Wednesday, February 29, 2012

Life Beyond Diagnosis: "A Hidden Madness"

A Hidden Madness
James T. R. Jones
ISBN: 978-0615571546
Publisher: James T.R. Jones
Date of publish: Dec 29, 2011
Pages: 336

There's an old traditional saying that to know someone you have to walk a mile in their shoes. James T. R. Jones, in his autobiography, “A Hidden Madness” takes us on precisely such a journey, lasting from his high school days through becoming a tenured law professor.

Most of us understand that being a law student is one of the most demanding of academic tracks (the old TV show “Paper Chase” did a fair job of showing the pressures), academically, socially, and, for those lawyers who qualify to teach, politically, challenging. Focus, self-confidence, long hours, and good social skills are critical.

But what if a student had a secret? What if he had an illness that was so stigmatized that simply letting anyone know he had it would jeopardize his chances for a successful career? If he had a broken arm, or was in a car accident, or developed cancer, there would be some degree of understanding, but this was different.

 James Jones had a secret. He'd been treated from an early age for bipolar disorder, a condition which can cause a number of different symptoms, including inappropriate euphoria, lack of focus, constant chatter, irritability, bursts of temper, catastrophic thinking, disabling hopelessness, suicidal thoughts, and more, all of which can be interpreted a number of ways by those around you. All of which in short order can tear through one's self-confidence and be a source of complete humiliation.

In my own college years, a fellow dorm student had a grand-mal epileptic seizure during a final exam, causing such disturbance in her fellow students that the exam had to be rescheduled. She had told no one of her condition, for fear of the stigma from other students, but had forgotten her meds when she'd stayed up all night to study for the exam. This incident was so mortifying, she left to go to another school, where nobody knew her. I can see why someone would hide bipolar disorder, as even day to day life could create mortifying moments, and going on despite them shows great courage and persistence.

In chapter one, James Jones takes us inside a manic event (a mild one to be sure) giving us a glimpse of what was going on internally. While his classroom students simply saw a very eccentric professor of law, he was desperately trying to stay on topic while his brain generated “racing irrelevant thoughts” at high speed, bouncing him from topic to topic, recalling “useless trivia” as he talked on and on,on topics having nothing to do with the class he was teaching. As a full professor, he had the clout and credentials to be given the benefit of the doubt (in spite of some complaints from students that he was side-tracking, wasting precious class time), but as we all know, teens and college students aren't quite so forgiving.

His decision to publish this book, given the character of the disease, shows an even greater bravery. Much as he wanted to to help others suffering from bipolar disorder, he was afraid.

“I saw danger all around me: student uprising, the wrath of my dean, loss of tenure, unemployment, insolvency, bankruptcy, homelessness, addiction, sexually transmitted disease, divorce, imprisonment, insanity and death through malnutrition, disease, violence or suicide.”

After Chapter 1, we don't see a lot of extended descriptions of what was going on inside the author's head (I would expect that reliving some of those moments was one of the more difficult parts of writing the book, as staying well means staying out of those thought patterns). As in most autobiographies, we see the progression of a career in terms of the events of a lifetime (I did this, and then that happened, and my response was...), in a straightforward matter. But the events themselves speak volumes.

What is life like when you are checked into a mental hospital for treatment? How do you keep folks from finding out? How does one find friends and support when one of the symptoms is social awkwardness? How can you maintain a work schedule and the self-confidence needed to practice law when struggling with disabling hopelessness and depression? How do you balance medications for an illness that shifts and changes as pressures shift and change, and explain their often-perplexing side effects? How much extra work do you have to do because the focus sometimes isn't there, or the will to fight back is threatened? How do you find someone to share your life with? All of us have had challenges in our lives, and as I grow older I see that nobody gets through life without some period of struggle, but James Jones managed to work at the highest levels in his field with a severe condition with so many challenges that it easily could have left him sidelined.

For those with bipolar disorder, and other psychiatric conditions, this book is vitally important, because once you know it can be done, that someone can keep the illness at bay, and work at the highest levels of competence, in a very taxing and demanding field, that's part of the battle won. People with mental illness should not have to set aside their dreams for fear that others have a built-in bias against them from the very start. The author's wish is that his story be a way to help others find their path in spite of this treatable illness, and that those without it can begin to understand the obstacles and challenges people face when dealing with bipolar disorder.

Bias that leads to stigmatizing people with mental disorders can be very insidious, and even unconscious. Someone out of focus and off topic can be easily construed as lazy or inattentive. A few incidents of irritability can lead to the belief that someone has violent tendencies. Inappropriate euphoria can be seen as a drug abuse problem. Hopelessness can be viewed as lack of self-esteem, and the assumption made that the person can't handle anything complex or stressful. Professor Jones takes on the issue of stigma head on.

“Many families of those with mental illness are so embarrassed by their loved one’s disease that they are afraid to acknowledge their condition. Indeed, advocacy group leaders report donors who condition gifts to help those with mental illness on keeping the donations anonymous. The donors do so because they fear if their generosity becomes public people will think they or someone close to them has a psychiatric condition. Job applicants hide hospitalizations or gaps in employment from mental illness as they fear they will not be hired if they disclose their condition; attorneys are particularly unlikely to be tolerant.

To this day those who take the bar examination in many states must reveal if they have ever seen a psychiatrist or been treated for any mental disease.

Insurance companies traditionally have stigmatized relentlessly against those with mental conditions. For example, health insurers long have distinguished between those with “physical” and “mental” ailments to the severe detriment of the latter. Before the effective date of the 2008 federal mental health insurance parity law many Americans were treated differently depending on their type of illness. Insurers put limits on coverage for psychiatric conditions that were much higher than those for other illnesses. They restricted hospital inpatient days and outpatient visits for mental health treatment when they did not do so for those with cancer, heart disease, diabetes, or other “respectable” sicknesses. “

Hiding a mental illness, however, has its own costs. How do you explain incidents that look like something else without giving away your secret? How do you tell someone you've known for years of your problem? How do you find others who've gone through similar challenges? And, for James Jones, how do you tell your story to the world and face the fear that comes with it?

Since James Jones first told his story in an article in the Journal of Legal Education, some things have started to change on the awareness front, but also in the fact that he was then urged to write this book to get his story out to a wider audience. Some of his colleagues were displeased that he “came out” in public to tell his story, somehow feeling the stigma would rub off on them or the school, or even feeling betrayed he'd not told them earlier. But the vast majority of response was positive, and he is now involved with a number of groups working to help those with mental illness remove the stigma of years past, and find the treatment and support they need to actually reach their dreams.

Seeing a life through the eyes of the person living it is one way for us to get a better understanding of bipolar disorder and the havoc it can wreak in a life, not only from the disease itself, but from the stigma society has placed on it. In an era where we see snap judgments in politics, sound bites instead of conversation on issues, and bullying of anyone deemed to be “different,” this book is a wake up call. Those with treatable mental illness should be able to take their place in society, but for them to do so, we have to face up to our biases, learn to see the people in front us for who they are, rather than through some judgmental shorthand lens, and abandon our willingness to quickly write off anyone we do not immediately feel comfortable with. If we do that, we will learn to bear with the differences without making negative assumptions that stigmatize those already working hard to put their illness behind them.


  1. This is a great review of a brave book by a courageous man.

  2. Very interesting and helpful book.

    Mary Goldwin (Best New Tire Replacements)


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