People who experience manic episodes often describe the sense of being overwhelmed by the intensity of life. This can interfere with careful and thoughtful deliberation, replacing it with impulsive behavior that can make the manic feel they are not in control.

In philosophical terms, we could ask whether manic episodes involve a loss of autonomy, the ability to make your own decisions, and control your own actions. In a recent paper in Philosophical Psychology, philosopher Elliot Porter argues that manic episodes do not imply a loss of autonomy, but simply change the way it works—and we in society can understand this so people prone to manic episodes aren't excluded from meaningful life activities.1

Understanding Autonomy

As Porter explains, autonomy involves two capacities:

1. Reasons-tracking: We need to be able to identify reasons for action and then act on them.

2. Regulative guidance: We need to monitor how well we’ve done this.

On the surface, manic episodes would seem to compromise both of these: people experiencing such periods may not feel they are responding to any reasons, much less reflecting on their manic behavior (at least not during the episode itself). Porter argues the picture is much more nuanced, but first, we need to appreciate a unique way to characterize manic decision-making and behavior.

Based on the testimony of people describing their manic episodes, Porter narrows in on the concept of demandingness. During these periods, people........

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