Heartache of the state, enemy of the self: bipolar disorder and cultural change in urban China.

Past works in anthropology and psychology have described the Chinese orientation toward life as situation-centered with an external locus of control. This model has also been applied to the understanding of affect disorders in China--depressive patients have been found to focus on outside circumstances surrounding dysphoric moods. However, dramatic economic, sociopolitical and cultural changes in post-Mao China may be affecting these cognitive orientations toward emotional distress. This paper focuses on the subjective experiences of individuals diagnosed with bipolar disorder in China. The study is based on semistructured interviews with patients at a Western-style mental health institution in Shenzhen, the first successful Special Economic Zone in China. My data suggest that the location of agency has shifted across generations. Whereas those who grew up in the Maoist era are inclined to use external circumstances to explain the control over and responsibility for their illness, younger patients tend to emphasize self-blame and individual responsibility. I argue that these intergenerational differences in ethnopsychology relate to the multifaceted rise of individualism in post-Mao China. The paper ends with an examination of this observed shift vis-à-vis recent theories of neoliberal discipline in China and a discussion of potential psychological implications.