I am very grateful for the thoughtful comments I have received about my small essay, “Bipolar Epidemic?” The surge in bipolar diagnoses in children is understandably a sensitive and controversial subject for many, especially those with children who are directly affected. My broader point, however—that whenever there is an explosion in a particular diagnosis, there is some cause for worry—seems not to have been fully understood. A few additional comments may help clarify what I had hoped to say before.
About two years ago, within weeks of each other, two teenage children of dear friends of mine were diagnosed with bipolar disorder, one in the Midwest, the other on the East Coast. The diagnoses were given by psychiatrists whom their parents had consulted. I am not a physician, but I am deeply interested in diagnostic categories and have read extensively in the history of the subject.
Sigmund Freud makes people irritable. Whenever someone mentions Freud, say, at a dinner party, I see eyes roll and listen to the nasty remarks that follow. The received knowledge, even among some highly educated and informed people, is that Freud was wrong and can be relegated to history’s garbage can where we discard outmoded ideas. There are still defenders of Freud’s theories, of course, but in my experience, the general attitude is one of out-and-out hostility.
To look and not see: an old problem. It usually means a lack of understanding, an inability to divine the meaning of something in the world around us.
There is a migraine aura phenomenon named after Charles Lutwidge Dodgson’s (Lewis Caroll’s) story of myriad transformations: Alice in Wonderland syndrome. The afflicted person perceives herself, or parts of herself, ballooning or diminishing in size.
Not every migraine has a prologue or “aura,” and not every aura is followed by a headache. Nevertheless, these overtures to pain or isolated events are the most peculiar aspect of the illness and may offer insights into the nature of perception itself.
I am a migraineur. I use the noun with care, because after a lifetime of headaches, I have come to think of migraines as a part of me, not as some force or plague that infects my body. Chronic headaches are my fate, and I have adopted a position of philosophical resignation.