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.
As it turned out, my "short" book ran to more than twice its projected length.
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My money quote from a leading bipolar expert:
“John McManamy has produced a brilliant book, north of normal, south of crazy. It’s as good an education about depression and manic states, and about psychiatry in general, as I’ve seen in one place, written from a first-person perspective of someone who’s experienced what he’s writing about. It’s well-informed, based on careful study, explaining complex concepts simply but not simplistically, citing all the right people, and the wrong ones too (on purpose). Read it, and it’ll cure you of your average-itis.” – Nassir Ghaemi, Professor of Psychiatry, Director, Mood Disorders Program, Tufts Medical Center
Some reader comments ...
"This is such a valuable book. Not only for people who have the diagnosis of bipolar, but for those who want to understand a bit more about psychiatry, the complexity of mood disorders, or how to understand a loved one with interesting brain wiring. John is ahead of his time in presenting balanced, well-researched information in a manner that is entertaining. A true writer, his words are easily comprehended – especially on such a sophisticated subject matter".
"When it comes to exploring the gray matter between our ears, John’s got chops in this area of the mental health field, period. As a been-there-and-back journalist-turned-expert, he disseminates profoundly complicated layers of history and inside drama into a story the lay person can understand without the glazed-eye effect. No snoring. The man gets your attention and keeps it!"
"I have been reading John McManamy for years and he is compelling, insightful and a fine writer. His thoughts on hypomania feeling the most “normal”, on managing cycles within cycles gives fascinating criticism to the DSM5 definitions that obscure rather than illuminate. …What is most compelling is his experience with the states, medications and choices he writes about. He has “skin in the game”. And that outweighs the excessively neutral tone of academic writing on the disease."
– Herb Lady
"His perspective is refreshing and thought-provoking. He has once again done a great service, not only to people with bipolar disorder but also to their loved ones."
"There are simply not enough of these books for the public to read. McManamy stares directly into the soul …"
"I find John an original and erudite thinker yet a very clear communicator (his years as a journalist no doubt plays a role there). He is devoted to science and firmly grounded in the reality of his own experiences as a patient. I have been following his work for years, and have been eagerly awaiting his latest book for some time now. All I can say is, John delivers."
"John McManamy has years of seasoned insight. In a world of too-quick pharmaceutical numb-downs, John presents a human experience that everyone goes through on one level of intensity or another. … I am grateful John holds up a lantern as he lights the way to open hearts and greater understanding."
"McManamy strives to make each person with depression and bipolar disorder an expert patient. Far from being at the mercy of doctors, therapists, programs, hospitals, family and other caregivers, people with mood disorders can take the driver’s seat and harness a care team to get to living the life we want to live. … Walking the walk and not just talking the talk is key to McManamy’s expertise …"
"Even as someone who has a mental illness, I tire of mental health books that re-hash information I already know and often tell depressing stories. Not Just Up and Down is different! He is an expert with a sense of humor …"
"This book is so well written I didn’t want to put the book down! My husband who doesn’t like reading about mental illness picked it up and said, “My goodness this guy knows how to write!” He goes into detail how bipolar works, how you can help yourself, how one is able to cope with this illness. John McManamy is a brilliant writer. What a gift he is to this world. I highly recommend this book to families dealing with bipolar and those who battle this illness."
"I read this book and found it to be very informative about a condition that can be very confusing to many. I loved the balance between reasearch and personal antidotes. I learned about the history of psychiatry and its impact upon diagnosis and treatment. Mostly, I love the hope this book offers."
In the meantime, here it is – my first book in The Bipolar Expert Series. Enjoy …
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