An Inappropriate Illness

Twenty years ago I was hospitalized for acute mania and diagnosed with bipolar disorder, a mental illness once called manic depression. It’s the result of an abnormal brain chemistry that arbitrarily turns up and down the volume, so to speak, of one’s emotions. The disorder can be controlled with medication, in my case mainly depakote, a prophylactic against manic episodes; and lamictal, an anti-depressant.

I decided early on that I would regard the illness as something I had, like a clubfoot, and not part of who I was. I also decided to acknowledge the illness openly in situations where to do otherwise would be to hide it away as something shameful. I did this despite the fact that my initial experience with the stigma attached to mental illness was a profound shock. My employer fired me (and was careless enough not even to hide his reason). Friends, thinking that my life was over, fell away. Even my family was less than supportive.

Nevertheless, thanks to the fidelity of a few close friends and the lack of an alternative -- one simply cannot fold a bad deal in life as one does a bad deal in poker -- I persevered. I started on my doctorate, completed it in five years, was hired as a tenure-track professor, published a successful first book, and received tenure a year early. Indeed, I was so successful during the first decade after my diagnosis that it was easy to regard the diagnosis as more theoretical than real. For most of that period I thought of myself as asymptomatic. I didn’t see a psychiatrist and took no medication.

A serious hypomanic episode nine years ago jolted me back to reality. In a hypomanic episode, a person remains functional and can even seem brilliantly charismatic, but those close to her or him know something is wrong. Left untreated, a hypomanic episode can lead to full-blown mania amounting to a complete break with reality. The experience forced me to acknowledge that I could never be like other people, that I would have to own, really own, the fact of my bipolar disorder.  I have taken medication, seen a psychiatrist, and visited a therapist regularly ever since.

My department has a new chair, and a couple of days ago I sent him a memorandum similar to one I’ve given every incoming chair for the past nine years. The memo gives an overview of bipolar disorder, details the symptomology, and lays out a suggested course of action to pursue if he ever has concerns that I might be having a manic episode:

• Approach me, outline your concerns, and ask for an explanation.
• If, after talking with me, you think it warranted, make sure that I call my therapist or psychiatrist.
• If I fail to do so, that is a bad sign, and you should ask me to go to the emergency room. My policy in such instances is to suspend judgment and do as told. This has actually happened on three occasions and in each case I complied.
• If I don’t go to the emergency room, that means I’m psychotic, and you should treat it as a medical emergency -- call EMT [Emergency Medical Technicians] and  have me taken to the ER by force if necessary. This has never occurred and I don’t expect it to, but it’s a theoretical possibility that has to be taken into consideration.

For potential hypomanic and depressive episodes, the first and second steps should suffice. If you still have concerns, contact one or the other of these people in the following order....

I then supplied complete contact information for my therapist (a clinical psychologist) and psychiatrist.

People often think that because I’m so up front about having bipolar disorder, that being candid about the illness must be an easy thing for me to do. In fact, it scares me. I’m up front about it only because I’m convinced that candor is better than the alternative. Being open with my colleagues, for example, populates the department with observers who have a decent chance of identifying unusual behavior as an artifact of the illness rather than erroneously attributing it to something else: simple high spirits instead of hypomania, for example. It enables me to ask for help when necessary without having to explain the illness from scratch. And it gives me a chance to combat, in a small way, the stigma that still attaches to mental illness. If a professor protected by tenure cannot summon the modest courage required for such an act, I do not know who can.

Because it’s a biochemical illness, no different than any other chronic ailment, and because my department has a long track record of being supportive, one might wonder why I feel any trepidation about discussing bipolar disorder. After all, aren’t the groves of the academy a place of unusual enlightenment, free of the prejudice one might find in other walks of life?

Well, no, not exactly. In the academy, nearly everyone knows better than to talk or act as if I ought to be chained up in an attic, but people have their own way of reflecting the age-old stigma concerning mental illness:

It’s inappropriate.

Sure, Grimsley can’t help having manic depression, but does he have to talk about it?

I first encountered this perspective about 10 years ago when a friendly senior colleague urged me to keep quiet about the illness. He had been around the academy long enough to fear that two things might happen. First, he worried people within my university would be publicly supportive but would privately tell one another, “He’s bonkers, you know.” Second, he feared that it would cripple my chances of ever landing a position elsewhere were I inclined to apply. “His books and teaching are solid, his letters of recommendation strong. But did you know he’s nuts?”

Of course, “bonkers” and “nuts” probably would not be the terms they would use. Academics are nothing if not clever in conveying their prejudices. And in this instance they could use my very candor against me. Such openness is inappropriate. He doesn’t show a sense of proper boundaries.

I was once told exactly this by a committee chair who was upset with me because he thought I had gone around him on a certain matter. I’ve since come to see that, on the merits, he was right and I was wrong, but at the time his anger baffled me. Trying to explain his strong reaction, my colleague blurted, “You might think you can just be informal and talk to anyone you want, but it isn’t like that. You might think you can give people a memo about your bipolar disorder and it’ll do some good, but it won’t. That’s not how people are.” The last two sentences were such a non sequitur and so forcefully expressed -- particularly by a historian I have always respected, then and since -- that I realized that in his anger he had said something he deeply felt but ordinarily would have kept to himself, or at least away from me.

(And in fact he was wrong.  When I did have a second manic episode, in 1999, my department chair and other colleagues came through for me like champs.)

On another occasion, I became interested in the idea of writing an article about the various explanations advanced for the sometimes erratic behavior and fiercesome speech of Union general William T. Sherman. One biographer posits that he suffered from narcissistic personality disorder; another implies that he had bipolar disorder. Most reject any explanation based on psychopathology, however, because they suppose that no one with a serious mental illness could function sufficiently to rise very far in life, and certainly not to command the principal army that won the Civil War.

I approached an editor about such an article and he was enthusiastic -- except for the part where I said I wanted to draw upon my own experience with bipolar disorder to help interpret the evidence.

Nowadays it is not unusual for historians to “place themselves in the narrative,” as it’s called -- to acknowledge the personal roots of their perspective and so reject the misleading “god trick” of objectivity. But no way was this editor going to accept an article from me that did that. Not about a mental illness. It was, he conveyed, inappropriate.

A few years later I heard a scholar give a public lecture on visual literacy in which the fact of  his badly impaired eyesight figured prominently. The audience of academics was wowed. This deployment of a physical disability, apparently, was not inappropriate.

I will give one final example. Because I am so up front about having bipolar disorder, I am occasionally approached by instructors and students, both graduate and undergraduate, who have been diagnosed with a mood disorder. Some look for advice and reassurance. Others just want to talk. 

One told me the story of what had happened to her when she was an adjunct professor teaching a course at another university. She had to miss several days because of a bout with clinical depression. When she returned, her students, with whom she had a good rapport, were very concerned and wanted to know what had happened to her. She told them. They did fine with the information (I have discovered the same to be true when I discuss the illness with my own students), but her dean did not. He called her into his office, explained at length that her disclosure was inappropriate, and did not renew her contract.