Toward a Spirituality of Bipolar Disorder
Religion, spirituality, and mysticism are all complex and contested concepts and it is often debatable as to whether any particular experience is “religious,” “spiritual,” “mystical,” or some combination of the three. However, we must take seriously the attribution of experience to one of these categories by the person who has had that experience—even if we disagree. If two people on a walk through a beautiful sunlit pasture have differing experiences—the one saying it was mystical, and the other simply that it was beautiful—we do well to find out why they describe their experiences as they do.
“BIPOLAR DISORDER” IS A TERM DEVELOPED BY MENTAL HEALTH PROFESSIONALS to describe the experiences of those who go through severe disruptions of mood, thought, and behavior. The British Psychological Society outlines the main features in this way: “Many people experience periods of depression and also periods of elation and overactivity. For some people, these episodes are frequent and severe enough to be seen as a ‘disorder’—bipolar disorder. The word ‘bipolar’ refers to the two extremes or ‘poles’ of mood: depression and ‘mania.’ Until recently the term ‘manic depression’ was also used. Each person’s experience is unique and there is a continuum between the extreme mood states … and the normal mood swings that everyone experiences. Some people, but not all, find it helpful to think of themselves as having an illness.”2 The swing between depression and mania is not necessarily sequential: “People do not necessarily swing from one extreme to another, but instead typically experience maybe one, two or three periods of significant mood problems over a two or three year period. Episodes may last several weeks and usually follow no particular predictable course—depression is not necessarily followed by a ‘high’; it isn’t inevitable that a period of mania will crash into low mood.”3 Losofa is originally from Trinidad but now lives in London. He is tall and well built and lifts weights as a hobby. Losofa is a family man who, at least when not struggling with aspects of his bipolar disorder, always puts his wife and two children first. He articulates the distress that accompanies bipolar disorder in this way:
Yeah, I mean the highs for me were and still are both tremendously difficult (although it doesn’t feel that way at the time). I know when it begins because I can’t sleep; I get anxious and really unsettled. I start to get racing thoughts, an uncontrollable sense of energy, and basically quite a blatant disregard for boundaries. I’ve been high [in the elated phase of his bipolar disorder] when I’ve been driving a car, and that is not good news. I sort of lose the sense that I should be keeping to a certain speed limit or observing certain road rules. And just basically the high sort of ushers in a certain level of overconfidence in your ability. Some people spend a lot of money or sleep around, but I don’t do that. I don’t have any money to spend! (laughs) But unfortunately, when I’m high, I’m actually very difficult to contain, like people can’t really get a word in. I like to sort of dominate discussions and conversation and basically, yeah, I’m sort of very difficult to be around. I also tend to wander. I once got completely lost walking the train tracks in Sydney, Australia. I thought I was gone. But God brought me back. When I’m not high, I’m mostly considerate and allow people to voice their opinions. I am always respectful of other people. So, its mixed, but I’ve lost a lot of friends over the years.
The highs can be wonderful! But coming down, not so much: “It’s the coming down that is the worst. You see what you have done, how you have treated people, the mistakes you have made. If it wasn’t for my wife, I don’t know what I would do. It’s kind of, well, I don’t know … shameful? Having bipolar is not shameful in itself; it’s just an illness. But the things I do … sometimes … I do feel ashamed.”
All of us understand the experience of mood changes, and all of us understand the feeling of shame and regret. What makes bipolar disorder different is the level of distress and disruption that occurs in response to people’s actions during their elevated state. After the high is when things get difficult, which contributes to the depth of the lows that often follow the elation. The painful rhythm of high and low is difficult to live with sometimes. Losofa’s lament, “I’ve lost a lot of friends over the years,” indicates something of the relational tragedy of his situation.
Jackson is forty-five years old. He lives in Seattle, Washington, where he has worked as a car mechanic for twenty-two years. Like Losofa, he lives with bipolar disorder. Both Jackson and Losofa were glad to have a diagnosis (unlike Monica Coleman, discussed earlier, who was very reluctant to accept diagnosis and medication). Jackson’s diagnosis helped him explain some things to himself and others and, in so doing, brought some healing release. However, accepting his diagnosis and having to take medication had not been easy for him:
I think that probably one of the things I struggled with early on was accepting the diagnosis as being helpful. I’ve had some really difficult experiences, and I could never really make much sense of them. But I think after the many relapses that I’ve had since the first episode, I’ve resigned myself…. I’ve basically come to view it in a positive way as the best approach to take, not only for me but also for the family and loved ones around me; my friends who are supporting me. It’s not quite “take the meds and everything will be fine!” But you know what I mean. I need it.
Bipolar disorder is one mental health challenge for which there is strong evidence for a biological origin.4 Recognizing this is key, not just in terms of treatment but also because it raises important theological and spiritual questions. We touched on this in our discussion about biology and medication. Jackson brings another dimension to the conversation. Without his medication, his spirituality suffers: “I still suffer from having my spiritual beliefs follow my moods, which are sometimes wildly swinging, and even within a day they can swing from extreme highs to extreme lows. It’s difficult to hold on to God in the midst of that sometimes. Solid spiritual ground can be hard to find.” There is a deep and soulful (in the sense outlined previously) connection between his biological state and his spirituality:
What always challenged me was that maybe some of my core beliefs, even my spirituality, is in itself biological. My brain is where my spirituality comes from. It’s a bag of salt water with proteins and DNA in it, that does complex reactions that leads me to have all the spiritual experiences. So, I guess it’s inevitable that when my chemistry is out of kilter, I get spiritually sick as well as physically. Some people think it can be dangerous to mix spirituality with mental illness, but every waking moment until I die I’m going to be mixing my spirituality with my mental illness, so hopefully it’s not all bad.
Jackson’s medication is necessary for his spiritual stability. As we discussed previously, as a biological creature, he required biological intervention to deal with a biological issue. Put slightly differently, as soulful creatures, we require soulful interventions, which include forms of intervention that affect our body-soul in quite profound ways. For the reasons previously discussed, that does not reduce our spirituality to chemical interactions. It simply indicates something of the nature of our embodiment. There is no shame or theological contradiction in taking medication.
However, Jackson’s emphasis on the biology of his spirituality does raise the issue of meaning: Does the fact that the experiences connected to bipolar disorder have a biological basis mean they are meaningless, that is, simply symptoms to be gotten rid of? Jackson’s answer is illuminating: “I think the experiences I have had are meaningful to me. The sum of my experiences and my genetic code make me who I am today. Every experience was a biological one, and that reductionist categorization does not reduce the meaningfulness of the experiences.” His unconventional and often very difficult mental health experiences may have been the product of biology, but they were also deeply meaningful to him and formative of him as a person. Biology provides an explanation for his experiences, but it does not capture the fullness of his experience. It’s important to be clear on what this means.
Previously we looked at the way in which explanations can be reductionist, in that by explaining something in a particular way, other ways of looking at it are downgraded and subsumed to that single explanation. We can see the problems with such explanations in the area of neurobiology. Neurology is posited as an explanation for a wide range of phenomena, including morality, art, and even love.6 Such explanations attempt to reduce complex human phenomena to a single explanatory framework.
In his fascinating (and often very amusing) book titled Aping Mankind: Neuromania, Darwinitis, and the Misrepresentation of Humanity, the English philosopher Raymond Tallis offers a helpful critique of this approach. Tallis points out the ways in which neurology has become the new “theory of everything.” He names this tendency to use neurology as an overarching explanatory framework for everything “neuromania.” In Tallis’s thinking, neuromania is a delusional condition that makes four key assumptions:
1 Human consciousness is identical with neural activity in the human brain.
2 I am my (you are your) brain.
3 The brain explains every aspect of awareness and behavior.
4 To understand human beings, you must peer into the intracranial darkness using the techniques of neuroscience.7
Tallis highlights neurological research into romantic love. The neurobiological exploration of romantic love goes something like this:
Through this process we discover that “Love (romantic) is due to activity in a highly restricted area of the brain: in the medial insula and the anterior cingulate cortex and, subcortically, in the caudate nucleus and the putamen, all bilaterally.”9 It is safe to say that this is not exactly how most people would describe romantic love!
Tallis’s point is that neurology is clearly necessary for all human experience, but it is equally as clearly not sufficient to explain key experiences such as love. He suggests this about love:
Love is something that we do together. Love requires lovers. Trying to reduce humans and human experience to nothing more than a cluster of firing and misfiring neurons makes little sense, convinced as the proponents of such a view may appear to be. Neuromania is, to say the least, troublesome. Reducing human beings to one dimension of their bodies—their brains—creates a very thin view of humanness.
Tallis’s challenge is important and will become still more important as we explore, below, the nature of religious experience in the midst of elevated moods and delusional experiences. Jackson views all experience as meaningful, but not all of it as authentic:
However, some of my experiences such as my delusions and hallucinations are meaningful in the way they caused me to develop as an individual, but by definition do not carry the weight of the nonpsychotic experiences in my life. They were madness, and for me to give them the same weight in informing my life view would make me less accurate of a product of my “true” biology. For example, I thought at one point I had died when I fell off a cliff at age eighteen. In my mania I thought I might be a living dead person. Once the mania passed, I was able to dismiss this concept, and even though my memories of being psychotic don’t have exact identifiers as being irrelevant or nonmeaningful, I have to curate them in my memory as meaningless.
Jackson’s position is complex. All his experiences are meaningful. But some he deems nonmeaningful in the sense that he realizes they are an aspect of the dimension of his experience he considers pathological. He realizes that the belief that he was a living dead person was not accurate, if for no other reason than that he now recognizes that he is alive. He had to go through a process of discernment to work out what was real and enduring and what was transient, real at the moment but recognized as unhelpful later on. The possibility of discernment in the midst of a high is not great:
For me I haven’t really been, to be honest, I don’t think I’ve really been good at discerning the difference. And I think when you’re undergoing, or when you’re going through, the relapse or the episode, the ability to discern is actually for me nonexistent. But I think it’s always in the aftermath and with discussing this with my wife or initially with my parents and siblings, and just hearing their feedback as to what took place and what was happening, it’s only then that I can sit down and discern, I can see that that type of experience was a real spiritual experience or not.
This kind of retrospective assessing of what is and is not real within unconventional mental health experiences is important and requires people who are open to listening in quite particular ways. We will examine what such looking and discerning look like in the next chapter when we think through how best to deal with beliefs that some people consider to be delusional.
People living under the description of bipolar disorder are not always ill, and every aspect of their experience is not inevitably pathological. Even when a person is going through a manic phase, there may be aspects of that experience that are deeply meaningful and important, and that have enduring significance, even if the test of their authenticity and utility comes retrospectively when the acute phase of the experience has passed.
The thing that marks elevated or depressed moods as requiring intervention is the level of disruption and distress the mood causes either to an individual or to those around her. Put slightly differently, the line between mood changes and mood disorders is the level of distress rather than the nature of the experience. It is important to bear this in mind, particularly when we explore spiritual experience. Some aspects of people’s experiences can be positive and, for some, even enjoyable.
Miriam lives with bipolar disorder. Some aspects of her bipolar disorder bring her real suffering: “A lot of people have really terrible and frightening experiences. I did, for example, believe I was in hell once, walking lost through Hackney on a freezing February night…. When I am low, I just feel I am in a big void. I have heard people say they meet God in their dark places, but I feel like I am completely on my own. I don’t necessarily stop believing in God, though sometimes that is the case. I just feel like he is behind a big black cloud.”11 Both from the perspective of psychiatry and in terms of her spirituality, Miriam’s bipolar disorder brings disruption and suffering into her life. When this occurs, Miriam is glad for the assistance of the mental health professions. However, not all her unconventional mental health experiences bring suffering or disturbance.
I have also had some really beautiful experiences and visions—like seeing angels and sitting on top of a hill in Lancashire for four hours, totally believing I was in heaven. I once went to a service at Sheffield Cathedral. The only other people there were three women sitting on the other side of the chapel. A sunbeam suddenly shone down on them, through the beautiful stained-glass window, and I had an overwhelming feeling that they were God the mother, God the daughter and God the Holy Spirit. A psychiatrist would probably call this a delusion or a hallucination, but to me it felt much more like a metaphor and still feels very special and real. A gift from God. There is a fine line between mystical and psychotic experiences. I think that probably a lot of the saints and prophets of old would nowadays end up in the psychiatric system.12
This kind of experience is clearly unconventional, that is, it does not adhere to what is considered by the majority of people to be “normal” experience. Yet it is not disordered in the sense that it is causing her distress. It may be the case that psychiatrists can authentically describe such an experience as a delusion within their frame of reference, but Miriam, with equal authenticity, can describe it differently, as a meaningful spiritual experience. Unless she is in distress, there is no inherent need for the psychiatric description to prevail. Both descriptions contain truth. It is how we work with that truth that is key. Miriam’s description may reveal important aspects that can become occluded if we lean too heavily on a description that focuses primarily or solely on pathology.
Even though people’s experiences may have been deeply troublesome, there can still be positive things to be learned. Losofa puts it thus:
I think my bipolar disorder has given me a heightened awareness of the reality of God in my life, that God is not distant or God is actually with me on a daily and continuous basis. And I think that has allowed me not to be, to not sort of view God as being so much transcendent and distant when I’m, when I live life on a daily basis. Religiously, I may not sort of conform to trying to sort of … how can I say it … maintain certain rituals and stuff because I know that I’ve had these experiences and I have this awareness that God is present, if that makes sense. Yeah, so regarding the ministry, I think it gives me a different type of lens to be able to appreciate peoples’ behavior or … yeah, and maybe adds a different level of tolerance and understanding compassion that may not be there without experiences.
Like many forms of suffering, bipolar disorder can open us up to a more empathetic understanding of other people and of God. Such can be the nature of suffering, although, of course, that is not always the case. However, the kind of suffering that accompanies bipolar disorder is complicated and worthy of further reflection.
1. C. H. Cook, Hearing Voices, Demonic and Divine: Scientific and Theological Perspectives (London: Routledge, 2018), 148.
2. British Psychological Society, Understanding Bipolar Disorder: Why Some People Experience Extreme Mood Status and What Can Help (Leicester, UK: British Psychological Society, 2010), 11.
3. British Psychological Society, Understanding Bipolar Disorder, 11.
4. For some helpful overviews of the science of bipolar disorder, see Kay Redfield Jamison, Touched with Fire: Manic-Depressive Illness and the Artistic Temperament (New York: Free Press, 1993); Jamison, An Unquiet Mind (New York: Vintage Books, 1995). Jamison has also written a very helpful book on suicide that will help readers more fully understand this tragic area of human experience: Night Falls Fast: Understanding Suicide (New York: Vintage Books, 1999).
5. This section originally appeared as John Swinton, “Medicating the Soul: Why Medication Needs Stories,” Christian Bioethics: Non-Ecumenical Studies in Medical Morality 24, no. 3 (December 2018): 302–18.
6. Darcia Narvaez, Neurobiology and the Development of Human Morality: Evolution, Culture, and Wisdom (New York: Norton, 2014); Jean-Pierre Changeux, “Art and Neuroscience,” Leonardo 27, no. 3 (1994): 189–201; S. Zeki, “The Neurobiology of Love,” FEBSPRESS Letters 581 (2007): 2575–79.
7. Raymond Tallis, Aping Mankind: Neuromania, Darwinitis, and the Misrepresentation of Humanity (London: Routledge, 2011), 237.
8. Tallis, Aping Mankind, 73–76.
9. Tallis, Aping Mankind, 76.
10. Tallis, Aping Mankind, 92–93.
11. Jean Vanier and John Swinton, Mental Health: The Inclusive Church Resource, Kindle ed. (London: Darton, Longman & Todd, 2014), Kindle location 316.
12. Vanier and Swinton, Mental Health, Kindle location 306–312.