Her success fed a longstanding debate on the relationship between mental turmoil and creativity. And her writing and speaking helped usher in a confessional era in which mental disorders have entered the pop culture with a life of their own: Bipolar is now a prominent trait of another famous Carrie, Claire Danes’s character Carrie Mathison in the Showtime television series “Homeland.”
“She was so important to the public because she was telling the truth about bipolar disorder, not putting on airs or pontificating, just sharing who she is in an honest-to-the-bone way,” said Judith Schlesinger, a psychologist and author of “The Insanity Hoax: Exposing the Myth of the Mad Genius.”
In a characteristic riff, answering a question about the disorder from the audience at the Indiana Comic-Con last year, Ms. Fisher said: “It is a kind of virus of the brain that makes you go very fast or very sad. Or both. Those are fun days. So judgment isn’t, like, one of my big good things. But I have a good voice. I can write well. I’m not a good bicycle rider. So, just like anybody else, only louder and faster and sleeps more.”
She then grabbed the mike and sang, in mock-ballad voice, “Oh manic depression … oh how I love you.”
That last line is a reminder too, that in Ms. Fisher’s lifetime, even the name of the condition had evolved, to bipolar from what was once more commonly known as manic depression.
Ms. Fisher has said that she was first given a diagnosis of bipolar disorder at age 24 but did not accept it until five years later. In time, she spoke often about her lifelong struggles with both addiction and bipolar disorder and her desire to erase the stigma of mental illness. She wrote her 1987 novel, “Postcards From the Edge,” after a stint in rehab after a near-fatal drug overdose. It was during her autobiographical one-woman stage show, “Wishful Drinking,” that she first posited the idea for “Bipolar Pride Day.”
Like the disorder itself, the wave of attention that occurred during Ms. Fisher’s life had its excesses. Through the 1990s, research scientists — many of them supported by drugmakers — expanded the definition of the disorder, describing “sub-syndromes” and permutations like bipolar II and “hypomania.” By the 2000s, doctors were diagnosing the condition in groups of people who had never been identified before, mostly young children — leading to thousands of children being unnecessarily treated with strong psychiatric drugs.
In recent years, that overheated enthusiasm has finally begun to run its course.
“I remember being at a psychiatric association event where Carrie Fisher was interviewed, and people were beginning to talk about the imperialism of bipolar,” how the diagnosis was expanding beyond its bounds, said David Miklowitz, a professor of psychiatry at the Semel Institute at the University of California, Los Angeles. He added, “I think doctors are much more careful now, in being sure they’re diagnosing the real thing.”
The American Psychiatric Association’s latest diagnostic manual discourages applying the label to young children.
Ms. Fisher’s vivid prose, wicked humor and striking performances inevitably led many people, including herself, to wonder whether bipolar mania fuels creativity.
“My experience is that it does spur creativity and insights and the ability to express connections you see but could not otherwise express,” said Terri Cheney, author of the best-selling memoir “Manic.” “But normalcy is so much preferable, being able to remember what I did — I tend to forget manic episodes.”
Scientists, scholars and writers have speculated for years about the connection between madness, and in particular mania, and artistic wizardry. The painters Edvard Munch and Vincent van Gogh, among many others, have been posthumously diagnosed with bipolar disorder.
“There is a particular kind of pain, elation, loneliness and terror involved in this kind of madness,” wrote the psychologist Kay Redfield Jamison, a prominent proponent of this connection. “When you’re high, it’s tremendous. The ideas and feelings are fast and frequent like shooting stars, and you follow them until you find better and brighter ones.”
But the debate remains contentious, and given the vagueness of so many diagnoses, not to mention the devastating effect of depression or psychosis on discipline and concentration, it is unlikely to be settled anytime soon.
“The case has really been built on sand,” Dr. Schlesinger said. “It’s been oversold.” She added, “Every course of bipolar is different, there is no one progression, no one symptomology, no one cure, so the effects are very individual.”
All the more reason that one particularly outspoken, charismatic and large personality could project so much toughness and vulnerability at the same time. Ms. Fisher learned to live a public life at a very early age, as the child of celebrities and with her early stardom.
In an interview with CBS this year, she said she liked being Princess Leia, understanding that “it’s a great role for women.” But, she added: “I’m not really one of those actresses like Meryl Streep. Those actresses travel outside themselves and play characters. And I’m more of an archaeologist. I play what I am.”
Ms. Fisher’s advocacy, visibility and public self-examination was made for the era of online self-confession. For good and bad, in part because of Ms. Fisher’s example, the language of bipolar and mental disorders has swept into the shared popular culture, seeding online support groups, punctuating texted exchanges — “so OCD” — and becoming featured in dimensions of movies and TV shows like “Monk” and “Homeland.”
Paul Cumming, a longtime advocate in San Diego who works for a company that helps people with mental disorders find housing, said, “The power of celebrity was best shown by Carrie that by being public, and funny, she demystified our diagnosis and showed by example we can live well and thrive.”