*Spoiler Alert*

The first season of the television show “Homeland” has just ended. For those of you who might not have watched the show, it is about a CIA agent named Carrie Mathison who suspects that a recently freed P.O.W. named Nicholas Brody is actually working with Al-Qaeda.

What makes this show important news for those with bipolar disorder is that Carrie, the main character, herself has bipolar disorder. Not only this, but bipolar disorder isn’t just a backdrop, but is central to the drama.

The Portrayal of Bipolar Disorder

I’m not going to spend time reviewing the show itself, though to quickly give my opinion of it, I thought that it was fantastically done. I loved the ambiguity in Brody’s behavior that made the audience never quite sure whether or not Brody is a terrorist. I thought that the various relationships in the show, such as those within Brody’s family and between Carrie and her mentor Saul Berensen were extremely poignant, though I thought the twist that there were two treasonous P.O.W.’s was a bit silly.

Instead, what I would like to do is look at the ways in which bipolar disorder itself was portrayed on the show. This show represents the first time that bipolar disorder has taken such a central role in an ongoing television series, and I thought it would be worth discussing how the illness is portrayed and the implications of that portrayal.

Symptoms

The show chooses to do something quite interesting. While it quite often shows Carrie having bipolar symptoms, it rarely ever explains what is going on. For instance, in an early episode, a hypomanic Carrie goes out to a bar in an attempt to pick up a man for some casual sex. This would seem to be a case of hypersexuality, but the term is never used.

In fact, much of Carrie’s condition is simply blended into the story this way. With the exception of the episode #11, in which Carrie’s sister asks if Carrie is manic (she is), no one ever explicitly addresses what symptoms Carrie might be having.

On the one hand, this makes for excellent drama, as it actually captures a lot of what it is like to be bipolar. What is actually symptomatic and what might just come from our personalities gets blurred together very quickly. There is no running commentary saying, “And here we have an instance of pressured speech. Note how the subject has difficulty finishing one…”

Take, for instance, Carrie’s affair with Brody. This wasn’t simply a symptom of her bipolar disorder in the way her earlier hypersexuality was. However, that doesn’t mean it wasn’t tied to it either. Effectively, she was desperately lonely and her month of surveillance had given her a false sense of intimacy with Brody.

Her bipolar disorder was clearly clouding her judgement, but that doesn’t mean that her relationship was just a symptom. She actually had put herself in a position where she had fallen in love with a terrorist. A lot of Carrie’s behavior is like this, from her obsession with Brody’s guilt to her strange behavior with Saul. We see the way that the symptomatic and the nonsymptomatic simply bleed together.

However, the downside of all of this is that, for many viewers, it will be a little unclear what is going on with Carrie most of the time. The word “bipolar” isn’t even used until Carrie’s manic episode in episode #11. No description of any of her symptomatic behavior is ever given.

As a result, viewers who want to learn more about bipolar disorder might begin to ask questions and puzzle out what is going on with Carrie, and in that sense it is educational. However, unless viewers are inspired to do their own independent research, they will not really learn anything concrete about bipolar disorder directly from this show.

Discrimination

One of the underlying motivations for Carrie to keep her bipolar disorder secret is that she is worried that she will lose her job if she were to have her bipolar disorder discovered. This is because her position requires a certain level of security clearance, and people with bipolar disorder cannot have security clearance above a certain level.

This raises an interesting question of discrimination with respect to certain jobs. There are some positions that people with bipolar disorder are not allowed to hold. For example, we cannot usually become police officers or be in combat. In Canada, this is complicated by rules introduced several years ago that only combat-ready troops may serve in the military at all, effectively barring us from the military entirely. Security clearance is another issue, as those with mental illnesses cannot perform many government jobs because they can never get the clearance.

This is a tricky issue, and it isn’t as straightforward as saying that discrimination isn’t fair. In some cases, if there are no reasonable accommodations that would allow a disabled person to perform a task, or if people’s lives are put at risk, discrimination is acceptable. For me, at least, it is simply unreasonable to expect that a combat situation wouldn’t trigger an episode, given that they can be triggered by far less stressful events.

However, blanket rules like, “bipolar people can never have security clearance beyond x level,” do seem to cross into the realm of discrimination. Presumably the issue is that bipolar people are less trustworthy with secrets than people without the disorder. Of course, if the person is hiding the disorder, the person is a security risk just like anyone who is hiding something, but not everyone with bipolar disorder is hiding it.

I suppose our effusiveness might be the issue. We tend to find it hard not to stop talking, and this might lead us to reveal something, but I have never actually heard that justification given.

Instead, it actually seems to follow from a belief that bipolar people and people with other mental illnesses are inherently less trustworthy. Given the sheer number of government positions bipolar people are locked out of because of this rule, there should be scientific evidence behind this sort of claim rather than just vague distrustfulness of the mentally ill.

Carrie Mathison, the Manic Savant

One of the plot points on the show is that somehow, Carrie’s bipolar disorder gives her special insight into what is going on. She has been established to have been some sort of musician, and she has a talent for finding patterns (often where there are none). Like Jack Bauer, the main character of 24 (made by the same creative team), she is often the only one who can solve a problem that hundreds of otherwise qualified government agents are working on, in her case through flashes of manic insight.

In a way, this portrayal of Carrie as some sort of manic savant reaches to the heart of what we think about bipolar disorder. On the one hand, there is the “bipolar disorder sucks” extreme that treats bipolar disorder like an illness with no redeeming features. On the other hand, there is the “bipolar disorder is spiritual enlightenment” extreme that treats bipolar disorder like it is a special power. Most of us lie somewhere in the middle.

Certainly there are flashes of insight while hypomanic. I know that I have had them, and I continue to have them. I’ll often need to grab a piece of paper and hastily write down whatever it is I’m thinking before the idea disappears. Once I’ve come down from my hypomania, about half of it will be, charitably, overreaching. However, the other half will actually be quite solid. I’d say most of the bases of my creative output come from these flashes.

On the other hand, this isn’t really a special power. As Kay Redfield Jamison points out, bipolar people are more likely to be great poets, but that doesn’t mean that there aren’t great poets who aren’t bipolar. The idea that bipolar disorder makes us some sort of savant with insight that only we can have is, I think, false. It is also somewhat dangerous, because it is precisely this sort of thinking that becomes prevalent in manic episodes.

Moreover, Carrie has her biggest revelation while she is in full-blown mania. This just doesn’t seem accurate, at least in my own experience or in those of people I’ve spoken with. At some point, the flash of logical connections that we see when hypomanic just breaks down in mania and we lose the ability to see connections (or rather, we start seeing too many connections that aren’t really there). Thought starts to race and become disjointed. If we were to sit down and start scribbling on things in various colors of pens, there would not be an insightful pattern to find there at the end.

As a result, I’m a little wary of the portrayal of Carrie as a manic savant. I understand that this is a part of the genre of the show. After all, she’s this show’s Jack Bauer. However, tying her special gifts as closely as they do to bipolar disorder is a potentially dangerous misrepresentation of mania.

Electroconvulsive Therapy

The show ends with Carrie receiving electroshock therapy after coming to believe that she was wrong about Brody all along (though she wasn’t). Between losing her job, her confused love for Brody and a manic episode, she decides to undergo electroconvulsive therapy.

The scene where she undergoes the therapy is a somewhat strange one. It is one of the few times we get a discussion in medical terms on the show, in which Carrie says that the old electroshock therapy from One Flew Over the Cuckoo’s Nest gives a misrepresentation of ECT (which it does). So, the script is telling us that ECT is now common and reasonably safe. In fact, it seems to go too far. Carrie treats ECT like a cure, when it is not.

The script then bizarrely decides to have the show end with a scene of Carrie getting ECT and in a convulsion. Suddenly, ECT is being used to shock the audience (pardon the pun), such that the show will end on a highly dramatic note. Convulsions look much worse than they actually are for the patient.

So, what is the show trying to do here? It can’t both try to rehabilitate ECT in the media through a little speech and then use it as their big, shocking ending. The show just seems to be a little confused here.

I worry, too, about the decision to have Carrie suddenly remember that Brody knew Isa right as she is about to undergo the therapy and right after a little speech about the amnesia caused by ECT. Effectively, this seems to be turning one of the side-effects of ECT into the especially cliche’d plot device of amnesia.

So, it’s really not clear what the show is trying to do here with ECT. The media have already done a very good job of slandering ECT treatment, and at first it seems to be trying to rehabilitate it. Then it uses it for shock value.

Conclusion

“Homeland” provides a lot of interesting perspectives on bipolar disorder. Most imporantly, though, it is the first show to really put bipolar disorder front and center. Other shows have had bipolar characters, but this show integrates the disorder right into the story and shows that way that it affects the main character and raises issues of discrimination and treatment for those with the condition.

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