The following is an excerpt from my upcoming memoir, BrainStorm: From Broken to Blessed on the Bipolar Spectrum.

I’m advocating that bipolar depression II is misnamed, misunderstood and misdiagnosed when we refer to it as a “mental illness.” If I had a knife in my liver, you wouldn’t ask me about my issues with my mother; you’d stop the bleeding. If I had a thyroid problem, you’d treat it. So if my brain has a physical malfunction that prevents it from operating properly, don’t look only for childhood trauma, even though it might be significant, because that won’t be sufficient to heal me. Find me a diagnosis and a treatment that addresses the physical nature of how this ailment impacts the brain.

This shift in mental models and how we view this disease is critical to alleviating the shame and humiliation those who carry it suffer. On an individual level, if I think the disease is all my fault, I invest countless hours and dollars analyzing my personal failings, my dysfunctional family, my life mistakes. On a therapeutic level some psychological professionals collude with this approach, which fits their world view, and helps make their livelihood. On a policy level those who carry the gene for bipolar are discriminated against in their relative lack of access to medical treatment and the insurance to cover it. Again, nobody questions that health insurance should cover heart disease. Why do we draw the line at brain disease?

This is not to say that all emotional therapy is misguided in the treatment of bipolar II. I have benefited enormously from skillful and compassionate guides in this domain. I have also seen the healing power of other healing approaches, including Shadow Work®, and attest to their value, especially for the millions of people in our country who are victims of violence, sex abuse, addictions, and any “ism.”

The point is that emotional and behavior modification therapies should not be viewed as sufficient for people suffering from a brain disorder. While they might benefit from therapy for other circumstances in their lives, no therapy alone can heal a bipolar brain anomaly. Period. Though they are inextricably linked,  let’s not equate the emotional domain of the psyche confused with the physical domain of the brain.

My friend Rosie, who has just read what I wrote above, comments, “Yeah, but it cuts both ways. Think of all the people who’ve been drugged up when they really needed good therapy.” And Mara, an elementary school librarian who knows the demographic, adds, “And all the ‘ADHD’ kids on Ritalin. The overuse of that drug is criminal.”

I imagine that there are millions of people on Prozac right now who really don’t have physical brain malfunctions and really do need some good therapy instead of drugs. The psychiatrists-turned-salesmen on the pharmaceutical companies’ payrolls encourage this trend. Who knows where to draw the line in the pool of those suffering from all kinds of depression, what percentage of people are down due to emotional trauma and what percentage are out because of a genetic brain malfunction? Perhaps it’s impossible to tell. Or perhaps research dollars dedicated to addressing this question in a credible scientific manner could shed some insight on the subtle interplay between physical and emotional triggers in brain chemistry. Perhaps more research dollars would be allocated to understanding the variety of brain functions and patterns if we removed the stigma that the term “mental illness” brings along with its connotation that somehow the mentally ill person is to blame for their troubles.  

Ultimately, I can only speak what is true for me. I spent too many years under the influence of the wrong concept, that my struggles were strictly psychological, spiritual and emotional. I like to think I have some control over my destiny. As a younger woman, this led me to refuse to believe that I had “the family disease” or that my struggles were a genetic thing that I could not conquer through force of will. If I only practiced an organic ideal of behavioral perfection, I could overcome any chemical vicissitudes of my brain. I was excessively disciplined in this approach, trusting that if I did it right, all the time, I could dodge the depressions I’d experienced earlier.

But this game of dodgeball exhausted me. It’s a relief to know and accept that there is a chemical component that controls when my brain works and when it doesn’t work. It’s a relief to surrender to this truth: I do not fully control my world. Nor do I control the world, for that matter. As Dr. Perlman said, “You have a chronic genetic illness. Lots of people do. You’ll learn to live with it. Thankfully in your case, there’s a cure.