GUEST POST: Use Empathy to Understand Bipolar

Mental illness has been around since before recorded history.  Yet, we’ve only just begun to understand it and establish proper methods on how to treat it. That means people with mental illness, rich and poor, have been subjected to quackery and crackpot remedies for thousands of years. Sadly, this includes the last century.

Virginia Woolf (1882–1941) may be better known to the general public for her non-sequitur mention in the title of an Edward Albee play (at least that’s the conclusion I draw from a recent Google search).  However  she was the much revered author of such works as A Room of One’s Own, To the Lighthouse,  and Mrs. Dalloway back in her day.

Woolf also had a mental illness for which she received the best medical and psychiatric care available at the time. Alas, it being the 1920s – before blood typing or penicillin, and in the infancy of the germ theory of disease and psychotherapy – the best help was sometimes little better than voodoo. She died, too young and tragically, at age 59 by her own hand.

Bipolar disorder

Woolf had an enormous talent, a devoted husband, and a bipolar disorder – formerly known as manic depression – specifically depression and hypo-mania. She experienced highs and lows, usually coinciding with whether she was currently writing or had just completed a book.

What she didn’t have was access to modern rehab clinics, prescription medicines or therapists who understood bipolar disorder.

Peter Dally – author of Virginia Woolf: The Marriage of Heaven and Hell – noted in a 1999 interview that he had “identified a pattern of depression occurring every January and February, followed by a ‘high’ in the summer.” He concluded that Woolf had “inherited manic depression,” diagnosing several of her ancestors with the same malady.

Some people who suffer from bipolar disorder self-medicate with alcohol or drugs. Maybe Woolf would have been better off if she had. Today she could always have detoxed with rehab in a luxurious, addiction treatment clinic.

Surgical bacteriology

One of the treatments Virginia Woolf received for her mental illness in 1922 was the removal of three of her teeth, a practice called surgical bacteriology and based on “focal infection therapy.” The idea was that mental illness was caused by infections, and that surgery could cure it.  This premise  was based on an obviously false reasoning (as we look back on it):

  1. People with a fever caused by infection hallucinate;

  2. people with mental illness hallucinate;

  3. mental illness is caused by fever/infection.

(“Another example is: All cats die. Socrates is dead. Therefore Socrates is a cat.” – Eugene Ionesco, Rhinoceros)

A Scene from the Knick (2014), a show that has depicted teeth removal for treating mental health

As barbaric as that sounds, it could have been worse. As practiced by Dr. Henry Cotton, surgical bacteriology often involved removing all the teeth – the practice was depicted on the recent CINEMAX historical drama series The Knick in 2014 – sometimes followed by the tonsils, spleen, stomach, colon, or other organs and body parts. (At least Cotton practiced what he preached; he had some of his own teeth removed, as well as those of his wife and two sons.)

Weight gain

Now teeth removal wasn’t the only treatment she received that we would now consider bizarre and at best counter-productive. According to Virginia Woolf’s great-niece Emma Woolf, “she was placed on a regime of weight gain: four or five pints of milk daily, cutlets, liquid malt extract and beef tea.”

Woolf must have felt like a goose being force-fed to produce pate de foie gras (fatty goose liver). Diet can affect mental health, but you need balanced nutrition – amino acids, complex carbohydrates, essential fats, minerals, vitamins and minerals and water – not gorging.

“Virginia’s mental illness was characterized by intensely creative highs, followed by paralyzing lows and physical collapse,” Emma wrote. “During the lows she would stop eating and her weight would plummet.” But when she was “happy and gay,” she enjoyed eating, Leonard wrote, and lamented that authors too often ignored food in their writings.

In Virginia Woolf’s WomenVanessa Curtis notes that “Virginia’s diary makes occasional reference to the torture of having to watch dinner guests … stuff their faces with suet pudding in front of her horrified gaze.” Being forced to eat so much must have been torture. She gained no less than 56 pounds in 19 months, and 15 pounds before that (according to Emma, based on Leonard Woolf’s diary).

Anorexia

Some people eat when they’re depressed, but that method didn’t appeal to Virginia. In fact, she may have had anorexia. Emma – who does have anorexia – believes Virginia did, in part because of how she looked in photos, and from Leonard’s copious notes. It’s known that she didn’t like displays of enthusiastic eating, and had to be coaxed to eat when she was in a depressive state.

Dally, who set up one of England’s first eating disorder clinics, told an interviewer that “Woolf was not anorexic, but had an undefined eating disorder.” Unfortunately, she didn’t have access to therapists who understood eating disorders either.

Bed rest

Virginia also was confined to bed or ordered to rest, and – shades of Charlotte Perkins Gilman – was not allowed to write or any other “intellectual stimulation.”

The prohibition from exercise or writing was ill-advised, though no doubt well-intentioned (so is the road to Hell paved). Some physicians believed that mental illness was caused by nervous exhaustion, physical and mental, so bed rest would allow the body to recover.

Now we know that physical activity can enhance mood – the so-called runner’s high – improve overall health and even make it easier to recover from drug addiction or other substance abuse. And occupational therapy improves mood, too.

Depression and anorexia nervosa often co-occur. Forced bed rest doesn’t help either condition.

Causes of Bipolar Disorder

Woolf’s bipolar disorder may have been the result of genetics, the deaths of her parents and other traumatic childhood experiences (some allege she was molested by her half-brothers George and Gerald Duckworth from ages 9 to 15, though Dally doubts it).

It worsened with time, as she became paranoid and feared she was losing her ability to write. The uncertainty of living in Britain during World War II (her home was twice hit by German bombs, and she feared for her husband if the Nazis won, since he was Jewish) couldn’t have helped.

virginia woolf bipolar
Its theorized that there is a link between bipolar disorder and creativity. Image courtesy of Christiaan Tonnis via Flickr, Licensed under CC BY-SA 2.0

Recent studies suggest there is a relationship not only between bipolar disorder and suicide, but between bipolar disorder and creativity. Contemporary psychologist, Neel Burton, theorizes that bipolar creative people may use “periods of mild depression … to retreat inside themselves, introspect, put thoughts and feelings into perspective, eliminate irrelevant ideas, and focus on the bare essentials. Then, during periods of mild elation they may be able to gather the vision, confidence, and stamina for creative expression and realization.”

For Woolf, things seemed much more dire with much less hope

In the end her suicide was the only way she knew to get off her bipolar express: at the terminus.

From Virginia Woolf’s experience we can understand how many people, trials, and tribulations that have gone into coming up with our current understanding of medical practice, especially in the world of mental health.  Poor Virginia was put through the ringer, which is a conclusion we only come to when we look back.  Yet if we try and examine history as, going back and looking forward, we can see that there were good intentions, by most clinicians that tried to treat her.

Moreover, her story can be an important reminder to keep physically well.  Habits in physical wellness cna make an impact on mental wellness.

FINALLY,

If you know someone who is suffering, lower the stigma of mental illness and offer an ear of support.

Use your fitness to bring others up.

You can’t change a people until you change what is in yourself

history giant mental health fitness
“If I have seen further, it is by standing on the shoulders of giants.” – Isaac Newton. Picture is derived from Greek mythology: the blind giant Orion carried his servant Cedalion on his shoulders to act as the giant’s eyes.

About the Author: 

Stephen Bitsoli writes about addiction, mental illness, history and related matters for many blogs and websites. A journalist for more than 20 years, and a lifelong avid reader, Stephen loves learning and sharing what he’s learned.

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