Carrie Fisher’s legacy shines bright in the galaxy.

I’m not talking about the trail she left as Princess Leia, the rebel Star Wars heroine who held iconic movie status for just over 40 years. I’m talking about her staunch advocacy for mental health, the brutal honesty — and humour — with which she spoke of her Bipolar Disorder.

Every life has its highs and lows — but perhaps none more so than a person who lives with this condition.

Bipolar Disorder — formerly known as Manic Depressive illness — is a mood disorder, affecting 2–3% of the population. Characterised by extreme shifts in mood, thoughts, energy and activity levels, it can severely impact the ability to carry out day-to-day tasks.

During the high periods, people may feel invincible, super-energised, high-wired and without a need for sleep; grandiose about their prospects and plans. In this manic state, people are at risk of impulsive and destructive behaviours, especially with money, alcohol, drugs and sex.

Then comes the depression, the crashing immobilising lows that can drive people to suicide.

A key difficulty with a Bipolar diagnosis, and people’s acceptance of it, is that the highs can be highly productive and great (if risky) fun, and this can lead people to abandon the medication they need to maintain emotional stability — and to stave off the depression.

As Fisher described it in her humorous 2008 memoir, Wishful Drinking, based on her one-woman show of the same name:

“You know how most illnesses have symptoms you can recognize? Like fever, upset stomach, chills, whatever. Well, with manic depression, it’s sexual promiscuity, excessive spending, and substance abuse — and that just sounds like a fantastic weekend in Vegas to me!”

And this.

“I named my two moods Roy and Pam. Roy is Rollicking Roy, the wild ride of a mood, and Pam is Sediment Pam, who stands on the shore and sobs. (Pam stands for “piss and moan.”) One mood is the meal, and the next mood is the check.”

Bipolar Disorder has a strong hereditary factor; Fisher claimed her father Eddie Fisher was Bipolar. In her book she says he once bought 180 silk suits in Hong Kong; together they took drugs and were like badly-behaved children.

Although she believes the early signs of her illness were apparent in her teens, it wasn’t diagnosed until 24. She didn’t really accept it until four years later when she overdosed, then sobered up. “Only then,” she recently wrote in the Guardian, “was I able to see nothing else could explain away my behavior.”

A self-confessed “bad-ass”, there have since been well-documented troubles with drugs, alcohol and relationships. She was psychotic at times and hospitalised. And the struggle went on: while her symptoms might have faded a little with age, the life course persistent nature of Bipolar Disorder means it never really sets you free.

As a psychologist, I am aware of Bipolar Disorder’s significant fallout. It is chronically difficult for those who live with it and hugely taxing on partners and families. Every mental health professional has witnessed the distress of someone raised by a wildly unpredictable mother or father (often with undiagnosed Bipolar), who forced them to be the parent too young, too often — and who left them to grow up anxious and insecure about the emotional world.

Of course, treatment helps. But it’s also true that long-term compliance with medication and a highly developed awareness of early warning signs (and strategies to address them — fast) is often all that stands in the way of an emotional breakdown and all its consequences.

On the positive side, though, history is littered with examples of people who have used Bipolar productively, have achieved wonderful things creatively; or who have simply demonstrated, as Fisher said, the “tremendous amount of balls” it takes to live with it. “They should issue medals, along with a steady stream of medication.”

If there was a medal for those “balls”, then Fisher earned it. She embraced Bipolar— “I’m so sane about being crazy” — and, with openness and humour, threw a lifeline to others like her.

Now, in death, there’s finally respite from what she once described as “bedlam” in her head. As so many of the tributes have said, Rest in Peace. For Fisher, and those who loved her, there’s an ironic truth in that.

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