PHILADELPHIA – Seeking to address issues of stigma surrounding bipolar disorder among patients and health care providers, a group of Canadian researchers and patient advocates commissioned a play aimed at giving a human face to someone who has succeeded at living with bipolar disorder.
The result was “That’s Just Crazy Talk,” an hour-long, one-woman performance by actor and playwright Victoria Maxwell, which premiered in performances in Vancouver and Toronto last July, was reprised several more times last year and this year, and is now available on DVD.
The show’s development also was part of a research project that measured the impact that seeing a performance had on stigmatized feelings among people with bipolar disorder, the health care providers who deal with bipolar patients, and people with relatives or friends with bipolar disorder.
Survey results showed that seeing the show reduced stigma, especially among health care professionals, Dr. Sagar V. Parikh said at the annual meeting of the American Psychiatric Association.
The researchers surveyed 84 health care providers who deal with bipolar patients, both before and after the providers saw a performance. The providers’ average scores, as measured on a standard inventory known as the Day’s Mental Illness Stigma Scale (J. Applied Social Psych. 2007;37:2191-219), fell significantly in several categories, including treatability, relationship disturbance, and hygiene. The magnitude of the average effect size in these domains was comparable to the effect of “8 weeks of treatment with a mildly or moderately effective intervention, such as an antidepressant, or psychotherapy,” said Dr. Parikh, a professor of psychiatry at the University of Toronto.
Courtesy Collaborative Research Team to Study Bipolar Disorder
"That's Just Crazy Talk" premiered in Vancover and Toronto in 2011.
The responses of patients with bipolar disorder and those of their family members or friends were not as robust, but their stigma levels also seemed to be reduced when they saw the play.
“People said that the play made them think again about decisions they had made about treatment, how to handle treatment at work or in relationships, and how to deal with stigmatizing comments,” he said in an interview. “We think we have an intervention that works.”
“That’s Just Crazy Talk” was commissioned by Dr. Parikh and his associates using funds provided by the Canadian Institutes of Health Research, and with the participation of the Collaborative Research Team to Study Bipolar Disorder, and the Canadian Network for Mood and Anxiety Treatments. The project grew out of a desire to address the stigmas surrounding bipolar disorder, and a hunch that this could be done through a patient’s story told in a comedic and dramatic way. Victoria Maxwell’s prior work served as a catalyst for the concept. Ms. Maxwell is a bipolar disorder patient who had, for several years, incorporated stories about her illness and dealing with it into her performances.
“We knew of her and her work, which made us think of this project,” Dr. Parikh said. Plus, “we had the idea that a personal story could have an impact. Someone’s individual story is often very compelling. We have seen a number of shows and movies where mental illness is portrayed in various ways.
“We were struck that something via theater might be a powerful way to tell this story, and we had the happy circumstance of knowing of Victoria Maxwell. We approached her about creating a play centered on her struggles. For artistic reasons, we deliberately did not give her a list of things to say, but after her play was written we compared it with the key issues. We were prepared to say that some things might need strengthening, but that wasn’t necessary. She dealt with relationships, job discrimination, treatment, [and] adverse effects, and she models how a patient can negotiate a treatment plan that works. She talks about how she deals with life.”
Photo Mitchel L. Zoler/IMNG Medical Media
Dr. Sagar V. Parikh
A discussion period between the audience and Ms. Maxwell has followed each performance.
After the initial performances and Dr. Parikh’s assessments last summer, Ms. Maxwell performed her show several more times last year, and this year in Toronto and Vancouver, with additional performances scheduled for later this year and in other sites such as Ottawa and Boston. Also, in April the Collaborative Research Team to Study Bipolar Disorder began making available a DVD of the performance; the first public screening of the DVD occurred in Toronto in early May. The DVD comes with an associated discussion guide, and a future edition of the DVD will include a separate video of a postperformance discussion session.