For many years, I misunderstood the grammar of "manic depressive". I heard it as shorthand for "manic and depressive" - summarising mood swings by putting the highs and lows side by side.
But, really, the manic in "manic depressive" is an adjective modifying "depressive". An ordinary depressive is just that - a person with a tendency to respond to difficulties with depressions which can plumb from minor to disabling. But a manic depressive is someone who is always depressed and always fighting it with the mania. The fight manifests itself on a spectrum from merely frantic behaviour to the pyrotechnic displays of disabling mania.
Escapism is either mania or very closely related. Sex, drugs, rock n roll - whatever kind of fun is the escape route of choice - serve to ward off or mask an underlying depression - to use more human terms, underlying grief, sadness, loneliness.
Here where I live you often see flyposters for gigs which offer to "Fuck the Pain". That about sums it up.
The hard bit is to realise that, for many people, there is no available alternative to escapism, except perhaps the passage of time. So we shouldn't be too harsh on it, or on people - young people especially - who are trying to escape. We shouldn't underestimate the number who have had wretched upbringings, often with a middle class veneer, and who are burdened with the consequences.
One-to-one counselling and therapy is a luxury good, not generally available and at least as variable in quality as street drugs. Street drugs are cheaper, more freely available and provide instant relief. Alcohol, ecstasy and weed are not obviously inferior to psychotherapy in the pain relief they provide.
They are not the only escapes, of course. Frantic socialising and partying, general busyness and, occasionally, studying very hard may all be doing a similar job.
I'm not saying that anyone who likes to party is a manic depressive. I'm saying that some of the frantic behaviour we see, especially in young people, can be made sense of as a manic defence. In which case, it's always worth remembering that behind it there is some pain.