Friday, September 12, 2008

Thoughts about Bipolar disorder, Addiction, and Tucker Max

The NYTimes Sunday Magazine article covers the diagnosis of bipolar disorder in children.

Much of it is terrible and awful: kids breaking down in Walmart, holding weapons over parents and siblings asleep in bed, banging into walls and hurting themselves in bouts of mania. I feel sick thinking of a person's lack of control over mood and behavior. I have seen this type of behavior before, not necessarily from someone that was bipolar, and watching a "self" perform in ways contrary to its personality and dignity is miserable and frightening.

At the same time, I find the personality of people with bipolar disorder or bipolar tendencies (those N.O.S. or "not otherwise specified" folks) absolutely compelling. These are people who violate social boundaries with confidence, unaware that they are crossing lines. Their uninhibited behavior would take other people mountains of alcohol and drugs to achieve. I love being the sidekick while a friend makes someone else totally uncomfortable with their audacity and boundary-pushing. Then there's the oversharing. With lives more dramatic than a soap opera, their lack of inhibition gives them a roster of compelling, play-by-play stories: willing to do anything, willing to tell anything.

Obviously I am making generalizations, I am one-sided, and reporting only on mania, but I truly feel that bipolar disorder actually benefits society at a whole: it concentrates feelings and creativity and makes others questions the norms they so willingly follow. Van Gogh always gets cited as bipolar, but what about Mary Kay LeTourneau? Not only has her life inspired Lifetime movies, she's also, seriously, become a lightning rod in the debate over age differences in relationships. I also suspect that people like "Slut Machine" over at Jezebel have bipolar tendencies, particularly when she wrote about a crazy April several years ago in which she went out every single night, slept with twenty men, and never missed a day of work. Purely gleaning from the writing (isn't that what the historians did with Van Gogh?) this type of behavior deviates from normal. Similarly, I am convinced that Tucker Max is bipolar. He's narcissistic slash overconfident, oversteps boundaries without realizing they have been crossed, cannot exercise restraint in sex or alcohol, overshares, is terribly mean towards women...the list goes on. While I find his life compelling, it is in a train wreck kind of way--I would not want to be anywhere near it, feel powerless to stop it, but nevertheless am swept up in watching such an extreme malfunction with catastrophic consequences. ARGH, he really riles me up. His behavior is just beyond offensive.

When you are dealing with psychiatric problems, how do you tell what is personality and what is a 'disorder'? I guess what I am really asking is that biology/environment question: to what extent are these disorders caused by hormonal imbalances in the brain, to what extent is it the result of environmental factors, and to what extent are these people culpable and responsibly for the poor choices they make? These are difficult questions, and I know the die-hard left position on this issue would omit the third one altogether. In defense of my inclusion of personal choice, I cite an essay I read recently in the NYTimes:

"Imagine two people trying cocaine, just to see what it is like. Both are 32-year-old men with jobs and families. One snorts a line, loves it and asks for more. The other also loves it but pushes it away, leaves the party and never touches it again. Different values? Different tolerance for risk? Many factors may distinguish the two cocaine lovers, but only one is at risk for a problem.

Asking for more drug is no guarantee of being seduced into routine use. But what if it happens? Jacob Sullum, a senior editor at Reason magazine, has interviewed many users who became aware that they were sliding down the path to addiction.

“It undermined their sense of themselves as individuals in control of their own destinies,” Mr. Sullum wrote in his 2003 book, “Saying Yes: In Defense of Drug Use.” “And so they stopped.”

Personally, I can totally identify with the bold statement, and think it is entirely true. I think one attribute this article leaves out, however, is that an individual's desire to gain or lose control is not only dictated by their genes, but also their situation. People who find themselves depressed or not caring enough about themselves to think that they are worth more than pursuit of transient, chemical-induced happiness could say "yes" in those situations where years before the same situation would have elicited a "no." Even week-to-week, it's considered within the realm of normal to medicate a rough week with a rough night of drinking/drugs. Then, at some point, the behavior crosses a line.

So a rather heady post for a Friday night, but I stayed in (no way I am taking a train to New Jersey to see a boy! I only do Manhattan :). I guess that might also mean "she's just not that into you")

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