NOT JUST UP AND DOWN

 

 

THREE or four years ago, my good friend Louise proposed that I self-publish a series of short books that dealt with bipolar. I responded that this was a great idea, then went straight to work writing a novel.

More recently, another good friend, Joanne, raised the same suggestion. Moreover, she came up with the name: The Bipolar Expert Series.

I intended my first book, NOT JUST UP AND DOWN, as a short introduction to my series. This was supposed to cover the standard stuff on our moods, but in no time the book took on a life of its own. Before I knew it, I was challenging conventional psychiatry – ironically citing the field's leading researchers in support.

These are your old-school practitioners that I refer to as keepers of the observational wisdom, a scientific tradition dating to the natural philosophers of the seventeenth century and further back to the ancient Greeks.

These include Frederick Goodwin, Hagop Akiskal, and Jules Angst – all well past retirement age – and the late Athanasios Koukopolous. All are champions of Emil Kraepelin, who coined the term, manic-depression, back in 1899.

In addition, I am indebted to the academic and popular writings of Kay Jamison and Nassir Ghaemi, who can put on their resumes their many collaborations with these wise old men .

At first I saw myself as simply getting out their word to a wider audience, but then I began connecting my own dots. I had written on moods many times before, but always in separate blog pieces and articles. It was only when I gathered all my material before me, then dug deeper, that the light bulb went off, namely …

Conventional psychiatry is serving up a badly distorted narrative of our illness, one that provides us with a rough guide at best and an impediment to our understanding and recovery at its worst. Among the many points I make in my book:

Psychiatry's diagnostic bible, the DSM, with its ubiquitous symptom lists discourages serious enquiry into our thoughts and feelings and behaviors. Worse, a lot of what's in it is misleading and just plain wrong.

Bipolar is the wrong term for our illness. "Cycling" much better describes what is driving our episodes and what we're up against. Adopting a cycling mindset encourages to pay attention to what is going on both inside our heads and around us and to anticipate what we may be facing next.

There's more ...

We need to conceive of bipolar as part of a mood "spectrum" that embraces a lot of what we call unipolar depression. A lot of us cycle from one depression to the next without ever experiencing mania or even light manias. These recurring depressions have a lot more in common with bipolar disorder than unipolar depression. This has huge implications for our treatment and recovery.

"Up" only has to be higher than down. Misdiagnosis is the norm, especially with depressed patients unable to recall when they ever felt normal, much less better than normal. Rather than quibbling over how high "up" has to be, we need to treat the cycle rather than the symptom du jour and thus spare patients and their loved ones years of heartbreak and frustration.

We know what "down" is like, but simply calling it "depression" is misleading. Rather, we are dealing with a host of causes and effects that we only vaguely understand. Nevertheless, working with what we know offers the hope of an improved outcome.

And still more ...

Mixed states – where "up" and "down" meet – may be more common than our pure states. These take the form of metaphorical road rages – agitated depressions and dysphoric manias. The issue is further complicated by anxiety, which needs to be regarded as a mood state in its own right.

Our mood "states" are influenced by our personality "traits." The two exist in a push-pull relationship that set the scene for how we think and feel and behave in any given situation.

Up and down and in-between are all relative. Someone's light mania may be someone else's exuberance. Someone's low-grade depression may be someone else's version of thinking deep. What may be bipolar behavior for one person may be perfectly normal for another. Our doctors, not to mention those around us, have trouble appreciating this.

"Normal" needs to be regarded as a mood episode in and of itself. Recovery is always going to be problematic until we learn to appreciate where our true normal lies.

As it turned out, my "short" book ran to more than twice its projected length.

My next book will pick up where this book leads off – at "normal." Here, we will take a close look at where mood and personality intersect, together with how our genes and environment set us up for success and failure.

My first two books, essentially, focus on the "who," as in who the hell are we. My third - on recovery - will be all about the "what," as in what can we do about it. Basically, once we become adept in the art of "knowing thyself," we can set goals and implement a range of practices and routines and tricks that work best for us.

This leads into my planned fourth book, which is all about the "why." In this book, we will take a close look the brain science, and how our genes and environment influence our behavior.

Knowing the "why" can deeply influence how we go about the "who" and "what." For instance, knowing that exercise and good diet and meditation can structural change our brain in a positive way, with lasting benefits, may actually motivate us to take a more active role in our recovery.

My fifth book will be on treatment, which takes us back to the "what." Usually, treatment is our first concern once we've been diagnosed. But unless we have a full understanding of our own individual natures and what we are aiming at in life, any treatment discussion will be superficial and simplistic, at best.

My sixth and final book will be on relationships. The books and articles I have read on relationships are inevitably one-sided. Namely, they assume that the bipolar partner is the problematic one in the relationship. I do not dispute this, but I will also explore the issue from the perspective of how to get along with your often clueless "normal" partner.

I'm hoping to get out two books a year, each about 50,000 words. This is about the length of your average self-help book, and will be easy to digest as well as timely. If you enjoy my first book, I hope you will contact me, as I can use your feedback and input in writing my next ones. Please use the links on this page to get on my mailing list or to send me an email.

In the meantime, here it is – my first book in The Bipolar Expert Series. Enjoy …

Check out my second book, IN SEARCH OF OUR IDENTITY

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