A piece of booty I brought back from my very recent east coast trip is a signed copy of the much-anticipated second edition to Goodwin and Jamison’s “Manic Depressive Illness,” hot off the press.
The first edition, which came out in 1990, is recognized as the definitive text on the topic, and won its authors universal acclaim.
With more than 1,200 pages of densely-packed polysyllables, the book is clearly intended for clinicians, but unlike most texts for professionals, this one goes to great lengths to assemble a very complex topic into a coherent whole. Thus, patients who are not intimidated by words such as endogenous and etiological appearing in the same sentence are strongly encouraged to stop drinking cappuccino for a month and invest the best $99 you will ever spend on your mental health.
The unifying theme of the book is the mood spectrum, more precisely what the pioneering diagnostician Emil Kraepelin meant by the term, manic-depressive illness, back in the early twentieth century. The new subtitle says it all: “Bipolar Disorders and Recurrent Depression.”
In other words, when Kraepelin was talking about manic-depression – a term he coined – he not only meant bipolar disorder, but also included unipolar depression, specifically depressions that keep coming back, that cycle in and out. These cycling unipolar depressions, the authors point out, have more in common with bipolar disorder than with unipolar depressions that don’t cycle.
By implication, the DSM has it all wrong. By lumping all unipolar depressions together, and splitting off bipolar, the authors contend, the DSM creates the impression of mood disorders being polar in nature rather than cyclical.
This is not mere academic hair-splitting, as the implications for treatment are enormous, a matter we will be discussing in future blogs.
Kraepelin also added another dimension to manic-depression one also largely overlooked by the DSM. These involve “mixed states,” symptoms of mania in depression and symptoms of depression in mania. Think of road rage, energized depression, foul mood, hellish mania … I’m sure most of you have felt like this at one time or another, perhaps nearly every day. Contrary to myth, most of us are not “just depressed” or “just manic.”
Again, the implications for treatment are enormous.
The mood spectrum has been gaining a lot of attention, as of late. Two popular books on the topic include “Why am I Still Depressed?” by Jim Phelps’ MD and my own, “Living Well with Depression and Bipolar Disorder.” Dr Phelps focuses on cycling while my book zeroes in on mixed states. Much of our thinking is heavily derivative of Dr Goodwin and his collaborators.
By all means, buy my book and Dr Phelps’ book. But if you want the straight poop, from an unimpeachable source, go to Goodwin and Jamison.
Future blogs: In the cover blurb to my book, Dr Goodwin graciously referred to “Living Well” as “a vast trove of knowledge and insight.” He lies. The true vast trove is “Manic-Depressive Illness.” In blogs to come, I will be dipping into this vast trove and reporting on my discoveries.
Published On: April 09, 2007
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