Sam Klions, Haylee Stiffler, Brady Kesterholt

Dr. Bartel

Intro to Psychology

20 April 2018

Carrie Fisher and Bipolar Disorder 1

The late Carrie Fisher, commemorated for her role as Princess Leia in the original Star Wars

movies, was diagnosed with manic depression as a young adult. Now known as the “bipolar and related

disorders” class by the DSM, her symptoms resembled those of bipolar disorder 1, a more serious form of

the illness. Bipolar 1 is characterized by intense, prolonged periods of mania and depression, more so than

bipolar 2. Individuals experience manic episodes lasting at least a week, or episodes so severe they

require medical intervention. During this time period they may have high self-esteem, feel energetic,

euphoric, jumpy, or agitated, have restlessness with trouble sleeping, talk quickly, and have racing

thoughts. They might also engage in impulsive and reckless behaviors such as drug use, sex, and spending

money (“Bipolar”). Manic episodes are typically followed by depressive episodes, which can last several

weeks. Individuals may feel despondent, have low energy, have difficulty sleeping or sleep too much, and

have suicidal thoughts or actions. It is possible for some to experience both manic and depressive

symptoms at the same time; for example, feeling depressed yet having high energy and activity levels.

During some manic and depressive episodes with bipolar 1, individuals may have psychosis in which they

experience delusions and hallucinations (“Bipolar”).

Bipolar disorders can be difficult to diagnose. When a patient presents with what might be a

bipolar disorder, doctors may first do blood tests and imaging to rule out any substance abuse, thyroid

problems, or other physical conditions (Krans). A psychologist will then do a mental health evaluation,

asking questions about various symptoms, the length and severity of those symptoms, as well as family

history. Psychologists might also talk to family and friends to gather more information about the patient’s
behavior. For a patient to be diagnosed with bipolar disorder, they must experience at least one manic

episode and one depressive, or mixed episodes with both manic and depressive symptoms. As mentioned

earlier with bipolar disorder 1, manic episodes must last at least a week or be severe enough for

hospitalization. Additional psychotic symptoms are also an indicator of bipolar 1. If the patient shows

multiple symptoms for both depression and mania, a diagnosis can be made (Krans).

The cause of bipolar 1 is unclear, but evidence points to “nature” factors such as genetics and

physical abnormalities. Bipolar disorders have been shown to run in families, although not all family

members end up having it (Bressert). The frontal cortex, responsible for decision making, has been shown

to shrink without treatment for the disorder. There is also an imbalance of neurotransmitters such a

serotonin and norepinephrine (“Brain”). According to Dr. Steve Bressert, if a single parent is bipolar, the

child has a 15% greater chance of developing the disorder; if both parents are bipolar, the child now has a

40% chance. With identical twin studies, there is a 40-70% chance that the second twin will show

symptoms of bipolar disorder after the first has been diagnosed. Although it is widely believed that there

are several genetic components at play, environmental factors such as stress or abuse can trigger episodes

or increase the severity of the disorder, like in bipolar disorder 1. In Carrie Fisher’s case, her drug use and

the pressures of being famous could have contributed to her most intense episodes.

Carrie Fisher dealt with a number of symptoms of bipolar 1, both manic and depressive. During

depressive episodes she often could not get out of bed and had experienced psychotic breaks which left

her hospitalized. She said she had paranoid delusions where she was the serial killer Andrew Cunanan

and the police searching for him, and had hallucinations of a “beautiful golden light” radiating from her

head. In addition, during her manic episodes she was incredibly impulsive, saying that once when she

stopped taking her medications she had a “weeklong escapade that ended in a tattoo parlor” (“Carrie” 1).

She also traveled from Australia to China because China was “only six-inches away” (“Carrie” 3). Her

mood swings were nothing short of extreme; her friend Griffin Dunne said that once Fisher mentioned a
rug he had borrowed from her and lost four years prior, she was “furious about it as if it had just

happened.” A few days later, the rug was no longer a big deal (“Carrie” 2). The psychosis and intense

nature of her symptoms strongly resemble those of bipolar disorder 1.

Bipolar disorder 1 cannot be treated, but it can be managed. A common medication to treat

psychotic and manic symptoms is lithium carbonate. It is not entirely known how lithium works, but

studies have shown it increases intraneuronal metabolism of catecholamines by altering sodium channels

in neurons, strengthening nerve cell connections in the brain (“Lithium”). A combination of other

antipsychotic medications and antidepressants can also be used, but antidepressants have been shown to

trigger manic episodes (Nordqvist). Fluoxetine, or Prozac, is a selective serotonin reuptake inhibitor that

treats the depression, obsessive compulsions, and anxiety that many individuals with bipolar 1

experience. Individuals can also undergo psychotherapy, such as interpersonal and social rhythm therapy

where patients develop a consistent schedule to lessen mood swings; cognitive behavioral therapy where

negative thoughts and behaviors are replaced with positive ones; psychoeducation where patients are

educated about their disorder, increasing awareness of their thoughts and actions; and family-focused

therapy where the patient receives support from loved ones to help them stick to treatment plans

(“Bipolar”). There is also electroconvulsive therapy, used mainly to treat depressive episodes, where

patients are anesthetized and given an electrically-induced seizure, thought to “reboot” the brain

(“Information”). Lithium and similar antipsychotic medications have been shown to be very effective in

decreasing symptoms. The effectiveness of therapies depends on the willingness of the patient and their

individual needs, but can help to improve their lifestyle. Electroconvulsive therapy has been controversial

and ineffective in some patients, but has had some benefits with severe cases of depression or mania

(“Information”).

As Carrie Fisher once said in an interview, “bipolar disorder can be a great teacher. It’s a

challenge, but it can set you up to be able to do almost anything else in your life” (“Carrie” 3). Although
Carrie had struggled with bipolar disorder 1 since she was young, she used her experiences and her voice

to not only increase public awareness, but to inspire others to get help.

Works Cited

“Bipolar Disorder.” National Institute of Mental Health.

https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

“Brain Differences in Bipolar Disorder.” PsychEducation.

http://psycheducation.org/the-biologic-basis-of-bipolar-disorder/1035-2/

Bressert, Steve. “Causes of Bipolar Disorder.” PsychCentral.

https://psychcentral.com/disorders/bipolar/bipolar-disorder-causes/

“Carrie Fisher and Manic Depression.” Healthy Place: For Your Mental Health.
 https://www.healthyplace.com/bipolar-disorder/articles/carrie-fisher-and-manic-

depression/carrie-fisher-s-account-on-bipolar/

“Information about ECT (Electro-Convulsive Therapy).” RC Psych.

https://www.rcpsych.ac.uk/mentalhealthinformation/therapies/electroconvulsivetherapy,ect.aspx

Krans, Brian. “Diagnosis Guide for Bipolar Disorder.” Healthline.

https://www.healthline.com/health/bipolar-disorder/bipolar-diagnosis-guide

“Lithium for Bipolar Disorder.” WebMD.

https://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-lithium#1

Nordqvist, Christian. “What You Should Know About Bipolar Disorder.” Medical News Today.

https://www.medicalnewstoday.com/articles/37010.php