An Open Letter to the APA: Why aren’t you speaking up about bipolar one and Kanye?
Greetings, I hope this done find you, because this is very important and directly effects the outcomes of people with bipolar one, including suicide.
As you have undoubtably seen, there is a global event going on in reaction to comments Kanye West, who is bipolar one, made on social media during an obvious manic or psychotic episode. As we speak, people around the entire world are condemning him for the known effects and defining symptoms of a serious brain disorder. You are psychiatrists, you know damn well that people with psychotic disorders say and do things during episodes that don’t make sense, that are disturbing, that are confusing or offensive or vulgar. How are you letting this go on? You are the medical authority here, with the ethical obligation, to stop the tidal wave of misinformation about psychotic disorders that is proliferating virally around the entire world.
Politicians, celebrities, influencers, religious organizations, even banks, are working together to punish Kanye in a show of unified condemnation of his “message” (aka, involuntary episode from a brain disorder). The size of this viral condemnation cannot be overstated — this is global. It’s on the news, the television, the podcasts, all kinds of publications, and all social media platforms… We are talking about a reaction here that easily eclipses global responses to many actual material tragedies, conflicts, mass death events, take your pick of them. This is nothing more than the form ableist attacks on people with psychotic disorders take: the extreme hyper visibility, the mass humiliation, the drive to take away our support systems and resources, the transformation of our deadly brain disorder into a spectacle.
They are doing to Kanye what society does to all people with psychotic disorders: punish us for our symptoms, blame us for our brain disorder, humiliate us, bully us cruelly for years on end, take away everything we have, and push us to the margins of society. Of course, this makes everything incalculably worse for us: it is the social rejection and abuse and loss of support and entire lives and careers built over decades, that drives us to the worst possible outcomes. As a fellow bipolar one, I am very concerned that Kanye will not survive this. 20% of us kill ourselves, and shit like this is a big reason why.
I don’t understand how you are allowing a Black man with bipolar one to be shamed, humiliated, to have his career destroyed and his legacy, you are letting Ye be absolutely tortured for the whole world to see, for exhibiting known symptoms of bipolar one? You’re not saying anything? You’re not trying to educate the masses about what a manic or psychotic episodes looks like, and what we know to be medically true about it? How come in 2022 everyone knows about anxiety, depression and borderline personality disorder, but can’t even recognize the symptoms of mania, still thinks a psychotic episode is something that the patient has any control over, and still thinks the “right” thing to do is punish and abandon psychotic people instead of supporting them, getting them help, or even just giving them privacy and dignity during the most vulnerable moments of incredible and possibly mortal illness.
This doesn’t just happen to Kanye, it happens to tons of people with psychotic disorders, just not on this level of celebrity and visibility. Why has there been no comment from your organization on the pattern of bullying, harassing and abusive hyper-visibility people having psychotic episodes experience over and over again? On the internet, our episodes are passed around virally as jokes. Many, many, many episodes unfortunately involve social media, there is nothing a manic bipolar one person loves more that Twitter. Turning us into a public mockery, as they are doing to Kanye now, is an incredibly common experience.
Even though bipolar one is known to cause people to do things like send insane messages to their entire company, say disturbing things, engage in out-of-character sexual behavior, consume drugs and alcohol, and make rash, illogical decisions, the cultural norm is that we punish people for known and involuntary effects of a severe brain disorder. When we are sick, the right thing for people to do is to check in on us, make sure we are safe or try to get us help (if relationship-appropriate), or simply to ignore it, because everyone experiencing a medical emergency deserves dignity and privacy. When we are feeling better, we should be able to return to our lives, but stigma and misunderstanding means people are more focused on punishment than in accommodations.
The fallout of manic episodes is so severe, in large part because there is no public understanding or grace of what this is. There is no public pressure, as part of the mental health movement, to extend understanding, dignity and support to us, because the mental health movement leaves out people with psychotic disorders. Oftentimes we come back from an episode, and everything and everyone in our lives is gone. This happens especially pre-diagnosis. I will take the opportunity to remind you that one of the reasons our episodes get so severe, is because the average time it takes for YOU, supposed doctors, to diagnose and treat us is 5-10 years *after* we start exhibiting symptoms, during which time the disease is progressing.
It is ableism, that the neurotypical community, the police system and the medical system are needlessly making this disease even more devastating than it is — having this disease is already very difficult, very painful, and very scary, as you know. Add on loss of everything in your life, and public humiliation and marginalization, and you have the perfect recipe for 20% of us dying from this.
The message that is being spread around the globe, with no counter from the psychiatric community, is that when sick people do things because of an involuntary brain disorder, holding them “accountable” is the right course of action. Removing their support system, taking away their resources, their friends, their families — we lose everything because of this belief. Why do you say nothing as totally false information about bipolar one spreads across the world? Do you know the damage this will do?
Anyone who claims that this has to do with one Tweet alone, ignores the long history of the public absolutely brutalizing Ye over and over again, for years, for exhibiting known symptoms of a known mental illness. And they are also ignoring the similarities to other bipolar one celebrities who have also been the butt of global ridicule: Britney Spears, Amy Winehouse (dead, overdose), Whitney Houston (dead, overdose), Demi Lovato (within 5 minutes of dying), Sinéad O'Connor, and historically, Kurt Cobain (dead, suicide), Marilyn Monroe (dead, suicide)… must I go on? I know you people know this. Your little Creativity and Madness conferences? Are you just there to gawk at us like everyone else, or are you actually interested in preserving the lives of discontinuous bipolar one talents?
One thing that is particularly disturbing is that the backlash is so serious that they are going directly for Kanye’s assets and the things that he *does* have, what remains of the wreckage that ableism and abuse has caused in his life. It’s never enough — they have to take everything from us. They are even forcing him to move his entire financial infrastructure; the absurdity of JP Morgan Chase kicking Kanye off when you consider their clientele consists of some of the worst people in the world, and JP Morgan itself has committed unconscionable economic crimes again and again. This sets a dangerous precedent for people with serious mental illness, that their access to financial infrastructure and other essential products and services, should be cut off as punishment for manic episodes They are trying, and have been for years, to cut Kanye off from his industry, his collaborators, his money, his friends, and potentially his children — when he is SICK WITH A DISEASE WE KNOW ABOUT, being punished for SYMPTOMS STEMMING DIRECTLY FROM THAT DISEASE. He is SICK as we speak and as he is very, very ill, the public is attacking him with absolutely horrific cruelty. That is the true embodiment of what bipolar one people go through, the ableism that WE experience.
How could you do this to him, and how could you do it to so many people who also have psychotic disorders? We are abandoned by our entire support systems when we get sick again and again, using the exact same logic that is being used against Kanye right now. People want us to take “accountability” for our totally involuntary symptoms stemming from a severe brain disorder that gives us literal brain damage. They get ANGRY at our symptoms and use them as a reason to discard us — right at our very lowest and most vulnerable moments. This is the stigma that leads to the terrible outcomes for bipolar one people. This kills us.
The entire world is being told right now that bipolar one and psychotic disorders in general, are not “excuses” for what people say when literally flagrantly manic or psychotic. They don’t understand, or pretend not to understand, that mania/psychosis are involuntary medical emergencies, and you should no more blame a bipolar one person for their symptoms than you would someone with a seizure disorder, Alzheimers or dementia — even if the symptoms may be disturbing to see, they are still medical symptoms and they should be treated that way.
So why aren’t you say anything? This is doing huge harm to bipolar one people. People are going to die as a direct result of this. The backlash sends the message that you can and should cut people who have psychotic episodes out of your life, that you should actually punish them, even though the fact is that this is a medical phenomenon, and in fact psychosis is a medical emergency. This will leave even more bipolar one people alone with no support; not to mention that the extreme stress of social shunning aggravates the illness; I hope that the glee of the attacks on Kanye isn’t lost on any of you, and that you recognize this as an ableist phenomenon.
The people in our lives blame us for episodes as a moral failing, or a revelation of someone’s true nature. Even though this is based on medically incorrect information, it will lead directly to bipolar one people being abandoned, abused, and cut off from resources. The stress, isolation and despair this brings will lead to yet more suicides — must I remind you again that 20% of us die from suicide? WHEN WE ARE HAVING EPISODES, WE ARE DYING. When it comes to people with psychotic disorders, you see the most extreme examples of mental illness stigma: people being cast from society altogether to die. That is what people are trying to do with Ye.
Do you really think there is no relationship between the fact that Ye is a Black man with a psychotic disorder, and the fact that this demographic has the absolute worst outcomes with regard to psychotic disorders, particularly homelessness, being incarcerated, and police violence, including outright murder of Black men with psychotic disorders by cops as a matter of course?
Are you going to allow the public to continue pretending there is no connection?
You cannot keep letting this happen to bipolar celebrities. You have let this play out on the global stage again and again without saying anything. You condemn them. How they are treated effects how people with psychotic disorders are treated all over the world.
I have a lot of people with psychotic disorders in my life, and all of them are hugely disturbed and saddened by this event. We are also worried about Kanye’s life, are concerned that this ableist torture of him is reaching a level that he might not be able to survive. We are watching all of our friends, families, coworkers and bosses light the torches to humiliate and kill someone with a psychotic disorder, and we know that this is what could happen to us the next time we have an episode. A lot of people are learning a lot about the people in their lives: that they are not safe to be around, and would abandon us and punish us when we are sick. These are devastating revelations.
You have a responsibility not just to your patients with ADHD, anxiety, and depression, ones that are palatable in the mainstream. You have a responsibility to your patients whose brain disorders can be disturbing, scary and alienating to people who don’t know what is going on. To the ones that are hardest to defend, to the ones that face the most stigma and the most death. If stigma for people with psychotic disorders is lifted, stigma for all things in the mental illness pantheon will reduce as well.
You have an ethical responsibility to broadly educate the public about these disorders, so they understand, so they know what is acceptable to do in these instances, and what is needed to help. You have an ethical responsibility to lessen the damage of episodes for all bipolar one people, by making it clear that these are the known, predictable, and common symptoms of people with this brain disorder. You have an ethical responsibility to step in where there is an event of such great magnitude, where hugely misleading and dangerous information is proliferating globally along with hatred and scorn of people with psychotic disorders.
Maybe you can also explain to the public that, because it takes you people 5-10 years from onset of symptoms to diagnose and treat us, because this illness is progressive, because for most of that 5-10 years you give us SSRIs that make it worse, literally poisoning us; that because of this, bipolar one people are, through no fault of their own, condemned to years of episodes and fallouts, so that we loose everything we have — family, friends, jobs, money, cognitive abilities — before we even get in sight of lithium.
Maybe you can explain the extraordinary gaps in the medical system that exist, that result in medical emergencies like psychotic episodes, and how the medical system itself is responsible for the fact that even though everyone knows about sun lamps and drinking water and therapy and fidget spinners and meditation and yoga for the “nice” mental illnesses, no one knows shit about bipolar one.
And that’s what gets us killed.
I hope you will take the necessary actions.