Does ABC’s “Black Box” Portray Bipolar Accurately? Fairly?

Does ABC’s “Black Box” Portray Bipolar Accurately? Fairly?

For weeks people have been asking me my opinion of ABC’s new show Black Box. According to Wikipedia, about 6.9 million people watched Black Box’s series opener and it seems like about half of them have contacted me about it.

People are wondering about this show because Black Box’s lead, Catherine Black, (played by Kelly Reilly) is a neuroscientist who has bipolar disorder. In fact, the first episode of Black Box details the Black’s descent (ascent?) into mania after she stops taking her medication (which includes lithium, an anticonvulsant, and an antipsychotic).

In short, I think Black Box tries for accuracy and they hit it here and there but, as with all television shows, it’s dramatized and so bipolar disorder isn’t terribly accurately, or fairly, portrayed.

Black Box’s Portrayal of Bipolar Mania

As I stated, in the first episode of Black Box, Black goes into bipolar mania. According to the show, she’s fairly stable on meds but she decides to go off of them when she needs inspiration for a speech. Immediately after missing a single med dose, she becomes very inspired, and by the next day she’s in full-blown bipolar mania which includes hypersexuality and psychosis. Admittedly, some of the manic scenes do ring true to real manic (or hypomanic) feelings, but everything surrounding those scenes certainly reads false.

Because, of course, people don’t become manic hours after missing a single dose of medication. If that were the case, we’d have manic people all over the place as people do miss their doses from time to time. More than likely, missing a dose of medications will just make you feel like crap as you experience some withdrawal effects.

Moreover, Black’s mania only lasts about three days and is magically corrected, instantly, by her medication. (Ah, if only life were so easy.) And while there is a scene where her therapist says she’s becoming depressed, we don’t see much of the corresponding depression that almost always follows a manic episode.

Black Box’s Portrayal of Bipolar Depression

There is one scene where Black seems like she may kill herself but the act is brought on by life stressors and doesn’t appear to be part of a depression per se. She really shows no signs of being depressed other than one moment’s desire to die.

Black Box’s Portrayal of Medication and Medication Compliance

ABCs new drama, Black Box, shows a neuroscientist with bipolar disorder. But is this portrayal of bipolar accurate or fair?

Kelly Reilly, Image by Georges Biard, Wikipedia

For once, we see a bipolar character on more than one medication for bipolar, which, of course, is the norm, rather than the exception. That is good. She even names the meds and they’re a real combination that someone might use (even if she can’t pronounce them correctly, which is odd, for a neuroscientist). That’s great. But what isn’t so great is everything surrounding the medication.

There’s all sort of nonsense. We’re supposed to believe that this woman is a world-class neuroscientist and yet she has a “history of noncompliance” and, according to the above example, becomes acutely manic moments after missing a single dose of medication? We’re supposed to believe that this has been her life and she’s still managed to become a world-class neuroscientist? We’re supposed to believe that she has been repeatedly psychotic and become this successful and published books? We’re supposed to believe that a neuroscientist, one that actually works with people with serious mental illnesses every day, just decides to stop her medication willy-nilly, repeatedly?

Yeah, I don’t think so.

Is Black Box’s Portrayal of Bipolar Fair?

There are real issues faced in the show and some of the scenes do really ring true. The scene where she tells her boyfriend that she has bipolar disorder is quite good, for example, so clearly there are bipolar consultants hanging around the writing room.

That being said, it tends to make people with bipolar disorder seem like mad geniuses with no self-control and little insight. While medication noncompliance certainly is an issue in the community, certainly a woman with that kind of career, with that kind of success on medication, it unlikely to have such issues. Someone in her position would understand the value and meds and not toss them out twice in one episode.

And while people in a manic state do become hypersexual, not everyone just bangs the nearest driver or neurosurgeon, cheating on their partner. And while people in a manic state are known to make poor choices, after a lifetime of practice, there is some moderation that happens there. And when people with bipolar who do have major, lifetime, successful careers, they do tend to (by definition) prioritize said careers and not show up at work manic. So, in short, I think the show plays into the stereotypes that:

Should You Watch ABC’s Black Box?

Well, hey, that’s up to you. It actually strikes me as being not a bad little show and might get some people talking about some of the issues surrounding bipolar disorder, such as the results of coming out as bipolar to friends and family. That said, I wouldn’t look to Black Box as your guide to bipolar or neuroscience but it is better than a lot of other portrayals of bipolar disorder that you might see.

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