A collection of theories about bipolar

Alongside green plates, pictures of flowers and the ceramic arms of dolls, I collect theories about bipolar disorder. I do this because I have bipolar disorder and I’m interested in trying to figure myself out. I also do it as a way to manage the condition. Knowing stuff makes me feel powerful and more in control. It helps me to engage in satisfying conversations with medical professionals and others, and to make decisions about my treatment and life. Also I’m just an obsessive nerd who’s intellectually curious about the world. 

Bipolar disorder has a long history of being pondered upon, in many different contexts and with many different conclusions. It’s an interesting condition and this makes for an interesting collection. It is important to say though, that ‘bipolar’ is nothing more than psychiatric nomenclature, referring to a bunch of behaviours as they’re perceived in a Western medical context (‘manic-depression’ is the same). Sometimes the term is perfectly accurate but sometimes it’s really not and I only use it for simplicity’s sake. 

Inclusion in the collection isn’t based on a theory’s use of the word ‘bipolar’ but rather how it relates to: 

• high and low ways of being (moods, actions, experiences, characteristics) that are connected (i.e. somehow they’re two parts of a single whole)
• extra-sensory experiences and/or beings (i.e. seeing, hearing, interacting with things and/or experiencing time in ways that don’t seem to match with the external world)

But these criteria are not very strict. It’s really just a ‘feels to me like it could be bipolar’ situation. Also ‘theory’ isn’t really the right word. There are stories, facts, histories, observations, metaphors, studies, and beliefs. 

For no particular reason they're organised into the following categories and order:

• Usual things included in mainstream histories of bipolar
• Te ao Māori
• Indigenous/non-Western
• Christian
• Associated deities
• Cosmological
• Physiological/biological
• Environmental
• Psychoanalytic
• Anti-psychiatry movement
• Psychological
• Miscellaneous interesting things

Usual things included in mainstream histories of bipolar:

• Aristotle, Socrates and Plato saw melancholia and mania as ‘divine states’, gifts bestowed by Apollo.
• The Greek physician Hippocrates (460-370 BC) believed an imbalance of the humors caused mental illness (all illness actually). Extreme sadness or ‘melancholia’ came from too much black bile ('Melanc') and mania from too much yellow ('coleric'). Purging aimed to lessen amounts and restore balance.
• Aretaeus of Cappadocia (first century BC) is generally credited with being the first to express the idea of a mood spectrum, with ‘euphoria’ and ‘melancholy’ at either end. He also suggested those on the spectrum had some kind of problem in the brain.
• Theophilus Bonet (17^th century) definitively linked mania and melancholy as a single condition. He called it ‘manico-melancholicus’ and it appeared in his book ‘Sepuchretum’, a text based on 3000 autopsies.
• In 1851 French psychiatrist Jean-Pierre Falret wrote an article about people switching between severe depression and manic excitement. He coined the (wonderful) term ‘la folie circulaire’ or ‘circular insanity’ to describe it. ‘Circular insanity’ is my favourite bipolar moniker.
• The German psychiatrist Emil Kraepelin really seriously studied mental illness and in 1921 published ‘Manic Depressive Insanity and Paranoia’. This book detailed the difference between manic-depression and dementia-praecox (now known as schizophrenia).  Kraelin’s classifications remain the basis for the DSM (American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders), the mental illness ‘bible’ used by professionals today.
• The term ‘bipolar’ first appeared in the in the third revision of the DSM (1980), replacing ‘manic-depression’ as the official moniker. The term refers to the ‘two poles’ of mania and depression and seems to me was largely developed so those with the condition could no longer be called ‘maniacs’.
  
  

^{Hippocrates's theory of the four humors} 

Te ao Māori:

• In Te reo Māori bipolar disorder is mate rangirua. ‘Mate’ means illness, ‘rangirua’ is to have two aspects, feel ambiguous and/or out of union.
• Te Pō is the second part of the Māori creation purakau or whakapapa, coming between Te Kore (the ‘void’ or realm of chaos) and Te Ao Mārama (the world of light). It is when Ranginui and Papatūānuku are separated by their children and light is first seen in the darkness, a time of both pain and potential. Bipolar episodes can be seen in this way.
• When we are sleeping our wairua wanders. It visits the dreamworld and connects with people and places we can’t easily access when we’re awake. Sometimes though our wairua gets distracted or lost and doesn’t come back to our body when it should. This effects our taha hinengaro or mental wellbeing, which is dependent on the strength of the connection between our spiritual and physical parts.
  
  

 Indigenous/non-Western:

• Many indigenous or First nation peoples (including Māori) can be described as having a holistic mental health model where well-being is dependent on the balance of the different aspects of being alive - physical, social, cultural, spiritual, family. Effective, equitable treatments must address all these necessary parts.
• Traditional Chinese medicine views bipolar in relation to the universal concept of Yin and Yang. Yin represents inward energy that’s feminine, still, dark, and negative Yang is outward energy, masculine, hot, bright, and positive. When Yin is deficient it cannot hold Yang resulting in elevated moods and hyperactivity (mania). Over time as Yin fails to nourish Yang, the energy and strength needed for daily life is lost (depressions). By replenishing Yin and regulating Yang in individuals, bipolar can be stabilized.
• In Andean culture, extreme moods and behaviours may be related to ‘waka’, the indwelling sacred spirits of natural features (usually rocks or rivers). Those having the experiences describe themselves as under the control of the waka or as being possessed by it. Suicide can be seen as sacrifice to the spirit.
• In Andean culture there’s also a word ‘kamay’ which is related to the power of creation and commandment. Individuals in manic states are sometimes said to have excess stores of kamay.
• In traditional Gaelic/Scottish culture those with big moods and extrasensory experiences are called Da Shealladh or Traibhse. It’s an amazing but painful gift from the little people or fairies, usually bestowed upon families (it’s hereditary). Sometimes individuals who haven’t got the gift will sacrifice a part of their health - physical or mental – to try and get it, i.e. make a trade with the fairies.
• In 1703 Martin Martin from the Isle of Skye wrote ‘A Description of the Western Islands of Scotland’. It has the best, most accurate description of my own bipolar-related visual experience (although I wouldn't call it second sight),
  “The second sight is a singular faculty of seeing an otherwise invisible object without any previous means used by that person that sees it for that end; the vision makes such a lively impression upon the seer that they neither see nor think of anything else except the vision as long as it continues; then they appear pensive or jovial according to the object which was presented to them…Strong reasons for incredulity will readily occur yet the second sight is only wonderful because it is rare, for considered in itself it involves no more difficulty than dreams”.
  
  

^{Te Wehenga O Rangi Rāua Ko Papa (The Seperation of Rangi and Papa) - Cliff Whiting} 

Christian: 

• In ‘Confessions’ (397-400 AD) Saint Augustine described the mind as the interface between the divine and the earthly, the site of the battle between God and the self. This manifested in extreme states of turmoil and despair.
• King Saul, the biblical first King of Israel and his extreme high, low and psychotic behaviour.
• The bible ‘guide us in all situations’ including a bipolar diagnosis, and it says mania or depression cannot make anyone ‘sin’. God just wouldn’t provide that kind of loophole. This means individuals with bipolar who behave in extreme ways are as responsible for their actions as anyone, they’re willfully sinning and need to repent.
• Similarly, while God could work a miracle and cure bipolar (or any condition) he usually doesn’t. This is because he gave the individual bipolar in the first place. It’s something to do with the moral benefits of a ‘thorn in the flesh’.
• After Jesus was crucified, the Virgin Mary, the other disciples and some early Christians hid from Roman persecution in the underground city of Cappadocia. They lived in its cramped, dark conditions for a long time, causing them to have extreme high and low moods. This propensity was somehow passed onto subsequent generations.
• Various denominations have and do ascribe extreme, unusual moods and behaviours to the possession of individuals by evil demons or spirits. The ‘cure’ was/is extreme religious practice and if this fails, exorcism.
• Conversely, manic states of grandiosity and fearlessness have been seen not as madness but a spiritual awakening and/or divine communication. Dark periods are needed to process this and make hard decisions about how to live as a result. This description fits many famous saints, including Joan of Arc.
• Saint Dymphna is the patron saint of mood, anxiety and mental disorders
• Saint Christina the Astonishing had a madness full of opposites. These included astral journeys to both Heaven and Hell, and that she could jump equally easily into hot fires and freezing lakes  without physical consequence.
• Sometimes there’s stimulation via a particularly charismatic religious leader. An example is the early 20^th Century Welsh preacher Evan Roberts, who was followed everywhere he went by a spike in asylum admissions. 
• There’s a condition called ‘Jerusalem syndrome’ which affects Christians who go to the Holy Land. Arrival makes them mad/manic and returning home they get deeply depressed. I dunno, sounds like a regular holiday experience to me.
  
  

^{Saint Christina the Astonishing}

Associated deities:

• Poseidon/Neptune/Tangaroa because the ocean is both calm and raging.
• Dionysus/Celtic mead goddesses because drunkenness can be hilarious and/or and maudlin, and the joy of a party is followed by the hell of a hangover.
• The Sirens because their calls are alluring like mania, but pursuit ends in wreckage.
• Athena, who in her lesser incarnation as goddess of arts & crafts (usually she’s associated with war) specifies the creative process as a dark mind in which the light of inspiration enters (it’s the idea of the lightbulb above the head).
• Persephone because she is queen of the underworld and the dead, and goddess of spring and rebirth.
• Hercules, whose madness manifests in extreme highs and lows.
• Kali, who embodies the fundamental opposites of human existence including life and death, and who manifests in both benign and terrible ways
• Beiwe, Sami goddess of the sun, the spring and mental clarity. Every year she restores sanity to those driven mad by the darkness of winter.
  
  

Cosmological: 

• For centuries, physicians and philosophers ascribed behavioral changes to the lunar cycle (hence the word ‘lunatic’). Different phases resulted in faster or slower actions and moods. Interestingly recent research seems to indicate a moon-bipolar relationship is conceivable, particularly regarding rapid-cycling. This could be because of individual geoelectric/geomagnetic sensitivities and/or moonlight affecting sleep and/or circadian rhythm.
• A related hypothesis about how aggressive and manic rapid-cycling behaviours caused by the moon, may be the basis for werewolf folklore (i.e. a myth created to explain a ‘real life’ phenomenon).
• The relative positions of the planets Saturn (responsible for depression) and Uranus (mania), and/or Mercury (the rational mind) and the Moon (the irrational mind).
• Ceres is the planet responsible for the seasons and their changes, influencing the accompanying behaviours and moods.
• Gemini seems to be the astrological sign most associated with bipolar.
• Specific, repeated Zodiac-sign patterns may trigger and/or correlate with episodes for the individuals involved.
  
  

^{Werewolf or rapid cycling? You decide.}

Physiological/biological:

• Genetic factors.
• Higher levels of some toxic trace elements – lead, zinc, cadmium, copper. The amounts fluctuate over periods of mania, depression and euthymia.
• Higher level of uric acid.
• Vitamin D deficiency.
• Bipolar as a particular type of epilepsy (interestingly it’s common to use epilepsy medicine and/or the keto diet to manage bipolar. I do both).
• Less gray matter in the brain, especially in the prefrontal and temporal cortexes.
• A smaller hippocampus.
• Task activation of the amygdala is stronger and that of the prefrontal cortex is weaker, suggesting an emotion/cognition imbalance.
• Functional connectivity issues between different parts of the brain.
• Out of balance neurotransmitters - dopamine, serotonin and/or norepinephrine and the systems that control them.
• Unusual amino acid sequences.
• Stronger than usual behavioral responses to amphetamine.
• Impaired mitochondria.
• Enlarged brain ventricles.
• Sodium and calcium imbalance.
• Increased basal calcium levels and responses in blood platelets.
• Excess histamine.
• Various issues with biomarkers including Monoamine, dexamethasone, Brain-derived neurotrophic factor, oxidative stress, immunological, and gene-expression.
• Issues with the gut-brain axis – malabsorption, inflammation, pathway dysregulation, chemical imbalance, malnutrition, allergies.
• Changes in hormones due to pregnancy, menstrual cycle and/or menopause
• High percentage of people with bipolar have comorbid conditions. Dariers, Wolfram, Coeliacs and Crohn’s disease are common physical ones. Schizophrenia, body dysmorphia, anxiety and borderline personality disorders are common psychiatric ones.
  
  

 Environmental:

• Cases of bipolar across identical twins are not 100% suggesting a role for environmental factors.
• Seasonal changes - spring and summer can bring on symptoms of mania, autumn and winter can bring on depression.
• Sudden increases in sunshine hours stimulating the pineal gland and triggering an episode.
• In-utero experiences - perinatal complications, maternal influenza infection and exposure to maternal smoking.
• Children who lose their mother before the age of 5 are really vulnerable, with a fourfold increase in bipolar diagnosis.
• Stressful life events. These are not generally seen to cause’ bipolar so much as trigger an episode.
• Economic situation, i.e. poverty.
• Loneliness.
• Disconnect from culture, language, history, family and identity. This is reflected particularly in the disproportionate mental health statistics of indigenous populations in colonized countries.
• Racism – systemic and individual, again reflected in the disproportionate mental health statistics of indigenous populations.
• Drug reactions – illegal and prescribed (antidepressants are notorious for triggering mania). Also substance abuse and addiction.
• Extreme internet use is becoming a risk factor for bipolar disorder. It’s thought to relate to the cultivation of impulsivity, physical isolation and big emotional responses.
  
  

^{Your pineal gland and your pineal gland on bipolar}

Psychoanalytic:

• The ‘anima’ is a Jungian archetype, essentially the feminine part of a man’s personality. It’s sometimes described as bipolar - simultaneously “…mother and maiden, fairy and witch, goddess and whore…” The male aspect of the female personality is the ‘animus’. Apparently it’s not mentally ill.
• Jung willed himself to experience depression, mania and psychosis, analysing himself as he did so. He concluded that to ‘wake up’ and/or achieve ‘sanity’ it was necessary to pass through these states, and that this need was common to all humankind.
• Bipolar individuals have an immature capacity for relationships with themselves and others. It’s the role of the therapist to ‘relaunch’ the development of this capacity, setting up opportunities for their patient to ‘re-experience’ different kinds of life interactions.
• Analytic treatment can lead to episodes due to its intense and extended period of emphasis on the self, supporting the grandiose and indulgent behaviours of mania. And the extreme highs and lows patients are likely to experience in their period of treatment.
• Depression is a form of guilt for the selfishness and ‘joy’ of the manic state.
• An ‘inborn’ propensity for emotional lability and vulnerability.
• Emotional ‘wounds’ caused by disrupted object relations.
• The aggressive and libidinal drives of an individual are not integrated.
• Individuals have limited ‘insight’ into their own unconscious.
• Mania as a form of defense against depression and depression as a form of defense against mania.
• A type of ‘hypersexuality’.
• The external manifestation of an unconscious fantasy world.
• Suicidal ideation (a very common bipolar symptom) is based on deep conflicts, such as the longing for a symbiotic love-death union with a mother figure, i.e. narcissistic and oedipal issues.
• There are a lot of psychoanalytic theories that say things like the following. I have no idea what any of them mean,
  "Manic symptoms are the occurrence of a subjective crisis without support from signifiers which are the discrete elements of language considered as different sounds, independently of their usual socially determined meaning, while the patient is dealing with fundamental self-directed epistemic questions or questions about the intentionality of the other. A characteristic of these questions is that they are organized around intimate topics such as sexuality, parenthood and life in light of death. Crises are triggered by unconscious confrontations over such intimate questions raised through daily life situations, while no support can be found by employing a master signifier. Due to the lack of a signifier representing the subject, all subjective order is lost”. - Stijn Vanheule 
• Freud himself thought that psychoanalysis didn't really work for people with bipolar. He thought those who experienced mania are impossible to treat because they can not make demands, face castration, be mediated by signifiers, etc.  
  
  

 Anti-psychiatry movement:

• Thomas Sanz believes there is an absolute definition of disease or disorder, which is the demonstrable presence of some physiological abnormality. Bipolar does not have this, hence it cannot exist as an illness. All ‘mental illness’ is therefore a metaphor or myth. 
• Similarly, disorders need to have an identifiable ‘cause’. Bipolar doesn’t have this so it cannot really exist in the way psychiatry says it does. Essentially mental illnesses have no independent reality and exist only in the minds of doctors (unlike for example, cancer or a broken leg).
• All mental illness is a 100% social construct, based completely on traditional perceptions and conventions of ‘normal’ behaviour.
  
  

^{The Great Red Dragon and the Woman Clothed with the Sun - William Blake. This picture is used in pretty much every article about Jung's anima/animus idea}

Psychological:

• Behavioural activation and inhibition systems, and/or extrovert and introvert behaviors are extreme and/or out-of-whack.
• Traumatic long-term relationships (e.g. parents or partners) creating learned behaviours and emotional survival strategies including fight (mania) or flight (depression).
• Early attachment interactions with parents and other adults whereby children develop their attachment behaviours and understandings. People with bipolar are highly likely to have attachment-related issues.
• Childhood experiences disproportionately centered around themes or expectations, for example the need to achieve, that are then contradicted or devalued later in life can ‘activate’ cognitive dysfunction. It often occurs in the transition from adolescence to adulthood.
• Just the inherent, insanely complex relationship between cognition and emotion. 
• Psychologists Mick Power and Tim Dalgleisha are very definite about the cognitive components of a bipolar episode - 1. There’s an initiating event (external or internal); 2. an interpretation’s made; 3. an appraisal of the interpretation’s made (especially in relation to goal relevance); 4. There’s a physiological reaction; 5. There’s action potential or tendency to action; 6. There’s conscious awareness; 7. And finally there’s overt behaviour. Crikey.
  
  

 Miscellaneous interesting things:

• Failure of character or a ‘choice’ made by individuals. Those involved just need to harden up and get their shit together.
• The Western spiritualism and mysticism movements of the 19th and 20th centuries (e.g. Swedenborgianism, mesmerism, theosophy, anthroposophy) saw bipolar as the necessary working through of karma from a previous life. For some individuals it’ was a ‘punishment’ representing the need to atone. For some it was a ‘reward’ for previous greatness, giving them the power to tap into astral realities. I’m not sure how they decided which was which.
• Bipolar behaviours evolved during the Pleistocene period in the Northern temperate zone to adapt to the pressures of severe climatic conditions.
• The Eugentics movement in the first half of the 20th century saw individuals with ‘mental degeneracy’ as inherently flawed and incurable. Sterilization was required to prevent them from passing on their ‘bad stock’.
• The American psychiatrist Henry Cotton believed all psychosis was septic and could be cured by the surgical removal of potential sources of infection from the body. In the 1910s and 20s he maimed and killed thousands of individuals by removing their teeth, ovaries, testes, colons and more to ‘prove’ his theory.
  
  

^{Woolly mammoths with bipolar fighting in the Pleistocene period}