Manic depression (MD) also known as bipolar disorder affects 2.5% of the U.S population (according to http://www.health.com). In Singapore, official figures estimate 1 in 167, a very conservative estimate according to Choo Kah Ying, author of Five Little White Pills… And Then There Were None, her autobiography chronicling her struggle with MD.
The list of famous sufferers, dead-or-alive, is so impressive that MD looks like an excellent excuse for erratic behavior. For instance, Ris Low, the beauty queen who’s been the butt of jokes for her Singlish, is manic depressive. But then, as Kah Ying says, “Given the stigma faced by those with manic depression and other mental illnesses, it is not the best move for someone to use it as an excuse,” so we should be sympathetic instead of sceptical.
MD celebs in no particular order include Catherine Zeta-Jones, Ludwig van Beethoven, Vincent van Gogh, Russell Brand, Kurt Cobain, Charles Dickens, Carrie Fisher, Connie Francis, Ernest Hemingway, Marilyn Monroe, Abraham Lincoln, Sinead O’Connor, Frank Sinatra, Amy Winehouse, Virginia Wolf, Axl Rose, Winston Churchill and hordes more.
If the U.S figures are taken seriously, up to 25,000 adults in every million are manic depressive. What should the public know about MD that would help them better relate to it, or self-diagnose?
Kah Ying: I think the public’s lack of understanding of MD stems from what I feel is the inherent treachery of the condition: the vacillation between two extreme mood states of despair (depression) and euphoria (mania). The gradual shift from depression to mania can often be mistaken both by sufferers and their loved ones as indications of recovery: their mood improves and their energy level rises — they are up and about, actively involved in life. Then the sufferers begin to engage in excesses in their behaviours (shopping sprees, impulsive and reckless behaviours, etc.) and their energy levels are super-high, it may now be difficult for the sufferers and the loved ones to rein in such behaviours.
While everyone can feel sad and happy, the intensity of these emotions and related feelings is amplified several times for people with MD. Just to give some insight as to how crippling manic-depression can be, I will describe a little bit about how I was (as captured in my book).
When I was depressed, just seeing the rising sun would strike fear, anxiety, and dread in me. I couldn’t stand the thought of going through another day when I cannot make decisions; have little energy and desire to do anything; struggle to focus on my school work; and feel that the whole world was passing me by. I even flinched at the thought of taking a shower because the refreshing sensation was so startling to my dulled senses.
In contrast, when I was manic, I felt deliriously happy: just walking down the street feeling the warmth of the sun on my skin and the wind in my hair would make me feel on top of the world. Bursting with energy, I would only sleep for three hours each night. At the first sign of the sun, I would burst out of the house on my bicycle, put on my Walkman (yes it was a while ago), and sing out loud to the music at the top of my lungs, not caring what other people thought. I was partying at clubs frequently: I could dance so fast, matching the music, that I was quite a spectacle to behold. In addition, I went on shopping sprees purchasing things that I just threw around in my home — I was constantly on the go, with so many ‘projects’ that would be started and abandoned, that I barely looked at the things I had bought on impulse.
What the public needs to understand is that MD is a serious mental condition: people’s lives are often destroyed when they are caught in the relentless grip of their depression and mania cycles, which undermines their ability to think, study/work, and lead a stable life. Most seriously, some have committed suicide, while in a state of depression.
I had a schoolfriend who went off to London to study after A levels, and we didn’t meet again until 20 years later. By then, he was divorced and diagnosed with MD but I didn’t know what to ask or how to show concern. I felt really bad about not being able to empathise and I feel there are more people like me who don’t know how we can help.
Kah Ying: To genuinely empathise with your friend, you could read up about the condition — information about MD is widely available. When you are with your friend and he speaks about his MD, listen with an open mind and heart, without preconceived judgments about the excesses of his behaviours (hopefully, they are already in the past). You could ask him how he is doing and how he has been managing his condition, and ask if there is anything you could do to help. I think your primary concern would be to see whether he is managing his MD well and that his life is not falling apart. After that, it is important to show unconditional acceptance, because so many people with MD and other mental illnesses experience stigmatisation and hide their condition with a sense of shame, which is debilitating to their self-esteem and self-image. Ultimately, such an attitude would adversely affect their ability to deal with their condition.
Has having a son who needs you so much helped by drawing your attention to him instead of focusing on yourself?
Kah Ying: As readers will find out in the book, I consider Sebastien, my son, to be my savior. In the midst of my struggles with postpartum depression, a psychiatrist convinced me to take medication (for the next 10 years) so that I could care for Sebastien. Sebastien became my inspiration to get my life together in order to meet his needs. During the early days, as he was a particularly demanding baby, I was really whipped into shape: there was no lingering in bed when a baby is crying to be fed, etc.
Once he was diagnosed with autism (at the age of 18 months), I was so focused on addressing his needs and getting the services he needed that my own condition was really not uppermost in my mind. By leading a stable and purposeful life, supported by medication (with visits every 3 months to the psychiatrist), as well as a healthy lifestyle of daily exercise and relaxation routines, I was ultimately able to wean myself off medication after 10 years. In the book, I share my lifestyle strategies and approaches, which have helped me to stay on-course without medication for the past eight years.
Author’s talk: 12 October 2013, 2-4pm at The Loft, 268A South Bridge Road (off Smith Street). The $10 admission fee includes refreshments. RSVP: firstname.lastname@example.org There will also be a mini-exhibition of paintings by Sebastien.