Review: Living with Bipolar

Channel’s 4 one-off documentary Living with Bipolar has had a pretty lukewarm response on social media. A number of people with bipolar found it offensive. I’m not bipolar, and I too found the arguments put forward early in the programme problematic. But I stuck with it, and on balance I’m glad…

The programme was a window into the lives of three very different people with Type 1 or Type 2 bipolar: Sian, a wife and mother who believes medication has saved her life but worries about her sons inhering “the bipolar gene”. Paul, an entrepreneur who, in the throes of mania, literally believes he’s divine and walks through the gardens of a stately home designing a golf course, and Ashley, a bedroom musician in his early thirties who can swing between mania and incapacitating depression several times a day. I was especially struck by Ashley’s story. He seemed to have been diagnosed with Aspergers Syndrome as a child but never to have received support. Adults with undiagnosed learning differences often show up in the mental health system but those who have been identified as children usually make more progress.

We were presented with extreme ends of the nature versus nurture debate. The presenter, psychotherapist Philippa Perry, believes most mental breakdown is caused by a traumatic environment. She poses the question: “How can these very different people all have a genetic condition?” Though I’m a huge fan of hers, it’s a bit of a puzzling argument, as you can make exactly the same one in reverse: “How can these very different people with very different backgrounds and circumstances all have been affected by something in their environment?” She is backed up by another psychotherapist, a softly-spoken lady in pastel colours, who says that masking difficult feelings with drugs is unhelpful. The programme’s participants repeatedly undermine the trauma theory. “Was there any childhood trauma or anything?” Philippa asks Paul and Sian. “No. Zero.” “He was a divine baby,” says Ashley’s mother. Philippa looks for more clues in their life histories. Paul’s an only child whose parents took years to conceive: might this exacerbate the feeling of “uniqueness” or being “different from the average” that occurs with mania or depression? Afterwards, a doctor with a wavy graph shows how bipolar is the result of a chemical imbalance in the brain. Sian, who’s worried about her boys being bipolar, visits some pioneering research at Cardiff University. An expert explains that, while there is no “bipolar gene” as such, and the probability a child will inherit it is just 1 in 10, there is overwhelming evidence of a biological role in bipolar. Philippa is forced to reluctantly concede that the condition can’t be explained by environmental factors alone.

I felt that by the end, the programme had resolved a lot of its problems from the beginning. It actually did a decent job of showing the limitations of an entirely medical or entirely environmental explanation for mental illness and concluded that, essentially, you can’t ignore either. I can be pretty sure some of my own complications are the result of premature birth, and I can be equally sure aspects of my environment were both helpful and unhelpful in recognising and dealing with them.

What stuck in my mind as awkward about the programme was Philippa’s view that medical labels can be limiting and encourage helplessness. I hear this a lot in my work, not just in relation to mental illness but also learning differences like dyspraxia and dyslexia. In its less benevolent form, it’s expressed as “You’re just lazy”  “It’s just an excuse.” Labels don’t have to be limiting. They are not an excuse. They are way of freeing you to focus on what you’re good at and manage the things you’re less good at, rather than just scuttle around in circles trying to work out what the hell’s the matter with you all the time. A label doesn’t mean you stop learning or growing. I don’t know a single person who has received a diagnosis of a mental health problem or learning difference and thought “Hooray, now I can sit on my tush and do nothing.”  True, there may be some sense of helplessness at first, as there can be over any major life event – especially one that involves being bounced from bureaucratic pillar to post while you look for the right help. For sure, someone may feel confused, uncertain, or look back over their life with regret and sometimes anger. But lazy? Not a chance. I have learned more about myself, the world and other people since being diagnosed with dyspraxia ten years ago than I knew in the 21 years before that. My life hasn’t been a picnic, but I’ve no doubt I am infinitely better off with a label than without. I heartily agree with Philippa that “A label isn’t the end of self discovery; it’s just the beginning.” I just wish she knew that most people who are labelled agree with her…

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