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4 minutes reading

Mania enhances the individual, for better or worse

Mania enhances the individual, for better or worse Mania enhances the individual, for better or worse
Source: Megan Sebesta via creativehowl
A First-Rate Madness
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A First-Rate Madness
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(…) if the nuances of depression are confusing, mania (ed. mental illness marked by periods of great excitement or euphoria, delusions, and overactivity.) seems even more complicated. Here mood is generally elated, even sometimes giddy, often alternating with anger. One doesn’t need to sleep much; four hours can do it. While the rest of the world is sleeping, one’s energy level is as high as it might be at 11 a. m. Why not clean the entire house at 3 a. m.? Things need to get done, even if they don’t. Redecorate the house; do it again; buy a third car. Work two or three extra hours every day: the boss loves it. One’s thoughts pour forth; the brain seems to be much faster than the mouth. Trying to keep up with those rapid thoughts, one talks fast, interrupting others. Friends and coworkers become annoyed; they can’t get a word in edgewise. This may make one more irritable; why can’t everyone else get up to speed? “Mania is extremity for one’s friends,” Robert Lowell remarked, “depression for oneself.”

Self- esteem rises. Sometimes it leads to great successes, where one’s skills are up to the task at hand. But often it leads to equally grand failures, where one oversteps one’s bounds. But for someone in a manic state, there is no past; there is hardly today; only the future counts, and there, anything is possible. Decisions seem easy; no guilt, no doubt, just do it. The trouble is not in starting things, but in finishing them; with so much to do and little time, it’s easy to get distracted.

Mania often impairs one's Judgment, and bad decisions typically fall into four categories: sexual indiscretions, spending sprees, reckless driving, and impulsive traveling. Sex becomes even more appealing; one's spouse may like it, or tire of it. The urge is so strong that one might look to satisfy it elsewhere; affairs are common; divorce is the norm; HIV rates are high. Divorce, debt, sexually transmitted diseases, occupational instability: mania is the perfect antidote to the cherished goals of most people—a family, a home, a job, a stable life. The depressed person is mired in the past; the manic person is obsessed with the future. Both destroy the present in the process. in the worst-case scenario, the depressed person takes her life, the manic ruins hers. in manic-depressive illness, one suffers from both tragic risks.

Yet for all its dangers, mania can confer benefits that psychiatrists and patients both recognize. A key aspect of mania is the liberation of one’s thought processes. My patients are sometimes eloquent when describing this freedom of thought (which psychiatrists label “flight of ideas”): “Everything was swirling like a whirlwind; you just had to reach up to grab a word. You could see it, but you couldn’t say it, like the word ‘flower.’ But when it got faster, you couldn’t even see it.” Or: “My thoughts were like fireworks, going up and then exploding in all directions.” This emancipation of the intellect makes normal thinking seem pedestrian: “It felt like my mind was a fast computer,” said one patient

(…)

theories of mania do not abound. It’s as if traditional psychiatry saw the condition as too superficial to merit explanation.

The psychoanalytic view, which sees mania as a defense against depression, is the most coherent but probably the most wrongheaded. Some of my own patients offer a version of this explanation. “Sometimes I think I make myself become manic to ward off a depression,” one patient told me. “I make myself be happy about everything and I do a lot of things and I stop sleeping because I know if I don’t do this, I’ll become depressed.” Such rationales seem logical, but I’m skeptical about them. Mania often occurs without any preceding depression, and in fact more commonly, depression follows mania, suggesting that mania causes depression, rather than the reverse.

For psychoanalysts, depression was respectable; mania was not. Freud at least was honest about this: he wrote practically nothing about mania, and he admitted that psychoanalysis had no role in understanding or treating manic- depressive illness. His followers spoke where he was silent, blaming manic patients for being too childish to face their depressions. Mania does seem to hamper self- awareness, perhaps another reason why psychoanalysts looked askance at it. In my practice, I often see patients who are manic but don’t realize it. Some others only see the benefits of mania: enhanced creativity, energy, sociability. Mania becomes a kind of temporary “personality transplant” where people take on the kind of charisma that our society rewards. But they don’t fully realize the negative aspects of the disease, which are usually even more pronounced than its benefits: irritability, promiscuous sexuality, and lavish spending.

Mania is like a galloping horse: you win the race if you can hang on, or you fall off and never even finish. In Freudian terms, one might say that mania enhances the id [ed. the disorganized part of the personality structure that contains a human's basic, instinctual drives.], for better or worse. All energies, sexual and otherwise, overwhelm the usual controls that we learn to impose over a lifetime. The core of mania is impulsivity with heightened energy. If to be manic means to be impulsive, then perhaps the expression of mania depends on how far the civilized veneer that holds our lives together is stretched. If it is stretched only a little, manic- depressive persons may function fine and actually be rewarded for their creativity and extraversion. If it is stretched too much, society disapproves, and tragedy may ensue.

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