Stigmatizing the Mentally Ill

“Hatred Often Lurks in the Shadows of Mania” by Dr. Julian Lieb (Commentary, Feb. 16) is an example of misinformation which is presented in an illogical manner and stigmatizes the mentally ill. As a practicing psychiatrist for over 25 years, it has been my experience that those afflicted with manic-depressive disorder (or bipolar disorder, as it is currently named) are no more filled with hatred than the population in general. It is those who have been victims of abuse by parents and society who are most filled with rage and paranoia. In contrast, many of our greatest writers, artists and composers have suffered from bipolar disorder.

It is illogical to imply that because many manic-depressive people are paranoid, many paranoid people are manic-depressive. People with bipolar disorder tend to show marked variability in mood with peaks of illness characterized by psychosis and disorganization. The sustained paranoia that is acted out by a Hitler or a Stalin is far more suggestive of a paranoid personality disorder that can exist independently of, or in addition to, mood-related illness.

To state that “the paranoid delusions of manic-depressive illness are as infectious and as virulent as a deadly microbe” is absurd. It totally takes away responsibility for morality from the followers, and it suggests that most of us cannot distinguish reality from psychotic delusion. Again, it is those with sociopathic and narcissistic character structure who succeed in gathering and influencing vulnerable followers. It’s time to stop projecting our own hatred on the mentally ill who are struggling enough to live balanced and productive lives.

BEVERLY FEINSTEIN MD

President, Southern California

Psychiatric Society, Los Angeles