IN my last article, I made the claim that Jekyll and Hyde syndrome is not DID, and it is not schizophrenia. I asked if it could be misconstrued as manic-depressive psychosis or bipolar disorder? It's an interesting thought.
Modern symptoms seem to fit well a diagnosis of split personality disorder, and it is often assumed that given the knowledge of mental health and the emerging diagnoses of the time, it is the most appropriate. The symptomology certainly seems descriptive of Jung's persona and shadow – or Freud's id and ego, but what if… what if Dr. Jekyll's ailment could better be described within another framework – a depressive framework?
Let's first note the third important point of this analysis: the symptoms under consideration should be interpreted as described from the client/patient perspective. That is, the perspective of our illustrious colleague, Dr. Henry Jekyll. What does Jekyll have to say in his own words?
In His Own Words…
As it turns out, this is an important point. The case 'as stated by Dr. Henry Jekyll' is shared primarily from the perspective of the rational, humanistic protagonist. While multiple or split personality disorder is often assumed as a fitting metaphor for the id and the ego, it serves the analyst well to weigh the descriptors as provided by the narrator against the id, ego, and super-ego as proposed by Freud – or perhaps as the archetypes of the shadow as proposed later by Jung.
Henry Jekyll states that he felt "…something strange, something sweet… lighter, younger, and happier in body… conscious of a heady recklessness," which informs us that Jekyll not only enjoyed the transformation into Hyde – at least initially – but he condoned it (Stevenson, 2013). This emotional recognition seems to be in contrast with Hyde's personification of the id to Jekyll's ego.
Freud tells us that the concept of the ego is that it is the "structure that balances the wants and desires of the id against the demands and expectations of the world in which we live" (Freud, 1954). Our rational mind. Granted, although these aspects of the human mind are not fully definite, separate, or even sometimes distinguishable, they do aid us in identifying a condition toward a better definition. It seems that this allowance is not something the ego would ever condone. Furthermore, it was not only condoned but indulged. It is not until later chapters that Jekyll finds Hyde and his actions repulsive and intolerable.
Could It Have Been Mania?
Another notable aspect of the story is the long periods of 'normality' as Jekyll between manic episodes of Hyde. For example, a client suffering from manic depressive psychosis being treated with pharmacologicals and psychotherapeutics may experience long periods of normalcy compared to the client showing consistent symptoms of multiple personality disorder (Disassociative Identity Disorder).
If Dr. Jekyll represents the depressive state and Hyde the mania, should we re-consider bipolar disorder as a possible diagnosis? The duration of the episodes, the commitment of Jekyll to rid himself of Hyde, and the fact (we are told) that Jekyll takes the drugs to transform into Hyde (rather than the opposite), suggest perhaps we should.
The drugs appear to trigger the manic episodes in Jekyll as the protagonist self-medicates. However, I suggest that comparisons to the associated symptomology and frequency as ascribed to the DSM-V likely exclude bipolar disorder as a diagnosis as Jekyll longs to undo the wrongdoings of Hyde, saving his otherwise good name (Diagnostic and Statistical Manual of Mental Disorders, 2013). Considering how blurred the lines are between mental states when describing bipolar disorder and manic depression, perhaps it is more accurate to describe Jekyll's condition as circular or dual-form insanity (Akiskal, 2004; Yount, 2019).
Suppose Jekyll represents the depressive state and Hyde the manic episode; in Jekyll's own words, the two characters are "I…am radically both…connected" (Stevenson, 2013). Is it possible that Hyde represents a psychosis Henry Jekyll does not recognize?
Projection
There is no seperate individual, Mr. Edward Hyde, and until the very end of the story, Hyde is referenced in the first person rather than as a separate and distinct entity. It is only when Jekyll is so utterly disgusted with the romping of Hyde, and as the episodes become uncontrollable, that he starts to refer to him in the third person. This may be recognized as another of Freud's proposed psychological defense mechanisms: projection – attributing unconscious attitudes, impulses, and behaviors to another (Freud, 1954).
It is also important to note though that at no time in the story is there an elicitation of grandiosity or inferiority in either personality, making projection questionable. More so the daylighting of the desires and passions hidden deep within Jekyll, contradictory to his station and status in life. It is not until the very last chapter of the story that Jekyll is so ashamed of Hyde that he separates him as a character (into the third person). As Yount (2019), so eloquently proposes, this reality is representative of the fact that there is no Mr. Hyde, only a deranged and psychotic Henry Jekyll in the midst of a manic episode.
Closing Thought – Era
Our understanding of the lines between mania as it manifests in bipolar disorder and the suffering of chronic depression are not fully defined. The prognoses are not wholly separate, and it is difficult for even the most skilled practitioner to distinguish between them. In recognizing the descriptors as coming solely from the first person when speaking of both personas, the practitioner is given vital clues that indicate the prevalence of mania instead of the most oft accepted reasoning of split personalities. While Stevenson himself laid bare that the story is representative of the evil that exists alongside the good in all of us - perhaps the very reason Jekyll and Hyde both are written in the first person - the manner in which the story is told suggests a deeper psychological issue with our protagonist – Henry Jekyll.
Of course, we cannot discount the period and burgeoning field of psychology, barely a handful of years recognized as an emerging discipline and 66 years before the DSM was published for the very first time. The reader must acknowledge and respect the mindset and understanding(s) of the time and era - and of course, the author's intent - a necessary fact we so often overlook in our judgment of practically everything we are critical of these days.
I invite you to please leave your thoughts in the comment section below.
REFERENCES
Akiskal, H. S. (2004). [From circular insanity (in double form) to the bipolar spectrum: the chronic tendency for depressive recurrence]. Bull Acad Natl Med, 188(2), 285-296; discussion 296.
Diagnostic and Statistical Manual of Mental Disorders. (2013). (5th ed.). Arlington, VA: American Psychiatric Association.
Freud, S. (1954). The Origins of Psychoanalysis: Letters to William Fliess, Drafts, and Notes, 1887-1902. New York, NY: New York Basic Books.
Stevenson, R. L. (2013). The Strange Case of Dr. Jekyll and Mr. Hyde. Boston, MA: Houghton Mifflin Harcourt.
Yount, A. (2019). The Depressive Dr. Jekyll and Manic Mr. Hyde. Coastlines, 1(6). Retrieved from https://aquila.usm.edu/