Britney and the Stigma of Bipolar Disorder

It’s been five years since Britney Spears has released a new song, but her personal life has once again pushed her into the spotlight. After disclosing her diagnosis with Bipolar Disorder in 2013, she’s been speaking out recently against the arrangement under which her father has controlled much of her life since her public breakdown in 2007. People have expressed surprise at how little personal freedom she has and the #FreeBritney hashtag is trending on social media.

Her experiences demonstrate the impact of stigma on people with mental health conditions, showing us that, although we’ve made progress in the last decade, we have a long way still to go.

Bipolar Disorder and the myths around it

Bipolar Disorder is a set of conditions in which people typically experience severe mood swings and changes in their energy level. Previously called “manic-depression,” most people diagnosed with a Bipolar Disorder exhibit manic periods in which they are unusually exuberant and excited, alternating with episodes of depression marked by low mood and low energy.

During manic phases, the person may display unrealistically inflated self-esteem, decreased sleep, constant talkativeness, extreme distractibility, and physical agitation. They may report an excessively positive mood and racing thoughts, and they frequently don’t realize there’s a problem.

It may sound like Bipolar Disorder is obvious and easy to recognize, but that’s not the case. Many people have more subtle symptoms and may never experience a full-blown manic episode. The difference between ordinary and pathological mood swings is a matter of degree and differentiating Bipolar Disorder from other psychiatric conditions requires an in-depth professional assessment.

We don’t know what causes Bipolar Disorder, although there’s evidence it involves genetics and neurochemical issues. It’s a treatable condition, with most people taking medications to stabilize their mood, and people diagnosed with it can live ordinary lives. Periods of stability can last months or years, with occasional breakthrough symptoms taking days or weeks to get under control. It’s considered a chronic relapsing condition, like some kinds of asthma, arthritis, hypertension, and MS.

Given the often obvious and severe symptoms, Bipolar Disorder is generally considered a Severe Mental Illness (SMI) and it’s surrounded by various damaging myths, such as:

• Myth: People with Bipolar Disorder are violent or unpredictable. Although they may be unpredictable during a manic episode, the rest of the time people diagnosed with Bipolar Disorder are like anybody else. As far as violence goes, people with Severe Mental Illnesses are significantly less likely to commit violent crimes than the general population, while they’re 10 times more likely to be the victims of violent crimes.
• Myth: People with Bipolar Disorder can’t hold down a job or manage their own affairs. People diagnosed with mental health conditions are just as productive as other people and there’s even evidence they may be more conscientious and dependable than the average person since they work hard to conceal their issues and maintain a sense of normalcy. Outside of manic periods, they manage their lives the same way we all do.
• Myth: People with Bipolar Disorder never get better. Although there is currently no cure for Bipolar Disorder, the treatment success rate is 80%. Since it affects almost 3% of the population, it’s likely you know someone diagnosed with Bipolar Disorder, but you wouldn’t realize that unless they tell you.

The varieties of stigma

Following her divorce in 2007, most of the press coverage around Britney was extremely stigmatizing. Comedians made fun of her struggles, paparazzi thronged around her, magazines featured unflattering pictures, and terms such as “crazy” and “psycho” were regularly applied. Although this kind of overt and ugly stigma is less common now, except perhaps in social media comment sections, other kinds of stigma remain the norm.

That’s the case with Britney’s legal status. After her public mental health crisis, her father was made her temporary conservator or guardian. This arrangement was later made permanent and, as a result, her individual rights are extremely limited. She does not control her money, cannot have a credit card, doesn’t decide who she sees or what she does, and isn’t allowed to make her own medical decisions -- including whether to have a child. All this, despite the fact that she has reportedly been stable on medication for over a decade and is apparently a normally functioning adult.

This is “benevolent” stigma, based on the myths that people with Bipolar Disorder are unpredictable, cannot manage their own affairs, and can never get better. Although it’s well intentioned, benevolent stigma can be even more damaging than the more overt kind, especially when it leads to limiting a person’s human rights.

#FreeBritney

I am a strong advocate for temporary guardianship for some people during mental health crises, and I have testified in court to support such arrangements in the past. But I just as strongly oppose permanently taking away anyone’s civil rights, especially when the reasons for doing so are nothing more than myths.

It’s important to know, though, that Britney Spears is just the most famous person caught in this type of civil nightmare. Her struggles are all too familiar to many people diagnosed with behavioral health conditions, and each of us almost certainly knows people who face similar challenges.

The fight against mental health and substance abuse stigma is much bigger than just freeing Britney, and, like any kind of prejudice, it requires that we each examine our own attitudes and behaviors in order to treat everyone with dignity and respect.

To learn more, visit https://www.psychologytoday.com/us/blog/people-are-strange/202106/freebritney-provides-good-lesson-mental-health-stigma and https://www.nami.org/blogs/nami-blog/october-2017/9-ways-to-fight-mental-health-stigma.

If you or someone you know needs help, call 1-800-273-8255 for the?National Suicide Prevention Lifeline. You can also text HOME to 741-741 for support from the?Crisis Text Line. The National Helpline for alcohol and drug abuse is at 1-800-662-4357. All three are free and available 24 hours a day, 7 days a week, every day of the year.

This piece was originally published on the Partners in Mind site for employee members of the Employee Resource Group (ERG) for mental health at The Standard.

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This piece is not intended as medical or legal advice. Always speak with your medical provider before initiating a diet or exercise regimen or if you have medical questions. If you have legal questions, consult with an attorney.

This article represents my own opinions as a non-physician and does not reflect the opinions or positions of my employer.