Bipolar Disorder
and Sports

1 Jun 04

Here's a good one for sports fans.

Every so often I read about an athlete who has been disqualified from a game or race. Sometimes the athlete has been taking a banned substance, and sometimes they claim that they have taken an innocent drug that mimics a banned substance.

I read about it, but what does that have to do with me. Well, recently I've been able to exercise consistently because I've finally found medication that more or less stabilises me. The improvement in my capabilities has been pretty impressive - in the last six months I've gone from someone who was decent but not great in bicycling or running, to someone who is considering entering adventure or duathalon races because I now think I have what it takes. I won't win anything because I'm just not that good, but I now figure that I've moved into the category of frontrunners - those that consistently do well and finish somewhere near the front of the pack.

What I've been thinking is, why can't I use my disability to my advantage in these races. Over the years I've been able to map my hypomanic and depression cycles and their effects pretty well, and one of the interesting side effects of being hypomanic (mildly manic) is that I am quite a lot better at exercise / sports. I am able to lift heavier weights, ride faster, and run faster. I have greater endurance when I am exercising and there seems to be an increase in tolerance to pain and fatigue - they don't affect me as much.

The effect is consistent; it happens whenever I am hypomanic. Moreover, in most of my hypomanic states, but I do not act substantially different from normal. Unless you knew me really well, you wouldn't notice.

So I was thinking - why don't I trigger a hypomanic episode before the races. The procedure is pretty straightforward for me - I can either get only a few hours of sleep the days before the race, or I can up the dosage of my antidepressant, or both. It will work. And because of the way my body reacts to antimanic drugs, I can use them to come off the hypomanic high within twelve hours after the race. So it's safe for me to do so.

I still won't win any races because my performance won't increase that much, but I figure that doing this can move me at least a few places up the rankings in a race. I would certainly be able to give people who are usually better than me a very good run for their money and I have a decent chance of winning them.

The question is, is this ethical. A second question is is this the same as using drugs such as steriods. Someone else can write up the argument on why it is unethical etc., but I thought I'd be the devil's advocate and write in defence of such a strategy.

One of the arguments people would use is that I am using drugs to enhance my capabilities. But that isn't true. Being hypomanic IS a natural state for me, just as being tall is a natural state for other people. I can point to a history of having hypomanic episodes for the last twenty years without being on drugs or any other stimulants. And in fact, before I was diagnosed as being bipolar, I thought that was the normal way things were. So the capabilities that I inherit while I am manic are indeed part of my natural capabilities. I am not doing anything wrong in using those capabilities.

But you aren't normal when you are hypomanic, some may argue. But I can equally argue that athletes aren't normal either. We may consider their attributes such as being able to run fast as a good thing to be respected, but it certainly doesn't make them normal. Moreover, if being normal was the criterion for sports, why are all the basketball players permitted to be so much taller than the normal person. Shouldn't that be banned too. My hypomania is no different and no more or less a variation on the spectrum of human normality than is being very very tall. The fact that it is has no visible manifestation like being tall or being well muscled does doesn't make it any less a human trait.

But what about using drugs to trigger the manic episodes. There are two answers to this. The first and more technical answer is that Wellbutrin (which is what I take) is not considered by any medical or sports establishment to be a strength or fitness enhancing drug. And it certainly isn't one - as any study with a normal control group is likely to show. The fact that I can use it to trigger a hypomanic episode and normal people can't do that is a happy happenstance for me, more in keeping conceptually with the idea that some East Asian herb (and why does it always have to be an Asian herb?) is used by one athlete to boost endurance. That herb isn't banned, so why should Wellbutrin be banned. Why shouldn't I take any advantage that comes my way.

If studies of Wellbutrin shows it it to be a fitness enhancer, then it should indeed be banned. Which brings me to the second part of my answer. I don't need a drug to trigger a hypomanic episode. All I need to do is to not get much sleep for a few days prior to the race and I'll become hypomanic. The lack of sleep won't affect my performance on the race - that much I know from experience - and I'll still get all the benefits of being hypomanic. I admit that at present not sleeping isn't quite as reliable a trigger for the hypomanic episode as upping the antidepressant, but by trying it a few times and monitoring what happens would allow me to fine tune missing sleep so that it is a very reliable trigger.

So I'm wondering why shouldn't I use my disability, which gives me natural fitness capability, to my advantage. It may sound like a cheat, but it isn't actually one at all. So, should I start doing it to put an edge on my performance?

An e-mail response to this article
“I was reading your theory on training for sports competitions. I believe that if you are truly healthy enough to manipulate your abilities to your advantage, why not? If I had a passion for that activity, I would try my best to be my best. Your disease belongs to you and is who you are so why not USE it? You have done the hard work to learn about it and understand it as well as you can - now use what you've learned!”