Bipolar Disorders and the Case of the Missing Self

Every few years, a new author comes along who is uniquely capable of giving voice to the ineffable aspects of their experience with serious mood problems:  Kay Jamison with her (An) Unquiet Mind, William Styron who perceived Darkness Visible, and Sylvia Plath’s The Bell Jar are the more modern prototypes.    Recently, a freelance journalist, Linda Logan, published a brief piece in the New York Times:  The Problem With How We Treat Bipolar Disorder 1.   This mini-memoir is second-to-none in capturing the roller-coaster ride that is far-too-often the case with this illness.

In prose that is simple, direct, and blunt, Ms. Logan describes her 25 year journey through missed diagnosis, misdiagnosis, and a cavalcade of treatments that alternately helped and worsened her underlying condition.  This is a sobering read; it is not for the faint-of-heart.

Beyond her gift for describing these diagnostic and treatment experiences, Ms. Logan focuses on a grossly neglected aspect of this illness:  what it does to one’s sense of self.  Starting from her early experiences with depression, moving through a kaleidoscope of hypomanic and psychotic states, including the psychological impact of various medications, she describes how the experience of intense mood states and their treatment challenge our most basic knowledge of ourselves.  As clinicians working in this area, we find that questions about self-identity almost inevitably arise in the course of this illness.   When a diagnosis of bipolar disorder is made, for example, people who knew of themselves as outgoing, upbeat, and irreverent are forced to consider whether their fast-paced levity was who they truly were or part of an illness.  Or the person who has spent so long in a depressed state that it comes to define both how they know themselves and how others know them.  This person too will have to consider the same questions if and when their depression is effectively treated.  Illness or identity?   Helping patients with mood disorders address and resolve these almost existential uncertainties is an often necessary part of their therapy.

In her article, Ms. Logan describes her long journey through bipolar disorder and her experiences with losing, questioning, despairing about, and ultimately finding a new sense of herself.  The final version incorporates some of her old and healthy qualities, while acknowledging the ravaging effects of the illness, and ultimately spins out a fresh original that combines bits of old and new, disturbed and undeterred, lost and found.

Bipolar disorder presents many challenges to those it afflicts.  Linda Logan’s writing brightly illuminates one such trial – that of her ‘vanishing self’ – and the torturous path towards recovered and reconstructed identity.   If you or someone you know has this illness, read this work, hold on tight, and gain inspiration from this brave author’s courage.

The Problem With How We Treat Bipolar Disorder.  Linda Logan.  New York Times.  April 26, 2013.