Bipolar Disorder: Valid Excuse For Letourneau?

Her cry of sickness didn't earn Mary K. Letourneau the sympathy her lawyer hoped for. Not in court and - despite a core of loyal supporters - not from a skeptical public.

"Bipolar, fourpolar or nopolar," scoffed a woman from the audience of the "Oprah Winfrey Show" last week. Having sex with a middle-school student was just plain wrong, she said.

"We have a very large state prison here," said a man in the audience. "I wonder how many men are cryin' `bipolar?' "

Yet Letourneau's attorney, and some psychiatrists, argue that the disgraced teacher is a sick woman, not a criminal. She has been diagnosed with bipolar disorder, a mental condition they say caused her reckless behavior.

While her case has prompted coffee-table debates around the world - Was it love or was it rape? - her claims of mental illness have prompted a parallel debate about the power of bipolar disorder.

The disorder caused Letourneau to take "really stupid risks," like violating probation to spend a night at the movies and shopping with the boy she is convicted of raping, says her attorney, David Gehrke.

The disorder is the root of Letourneau's fatal attraction for the boy, her willingness to bear his child, and her insistence that she loves him, says the psychiatrist who evaluated Letourneau for her sentencing.

"It's like she has a happy button and a love button and a hypersexual button in her brain and it's being pressed," says Dr. Julie Moore. "When it's pressed, there is little room for self-reflection. That's why Mary is such an inept criminal."

The disorder, Moore says, led to the behavior that landed Letourneau back in prison to serve out her 7 1/2-year sentence, and that has police investigating additional charges.

"She met with the boy under a lamppost," she says. "It looks like stupidity and flaunting of the law, but it's really total preoccupation with emotion."

Not so, counters Susan Moores, a sex-offender-treatment specialist.

"The cause of Mary's or anybody's sex offense is the decision to do it. The cause is not bipolar, it's not poor impulse control; the cause is a decision to do it."

Disorder has different degrees

Perhaps 3 percent of the population suffers from some form of bipolar disorder - a less judgmental term for what was long known as manic-depression, and was once confused with schizophrenia. The condition is marked by cycles of euphoric highs and depressions.

The most severe type, Bipolar I, is characterized by a "severe manic episode" that may include delusions or hallucinations.

Extreme manic behavior creates what Dr. David Dunner, director of the Center for Anxiety and Depression at the University of Washington, calls "psycho-social difficulties" - jail time, hospital commitments, divorce. In the depressive phase, suicide is not uncommon.

Bipolar II, less severe, is marked by episodes of "hypomania," or euphoric highs that may include inflated self-esteem, decreased need for sleep, extreme talkativeness, distractability, racing thoughts, excessive involvement in pleasurable activities (without regard to painful consequences) and an increase in goal-directed activity or agitation, including irritability.

Bipolar II often goes undiagnosed; people afflicted come across as exceptionally productive and energetic. "These people are generally very bright and personable," Moore says. "They can get away with it because it's quite engaging."

Indeed, the disorder has a strong link to creativity. Vincent van Gogh, Michelangelo, Sylvia Plath, Virginia Woolf, Tennessee Williams and Ernest Hemingway all fit the profile. Johns Hopkins University psychologist Kay Jamison estimates rates of bipolar disorder are 10 to 40 times higher among artists than in the general public.

Left untreated, about 10 percent of patients who suffer from milder bipolar disorder will "cross the line" into Bipolar I with a socially unacceptable manic episode, says Dunner.

Cause remains unclear

The cause of the disorder is unclear, with some researchers examining genetic culprits and others eyeing the environment. Most studies say the problem can be traced to biochemical imbalances in the brain.

Evaluations indicate Letourneau likely had Bipolar I disorder since adolescence, according to Moore. As a popular teacher at Shorewood Elementary School in Burien, she had boundless energy. She juggled four children at home and 28 more at school. She often worked long past midnight, grading papers, devising creative teaching projects. Moore says she sometimes went three or four days without sleep.

During the month she was free from jail - between her release Jan. 2 and her re-arrest Feb. 3 - she fell back into her late-night patterns. A friend says she and Letourneau spent an entire night talking and watching movies in between spurts of cleaning and laundry. They went to bed about 7 a.m.

San Juan Island businesswoman Kate Monahan was diagnosed as bipolar in 1983. The years leading up to her diagnosis were marred by sleeplessness.

"When you're not sleeping at night, you begin to have these dreams in the daytime," she says. "Your real world is meshed with your dream world."

During a sleepless manic high in 1982, Monahan crashed a meeting of the men's-only Rotary Club. She strode to the front of the room and belted out a song parody ("And I have a terrible voice," she groans.) - "The song of women is a sad song, hi lily, hi lily, hi lo."

She remembers "some sheriff" dragging her out. She was sent to Western State, the mental hospital.

Monahan, 47, now takes a full dose of lithium, a common medication prescribed to bipolar patients. Faithful use of mood-leveling drugs minimizes the risks of a severe manic episode, making bipolar among the most treatable of mental illnesses.

If the disorder causes poor judgment and impulsive behavior, it has proved an unreliable legal weapon.

A Florida murderer, William Lee Strausser Jr., had his death sentence overturned last year by the state Supreme Court on grounds that he suffered from a depressive type of bipolar disorder with manic episodes. He was resentenced to life in prison.

But just last month in New Hampshire, a jury rejected an insanity defense for William McCallum, a former assistant attorney general who argued that bipolar disorder and other illnesses propelled him to steal more than $100,000 worth of art, antiques and rare books. He faces up to six years in prison.

Some states allow juries to consider whether a defendant acted under an "irresistible impulse." Washington is not among them.

Washington judges have some discretion to consider psychiatric disorders in sentencing and in cases of probation violation, but seem loathe to let a bipolar defense soften their stance.

John Strait, at Seattle University's law school, says a bipolar defense poses a vexing dilemma for judges.

On the one hand, Strait says, it may be obvious that the disorder is prompting abnormal, and sometimes criminal, behavior. "The flip side is, because you do have a sick person, normal threats of being sent to prison won't apply, because the person doesn't weigh the consequences," he says.

For all its history, bipolar disorder is not universally accepted as a medical condition.

And even some of its sufferers resist the argument that it causes behavior.

"They say, `You're giving bipolar a bad name,' " says Moore, the psychiatrist who evaluated Letourneau. "Not every bipolar rapes young boys."

But Moores, the sex-offender specialist, doesn't hold with the popular lineup of excuses for sex crimes, whether that's bipolar disorder, alcoholism, a dismal childhood or too much sugar.

"People who rape and molest children have a sexually deviant arousal system," she says. "That's separate from anything else."

If the experts disagree as to cause and behavior, they find common ground about treatment: Medication is a must.

Former King County Executive Randy Revelle was diagnosed with a form of bipolar disorder, but still managed a high-power, high-stress job. After one manic episode, and three weeks when he says he was "completely helpless," he went on a strict lithium regimen.

But one of the ironies of the disorder is that patients often discard their medication when they start feeling better or are barraged with side effects.

Letourneau stopped medication

Letourneau stopped taking medication soon after being released from jail last month, saying she was worried about hair loss, mental fuzziness and queasiness, according to friends.

She claimed she had her doctor's permission - a claim he won't respond to, citing confidentiality. Shrugging off her medication, Depakote, friends say she bought heaps of vitamins and other "natural" remedies.

"This is not something to be toyed with," Dunner says. "This is a disorder where people . . . have killed people, spent the family fortune, divorced, gotten jailed. Vitamins and herbs is not a way to treat bipolar disorder."

Responsible naturopaths and other alternative practitioners understand that the stakes are high with bipolar. While they believe in the healing powers of minerals, nerve tonic herbs and vitamins, they often work in partnership with a psychiatrist, says Lise Alschuler, a naturopathic doctor at the Bastyr Natural Health Clinic.

"Most people don't realize that bipolar is a life-threatening illness," she says. "When people are in a state of mania or depression, they can be a danger to themselves or others."

Information from Seattle Times staff reporters Jake Batsell, Jack Broom and Nancy Bartley is included in this report.