Sharing Public Breakdowns: What We Can Learn From Jason Russell

San Diego police recognized that the Invisible Children founder's episode this week was not a criminal one. Why have most of us ignored that?

Jason Russell during a recent interview about Kony2012 Screenshot

Some responses to Jason Russell's detention by San Diego police this week, after the co-founder of the charity Invisible Children was found ranting and raving in the street in a state of undress, betray an insensitivity to the nature and frequency of brain diseases. Russell's nude fit was no mere "meltdown" as Slate political writer David Weigel describes it. This is not an office temper tantrum. Much of this tasteless commentary is searchable on Twitter via the hashtag #Horny2012, chosen to mock the witness reports of "public masturbation." Russell's Kony2012 video inspired young people toward a higher cause, and in an instant he's become the subject of base, juvenile name calling on his Facebook page. But this type of involuntary behavior is no Paul Reubens moment.

Just as we recognize that it's abhorrent for roommates to record the private sexual activity of gay teens in their dorms, we must cultivate societal norms around the recording of acute medical events.

Based on my read of the reporting out Friday and after viewing TMZ's video -- and this is only one brain injury physician's reading -- it is highly unlikely that Jason Russell's behaviors in the streets of San Diego on Thursday March 15th were intentional. It is much more likely that he was experiencing a psychotic episode -- a manic state -- an event as recognizable to some clinicians as a heart attack. There are many possible endogenous or exogenous causes for such behaviors beyond a "purely" mental illness such as Bipolar Disorder (antibodies to certain regions of the brain, for example, or LSD), and these will have to be ruled out by Russell's doctors. Depending on his medical and psychological history and any other symptoms he may be exhibiting, numerous lab tests and studies could be necessary to determine his diagnosis and treatment.

Whatever the diagnosis, it should not "shred" Russell's reputation, as Weigel asserts. This was not willful. A similar episode may never happen again. The spell was clearly of an episodic nature as Russell's usual public comportment suggests. Some on Twitter are starting to point out the atypically high-energy or hypomanic features of Russell's public persona as a human rights advocate, and are speculating about Bipolar Disorder in particular. Bipolar may well be the diagnosis, but it is a condition shared by many high-functioning CEOs, scientists, lawyers, writers, etc.

The revival of the 1960 play The Best Man, now on Broadway, features a Secretary of State (played pitch perfectly by John Larroquette) who suffered from a depressive "breakdown" in his past and now faces down rumors about the period while he's in the running for his party's presidential nomination. We are still condemning good people for no reason. Maybe more of us need to see Gore Vidal's play.

Presented by

Ford Vox, MD, is a physician, based in Atlanta, who specializes in caring for people with complex brain injuries. He has written for Newsweek, Slate, and the Los Angeles Times.

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