Emily Martin - Bipolar Expeditions: Mania and Depression in American Culture

Bipolar Expeditions

Bipolar Expeditions

Mania and Depression in American Culture

EMILY MARTIN

Princeton University Press

Princeton and Oxford

Copyright 2007 by Princeton University Press
Published by Princeton University Press, 41 William Street,
Princeton, New Jersey 08540
In the United Kingdom: Princeton University Press, 6 Oxford Street,
Woodstock, Oxfordshire OX20 1TW

All Rights Reserved

Third printing, and first paperback printing, 2009
Paperback ISBN: 978-0-691-14106-0

The Library of Congress has cataloged the cloth edition of this book as follows

Martin, Emily.
Bipolar expeditions : mania and depression in American culture / Emily Martin.
p. cm.
Includes bibliographical references and index.
ISBN-13: 978-0-691-00423-5 (hardcover: alk. paper)
ISBN-10: 0-691-00423-4 (hardcover : alk. paper)
1. Manic-depressive illnessSocial aspects United States.
2. Medical anthropologyUnited States. I. Title.
[DNLM: 1. Bipolar DisorderUnited States. 2. Anthropology,
CulturalUnited States. WM 207 M379b 2007]
RC516.M382 2007
362.19689500973 dc22
2006036317

British Library Cataloging-in-Publication Data is available

This book has been composed in Electra

Printed on acid-free paper.

press.princeton.edu

Printed in the United States of America

3 5 7 9 10 8 6 4

Does the sign-post leave no doubt open about the
way I have to go? Does it shew which direction I am to
take when I have passed it; whether along the road or the
footpath or cross-country? But where is it said which
way I am to follow it; whether in the direction of its finger
or (e.g.) in the opposite one?

Ludwig Wittgenstein, Philosophical Investigations

For my students

Contents

INTRODUCTION
Manic Depression in America

PART ONE
Manic Depression as Experience

CHAPTER ONE
Personhood and Emotion

CHAPTER TWO
Performing the Rationality of Irrationality

CHAPTER THREE
Managing Mania and Depression

CHAPTER FOUR
I Now Pronounce You Manic Depressive

CHAPTER FIVE
Inside the Diagnosis

CHAPTER SIX
Pharmaceutical Personalities

PART TWO
Mania as a Resource

CHAPTER SEVEN
Taking the Measure of Moods and Motivations

CHAPTER EIGHT
Revaluing Mania

CHAPTER NINE
Manic Markets

CONCLUSION
The Bipolar Condition

Illustrations

Figures

Tables

Preface: Ethnographic Ways and Means

Studies are outcomes rather than realized objectives. They are intellectual footprints, not blueprints.

Herbert Fingarette, The Self in Transformation

I have done ethnographic projects before, but none has tapped into my personal experience as deeply as this one did.

A couple of years later, in 1996, I was spending a semester at the Humanities Research Institute in Irvine, California, when I saw an announcement in the local paper for weekly meetings of manic depression support groups held at several locations in Orange County. As I began to attend these groups, I realized I might be at the start of a new ethnography. I had already been surprised to find, during my last fieldwork project, that authors of books and magazines for businesspeople were discussing both manic depression (also known as bipolar disorder) and Attention Deficit Hyperactivity Disorder (ADHD), praising these conditions for the creative potential they offered corporations. Now I wondered if I were facing an opportunity for a broadly based ethnographic inquiry into how such a strange juxtaposition could be taking form. I explained to each support group I attended that I was thinking of doing an ethnographic study of manic depression and ADHD, although I had no idea yet what that would mean. The groups made it clear it was not a problem for me to wear two hatsa writers and a patientsbecause I had already met the criteria for admission to the group: I had received the diagnosis of a mood disorder and was on medication under psychiatric care. Their only request was that I not reveal any members identity. But through looks and gestures the first time I took out pencil and paper, people also made it abundantly clear that they would not tolerate note taking of any kind.

So I faced a challenge. My own condition might provide a route for me to study aspects of mental illness that could not be witnessed in any other way. But fears around the stigma of mental illness would prevent me from using key tools in the craft of ethnography, which involve careful note taking or recording, preferably as events take place. After a long period of uncertainty, I decided to do this ethnography more the way I had done my work in Chinese villages in Taiwan years ago than the way I had done my more recent U.S. fieldwork. I would participate in events and observe them mostly without tape recording and I would consider carefully before requesting interviews. I would take notes on the fly, in the moment whenever possible, or immediately after events were over, if not. My reasons for this are important to clarify. Some were practical: the stigma against mental illness is so great that my knowing someones phone number and address, which I would need to do a lengthy, confidential interview, could be threatening. People have lost jobs and relationships when such information has gotten into the wrong hands and for this reason participants rarely revealed their last names or addresses in support groups. To understand something like madness, defined as outside rationality, I would need to venture into unfamiliar territory.

I used the word madness in the last sentence intentionally, although the term mental illness has the benefit of grouping mental phenomena with physical phenomena, implying optimistically that both have biological causes and potential cures. Without denying the utility of this grouping, I would say that the term mental illness also robs the experience of being mentally ill of its complex darkness, and it is this darkness that I want to understand better. I knew from my own experience and that of my interlocutors that grappling with the category of madness would require me to find ways of pursuing the darker forces in human life, as James Baldwin puts it. He was concerned with the repression and denial of human weight and complexity to African Americans, but many of his arguments bear full weight against the ways those deemed mentally ill are denied the status of the fully human. The stigmas of race and mental illness are certainly not identical, but both draw on terrible reserves of repressed fears and angers.

In my own work and employment, facing the stigma of mental illness has been an ongoing problem. When, as part of fieldwork, I had been trained to lead support groups for people with manic depression, the organization that provided the training strongly encouraged us trainees to start a support group in our own local town or workplace. I was a professor at Princeton at the time and I knew that several of my students were struggling with bipolar disorder. I went to the psychiatrist who was head of the student counseling service and explained what I had been trained to do, offering to facilitate the formation of a group in some small way. She thanked me but explained that students at Princeton did not need such a group. She said that students with those kinds of serious mental problems would simply not be able to function in the intellectually demanding environment at Princeton, so there was no need to form a group. In this social setting, if you say you have manic depression, you may well be categorized as a nonfunctional person, as a less than a fully rational person. I did not tell her that I, too, had the diagnosis because at the time this admission felt too terrible to bring to light. Would I, too, be judged incapable of functioning at Princeton?