't doing your credibility any favors . . .) It hardly needs saying that the DSM-V is not a perfect guide to mental illness, and that some of the “illnesses” that have been described there in the past are no longer considered illnesses at all. Unlike pregnancy, you can't pee on a stick to find out if you have bipolar disorder. Definitions evolve over time, and in a hundred years, the category “bipolar disorder” might be as antiquated as the category “hysteria” is today. The purpose of the following section is to discuss the common symptoms of mania, hypomania, and depression and what they can feel like—and also to help you resist the urge to dump every experience in your life into one of those categories.

      NORMAL HAPPINESS AND NORMAL ENERGY—HUZZAH!

      When you've just been diagnosed with a major disorder like bipolar, you might have the urge to reinterpret everything in terms of either mania/hypomania or depression. But honestly, not every moment in your life is depressed or manic: much of the time, you're just plain old you. Normal happiness and energy are just that—normal. You don't need to pathologize your enthusiasm for flying kites or attribute your last romantic success to hypomania. You're probably a charming, loveable, energetic person in “real life”—good for you! You can be ambitious, adventurous, and fun loving outside of mania. The key difference between a “normal” state and a manic or hypomanic state is whether or not your perceptions of reality and your own abilities have shifted, and whether this shift messes up your ability to relate to other people or get your work done. If you're normally a beast on the dance floor who loves to hook up with hot strangers, good for you! If you're a lifelong wallflower who is suddenly electrified with the belief that you're Justin Timberlake bringing sexxy back—well, maybe that's not normal. Let's be perfectly clear: you're allowed to grow and change, try new things, whatever. If done with a clear mind, almost any action you undertake can be considered normal. You should worry about it only if you start basing your actions on unusual logic or logic radically different than your default setting, or if people around you start noticing a marked departure from your usual behavior.

      Going skydiving because you think it's cool = normal. Going skydiving because you temporarily believe you're an invincible god = not normal. Being a talkative person = normal. All your friends are staring at you because you've been talking like an auctioneer all day = not normal.

      MANIA

      All ghostin' aside, what is mania, and how can you or other people СКАЧАТЬ