Bipolar Depression. A Comprehensive Guide. El-Mallakh RS & Ghaemi SN. American Psychiatric Publishing, 2006.

One sentence opinion: A necessary but typically uninspiring review of an important subject.

Is there a need to devote a book specifically to the depressed phase of bipolar disorder? Absolutely. Should it present data from each of the important research areas on this subject? Of course. Does it need to do so in a formulaic and bland fashion? Judging from the products of the major psychiatric publishers, the unfortunate answer appears to be yes. With a few rare exceptions, such as the stellar Manic Depressive Illness by Goodwin and Jamison or A Mood Apart by Peter Whybrow, review books on psychiatric topics are all too often poorly written, uncreative amalgams of multi-authored chapters without a coherent editorial voice or viewpoint. The result is reading that becomes as dutiful as the writing.

Ok. Now that that’s out of my system, let me return to some specifics about this book.

Despite my overall take on this work, several chapters rise above the tepid baseline. Ghaemi’s pleasure in challenging the prevailing nosology of mood disorders in American psychiatry is evident in the introductory chapter. It is fun and informative. Likewise, the sections on suicide, mood stabilizers and antidepressants show similar signs of life while conveying important information.

The rest of the book is a painful slog. Data is presented in dense and rote fashion. Too many of the references are dated, even for the 2006 publication date.

The chapter on neurobiology is the most disappointing. The emphasis is on neurotransmitter studies of bipolar illness, many dating back to the 1970’s. More recent research on 2nd messenger systems, functional neuroimaging, and kindling are paid token attention in single paragraphs that feel like afterthoughts.

While this book is indeed, so much less than it could have been, it did have one significant stealth asset: at the time of it’s writing, it was the first work published specifically on bipolar depression. Readers interested in this subject are, fortunately, no longer constrained by this former exclusive status.

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