How we become ill

Abstract

This dissertation describes the seemingly circuitous pain of the moods depression and mania, some of the conditions of their occurrence, and some of the practices used for living with them as chronic diseases. One of the primary goals is to portray the pain of depression and mania in ways that do not rely on psychiatric representations of these moods as pathologies. This is accomplished through a phenomenology of moods which describes the activity of moods while avoiding the construction of symptomalogical representations of them, which is the foundation for psychiatry's analytic approach. A recounting of depression and mania as self-regulatory phenomena is provided that emphasizes the similarity of these moods rather than the bipolarity commonly assumed in psychiatric models. My portrayal of moods as incomprehensible without the context of their occurrence opposes psychiatric representations of moods as dissociable states. I assume that differences between the analytical method and the phenomenological method underscore discursive differences between sufferers' experiences of depression and mania and the ordered knowledge used to inscribe these moods into illness experiences. My work attests that more than a medical 'cure' is necessary to alleviate the suffering of mania and depression; a 'cure' also requires that individuals learn what to know about themselves and how to order self-knowledge in order to live with mania and depression as chronic mental illnesses. To this end, I represent psychiatry as a tool for moral action utilized by sufferers in their unique efforts to avoid the pain and circularity of depression and mania. I conclude with a description of how persons learn to identify and presume distinctions between their normal and abnormal selves as they create self-perceptions as mentally ill, and more specifically, as depressive or manic depressive.