There comes a time when the way you are is not just the way you are, but also the way you might die. There arrives at that time a word for what you said or hoped was indescribable, a diagnosis for your lure. Always there were moods you had that others did not, moods that were your organizing principle. Now they become your undoing. You weren’t wrong to think nobody else was like you. Not many people are. Almost nobody would want to be, and that’s where — in your wilding moments — you were wrong. I was.
The numbers could also be wrong. If not, and if you’re an adult in America, there is a two to five percent chance you have what is now called bipolar affective disorder (and I want B.A.D., an acronym that feels somehow bratty but also courteous, like a warning, to catch on). If you write for a living, multiply that chance by ten. Of course, you (or I) don’t write only for a living, but also to live; you (well, I) believe writing is both a reason to keep doing so and the effect of doing it singularly. Then comes a time when writing is just another symptom.
Records of the human condition are often kept by its least reliable narrators. Consider the case study conducted by the American psychologist Nancy Andreasen and compiled in her 2005 book, The Creating Brain, for which she chose 15 authors from the Iowa Writer’s Workshop, class of ’74. As the connections between one’s creativity and one’s psychiatric history, or diagnosis, began to light up, Andreasen’s group grew to 30; so did the control group. Over the next fifteen years of follow-up studies, two of the Iowa writers committed suicide. Nobody in the control group died.
In 1983, the psychologist Kay Jamison, herself bipolar, surveyed 47 British artists and writers and found that 38 percent had sought treatment for mood disorders — a percentage about 30 times the national average. Writers, according to writers, were suffering at a higher rate of breakdown, while among them poets had it worst of all: Half of those surveyed had been hospitalized for depression and/or mania. Poets, decided Jamison, had the most “creative fire.” At first, this seems a suspiciously convenient thing for poets to believe: It’s better to burn, burn, burn than to pay the heating bill. Still, there are few other explanations for the survival of poetry, which must feel like rubbing together sticks while other writers use barbecue lighters, blowtorches, barrels and barrels of oil. The poet, always having to prove she’s not dead, must be more concerned with breaths and heartbeats and flickers of viscera than any other writer, and so, more than any other writer, it’s the poet who remains our most stubbornly libidinal subject, at odds with the fleshless world, embodying at least one early, Freudian notion of bipolarity.
Whether a person is bipolar before being named as such is for structuralists to contest. After the diagnosis, certain erraticisms do cohere. Certain flaws get excused. Six close friends say they’d “always known it.” All we actually “know” is what studies say, and what studies say is that manic depression (as it was once known, and is still better described) gets diagnosed later in life than depression, in part because it’s often misdiagnosed as the latter. For women, the first episode is typically depressive; for men, manic. Whether or not that divide collapses when gender norms do, doctors agree the first episode tends to occur before 25, and is easily confused with, well, being under 25.