Audrey Elizabeth Hale, who killed three 9-year-old students and three adult staff members at the Covenant School in March 2023, referenced “bi-polar” in the journal from her “manifesto” released by The Tennessee Star on September 3.
Hale wrote in an entry dated January 16, 2023, “I’ve been anxious all last week, all day today [stressed] then I’m told I’m bi-polar by some prideful b****.”
The killer continued, “no one gets me – everyone misunderstands autism,” before later writing, “I’m not emo or bi-polar” but “a f***** with no lover.”
Once known as manic depression, the progressive mental condition bipolar disorder is characterized by periods of extreme mania, often followed by depression, and Medical News Today explains it is considered “a progressive condition that worsens with age” by many experts.
Research tracked by the National Institutes of Health (NIH) indicates there is some evidence those who develop with bipolar disorder as a child may see the illness progress as they age. Specifically, some studies showing patients who present with “soft” symptoms of bipolar disorder could later be diagnosed with bipolar II, which is characterized by periods of mania, or bipolar I, the most serious form of the illness, which also includes major depressive episodes.
One 2011 study found 42.1 percent of college-aged adults who presented with “soft” bipolar conditions had been diagnosed with either bipolar I or bipolar II after a 4.5 year follow up.
Hale was 28 at the time of her fatal attack on the Covenant School.
Neither Hale’s journal, nor the police documents obtained by The Star, suggest she was formally diagnosed with bipolar disorder. They confirm Hale was diagnosed with an anxiety disorder, and that her parents claimed she was diagnosed with autism, though investigators appear to have been unable to locate a clinical diagnosis.
There is similarly no evidence Hale was prescribed Lithium, which a 2023 article published in the scholarly journal Lancet explained is often used to treat those with bipolar disorder and, “has the strongest evidence for long-term relapse prevention.”
Police photographs and documents obtained by The Star reveal Hale was prescribed at least five medications. These include the antidepressant Lexapro, the anti-anxiety medication Buspirone, the allergy and anti-anxiety medication Hydroxyzine, and the anti-anxiety drug Lorazepam, as well as a common nasal spray.
While not specifically billed as a medication for those with bipolar disorder, Carlat Publishing in 2021 reported that Buspirone can be used to reduce anxiety for those suffering from the illness, as most patients tolerate it well and it rarely induces mania.
Though Hale was a 22-year mental health patient at Vanderbilt University Medical Center (VUMC), where she was twice evaluated for commitment, these medications were all prescribed by a nurse practitioner who has been affiliated with a Nashville psychiatric practice as well as her own practice.
The Star obtained one of two journals Hale left in her vehicle prior to her attack on the Covenant School, as well as a portion of Metro Nashville Police Department (MNPD) documents related to the Covenant investigation, in June, after receiving them from a source familiar with the investigation.
Both Star News Digital Media (SNDM) Inc., which owns and operates The Star, and Editor-in-Chief Michael Patrick Leahy have sued MNPD in Tennessee court and the FBI in federal court to compel the full release of Hale’s writings.
Leahy and SNDM announced their intention to appeal the Tennessee lawsuit after Chancery Court Judge I’Ashea L. Myles decided against those seeking the release of Hale’s writings in a July 4 ruling that claimed they could not be released due to the purported transfer of the killer’s copyright to the Covenant Children’s Trust.
Myles said other investigative documents related to Hale’s murders should not be released so long as the MNPD case remains ongoing. MNPD told The Star it had advanced to the documentation phase of its investigation in late August.
The federal lawsuit against the FBI remains ongoing.
Tom Pappert is the lead reporter for The Tennessee Star, and also reports for The Pennsylvania Daily Star and The Arizona Sun Times. Follow Tom on X/Twitter. Email tips to pappert.tom@proton.me.
