Is Bipolar Disorder Real? Version One: Is Bipolar Disorder a Brain State?
I’ve increasingly lately met a number of people who doubt the very existence of bipolar disorder. As someone who thinks he has bipolar disorder, figuring out whether or not they are right is of no small importance. After all, if I don’t have bipolar disorder, then I’m really wasting a lot of my time (for one thing, I’d have to retitle my blog “The Tooth Fairy Today”).
What I’ve found quite interesting is that the question “Is Bipolar Disorder Real?” actually says as much about what people mean by “real” as by what they do by “bipolar disorder”. I’ve discussed this sort of phenomenon before in my discussion of what “causes” bipolar disorder. However, this question cuts even deeper. While everyone uses the term “cause” in multiple, compatible ways, the question of whether or not bipolar disorder is “real” shows significant disagreement of what the conditions are for something being called “real”.
So, I thought I’d answer the question in the different senses in which I think the question is asked. Each of these answers will be put in its own post. I’ll be writing these answers as a series, though I will be treating it more as an occasional feature rather than publishing them all consecutively.
Is Bipolar Disorder A Brain State?
One version of what people mean by asking if bipolar disorder is real is whether or not bipolar disorder is some identifiable state of the brain that can, for example, be recognized in a CT scan. So, for instance, if we can’t see that there is activity in a certain, unique area of the brain during episodes (and I imagine there would need to be different areas for different types of episodes), then bipolar disorder doesn’t exist.
Physical Descriptions and Mental Descriptions
So, for instance, let’s say that the belief that swans are blue always occurs when certain brain neurons fire. That might be true. However, on what grounds do we call that firing “the belief that swans are blue”? Only a person who understands what “swans are blue” means will even understand what it means to say that a particular brain state is the belief that “swans are blue”. In other words, even if we completely describe the brain state, we have not described the mental state.
However, the problem is worse than this. It’s not unimaginable that the belief that “swans are blue” always corresponds to a certain type of brain state. It’s also not imaginable that the belief that “4+3=9” always corresponds to a certain type of brain state. However, this does not imply that there will be some physical sign that we can look for to find “false beliefs”. The falsehood of these beliefs is something that can only be understood in terms of their mental descriptions, not their physical descriptions.
Bipolar Disorder is Described in Mental Terms
Bipolar disorder is something going wrong with our emotional states, in some fairly consistent patterns. However, these problems with our emotional states are ultimately mental descriptions, not physical descriptions. The symptoms of bipolar disorder are ultimately be like “false beliefs”, that is, something that can be described only in mental terms that simply cannot be reduced to physical descriptions.
One the one hand, bipolar disorder may be the result in a physical defect in the system that produces certain neurotransmitters. In that case, there will be a corresponding physical description. On the other hand, this would just be a contingent empirical fact. It is at least theoretically possible that there would be no corresponding physical description, just like with falsehood.
Now, I think that the evidence is pointing more and more to there being some sort of physical cause for bipolar disorder that can be described in terms of brain states. There does seem to be some sort of problem with neurotransmitters, and the twin studies would seem to indicate that it is not the result of environmental factors such as trauma.
However, there are other mental illnesses, such as post-traumatic stress disorder, that do seem to be the result of trauma and other environmental factors. Even if bipolar disorder has a physical cause, it is no more a mental illness and no more real than mental illnesses whose causes can only be described in mental terms. Not only this, but it is real for exactly the same reason: it is a discernible pattern of mental states that can be described in mental terms.
I therefore would argue that this is irrelevant to the question of whether or not bipolar disorder is real. The description of bipolar disorder is ultimately a mental description, not a physical description. Like many mental states, whether or not there is a unique corresponding physical description is irrelevant to whether or not bipolar disorder is real.