Absence of understanding is dangerous.

Much of the media fuels hatred of Islam by discussing the religion primarily in the context of extremist violence, as the nation witnessed in the news’ treatment of Omar Mateen, the shooter in June’s devastating Pulse nightclub massacre in Orlando, Florida. In a similar (although less recognized) vein, most media, in describing Mateen’s character, also exacerbated fear of mental illness, reporting as fact Mateen’s ex-wife’s suggestion that he suffered from bipolar disorder. But as psychiatrists Maryam Hosseini, Christina Girgis, and Faiza Khan-Pastula noted in a recent CNN article, it is unlikely, given descriptions of Mateen, that he met the criteria for bipolar disorder. In fact, daily flashes of anger, like those his former wife recalls, are not an established symptom of the illness. More significant, however, is the implied association between bipolar disorder and violence—a source of alienation for the 5.7 million Americans living with the illness, whose true lived experiences remain underreported and misunderstood. Nearly 40 percent of news stories that discuss mental illness associate it with violence—a distortion of statistics: just 4 percent of violence is related to psychiatric disorder.

This misunderstanding extends into the entertainment industry as well. Some well-known movies that feature mental illness, such as American Psycho, revolve around horrifically violent protagonists. And even when mentally ill film and television characters are more benign, they still often contribute to inaccurate stereotypes. Elaine Flores, a writer and editor with bipolar disorder, wrote for The Root the television show Empire’s depiction of bipolar, for instance, was overly dramatized, treating the “worst-case bipolar scenario” as the norm. Approaches such as Empire’s, which exaggerate the severity of psychiatric disorders, do little to correct newspapers’ erroneous focus on mental illness and violence. And although recent improvement in portraying those struggling with such diseases is cause for optimism, both the media and entertainment industries have a ways to go to do justice by the mentally ill.

The Private Life

For Kevin Hines, who has lived with bipolar disorder since his teenage years and works as an activist to raise awareness about mental illness and suicide, these issues are personal. “Mass media has a huge problem with scapegoating mental illness when things go south. First of all, we in this country, if we watched mass media and only looked at mass media and what happened when there was a shooting or there was something terrible that happened,” he told the HPR, “you often see them referring back to bipolar disorder or depression or mental illness when, in fact, the mentally ill population is no more likely to commit a homicidal act than any of the rest of the population. Yet you never hear that on the news. You only hear the opposite.”

His assertion is supported by government statistics: mentally ill people are responsible for just 3 to 5 percent of violent crimes, and most individuals with even severe mental illness are no more predisposed to violence than are individuals with no psychiatric history. In fact, violent crime disproportionately victimizes the mentally ill, who are more than 11 times as likely as the average American to have violence perpetrated against them. Hines argued that this distorted media focus is itself dangerous. “We’re conditioning the American people, and certainly even globally, to look at someone with this disease and think, ‘Oh, that’s what they’re capable of.’”

Bipolar disorder, a usually chronic illness characterized by episodes of high-energy mania and intensely dark depression, has an average age of onset of 25 years. Its reality is, of course, not well known by those distant from depression and mania, and the word “bipolar”—like the terminology of many psychiatric disorders—is both an overused and often misused descriptor.

Olympic sailor Kevin Hall published his memoir, Black Sails White Rabbits; Cancer Was the Easy Part, in December 2015 about his experience with bipolar disorder. He explained to the HPR, “There are some things that are unique to bipolar: the mania side of it is alluring in many ways and, frankly, hypomania is a very enticing state of mind and state of being. For me, before I get actually sick and become really irritable and then psychotic, I get a lot done, and I do have more ideas, and I am more energetic. That part of it is hard to manage, and [I can see] why that part would be sexy for entertainment and the media.”

Models for more productive plot lines do exist, however, in newspaper tales of daily life as well as in the entertainment industry. The task now is to place these stories at the fore. The Voice Awards—created and run by SAMHSA, the U.S. government’s Substance Abuse and Mental Health Services Administration—addresses this challenge by annually honoring directors, writers, and producers of movies or television episodes with especially accurate or positive storylines related to mental health. SAMHSA’s goal for the awards, according to its website, is “to counter negative attitudes, beliefs, and behavior associated with mental and substance use disorders by recognizing accurate depictions of behavioral health conditions by entertainment media.”

The Arc of Disaster

Perceptive discussions of bipolar disorder tend to focus on families. Sickness naturally hurts family members and often affects relationships. And bipolar is frequently, if indirectly, a hereditary disease—it seems to have an unusually strong genetic component. This trend in arts and media of depicting bipolar disorder as a family affair pays special attention to children.

In a 2008 New York Times Magazine article, author Jennifer Egan wrote, for instance, of a family in which both parents and their two children had been diagnosed with bipolar disorder. The children’s behavior was a mix of typical childhood activity and distressing complaints about internal pain and, in the girl’s case, flirting with grown men. Their mother balanced this complexity by integrating both the normal and the abnormal into daily life—she topped their nightly psychiatric medications with whipped cream.

Though bipolar disorder’s prevalence as a pediatric condition remains hotly contested, many psychiatrists believe that children can suffer from the illness. And earlier age of onset often correlates with a more severe course. Children with bipolar disorder, like their adult counterparts, struggle with both stigma and fear of aggression. Alexis (she kept her last name confidential), the mother of an 11-year-old girl with bipolar disorder, wrote an article for Babble as an attempt to clarify misperceptions of the condition. After her daughter, Tara, told her best friend about her illness, Alexis recalled, the friend pulled away. The friend’s mother had warned the friend to steer clear, worried that Tara was “probably ‘crazy’ and might do something strange.”

A more extended tale of a family’s experience with pediatric bipolar disorder is Boy Interrupted, a 2009 documentary that Dana Heinz Perry created to tell her son’s story. It provides an unusually thorough view of a lifetime of mental illness—in this case, Evan Scott Perry’s brief 15 years. Diagnosed with bipolar II in his prepubescent years, he was frighteningly troubled even in elementary school. As a teacher in the film recalls, Evan considered suicide as a kindergartener. He went as far as to specify his method: jumping out a window, the act he would one day execute.

It is tempting, watching the documentary, to regard the two sides of Evan as separate. But in reality, there is no clear dichotomy. Personality and psychopathology are tangled from the start. In the words of one woman with bipolar disorder, interviewed in the documentary Of Two Minds, “Bipolar affects everything. There is no, ‘Oh, I’m going to calm down.’ You can’t: It’s your brain.” Nor can one define mental illness as isolated strictly to those diagnosed, walled off from healthy human existence. Like all experiences, psychiatric disorder falls along a spectrum punctuated by the idiosyncrasy of each individual.

Evan seemed his most calm, his most healthy in the few years before his suicide. The numbered lists that eventually composed the 15-year-old’s suicide note were written, in his psychiatrist’s words, “hyper-sanely.” As the psychiatrist himself pointed out, they differed starkly from the typical representations in film or other media of what it means to be psychiatrically ill. In this way, Boy Interrupted forces a normalization of mental disorder onto its viewers, even as the documentary defines Evan’s experience as unusually severe. This normalization disrupts a framework in journalism and the arts of regarding the mentally ill as the “other” and forces viewers to accept that, in many ways and at many times, those suffering from mental illness don’t look much different from them.

The Self and the Screen

And even though works like Boy Interrupted reach a relatively niche audience, the topic of bipolar sometimes makes its way into the mainstream. David O. Russell’s 2012 Silver Linings Playbook, for instance, whose main character, Pat, has a bipolar diagnosis, earned and Academy Awards nomination for Best Picture. Admittedly, the film’s approach to the illness is somewhat vague, highlighting an amalgamation of traits loosely categorized as bipolar. And it is unclear why Pat’s illness fades as the film ends. Still, Hall considers the film to be “pretty good.”

But he and Hines turn to Carrie, the protagonist with bipolar on the Showtime series Homeland, for an especially accurate portrayal of life with bipolar disorder. “I remember feeling like she didn’t misrepresent me more than she represented me when I first started watching it,” Hall recalled. Hines finds the show “absolutely phenomenal.”

Yet even the finest characters cannot always do justice to reality. Hall pointed out the difficulty of seeing oneself in a celebrity or fictional character: “I think that the challenge for entertainment is that, if they make it too much about the day-to-day slog that it is for many of us with mental illness, it’s not a very compelling storyline. They have to balance something sexy enough to be entertainment with something responsible and compassionate to the mental health community, and I’m sure that’s a tough balance.”

Keris Merick, director of the Office of Consumer Affairs at the Center for Mental Health Services at SAMHSA, on the other hand, argued in an interview with the HPR that there exists “really important work that can still be entertaining”; that there is “no need to be derogatory or [to] stretch” to create compelling content around mentally ill characters. She pointed toward the Carter Center’s recommendations for portraying mental and behavioral health conditions, a thorough and easily digestible compilation of advice. The Carter Center guidelines make clear that psychiatric conditions constitute a piece of the nation’s public health landscape, a perspective that makes it all the more difficult to justify their often nonscientific portrayal.

Merick is optimistic about the progress already underway—particularly in movies and television. “In general,” she remarked, “TV and film, the entertainment industry, are doing a much better job of portraying mental illnesses accurately.” She admitted that news outlets have been slower to improve, “but they have also had good profiles of mentally ill people.

Because of the sway media, television, and film have over American public opinion and awareness, the responsibility for stamping out stigma around mental illness generally and bipolar disorder specifically falls most clearly to these industries. This process will require more profiles with the realism of Jennifer Egan’s and the depth of Dana Heinz Perry’s. It will demand careful scrutiny of plot lines and characters, following The Carter Center’s advice and the model of the television episodes and movies that the Voice Awards highlights. The truth of bipolar disorder is more complex, and less tied up in danger and violence, than the stigma.

Image Credit: Flickr/Wolf Gang

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