Desire theories of well-being claim that how well our life goes for us is solely determined by the fulfilment and frustration of our desires. Several writers have argued that these theories are incorrect because they fail to capture the harms of self-sacrifice and severe depression. In this paper, I argue that desire theories of well-being can account for the harm of both phenomena by rejecting proportionalism about desire and motivation. This is the view that desires always motivate proportionally to their (...) strength. If we reject this view, then we can explain the harm of many cases of self-sacrifice as arising when we act upon our weaker desires and thereby frustrate our stronger desires. Moreover, the harm of many cases of severe depression can be explained by its suppression of the motivational force of desires. This inevitably frustrates desires that we are left unmotivated to fulfil. I argue that this approach captures the experiential quality of self-sacrifice and severe depression better than rival views that seek to problematise these phenomena for desire theories of well-being. Moreover, these theories have sufficient conceptual resources to account for residual cases of self-sacrifice and severe depression that are less well explained by this approach. (shrink)

There is a strong presumption that mental disorder injures a person's autonomy, understood as a set of capacities and as an ideal condition of agency which is worth striving for. However, recent multidimensional approaches to autonomy have revealed a greater diversity in ways of being autonomous than has previously been appreciated. This presumption, then, risks wrongly dismissing variant, neuro-atypical sorts of autonomy as non-autonomy. This is both an epistemic error, which impairs our understanding of autonomy as a phenomenon, and a (...) moral error, which withholds recognition and respect that autonomous agents are due. I argue that careful attention to the different 'shapes' of agent's autonomy reveals that there are indeed distinctive kinds of neuro-atypical autonomy that are widely mistaken for non-autonomy. This project argues for two propositions. First, that there is a kind of autonomy, with a distinctive shape and texture, available to bipolar agents. This is a variant sort of autonomy, but not a defective or deficient sort. It is the ideal of autonomy that it is worth bipolar agents striving for, given the range and intensity of experiences that they will have to confront. Whilst bipolar autonomy will look unlike more neurotypical kinds of autonomy, it continues to be owed recognition. The second proposition is that we should understand the ideal of autonomy to be both pluralist and highly context sensitive. Given the range of starting points from which agents will strive to an ideal of autonomy, there will be some variation in the ideals worth striving for. The variation in ideals will reflect the existential realities they are local to. Theory of autonomy must be adapted to recognise bipolar, and other neuro-atypical, kinds of autonomy, and to reflect this wider pluralism. These propositions will be argued for with careful attention to the experiences and agency of people living with bipolar, or related, disorders. Understanding the ways that manic or depressive episodes, and the shifts between them, alter and apply pressure to our agency will inform an account of the distinctively bipolar autonomy that can be built on top of it. (shrink)