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When it comes to mood disorders, American psychiatry, by and large, lacks rhythm. That is, it lacks an interest in research on circadian rhythms, the relevance of circadian neurobiology for understanding the pathophysiology of affective disorders, and in the application of such studies to generating new treatment techniques. Several European countries, in contrast, appear to feel this groove and have generated decades of clinical research in this area. So what gives?

Continue reading » “Chronotherapeutics for Affective Disorders. A Clinician’s Manual for Light and Wake Therapy. Wirz-Justice A, Benedetti F, and Terman M. Karger, 2009”

Finally, a book devoted to the other bipolar disorder. Bravo! Gordon Parker, the Australian psychiatrist, researcher and head of the venerable Black Dog Institute in Sydney, deserves credit on this basis alone. But this is far from the only virtue of this monograph. Here we get a rich, quirky wonderful assemblage of opinion from the leading authorities on this prevalent and understudied form of manic depression. The combination of being the first publication out of the gate on this important area together with its quality, diversity and depth make this required reading for all clinicians and those patients and significant others thirsty for knowledge of this bipolar subtype. For this group, here’s the bottom line: Read this book!

Continue reading » “Bipolar II Disorder. Modelling, Measuring and Managing. Gordon Parker. Cambridge University Press. 2008”

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.

Continue reading » “Bipolar Depression. A Comprehensive Guide. El-Mallakh RS & Ghaemi SN. American Psychiatric Publishing, 2006.”

Though almost 5 years old, Treating Bipolar Disorder, by Ellen Frank is still one of the first and most frequent reading recommendations that I make for newly diagnosed patients. Written in plain, easy to understand English, this little gem asserts that affective relapse in bipolar disorder follows from disruptions in social and circadian rhythms. This theory led to the development of a disorder-specific therapy, Interpersonal Social Rhythm Therapy (IPSRT) whose case-based description is the mainstay of this book.

Continue reading » “Treating Bipolar Disorder. Ellen Frank, Ph.D., Guilford Press, 2005”

This is an excellent overview of bipolar illness and is written for the practicing clinician. It covers bipolar types I and II as well the more subtle “soft” bipolar spectrum disorders.  The comorbid medical, psychiatric and substance abuse problems associated with bipolar illness are examined in detail.  Treatment interventions including pharmacologic, psychotherapeutic, and psychosocial are explained clearly and concisely.  I would highly recommend this book for any clinician, therapist, etc. who works with bipolar patients.  Informed lay people could also benefit from this book as well.

The long awaited follow-up to the 1990 definitive and comprehensive text has finally been updated.  The second edition not only maintains the overall quality of authorship of the original, it surpasses its forerunner in presenting its data in more succinct and readable form.  The result is the highest level of scholarship wherein dense levels of information are made palatable by simple but elegant synthesis and writing.  As with the first edition, this book is mainly intended for a professional audience. Starting from the beginning, the 2nd edition adds the subtitle “Bipolar Disorders and Recurrent Depression.”  A subtle but hardly insignificant change.  This shift emphasizes the author’s belief that recurrent affective disorders, regardless of the presence of mania/hypomania, share fundamental diagnostic, etiological and pathophysiologic attributes and that they should rightfully be classified together.  This contrasts with the prevailing American model of diagnostically prying apart mood disorders on the basis of episode polarity.  With this change, Goodwin and Jamison place themselves squarely in the spectrum’ camp of those that see recurrence as the defining essence of bipolarity.

Continue reading » “Manic-Depressive Illness. Bipolar Disorders and Recurrent Depression. 2nd Edition. Goodwin FK & Jamison KR. Oxford University Press, 2007.”

Goodwin and Jamison, 1990: The Bible on MDI circa 1990, this book reviews and summarizes all scientific info on all aspects of this disease (genetics, diagnosis, pathophysiology, subtypes, treatment, etc…) Not an easy read and generally, not for the lay public. Unsurpassed reference work.

Responding to the general absence of information for the lay public on the less acute forms of manic depressive illness, this book provides a helpful overview of the symptoms, course and diagnosis of these less well-known bipolar subtypes.  Written in ultra-basic, simple language, by Dr. Jim Phelps, the Corvallis, OR psychiatrist behind the incredibly useful website psycheducation.org, this work is designed to familiarize readers with the characteristics of Bipolar Disorder Type II.  But there is another, larger agenda here:  to present a different diagnostic viewpoint on bipolarity itself, one that emphasizes illness course, and specifically recurrence, as the hallmark of the illness.  This, in contrast to the current American schema, exemplified in DSM IV TR that sees episode polarity, specifically mania/hypomania, as the defining essence of the condition. Dr. Phelps explains in a clear, pain-staking and repetitive fashion the rationale for using recurrence as the defining standard, the implications this has for diagnosis (it vastly broadens the scope of the condition to include all other recurrent mood disorders such as recurrent depression, SAD, PMDD, etc…) and for treatment.  With regard to treatment, Dr. Phelps repeatedly emphasizes the hazards that can occur from both antidepressant monotherapy (using antidepressants alone without a mood stabilizer) and using antidepressants in combination with mood stabilizers.  My only quibble here is that this is presented as fact rather than the actual, active controversy that surrounds this issue today.  In my opinion, we are far from agreement on the appropriate role of antidepressants in the treatment of the bipolar depression.  This aside, Dr. Phelps should be commended for authoring a much-needed and easily understood treatise on the spectrum concept in manic depression.

This book is directed at a lay audience and devotes itself to defining and explaining this most common subtype of bipolar illness. This book is very informative for any patient with bipolar II but also has some serious problems. So, first with the good. Dr. Fieve’s writing is clear and concise, and his patient examples are both interesting and appropriate. He differentiates Bipolar II from Bipolar I quite well and explores all of the aspects of bipolar II. He covers the range from genetics to the critical importance of sleep/biological rhythms to the behavioral disturbances (e.g. substance abuse, hypersexuality) associated with bipolar illness. The second half of the text details the diagnostic and treatment modalities and prepares the patient as to what to expect in that process. Comorbid illnesses, such as ADHD and panic disorder, are also discussed.

Continue reading » “Bipolar II: Enhance Your Highs, Boost Your Creativity, and Escape the Cycles of Recurrent Depression–The Essential Guide to Recognize and Treat the Mood Swings of This Increasingly Common Disorder. Ronald Fieve, M.D. Rodale Books, 2006.”

Both literary and scientific, presents info mainly on BPI D/O (but also prodromal and softer forms of illness and their relationship to acute episodes) in accessible form. Beautifully depicts relationship between person’s environment and illness, contextualizes illness in personal history and psychology.