Divining Disorder

I kicked off my shoes and sat them next to the door of the temple, glad that I remembered not to wear the socks with a hole in the toe.

Inside, I was alone in the large open room. Hidden speakers softly filled the air with the sound of monks chanting in Vietnamese. The walls and corners were awash in color, from brightly hued banners to vivid murals depicting sacred scenes.

I mimicked what I’d seen others do on earlier visits: I walked to the front of the room and dropped a dollar into a slot for donations. I lit a stick of incense and stuck it upright in a box of sand.

I walked to the center of the room and turned back towards the front to face the enormous Buddha behind the altar. I knelt on the floor and looked up, suddenly realizing that he was gazing right into my eyes. I whispered, “Please give me strength,” and quietly wept.

Epiphany or Delusion?

I am not Buddhist. But I am bipolar. Two years ago, I was diagnosed with bipolar I disorder after over 20 years of being treated for major depression and anxiety. In retrospect there were signs over the years that I was actually bipolar, but it wasn’t until I experienced a severe manic episode lasting months that the true nature of my condition became clear.

It was during that episode that I started frequenting the Buddhist temple near my house. I also began to revisit the Catholic faith of my youth, before my personal and academic explorations into the nature of what makes us who we are had rendered me a nonbeliever.

At first, I approached my renewed interest in religion and spirituality much as an anthropologist would examine the belief systems of some foreign culture. What psychological and sociological factors drive people to believe what they do? How did historical forces shape the spread and evolution of major religions? Are our brains hardwired to predispose us to believe in…something?

But then my thought processes started to shift. My mania was increasingly filling me with energy. I felt stronger and faster. My senses were heightened; everything had suddenly switched to high definition. My mind raced, making all sorts of creative and meaningful connections that I wanted to share with those around me—if they could just keep up when I tried to explain things to them.

Was this how religious prophets felt? Was I some kind of modern-day prophet? Was this how the Buddha or Jesus felt? Was I…?

I was afraid that if I started talking like that, I’d be labeled schizophrenic and get put away somewhere. Better to write those thoughts down. And in case anyone wanted to read my notebooks, I’d better obscure the thoughts by using mirror writing—like Leonardo da Vinci. I didn’t even know I could do that.

BPD and Hyperreligiosity

Many individuals with bipolar disorder experience hyperreligiosity during manic episodes. The number can vary by country in relation to the prevalence of religious vs. secular attitudes. In the U.S., an estimated 15 to 22 percent of bipolar individuals with mania experience religious delusions, such as thinking that demons are watching them or that they are Christ reborn. Short of frank delusions, hyperreligiosity can be hard to identify among the fervent of faith.

Many people turn to the comfort of faith to help them through trying times; an uptick in religious thought and activity can be viewed as a normal response to illness. It’s only when behavior falls outside of social norms that it becomes concerning.

Kanye West is arguably an example of the difficulty of this distinction’s playing out against the backdrop of artistry and fame. West’s public on-again-off-again approach to medication for bipolar disorder has been linked to increases in erratic behavior.

While West has referenced God and Jesus throughout his career, his adoption of the nickname “Yeezus,” the statements he’s made about his single titled “I Am a God,” and his leading of public and private worship services have been alternately interpreted as a God complex, an artistic device, or an evolution of his personal faith.

I never thought I’d have something in common with Kanye West. Yet there I was, on the verge of becoming a sort of dime-store Yeezus.

Religion in the Brain

In the past few decades, several highly publicized research studies have claimed to find “God spots” in the brain, distinct areas that are responsible for religious cognition.

Subsequent research has thrown cold water on the idea of a single God spot, instead suggesting that such complex phenomena as religiosity and spirituality involve networks of brain nuclei responsible for differing aspects of such experiences.

The parsing of brain areas contributing to facets of religious cognition also appears to explain a distinction drawn by researchers between religion and spirituality. Religion is typically defined as a system of beliefs and practices to approach sacred or divine truths. Spirituality has more varied definitions but is generally associated with feelings of peacefulness, life purpose and meaning, and spiritual transcendence.

The distinction between the two may map onto different brain networks. For example, spirituality may draw from parts of the parietal lobes associated with awareness of body state and multisensory integration. These areas also appear to be involved in awareness of extrapersonal space and spiritual transcendence.

In contrast, religion may draw more from brain areas involved in semantic processing, storage, and cognitive control. For example, the ventrolateral prefrontal cortex and parts of the temporal lobe appear to be involved in storing and retrieving religious beliefs, while the dorsolateral prefrontal cortex and anterior cingulate cortex appear to be involved in cognitive control and the interpretation of religious beliefs. The medial prefrontal cortex, along with other areas, appears to be involved in “theory of mind,” or the rationalization of mental states, in relation to religious beliefs.

Both religion and spirituality, however, may link into the brain’s emotion and reward circuitry. The ventromedial and dorsomedial prefrontal cortices, along with the nucleus accumbens, are involved in evaluating beliefs and reinforcing religious thoughts and practices as rewarding experiences—ironically, the same circuitry activated by sex, drugs, and rock ’n’ roll.

But such a general portrait of normal brain function doesn’t explain hyperreligiosity during bipolar mania. A clue, however, might lie in reports of patients suffering from a very different type of neurological disorder.

A Lifetime Believer Unmoved

I’ll call him “Carl.” Carl was a distinguished elderly gentleman and a decorated veteran of World War II. He still worked as an engineer on consulting projects but had been withdrawing from aspects of his job and personal life as his symptoms progressed. Carl had Parkinson’s disease.

His wife explained to the neurologist that he hadn’t pulled away from everything, “just social parts of his work, some physical stuff, and unfortunately his private religious devotions.” The neurologist asked what she meant. She explained that Carl used to read his Bible and pray all the time but had been doing so less and less.

Carl shared that although he had been devout all his life, he had completely lost interest in religion. In fact, he said he wanted to believe but found it difficult to access his religious memories, experiences, and feelings. Despite being able to easily answer questions about religious doctrines and ideas, Carl said he now found faith, “hard to fathom.” This wasn’t an intellectual deficit, but a deficit in belief.

The “God Chemical”?

Parkinson’s disease patients have a deficiency of neurons that produce dopamine. Specifically, they experience a degeneration of dopaminergic neurons in the substantia nigra and adjacent ventral tegmental area of the brainstem. The substantia nigra sends dopamine to a subcortical area called the striatum, where a decrease in dopamine release impedes the initiation and coordination of muscle movement.

The ventral tegmental area, however, projects dopamine to the nucleus accumbens and the prefrontal cortex. It has been understood for some time that this dopaminergic input (or lack thereof) affects such functions as working memory, attention, stress, and reward. Less well known, however, is the impact of these dopaminergic cells on religiosity.

Since Parkinson’s patients experience decreased dopamine in prefrontal circuits while bipolar mania drives a surfeit of the neurotransmitter in the same areas, it is compelling to think that dopamine may be the fuel for religiosity in the brain. It also explains why, when my dopamine levels were tamped down with antipsychotic medications, my hyperreligiosity was, too.

The Road to Damascus

One of the many things I was obsessed with during my hyperreligious mania was revisiting the history of Saint Paul. In my Roman Catholic boyhood, I had to choose a confirmation name based on a saint with whom I felt some affinity. I chose Paul.

I liked Paul. He was smart, stubborn, and hard to win over. He converted to Christianity after being struck temporarily blind by a bright heavenly light on the road from Jerusalem to Damascus. I was a believer, but I had a lot of questions. The kind of questions that always seemed to prompt the priest to answer, “That’s just a matter of faith.” I liked the idea of naming myself after someone who wasn’t convinced until God smacked him in the face.

Some have even suggested that Paul’s light and conversion were manifestations of a primary or mood disorder or associated psychotic disorder.

Now that I’m stable on bipolar medication and back to my atheist self, I wonder what would happen if I were to suddenly experience a heavenly intervention like Paul? I’d probably think that I needed to up my medication.

Frankly, I’d probably think the same thing if I had any kind of change of heart regarding faith.

Has my experience inoculated me against religion? Perhaps. At the very least, I think I’ve become more stubbornly skeptical and a harder nut to crack when it comes to faith. Choosing Paul’s name turned out to be more prophetic than I ever could have imagined.

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