Mailes Kanapi, living with and beyond bipolar disorder

Mailes Kanapi, living with and beyond bipolar disorder
By Walter Ang
November 2013
Look Magazine

Actress Mailes Kanapi had been an insomniac since she was a child. "I had lots of energy. I did everything. I used to do writing projects and I would write really fast. I was always the life of the party. I had extreme courage. I felt like Superwoman. I only hated that I couldn't sleep."

But it wasn't super powers that gave her such an energetic life. In 2006, she was diagnosed with bipolar disorder. "It's a psychiatric diagnosis for a mood disorder," says Dr. Ronald Elepaño, chief consultation-liaison psychiatry fellow of The Medical City hospital's Department of Psychiatry. "People with bipolar disorder experience prolonged episodes of mania that alternate with prolonged episodes of depression. Mania and depression are the two 'poles' of 'bipolar.'"

As it turned out, Kanapi had been in a manic state for quite a long time. "I felt everything intensely. Sometimes it would be unbearable." The diagnosis has helped her find appropriate treatment that's put her in "a good place right now" but getting there has been fraught with complexity and difficulty.

Fears disappear
Kanapi got into acting shortly after enrolling in the theater program at University of the Philippines. She started landing roles in different productions with Dulaang Unibersidad ng Pilipinas, the defunct Dulaang Talyer, and Tanghalang Pilipino. She hasn't stopped since.

She won the 2010 Philstage Gawad Buhay! for Outstanding Female Lead Performance in a Play for her work as Josefina (Masha) in TP's "Tatlong Mariya," a Tagalog adaptation of Chekhov's "Three Sisters." She followed this up with playing Tamora in DUP's Tagalog adaptation of Shakespeare's "Titus Andronicus" and, last year, as Chabeng in Mario O'Hara's "Stageshow" for TP, for which she won the 2012 PGB for Outstanding Female Featured Performance.

She's recently been doing more film work. She's part of "Juana Change The Movie," a satirical film based on the Youtube character played by Mae Paner (Kanapi's castmate in "Stageshow"), which will be out in theater this May.

"When I act, all my fears disappear." While acting is where she feels most comfortable, it's neither a crutch for her disorder nor is it immune to her condition's effects.

Diagnosis
The road to a final, definitive diagnosis of bipolar disorder is usually protracted. "It's not an easy condition to identify. Usually, though not always, there is an initial diagnosis of depression before an eventual diagnosis of bipolar disorder," says Elepaño.

In Kanapi's case, given her prolonged manic episodes, she was first misdiagnosed with attention deficit hyperactivity disorder (ADHD) in the early 90s. She had just given birth to her son and fears of being unable to take care of him led her to seek medical attention.

She didn't feel any improvements but partly due to a string of unproductive encounters with other doctors who she felt weren't right for her, concerns about finding an answer to her situation fell to the wayside.

Not for a lack of trying to solve the problem, by the early 2000s, her mood swings were starting to take a toll. She had become bulimic and she'd started self-mutilating, cutting into her arms and legs in a struggle to communicate her plea for help to those around her.

Denial
But then, there was a cloud of denial and dismissiveness from the people in her life. Her family and friends had become used to her "antics" (that had been manifest since her childhood), so her self-inflicted wounds was considered par for the course. "I was considered a black sheep in my family," says this eldest sister of seven siblings. "I was called KSP. I was told I had a 'star complex.'"

There was also self-justification/self-denial of sorts on her part. Kanapi had been molested as a teenager for a number of years. She had also had to deal with being battered by the father of her son when they were still in a relationship. She assumed that whatever it was she was going through was related more to the trauma of those horrible times than it was to any possible chemical imbalances in her body.

"Research has pointed out that, aside from a possible genetic disposition to acquiring bipolar disorder, there are also 'outside' factors such as environment, trauma and substance abuse," she says. "I definitely got hit on the growing up environment and trauma factors."

Intervention
Elepaño notes that the episodes of mania and depression vary in duration and intensity. A "low" level of depression could manifest as fatigue and disinterest in daily activities; a "high" level could result in stupor or catatonia.

A "low" level of mania can result in individuals being energetic, excitable and highly productive, while in "high" levels, individuals can be erratic and impulsive.

"At the highest levels of either mania or depression, individuals can have delusions-very distorted beliefs about what is actually real," he says. "This is known as psychosis."

Due to lack of proper identification of her condition and treatment that could have addressed it, Kanapi reached psychosis temporarily in 2006. A confluence of multiple stressors overwhelmed her. She started hearing voices and noises. "I'd complain to the barangay captain and find out there wasn't anyone making noises after all." She developed paranoia and agoraphobia. She became suicidal.

It was then that a friend staged an intervention and was able to refer Kanapi to Dr. Augusto "Jojo" Cruz, a psychiatrist at Philippine General Hospital's Department of Psychiatry & Behavioral Medicine, who was (finally) able to diagnose her disorder accurately.

Appropriate
"Research has shown that the prevalence of bipolar disorder is similar in men and women, across different ethnic groups and cultures," says Elepaño.

While some possible causes of bipolar disorder have been correlated to various physical and chemical abnormalities in the brain (no single cause has been identified), "unfortunately, despite research and technological advances, a cure has yet to be found. Bipolar disorder is still primarily managed by controlling its manifestations. It's best treated with mood stabilizing medicines and psychotherapy."

It took Kanapi and her doctor about a year to figure out the appropriate combination and dosages of different medicines that could stabilize her moods to a point where she could function "normally."

It wasn't a smooth ride. She had to adjust to the different side effects, bristling at having to constantly monitor her medicine intake and any changes in her moods and behavior.

Kanapi, like many other individuals with bipolar disorder who struggle to reconcile authority over their bodies, once went "off meds." She stopped taking her medicines in 2009, derailing progress she had already accrued.

"I was tired and angry at the label of being bipolar." But with support from Cruz, she eventually found her way back to taking her medication.

Disclosure
Unlike when she didn't know what was causing her erratic and intense mood swings, the diagnosis had liberated Kanapi from her former fears. With a more stable persona and newfound confidence, she'd started to disclose her condition to her colleagues in the theater industry. But her initial efforts were met with confused reactions, to say the least.

Kanapi recounts when she had returned to rehearsals after an absence of two days and, another time at another production, after she'd been in a motorcycle accident. "People patronizingly presumed my poor performance during rehearsals were because of me being bipolar. But anyone who'd been away from those rehearsals for legitimate reasons like I did would have had the same problems catching up."

Insensitive and uninformed non-sequiturs irked her. "People would say, 'No wonder you're a good actress, you're bipolar,' and that upset me because it doesn't make sense and it's a strange assumption. It's like saying someone is creative just because they're gay or someone is a good runner just because they're from Africa."

"You don't need angst and you don't need to be traumatized to be an actor. That's why it's called 'acting!' You just have to work hard on your craft. I've been saying that even before I was diagnosed."

Working hard
Statements that credit bipolar disorder for her own achievements insult her because it diminishes the hard work she puts into her craft as an actress, as a person. "I am not my disorder," she proclaims. "I'm responsible. I take my meds. I know what's going on. I work hard."

She's developed a straight-to-the-point spiel for informing the people she works with about her condition. "I tell them I have bipolar disorder. I tell them I'm taking my meds and I see my doctor at least once a month. But if I start noticing any strange behavior from myself or if they start noticing anything, we can work it out."

There is power in knowing the limitations of her body, now that she knows the real score in terms of what's going on inside her. Kanapi always consciously observes her moods and behavior. In fact, at one point, she even voluntarily had herself admitted to a healthcare facility to augment her treatment because she acknowledged she needed the help.

Beyond
She admits she could do with more assistance if it were available. "I hope for that day that mental health disorders could be covered by medical insurance here in the Philippines," she says.

She occasionally skips meals so she can have enough money to buy her medicines. "Drugs for mental health do not come cheap but I prioritize my medicines because I'm aware of my responsibilities to myself, my colleagues and to society."

A society that still stigmatizes mental health disorders, she points out. "For example, it's easy to fall into the trap of joking about how actors are all a little crazy anyway." But Kanapi emphatically advocates against the use of medical terms when making jokes.

"People sometimes joke about how they're feeling 'bipolar' or they tease a friend as 'schizophrenic,' and that's not appropriate. You don't know what it's really like. And if you don't really know what it means, don't use it flippantly. You wouldn't want to be where we are."

Thriving
But this doesn't mean she's lost her sense of humor. When asked why she chose to grant an interview detailing her condition, she replies, "Well, I've always been considered 'luka-luka' anyway," with a loud bellow.

Facetiousness aside, she says that she's at a point in her life where she's finally come to terms with her condition. "It's still a tough disorder but I don't mind what people say anymore."

Kanapi doesn't harbor goals of becoming a poster girl for bipolar disorder. While she would like to see changes in society, her energies are focused on living a stable a life as possible. Her relationship with her now adult son has improved since she was diagnosed. "Now we both know what I have and we deal with it. I'm thankful for that."

Meanwhile, she thrives as best as she can. "I stay at home when I don't have acting jobs. I channel my restlessness with my biking, running and swimming. I transform my listlessness by dancing to music. I continue to do acting work. I live my life."

Dr. Augusto "Jojo" Cruz of Philippine General Hospital can be reached at +63-917-896-4210. 
Dr. Ronald Elepaño of The Medical City Hospital can be reached at +63-927-468-9708.