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From One Extreme to Another: 'Homeland's Portrayal of Bipolar Disorder
December 14, 2012  | By Monique Nazareth  | 94 comments

By Monique Nazareth

Since sweeping the 2011 Emmy Awards, Showtime's Homeland has been on the must-see TV radar screen. Its protagonist, CIA operative Carrie Mathison, as portrayed by actress Claire Danes, is a strong-willed, intuitive, dedicated agent who's hell-bent on preventing another 9-11. She also has bipolar disorder, and much of the show's first season explored her battle to suppress her symptoms and keep her illness a secret from her employers.

As the series progressed to Season 2, and Carrie has been proven right, time and again, rather than delusional, her stresses — at least in regard to her bipolar disorder and paranoia — have become less acute. But the disorder remains a key component of her personality that the show will no doubt revisit in the future.

The National Institute of Mental Health (NIMH) defines bipolar disorder as a brain disorder that causes unusual shifts in mood, energy, activity levels and the ability to carry out day-to-day tasks. According to the NIMH, bipolar disorder affects 2.6 percent or approximately 5.7 million adults in the U.S.

Meredith Stiehm, a lead writer and consulting producer for Homeland, grew up with a sister who has bipolar disorder. In a New York Times opinion piece last January, Jamie Stiehm praised Homeland as having “done us all a public service: perhaps, with the show’s glowing reception, Americans can finally talk openly about bipolar disorder.” 

Mental health organizations seem to agree with Stiehm’s assessment. Courtney Reyers of The National Alliance on Mental Illness praised Homeland as doing “one of the best jobs of portraying mental illness in modern television today with compassion, clarity and responsibility attached.” 

The show also recently received a Voice Award. Sponsored by the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, and Center for Mental Health Services (CMHS), the award recognizes consumer and peer groups, as well as TV and film professionals, for educating the public about behavioral health problems.

“I think part of the image that it’s giving the public, is that a person can have a mental illness and still function," said Wilma Townsend of CHMS. "It is a good educational piece for both the general public and people who have a mental illness."

But just how true to reality does the show portray bipolar disorder? Dr. Ellen Leibenluft, Chief of the Section on Bipolar Spectrum Disorder in the Emotion and Development Branch of the NIMH says Carrie’s bipolar disorder, as characterized by episodes of mania and depression, were “extremely well portrayed.” 

Leibenluft cites the scene in the Season 1's penultimate episode, "The Vest," in which Carrie — deprived of her medication while being treated at the hospital for a concussion and facial lacerations — is manically seeking a green pen.

Carrie: “A green pen is what I want."

Nurse: "And blue is what is available."

Carrie: "Green is important, Green is necessary. It doesn't make sense if it isn't green. And it's really not an unreasonable request..."

Saul (approaching): "Carrie?"

Carrie: "Saul. Thank God. My green pen is dry. I’ve asked four, five, six times for a new one but there’s no understanding. They offer me blue, they offer me black. I mean is green so hard? Is green elusive? I mean my kingdom for a fucking green pen.”

A few moments later, Carrie has turned her full attention to the situation with Brody, the former American prisoner of war whom she alone in Season 1 suspects is aiding al-Qaeda with a planned attack against the U.S.

“She has fast speech and her thoughts are clearly going fast," said Dr. Leibenluft. "She very focused on this goal of figuring out what going on with Brody — she’s obsessed with it. In the context of all else, I thought that was a very good portrayal of mania. Similarly when she’s depressed and she can’t do anything, and she feels somewhat suicidal that’s also a very accurate portrayal.”

To the question of whether Carrie functions because of or despite her mental illness, Dr. Leibenluft said, “There is a bit of a debate in the literature as to whether certain temperaments or personalities do put people at risk of bipolar disorder. ... I guess I would say Carrie is this obsessive, intense, intuitive, very intelligent person who also has bipolar disorder.”

Danes told NPR’s Morning Edition in September that she turned to YouTube to research the character. “There was a lot of footage of people who recorded themselves when they were in manic states. I think they were probably up in the middle of the night and lonely and, you know, needed to talk. So they talked to the camera. So I gorged on sort of manic confessionals on YouTube."

Dr. Leibenluft was not surprised that Danes' best sources of inspiration were found online. Given privacy concerns, she said it’s unlikely Danes would have had access to patients being treated for bipolar disorder to see what mania looks like first-hand. 

One decision Dr. Leibenluft did question was the scene in Season 1's finale, where Carrie opts to undergo electroconvulsive therapy (ECT). “The only way it would be realistic if she’d tried many medications first,” said Dr. Leibenluft. "The preference is to treat the mania with medications, and there are also so many more medications now than there use to be decades ago."

Dr. Leibenluft does concede that the story doesn't delve deep enough into Carrie's medical history to discount the choice. “We don’t know her whole history. It’s possible she’s been through many drug trials in the past.” She added that, “[ECT] is extremely effective and one of the most effective treatments around.”

Dr Leibenluft — who says she's a fan of the show not only because of the inclusion of bipolar disorder but the general plot, engaging characters and excellent acting — also praised Homeland for portraying the family as being important to helping someone with bipolar disorder.

While mental illness still carries a stigma, "that is changing," says Dr. Leibenluft. "Things have gotten a lot better, with people being more open with bipolar disorder and public campaigns. But I think there are still issues in terms of people being comfortable with these illnesses being brain diseases. This is a disease of the most complex and arguably most important organ of our body, the brain. I do think there's been a lot of progress and think it is helpful to have relatively realistic portrayals of it."


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