Alice Flaherty isn’t the only physician out there who both suffers from and treats mood disorders. Nevertheless, as this NY Times profile suggests, the 45-year-old with an M.D. from Harvard and a Ph.D. from MIT brings an interesting way of looking at and addressing these conditions, and it’s likely because she’s approaching the issue not from the traditional psychiatric “box” but from the standpoint of someone whose earlier bailiwick was something entirely distinct (movement disorders).
Dr. Flaherty, now 45, is director of the movement disorders fellowship at Massachusetts General Hospital and an assistant professor of neurology at Harvard Medical School. But those technical descriptors do not begin to capture the way she uses the racing mind of her manic phases to drive her ideas into forceful, highly personal treatments.
“Doctors tend to see patients with an overtone of category,” said the writer Rose Styron, whose husband, the late novelist William Styron, was a patient of Dr. Flaherty’s. “Alice never did. She understood Bill’s depression and his movement problems. But she really understood his needs, appetites, moods, guilts, sadnesses and potential pleasures.”
These days, Dr. Flaherty is preoccupied with the neuroanatomy of empathy — especially the mirror neuron system in the insula, cingulate and inferior frontal parts of the brain, which become active when one person witnesses another experiencing emotion. The routes to her interest were interconnected and highly personal.
“What made me empathic was my depressions,” she said recently. “People’s emotions were pounding me in the face. The mania is like wasps under the skin, like my head’s going to explode with ideas. But the depressions help the doctor aspect of me.”
The two things that are most striking are Flaherty’s embracing of her manic periods and her willingness to see her disease–tripped into existence after she gave birth to stillborn twins ten years ago–as an integrated part of her personality, her being.
The usual model is to tell people diagnosed with depression, anxiety, bipolar disorder and so on that their disease is distinct from “who they are”–something that sits on their mind, perhaps, rather than defines it. Also, the idea of allowing manic episodes to flourish untrammeled, and in fact attempt to put them to use, is generally a no-no: The preferred aim among psychiatrists is to rise from the depressions, nip a racing mind in the bud, and in general stay the middle of the road to the fullest extent possible. (The latter notion goes hand in hand with an apparent de-emphaziing of medications; the article does not explicitly say whether Flaherty takes any herself, but her preferred treatment modalities are much more oriented toward electrophysiological therapies than pharmacological ones.)
Flaherty’s ideas are refreshing because they are far more realistic. We don’t look at the moods of so-called normal people as distinct from their personalities; indeed, we merely accept that they constitute them. But those whose mood swings cross the hazy boundary into pathological territory are suddenly instructed that their moods are “a disease,” like a toxic gremlin leering over each shoulder in turn. This smacks of Cartesian dualism and really makes no sense, especially given the fact that bipolar people are repeatedly told that they will have their “sickness” for life (and rely on meds forever). If you’re going to tell people that they’re going to be who they are for the rest of their days, it makes more sense to frame it in those terms than it does to say, in a nutshell, “You’re sick and you can’t get better, so watch your ass and mitigate your gremlin with this or that chemical.” (If this sounds like an indictment of drug therapy, it’s not, but the reality is that drugs for bipolar disorder have limited efficacy, both directly and longitudinally, as anyone with the condition or a relative who has it knows too well.)
I very much got a charge out of this: “[Flaherty] writes during manias and edits during depressions.” This thought has bounced around in my head in the past, but never coalesced into something so simple and clear. Anyone who thinks that something produced in a manic or hypomanic episode, however powerful the verbiage, will pass muster without being edited later when the author is in a different state of mind might also believe that a cavalcade of drunken monkeys really can churn out Shakespearian works. There is nothing quite so brutal as a mania-soaked screed full of florid language and run-on sentences, especially when the rant is self-referential, which is usually the case.