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INTRODUCTION
Waiting in an airport to fly out of San Francisco, Nic Sheff was approached by a young
woman who asked whether she could pray for him. Nic sensed a beam of energy shoot between
them as she murmured pleas towards the musty ceiling. In that instance, God came into
existence for Nic and following that day the two of them would talk on the phone for hours on
end. Nic arranged to join the womans church in Redding. However, his plans were thwarted
when Nic found himself unable to leave the fetal position on his bedroom floor (Sheff).
These extreme states of heightened emotions and crippling despair represent two sides of
the same mental illness: bipolar disorder. The extremely disruptive disorder affects over 2% of
Americans, coming to a total of about 2.3 million people (Krans & Cherney, Healthline
Editorial). However, despite the prevalence of bipolar disorder, it remains largely misunderstood
and stigmatized by the general public, with 70% of people with bipolar disorder having been
initially misdiagnosed (Healthline Editorial). While media coverage of bipolar disorder has
increased in the last decade and a half, boosting public awareness, dramatized narratives sour
perceptions of mental illness. Oftentimes, individuals wrestling with mental disorders internalize
these negative messages, which may lead to the denial of symptoms, refusal to follow treatments,
and intense self-deprecation. As such, for the psychological stability of those with bipolar, it may
prove beneficial to alter the tone of news reports and portrayal of fictional characters to become
less extreme, and more representative and hopeful. This may also encourage undiagnosed people
with bipolar disorder to seek treatment, which should be prioritized as 30% of this population
commit suicide (Healthline Editorial). In order to prevent more unnecessary deaths and improve
the quality of life for those receiving treatment, vested parties should target media sources as a
significant shaper of public perceptions. This paper will explore the societal issues surrounding
bipolar disorder by first describing its symptoms and subtypes, the progression of scientific
research, modern treatment methods, the effect of media on public perceptions, external and
The National Alliance on Mental Illness defines bipolar disorder as a chronic mental
illness that causes dramatic shifts in a persons mood, energy, and ability to think clearly. It
consists of cycling states of mania and depression that most commonly begin in ones 20s, but
can occur at any age (Krans & Cherney). Figure 1. details common symptoms and behaviours
Furthermore, psychology experts describe bipolar disorder as a spectrum and have identified
Research into bipolar disorder is ongoing, however, with additional classifications and precision
Since bipolar disorder was first identified by humans, it has been a subject of social
scrutiny, confusion, and derision. The oldest mention of the depressive state of bipolar was found
in ancient Mesopotamian texts from around 2000 BC under the name melancholia (Nemade et
al). The writer of this text attributed the condition to demonic possession that could only be
cured through the holy healing power of priests. The term mania was later coined during the
golden age of Greece and Rome. In the first century AD, Aretaeus of Cappadocia linked the
conditions of mania and melancholia (Krans & Cherney). Unlike the majority of societies at that
time, which ostracized and executed those with mental illnesses, Grecians treated bipolar
disorder as a physical condition and discovered that lithium slat baths eased its symptoms. In
Unfortunately, religious views of mental illness prevailed until the 1700s when
inquisitive aristocrats began to study them from a scientific perspective. For instance, Theophilus
Bonet used his observations from performing autopsies to demonstrate a biological connection
(Krans & Cherney). Research on bipolar disorder continued to creep along, with Jean-Pierre
Falret, a French psychiatrist, establishing a more concrete connection between the two states in
1851. He published an article describing the switching between severe depression and manic
insanity, which Falret called la folie circulaire or circular insanity (Krans & Cherney). This
was considered the first modern diagnosis of what is now known as bipolar disorder and Falret is
also reputed for his mention of a possible genetic connection. However, it wasnt until over a
hundred years later, in 1980, when the American Psychiatric Association adopted the term
bipolar in their Diagnostic and Statistical Manual of Mental Disorders, as opposed to the
phrase they had used previously, maniacs (Krans & Cherney). This transition represents a shift
within the medical community from treating bipolar disorder as an aberration to a mental illness
that can be studied and treated. Yet, even though people with bipolar disorder no longer face
their untimely deaths on the end of a burning stake, they are often still considered maniacal by
While significant research has been conducted to determine the causes of bipolar
disorder, no direct source has been found. As a mental illness, it comes by no surprise that
bipolar is associated with a region of the brain, specifically the hippocampus (University of
Texas). The hippocampus also plays a part in multiple mood disorders, perhaps for its role in
regulating serotonin, dopamine, and noradrenaline, where the malfunctioning of these hormones
may induce bipolar disorder (Bressert, Causes). Stress may also trigger someone who is
genetically predisposed with these hormonal irregularities to experience their first manic or
depressive episode. A specific bipolar disorder gene has yet to identified, and it would be more
likely that a combination of genes is involved, but research has demonstrated that mood
disorders are inheritable. For instance, children with one parent that has bipolar disorder have a
10-15% chance of inheriting it, and when both parents are bipolar the child has a 30-40%
likelihood (Bressert, Causes). That being said, traumatic events, altered lifestyle, alcohol and
drug abuse, or even taking antidepressants can trigger bipolar disorder, even in those without a
genetic relation.
Once an individual has been diagnosed with bipolar disorder, they cannot be completely
cured but their symptoms can become significantly more manageable through various forms of
treatment. The most effective regimens include a combination of medication and psychotherapy,
often varying as patients experience different phases of the manic-depressive cycle. Mood
stabilizing drugs include lithium, which has few side effects, or artificial psychotics, that reduce
symptoms more significantly but are accompanied by additional side effects (Bressert,
Causes). Psychotherapy addresses the behavioural aspect of bipolar disorder by helping
patients to develop coping skills and unlearn harmful thought processes or behaviours. In
addition to these well-established treatments, several therapies are still being tested for their
imaging a bran scanning technology similar to MRIs which improved the mood of
conducted, more effective treatments will hopefully be implemented and improve the quality of
life for people with bipolar disorder. Unfortunately, under the sometimes euphoric influence of
mania, many patients abandon their treatments only to return after hitting the low of a depressive
episode. Despite these flaws, however, if properly following a treatment regimen someone with
bipolar disorder can manage their symptoms and achieve a productive and happy life.
Among the general public, the primary dissemination method for information on bipolar
disorder, and other mental illnesses, is through news and entertainment media, such as television,
movies, and newspapers. News stories wield the most influence between these mechanisms,
covering incidents involving people with mental illnesses. However, the nature of the media
leads to practically all news stories involving violent or aggressive behaviour from people with
mental disorders, which represent a slim minority of the entire group. Furthermore, media outlets
often sensationalize already rare events to attract a higher viewership, skewing impressions even
farther. Rarely do stories featuring functional people who have recovered from mental illness
receive any attention to balance this negative image. Mention of mental health experts are also
notably lacking in publications, being included in less than 15% of articles involving mental
illness (Stuart). As research into the role of media on public perceptions of mental disorders
remains limited, regrettably, the statistics cited in this and following sections will refer to mental
illnesses in general. To better understand specific attitudes towards bipolar disorder, additional
In any case, mention of mental illness has also increased within entertainment, including
in one fifth of American prime time programs (Stuart). Among characters with mental illness,
included in 2-3% of shows, half physically harm others and a quarter commit murder (Stuart).
They are also often depicted as disenfranchised, being distanced from their family, and jobless.
The culmination of these negative traits, coupled with the fact that the only exposure some have
had to people with mental illness may be through entertainment, will likely lead to an unfair
SOCIETAL STIGMA
Exposure to only the worst aspects of mental disorders not only forms a negative image
among the general public, but manifests itself in discrimination towards otherwise normal
members of society who happen to be managing a mental disorder. The term societal stigma
describes this prejudice disseminated through out the general populace. In fact, research shows
that most people drastically over estimate the danger they are exposed to when interacting with
someone with a mental disorder (Stuart). This unwarranted fear allows others to feel justified in
behaving with hostility, such as coercive treatment, bullying, or even legal action. Indeed, a
study conducted in the UK found that 25% of surveyed mental health patients said that they
experienced hostility in some manner from their neighbours due to them having a mental illness
(Stuart). A third also said that their own family members and friends treated them differently
because of media coverage, which 75% described as unfair, negative, and unbalanced. In reality,
someone with a mental illness is more likely to be the victim of a violent act than the perpetrator
(Stuart).
Adding on to negative stigma towards people with mental illnesses, media coverage also
influences public perceptions of psychiatric treatments. After all, the typical representation of
treatments in media appear ineffective or horrifically violent and archaic, in the case of
entertainment. Beyond influencing lay people, this aspect proves particularly concerning when
policy makers are involved. Indeed, one is unlikely to support or make more accessible a system
believed to be ineffective. Therefore, skewed reporting and narratives not only contribute to
discrimination towards individuals with mental disorders but may impede on their ability to
receive treatment.
INTERNALIZED STIGMA
In addition to altering the way people regard others with mental disorders, it also changes
how those with mental disorders regard themselves. For instance, in a UK study on individuals
using mental health services, 50% said that media coverage negatively affected their mental
health (Stuart). They also reported that the media directly impacted their ability to pursue self-
advancement, discouraging a third from applying to jobs or volunteering. Fearing the social
repercussions, people with mental illnesses often refrain from telling others about it and may shy
away form social interactions altogether. In this way, increased media coverage made people
with mental disorders feel more isolated, rather than understood or accepted. The internalized
shame individuals subject themselves to also contributes to a denial of symptoms, refusal to seek
treatment, and lack of motivation to follow through with treatments after they have been
prescribed (Stuart). Due to this, stigma that people with mental disorders develop towards
themselves may be even more damaging than external derision as it discourages them from
CHANGING PERCEPTIONS
In light of the harm that media has had on those struggling with mental disorders, it is
imperative that effort be made to balance the largely negative stories about mental illness with
with mental disorders need to be fostered in order to associate a face and personality to the
nameless, deranged masses of mentally ill people constructed by the media. Celebrities
disclosing their mental disorders boosts this effort as they are already known figures who have a
pre-established public image. For instance, pop singer Demi Lovato, among others, publicly
shared her experience with bipolar disorder and produced a documentary on mental illness,
Beyond Silence (Weaver). In fact, bipolar disorder may be particularly well represented mental
disorder among celebrities, as it is associated with high childhood IQ and heightened creativity
(Cirino). Stigma relating to mental disorders may also be lessened by emphasizing its genetic
In addition, attention should be put into reducing negative perceptions directed towards
mental health caregivers, who deserve respect for their work improving the lives of others and
not suspicion for promoting ineffective or torturous treatments. Further research needs to be
conducted on public perceptions of mental illness, the role of media, and the impact on patients.
Many of the studies conducted so far are of low quality, using small samples that were selected
based on convenience and do not accurately represent the demographic composition of the
mental illness in different cultures, regions, and over time. With the current state of research on
mental illness, and bipolar disorder specifically, it would be irresponsible to come to any
definitive conclusions.
Since the stake-burning ages of old, religions relationship with mental illness has
evolved into a neutral or even beneficial role. For instance, during the 19th century when those
with mental disorders were largely neglected or treated with contempt by governmental
institutions, such as in insane asylums, priests welcomed the mentally ill into their monasteries.
There those with mental disorders were treated with compassion and allowed to live somewhat
normally, without binds or padded rooms to restrain them. While the church no longer plays this
role, research indicates that religious affiliations may benefit the health of those with bipolar
When faced with a life-altering and somewhat debilitating mental illness, many find
Center of Psychiatric Rehabilitation at Boston University, 54% of patients with bipolar disorder
reported using meditation as a coping mechanism, and 41% prayed (Koenig). These behaviours
may help lessen the stress of dealing with a mental disorder and foster a sense of peace within
patients through cultivating ones spiritual characteristics, appealing to a religious power, and
reaffirming ones sense of purpose. Indeed, multiple studies have found that patients that
regularly practice their religion have lower suicide rates than their non-religious peers (Koenig,
Dervic et al). However, this will to live may also be motivated by the discouragement of suicide
by Christianity and Catholicism, among other religions, where it is regarded as a sin. Another
university study found that depressed bipolar patients who were religious experienced their first
manic episode and first hospitalization due to bipolar disorder later in life, but experienced major
depression earlier than other patients (Dervic et al). As before, it is unclear whether the culture of
their particular religious group had an effect on when these signs were first reported. Regardless
of measured benefit, it is likely that people with bipolar disorder involved in religion receive
support from their communities and ease of mind that lessen the hardship associated with
On the other hand, religious beliefs can also impede the treatment of bipolar disorder and
even worsen its symptoms. A questionnaire received by 81 participants with bipolar disorder
indicated that self-identified religious people were less compliant with following their
medication regimens (Mitchell & Romans). These participants said that they would stop taking
their medication after a spiritual leader told them that they had been healed through the power of
god and no longer needed it. Indeed, 19% reported that they were given conflicting advice from
medical and spiritual counselors (Mitchell & Romans). While prematurely refusing to take
medication certainly harms the recovery of a patient with bipolar disorder, religious delusions
can prove even more detrimental to their overall well-being. Religious delusions were found to
delusional thoughts (Koenig). Chris Cole experienced such a delusion as a freshman in college
when he woke up feeling a oneness with the universe and began attempting to recruit his
friends to become his disciples and perform miracles for them. Not only are these psychotic
episodes extremely disruptive, landing Cole in jail, for instance, but those who experience them
often face more severe symptoms, have a lower ability to function, and require higher doses of
medication (Koenig). While delusions are not isolated to religious patients, the higher likelihood
Bipolar disorder throws those who suffer it through alternating cycles of exhilarating
mania and paralyzing depression. Yet, through a combination of medication and psychotherapy,
many of those with bipolar disorder are able to control these intense mood swings and achieve
productive, healthy, and peaceful lives. Bipolar may also prove a boon to some by increasing
their creative capabilities, and outreach from such high-profile celebrities improves public
perceptions of the mental disorder. Indeed, the intentional proliferation of positive messages
need to join the conversation currently surrounding mental illnesses, which is dominated by the
violent actions of a few individuals or exaggerated fictional narratives. Research has shown that
these unfair messages infiltrate into peoples psyches and worsen the way those with mental
disorders are treated, perhaps even leading to them sabotaging their own recovery. The role of
religion in managing bipolar disorder remains debated, with some perceived benefits but also
increasing the chance of experiencing extreme delusions and refusing treatment. As a whole,
more research is needed to determine the effect of media, stigma, and religion on people with
bipolar disorder, as well as into the causes of the condition itself. Genetics will likely play a
significant part in future research and lead to revolutionary new treatments. Until that utopian
future where bipolar disorder can be cured with micro robots replacing tiny segments of DNA in
human cells, however, some will be left to battle these cycles of mania and melancholia.
Works Cited
www.healthline.com/health/bipolar-disorder/famous-creative-people?ref=tc#1. Accessed
28 May 2017.
Dervic, Kanita, et al. Moral or Religious Objections to Suicide May Protect Against Suicidal
Behavior in Bipolar Disorder. Journal of Clinical Psychiatry, vol. 71, no. 10, Oct. 2011,
pp. 1390-1396.
Healthline Editorial Team. Bipolar Disorder: The Basic Fact Sheet. HealthLine, 5 April 2012,
Krans, Brian, and Kristeen Cherney. The History of Bipolar Disorder. HealthLine, 28 Jan.
May 2017.
Mitchell, Logan and Sarah Romans. Spiritual beliefs in bipolar affective disorder: their
relevance for illness management. Journal of Affective Disorders, vol. 75, no. 3, Aug.
2017.
Sheff, Nic. Why cant Hollywood get bipolar disorder right? Salon, 5 Feb. 2013,
www.salon.com/2013/02/05/misdiagnosing_bipolar_disorder_in_tv_and_movies_partner
Stuart, Heather. Media Portrayal of Mental Illness and its Treatments. CNS Drugs, vol. 20, no.
University of Texas Health Science Center at Houston. Area of brain linked to bipolar disorder
Weaver, Hillary. Demi Lovato Says She is Bipolar and Proud. Vanity Fair, 22 Feb. 2017,
www.vanityfair.com/style/2017/02/demi-lovato-mental-health-awareness. Accessed 4
June 2017.