The not so secret life of the manic depressive, ten years on – and how it might have been

Nicky Hayward’s take on Stephen Fry’s programme ‘The not so secret life of the manic depressive, ten years on’, which aired on BBC One in February 2016.

Just before the end of the summer holidays last year, I responded to an advert which had been shared by the Mental Health Foundation on Twitter. 

It read: “BBC documentary looking for people currently struggling for correct diagnosis & treatment for bipolar”. 
I emailed one of the producers who had been inviting input, to ask “Would you also be interested in talking to survivors who, like me, are now living ‘normal’ lives but realize things could have turned out very differently if they’d had been handled better from the outset; who are concerned that mental health services’ interventions have done at least as much harm as good?” 

We engaged in a brief correspondence. 

I explained that, having extensive experience of the phenomenon which he was supposedly researching thoroughly, I personally don’t believe anymore that a one-size-fits-all ‘correct treatment’ exists or is even something to be desired, and have become distrustful of the ‘disease model’ paradigm in general.  

He was interested in conversing initially because I told him I know a number of people who might be interested in being involved.  

I conceded “You may well want to keep your discussion within the parameters of current mainstream mental health service practice,” but told him I’d written just in case he might be interested in considering expanding the scope of enquiry, attaching a number of documents to acquaint him a bit more with alternative perspectives on conventional medical treatment and even the currently accepted psychiatric diagnostic system. 

I explained that if he could tell me the programme’s angle I’d be in a better position to know who to put him in touch with. Then it all went quiet.

Out of the blue a couple of weeks ago, an (evidently generic) email arrived from him thanking me for my support and guidance, apparently without which the making of the film would have been very difficult 🙂 

I now know that a number of my professional colleagues who take a broadly critical perspective on mental health issues also discussed the programme with him in the autumn and encouraged him to acknowledge the debates in this contested area.  

I hoped that at least some of this would be represented in the programme.  Sadly, when I tuned in to BBC 1 at 9 pm on Monday night, this was very far from the case.

I wondered what the critics have made of it. 

In The New Statesman,  Jenny Landreth – who on balance seemed to consider the programme helpful – conveyed in her article Would You Swap Places With Stephen Fry? concern both about the growing amount of mental ill health in the UK and the woeful lack of adequate provision to help sufferers. 

But she, several times, disappointingly quoted the hackneyed ‘1 in 4’ statistic, claiming: “The chances of (mental breakdown) happening to a person we know are high. 1 in 4 people will have some kind of mental health issue this year.”

Statistics are slow to change in public folklore and we still hear this mantra bandied about not only in general but in survivor and activist circles and, indeed, professional ones too. 

Naturally it fans the flames of stigma rather than helping extinguish the fire as nobody likes to consider that it will be him or her who might crumple next, under the weight of life’s pressures.

It’s so much easier to believe in a hereditary life-long condition that other poor sods, but not us, are afflicted with. The number officially implicated will naturally be escalating towards one in three anyhow, if we stop to think about it, as our unforgiving culture and unequal society pushes more of us to breaking point.

The Only Us Campaign which is vocal on both Twitter and Facebook, however, challenges received ‘wisdoms’ simply and incisively with some brilliant slogans:

“No Them and Us, Only Us”

“Not 1 in 4, but 4 in 4”.

For we are all vulnerable – and all of us have a tipping point – as Jenny Landreth goes on to acknowledge, “What are we waiting for? Are we only going to try understanding once it’s our own mum/brother/self? Do we really have to gather the yeses one by one? Because there’s still a loud and basic NO to the question of whether much has changed, and it plays out in the form of stigma”.

I was confused by the end of her article about whether she considers such conditions to be hereditary, life-long and diagnosable or really believes, like me, that increasing mental breakdown is a logical consequence of the burgeoning pressure of social disintegration.  

There seems to me to be a lot of rather woolly, mixed-up thinking around about mental health issues, even in modern times.  But that’s hardly surprising considering the vested interests backing certain approaches.   

Some of our largest mental health charities (including Mind) are now effectively government subsidized, and therefore, run. 

Thinking, in statutory services, tends to lag behind progress. 

The media latch onto any story that will sell papers or crank up ratings and yet, if you suddenly have a crisis at home, it’s not clear how to get help and the little that’s on offer is very often inadequate and sometimes worse than useless.
I wholeheartedly agree with her summing up, anyhow: “The timing is pretty critical: the programme went out as a leaked report showed how the mental health provision in this country is now at crisis levels.

The current government’s actions make Thatcher’s “care in the community” look positively benign. So while we watch this and try and get our own house in order, the government is loudly telling us they don’t give a shit”.

Sally Newall, in The Independent, considered this “a memorable film, part of the BBC’s commendable In the Mind season, that everyone could benefit from watching” asking not but talking about how “attitudes and awareness concerning mental health have changed in what she calls “this important film”.  Her review was very enthusiastic and gave attention and credit to each of the people who had offered themselves as case studies. 

Along with everyone else, I was full of admiration for each of them as they courageously bared their souls and offered an intimate window into their lives, thereby making themselves publicly vulnerable. 

This is particularly brave in an age where people can so easily make hateful personal attacks remotely, sometimes in gangs, by clicking a few buttons, knowing there’s no chance they’ll be held to account for their cutting words and actions. 

Alika’s story demonstrated poignantly how devastating it feels to be on the receiving end of such thoughtless bullying and venom, as indeed did Stephen Fry’s retreat from Twitter after the row following the Baftas just the week before the film was shown. 

It was great to see how Alika now uses his excellent anti-stigma work with teenagers in schools to demonstrate that even huge and painful setbacks can be cathartic, transformative experiences and to encourage the students to educate themselves and be compassionate.

However, unlike Sally Newall, I feel so much more could have been made of the material the film makers had available to them. 

The questions posed in the programme’s introduction were: “As a society, do we need to do more for those with the illness? Is the treatment better? Has the stigma reduced?”

While undoubtedly inroads are being made into the issue of stigma (Rachel’s story touching on her new role as a peer worker, also demonstrated ways in which survivors can give back to others and use their experiences constructively), it is well established by research that “illness like any other” campaigns are almost completely ineffective in reducing stigma.

To put it more precisely, they may induce a sense of pity, but do nothing at all to increase people’s desire for contact with those who are psychiatrically labelled, in the sense of “you’ve got it; I haven’t, and I’m going to stay away as I don’t want to be contaminated!” 

Such phenomena as the cartoon pictures that constantly do the rounds on social media (and I have to say I’ve shared them myself in the past, despite my experiences, views and convictions, before I really stopped to think about the message they are giving across) fuel notions of illness/disease and the validity of diagnostic categories rather than the perspective that breakdown is a natural human response to unendurable pressures and impact and can happen to any of us.

There’s little evidence that attitudes in general are changing. Surely, in the end,  the most important message we can give is Sting’s: “Don’t judge me, you could be me, in another life, in another set of circumstances” … indeed, in this life! 
We never know when life’s about to bowl us a mega-curveball.

As far as the other two questions go … the film didn’t, it seemed to me, address either of them overtly.  However, I felt, it answered them fully and depressingly through its coverage, whilst apparently considering it had imparted unbiased facts along the way and done the subject justice.  

As a survivor of mental breakdowns who now leads a full life, having had two first degree relatives with diagnoses of ‘serious mental illness’, I find it ineffably sad that this whole project culminated in a confirmation of the traditional belief that some people will inevitably suffer with lifelong diseases of the mind.

I liked the talk right at the end of the programme about “the triumph of the spirit”, and enjoyed  seeing teenager Rachel and her supportive friends together.  She summed up: “I wouldn’t want people feeling sorry for me, cos … now, I’m fine”.  She clearly is.  But otherwise the programme didn’t feel anything like the attitude-changing, intelligent discussion of the rich resource of available subject matter many of us had hoped for.

The whole atmosphere, from the doleful music and studiously sensitive, lowered voice of the narrator to phrases like ‘the manic depressive’, and talk about ‘his’ and ‘her bipolar’ – together with discussion about people ‘having’ and even ‘ bipolar’ – made the production feel uncomfortably dated and superficial. 

It seemed as though the film makers had evidently looked for personal stories that were sensational in different ways and make good advertising copy, and stopped short of exploring their subjects’ predicaments in any great depth (or, by bringing more perspectives in to the mix, potentially offering them a greater variety of options and more – perhaps better – help).  

I’m sorry if that sounds cynical, but this particular programme was put on Prime Time TV (and the others in the series were scheduled after most people’s weekday bedtime. Why was this, when this is supposed to be a series aimed at informing and educating  people? 

I can only assume it was because the subject matter in the others was considered too distressing for Prime Time viewing. 

But I can think of much disturbing material that’s regularly aired then (usually fictional, perhaps), and if such content is seen as unfit to be broadcast at the time when most people are watching, we’re never going to get anywhere).
Difficult, distressing and tragic experiences were discussed but not shown in this flagship first film of the series. However, in my opinion it went nowhere.

As I said before, I have nothing but admiration for all of the subjects who put themselves in the hands of the film makers in the belief that their stories were being told for a good reason.  Having allowed myself to be filmed a year or so ago, though, I know that as a subject you have no control over the context your scenes are put in and the overall message a production conveys. 

The programme left me feeling paradoxically inspired by its subjects, their endless reserves of courage and tenacity, and frustrated by its framing and, to my mind, manipulation of the subject matter, using the human interest scenes very largely to substantiate its central message. 

Having had experience, in various capacities, of mental health services since the seventies, my overall feeling was that – were it not for the improvements in technology, advances in seamless production skills over the years and modern day phenomena like Twitter, computers and mobile phones this programme could have been made twenty or even thirty years ago – for all the advances in thinking and consciousness it had to offer. 

It hardly touched on any management options other than psychiatry (incidentally, has anyone tried to access a psychiatrist lately? You’re most likely to draw a blank and be referred back to your GP) and interviewed nobody who has had similar experiences to its four subjects who have completely recovered and have either had the diagnosis removed or dissociated themselves from the diagnosis. 

I am one of them and others like me do exist, but you wouldn’t think so if this film was anything to go by.
My conclusion, sadly, has to be that that makes it a dangerous piece of propaganda which has seriously short-changed its subjects and essentially let down those who are unwell right now by denying them access, or greater access, to all the alternative viewpoints and opportunities that are on offer in 2016. 

Moreover, it has essentially ignored those who are currently living full lives despite having experienced bipolarity in the past, and has misinformed the general public – a number of whom, themselves, will become unwell in similar ways in the future. 

I googled the BBC producer I had been in touch with, in the process of writing this article and discovered, on his page, that this film was listed under what I can only presume was a working title: Stephen Fry. Bipolar, There is No Why
Aha, I’ve finally been told the angle!  In other words, it’s a piece of glorified Reality TV.  But the film makers have been dabbling in immensely sensitive and fiercely contested territory where matters of life and death are at stake, and Stephen Fry as President of Mind is inextricably linked with its outmoded and regressive message; indeed, actively promoting it.

This gives me cause for great concern.

The fact is – there ARE ‘whys.’ There is a massive amount of research about the causal impact of personal and social factors in ‘bipolar disorder’ as well as every other mental health condition. This includes difficult early relationships, all varieties of loss, trauma and abuse, and all kinds of social adversities such as unemployment, poverty and inequality.
Those of us with lived experience who have been able to re-build our lives, and leave our labels behind, have done so by acknowledging these painful truths and working to understand and resolve their impact. 

I’ve been delighted to see, anyhow, that a great many others have been demonstrating their concern about the programme:
 – Richard Bentall’s Open Letter to Stephen Fry – as I write, five days from publication, has had well almost 135,000 hits.
– An Open Letter to The BBC which has been signed by well over 1000 people in less than 72 hours (instructions, if you’d like to sign yourself, are given at the end of the letter).

It is gratifying, at least, to see that the controversy the programme has unleashed has engendered a lot of authentic and purposeful discussion and focused a movement determined to change the unsatisfactory, unfit-for-purpose status quo. 

To  coin a phrase used by a colleague of mine who has herself bravely endured years of immense difficulty and made a life for herself the other side, the film makers “either knew what they were doing, in which case it was unethical, or they should have known, in which case it was incompetent”. 

Well, we offered to help …