Carrie Mathison's Diary

Mythbusting for bipolar!  There are so many misconceptions and myths about mental health issues in general and bipolar affective disorder is no exception.  But understanding the condition is crucial to understanding and really connecting with Carrie as a character so here are a few myths and facts about Carrie's illness...

 

Myth #1: Bipolar is just another name for mood swings.  Umm, not exactly.  Yes, one of the main characteristics of bipolar affective disorder is the extreme swings in mood from extreme mania to major depression and the word 'affective' means that it's a mood disorder (which is also how Carrie refers to it when she's explaining it to Virgil) but the changes in affect in bipolar disorder are much, much more significant than general 'mood swings'.  They are severe, long lasting and interfere with a person's ability to function, work or study and it's the clinical significance of this that differentiates bipolar disorder from sual fluctuations in mood.  To be classified as bipolar disorder, the person must have experienced at least one episode of clinical mania lasting at least a week (see the 'Symptoms and Diagnosis' subpage for more information about diagnosis) and at least one episode of clinical depression lasting at least two weeks.  These must also have a significant impact on a person's daily functioning in order to classify as clinically significant.

 

Myth #2: People with bipolar disorder are constantly swinging between mania and depression.  Although people with bipolar disorder do experience extremes in mood, many people also have long perionds where their mood is 'stable' and they do not experience any symptoms.  On average, people with bipolar disorder experience more depressive episodes than mania although some people can experience mixed episodes which involve aspects of both depression and mania such as feeling agitated and excited while at the same time experiencing significant drops in mood or motivation.  Bipolar disorder is a spectrum condition like most mental illnesses and everyone with bipolar experiences it in a different way.

 

Myth #3: People experiencing mania are always happy.  This myth is understandable, in part because of the way that bipolar disorder is sometimes portrayed in the media, but is not technically true.  Yes, mania is characterised by elevated mood and some people experiencing hypomania in particular often 'like' that part of the condition which Carrie tries to explain to Jonas as "elation...like flying down a ski slope with no chance of falling", but there is also the flip side of irritability, irrationality, agitation and fear which we've also seen with Carrie during her manic episodes.  People experiencing mania have a reduced need for sleep and can be hyper-productive but this can also lead to thought disorder or difficulty concentrating, and even psychosis as we see with Carrie during season five.  Mania takes away a person's control of their thoughts and actions and that can be incredibly scary and potentially dangerous, and most inpatient admissions for bipolar disorder are as a result of a manic episode.

 

Myth # 4: People with bipolar disorder cannot make and keep stable relationships.  This is a myth that Carrie herself believes for most of the Homeland seasons we've seen so far.  There are many misconceptions that lead to this belief- that people with bipolar disorder are 'dangerous' and other people shouldn't be 'exposed' to that, that people would somehow 'pass on' their mood disorder to others, that people with bipolar are 'unlovable' or impossible to live with, that a person's thought patterns interfere with their ability to make real emotional connections with other people, that people with mental health issues are selfish and unable to empathise with others...  These and so many more misunderstandings contribute to the idea that people with bipolar disorder (or other mental health issues) cannot be in a stable relationship but this is not true.  Although the extremes in mood can be difficult to deal with, both for the person experiencing them and for people around them, they are transient experiences rather than characteristics of the person themselves.  A good analogy is to use the weather: think of mania as an extremely bright, sunny day and depression as an intense thunderstorm.  In between times, there are periods of relative sunshine or cloudy days that are easy to manage, but the occasional heatwave or thunderstorm can derail you for a few days.  You can't control the weather and heat-induced irritability or being stuck in floods and traffic chaos from thunderstorm-related floods don't define you as a person.  So for a person with bipolar, the intense moods will eventually pass (even if they don't feel like it at the time) and a person HAS bipolar, not IS bipolar.  As Carrie finds out in season four, it wasn't her father's bipolar disorder that broke up her parents' marriage and we see in season five that she really is capable of forming and sustaining stable relationships.  It was her job role and lifestyle that caused her split from Jonas, not her illness, and I'm really hoping she realises that in season six...