Bipolar disorder is a mood disorder characterized by alternating episodes of mania, marked by elevated energy, impulsivity, and sometimes psychosis, and episodes of depression. According to the National Institute of Mental Health, approximately 2.8% of US adults experience bipolar disorder in a given year, with most cases first appearing in late adolescence or early adulthood (National Institute of Mental Health, "Bipolar Disorder," NIMH Statistics, n.d.). Fisher was diagnosed in her 20s and describes her symptoms in personalized terms, playfully naming her two moods "Rollicking Roy" and "Sediment Pam" (121). This framing reflects how patients often develop coping language to externalize illness, and Fisher's public openness about her diagnosis helped reduce stigma during a period when bipolar disorder was rarely discussed publicly by major celebrities.

Electroconvulsive therapy (ECT), one of the treatments Fisher undergoes, was developed in 1938 by Italian neurologist Ugo Cerletti and psychiatrist Lucio Bini, who applied electrical currents to a patient's scalp to induce a therapeutic seizure. Early procedures were administered without anesthesia or muscle relaxants, sometimes causing bone fractures and severe memory loss. The therapy's reputation suffered further after Ken Kesey's 1962 novel One Flew Over the Cuckoo's Nest and its 1975 film adaptation, in which Jack Nicholson's character is punitively shocked into compliance. Fisher cites this exact reference, recalling that the procedure "looked traumatic, dangerous, and humiliating" (13) and that this cultural image initially deterred her from accepting ECT despite repeated psychiatric recommendations across many years of severe depressive episodes. The film's lasting influence demonstrates how a single dramatization can shape medical decision-making for decades.

Modern ECT, as outlined by the American Psychiatric Association, is performed under general anesthesia with a muscle relaxant, while electrodes attached to the scalp deliver a brief controlled electrical stimulus that induces a therapeutic seizure (American Psychiatric Association, "What is Electroconvulsive Therapy (ECT)?" Psychiatry.org, 2023). It is typically administered in a course of multiple sessions and is most commonly used for severe major depression, treatment-resistant bipolar disorder, and catatonia. Memory loss, particularly surrounding the treatment period, remains a documented side effect, which Fisher discusses candidly when she describes needing to reacquaint herself with her own life after a three-week treatment course. Her memoir functions partly as a reconstruction of memories displaced by ECT, framing the book as both autobiography and ongoing medical aftermath.

Situating Fisher's personal experience within the broader development of psychiatric medicine highlights Wishful Drinking’s attempts to challenge the long-standing stigma surrounding serious mood disorders and reframes ECT not as the barbaric procedure of cultural memory but as a contemporary, often lifesaving intervention.