Bipolar: Valid Label or Excuse?

Q: A relative of mine, a young woman of 19, has been diagnosed with ‘bipolar disorder.’ Is this a valid diagnostic label or simply another excuse? [Note: ‘Bipolar Disorder’ is the psychiatric term for mood instability, characterized by vacillations between periods of exaggerated negativity (depression) and exaggerated optimism (mania).]

A: I’ve said it many times before: we humans are both mind and body. As a result, we possess free will to exercise our mental capacity through the formation of concepts. The concepts can be as simple as ‘table’ and ‘chair;’ or as sophisticated as ‘justice’ or ‘the theory of relativity.’

Deeply held and internalized concepts — especially value-oriented ones — can lead to emotional states of different kinds. For example, the concept that ‘my life is only worthwhile if I serve others’ will (if deeply internalized) lead to emotional states of neurotic guilt, depression, and self-effacement; while the concept that ‘I should be happy and go after what I want in life’ will contribute to an emotional state of optimism, benevolence and contentment.

Similarly, a deeply held viewpoint that life is basically good and full of opportunity will lead to one kind of emotional state and personality; a deeply held belief that you do not own your own life and that reality is not a place where values can be achieved will lead to a very different personality.

Souls (i.e. minds) are not mystical ghosts floating through space, devoid of any physical correlation. Nor are they merely a series of chemical reactions and genetic structures. Souls consist, must fundamentally, of ideas, premises, beliefs, emotions, and convictions — true or false convictions (most often, a complex mixture of each).

Whether medication effects a desired change or not in a particular emotional state is not always clear. Sometimes there is evidence to suggest so; at other times there really is no evidence. Many psychiatrists and drug companies greatly inflate and exaggerate the benefits of psychiatric medication. They imply that improvements in mood are due solely to physiological changes. They feel no burden whatsoever to consider any other factors.

What is clear is that emotions are not formed or determined, at least exclusively, by physiological states. It’s just as plausible, for instance, that one’s biological states — including the ‘chemical imbalances’ thought to determine bipolar disorder — are results, rather than causes, of inner emotional turmoil. In other words, it could be that ideas and emotions change the physiological structure of the brain, rather than the other way around.

Yet this startling hypothesis is never put to the test by mental health experts or scientists. Why? Because the bias today is overwhelmingly in favor of the notion that ‘biology is destiny.’ Nobody — not the scientist, not the layperson — seems interested in the possibility that one’s concepts, beliefs and premises even contribute to emotional states, much less create them.

Now back to your specific question: Is someone making an excuse simply because he honestly acknowledges having symptoms of what’s called ‘bipolar disorder?’

Not necessarily. The label with which one identifies is relevant, but is not the crucial issue with respect to the issue of personal responsibility. The crucial issue is whether one allows himself to recognize that there is such a thing as free will, and that free will resides in his choice to think, exercise judgment, and validate or refute basic ideas.

To paraphrase psychiatrist Aaron Beck: man is a practical scientist and, like a scientist, he possesses the capacity to form and reject hypotheses about everyday events and issues. In other words, reason and logic are not just for the ivory tower or the research lab. They’re needed in everyday life, too.

For example:

Which house should I buy?

What career decisions make sense for the long- and the short-term?

Does this woman share my values?

Should I marry her?

What’s the best way to spend my paycheck?

How much money should I save?

The list goes on and on.

Less important than the label of ‘bipolar disorder’ is the individual’s explicit and implicit philosophy of life. His modus operandi, in effect, must be as follows: ‘I have this bipolar syndrome and as a result will take medication only if I see objective evidence that it’s helpful in providing me some relief and emotional stability. If it doesn’t help, I won’t take it. I still have control over my choices and the ideas I accept or reject. If I discover, through introspection, that some of my ideas are irrational, mistaken, or harmful to me, then I will take responsibility for challenging, correcting and refusing to act on them. Medication, at most, is a means to this end; but not an end in itself.’

Medication and acceptance of the bipolar label is simply an excuse if one defaults on the responsibility of thought and introspection. One will pay the price, too; because even if medication works initially as a wonder drug (which it usually does not), my clients report that its effects generally wane over time.

The mainstream of today’s psychiatric profession, regrettably, encourages and enables this defaulting of responsibility on a massive scale: Not by explicitly rejecting responsibility and thought, but simply by acting and speaking as if no such things exist.

The fatalism and determinism of today’s psychiatric establishment — and the whole victim-oriented culture it has spawned — is a much greater threat than any bipolar ‘disease’ could ever be.

So tell your 19-year-old relative to call herself bipolar if she likes. But she’s still in control of her destiny — so long as she chooses to think, introspect and take responsibility
for her life.