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Summary
Summary
A handbook for persons with bipolar disorder, and their families. It offers a practical guide to the symptoms, diagnosis, treatment and causes of this potentially devastating psychiatric illness, formerly known as manic-depression. Dr Frank Mondimore offers advice on getting the most out of the various treatments that are now available -from medication, psychotherapy and electroconvulsive treatment to new approaches such as St John's wort and transcranial magnetic stimulation. For each, he discusses advantages, disadvantages, side effects and other information to help patients make informed decisions about treatment options.
Author Notes
Francis Mark Mondimore is a psychiatrist and a member of the faculty of the Johns Hopkins University School of Medicine.
Reviews (1)
Kirkus Review
An exhaustive, scientific, yet compassionate assist for sufferers of ``the chameleon of psychiatric disorders'' and their families. Psychiatrist Mondimore (Univ. of North Carolina, Chapel Hill) looks first at the symptoms and diagnosis of bipolar disorder, or manic-depression: the disease wears many masks that can make diagnosis difficult. Mondimore concedes that at present psychiatrists are generally working with the same diagnostic tools that were used in the 19th century: their eyes and ears. He goes on to discuss treatment. Medications are first and foremost'primarily mood stabilizers, antidepressants, and antipsychotics. He follows with a thoughtful considerations of electroconvulsive therapy, counseling, and psychotherapy. Mondimore is especially clear on medication side effects (and how to avoid them), how various treatments have been used and misused, and what a reasonable standard should be. In part three, Mondimore considers how bipolar disorder affects children, adolescents, and women; and how it is affected by alcoholism and drug abuse, seasonal affective disorder and chronobiology, genetics, and other medical conditions such as stroke and hormonal problems. In part four, Mondimore offers real, detailed help for living with the disease. The key is to recognize that bipolar disease is relentless and that the way to keep it at bay is for the patient to be relentless, too''about getting needed treatment and sticking to it''. Illustrative case studies here make it clear this can be done, but it isn't easy. An absolute gold mine, then, for those with the disorder and their families: thorough, candid, and up-to-date advice, full of new possibilities for help.
Table of Contents
Preface | p. ix |
Acknowledgments | p. xi |
Part I Symptoms, Syndromes, and Diagnosis | p. 1 |
1. Normal and Abnormal Mood | p. 5 |
Abnormal Mood | p. 6 |
The Manic Syndrome | p. 9 |
The Hypomanic Syndrome | p. 15 |
The Syndrome of Depression | p. 18 |
Mixed Mood states | p. 25 |
2. The Diagnosis of Bipolar Disorder | p. 28 |
Psychiatric Diagnosis | p. 29 |
Bipolar I | p. 30 |
Bipolar II | p. 37 |
Cyclothymic Disorder | p. 41 |
Bipolar Spectrum Disorders | p. 45 |
Rapid-Cycling Bipolar Disorder | p. 50 |
Schizoaffective Disorder | p. 51 |
3. A Summary of the Diagnostic Categories of Bipolar Disorder in DSM IV | p. 54 |
What is the DSM? | p. 54 |
A "Multiaxial" Diagnostic System | p. 57 |
Bipolar Categories in DSM IV | p. 58 |
4. The Mood Disease | p. 61 |
Before "Bipolar" | p. 61 |
Dr. Kraepelin and "Manic-Depressive Insanity" | p. 63 |
Dr. Cade and Lithium | p. 68 |
Part II Treatment | p. 73 |
5. The Brain: Neurons, Neurotransmitters, and More | p. 75 |
6. Mood-Stabilizing Medications | p. 84 |
Lithium | p. 84 |
Valproate (Depakote) | p. 92 |
Carbamazepine (Tegretol) | p. 95 |
Lamotrigine (Lamictal) | p. 97 |
Other Mood Stabilizers | p. 99 |
7. Antidepressant Medications | p. 100 |
Tricyclic Antidepressants (TCAs) | p. 100 |
Selective Serotonin Reuptake Inhibitors (SSRIs) | p. 103 |
Other New Antidepressants | p. 105 |
Monoamine Oxidase Inhibitors (MAOIs) | p. 105 |
Treating Bipolar Depression | p. 107 |
8. Antipsychotic Medications | p. 109 |
Therapeutic Profile | p. 110 |
Side Effects | p. 112 |
The New Antipsychotic Medications | p. 113 |
9. Other Medications, Hormones, and an Herb | p. 116 |
Benzodiazepine Medications | p. 116 |
Calcium-Channel-Blocking Agents | p. 118 |
Stimulant Medications | p. 119 |
Thyroid Hormones | p. 121 |
St. John's Wort | p. 122 |
10. Electroconvulsive Therapy | p. 124 |
Modern ECT | p. 126 |
ECT for Bipolar Disorder | p. 129 |
Transcranial Magnetic Stimulation | p. 130 |
11. Counseling and Psychotherapy | p. 133 |
Brain and Mind | p. 134 |
What Can Therapy Do? | p. 136 |
Group Psychotherapy | p. 136 |
Individual Therapy for Depression | p. 137 |
New Psychotherapies for Bipolar Disorder | p. 140 |
"Traditional" Individual Psychotherapy | p. 142 |
Psychotherapy in Bipolar Disorder: Is It Really Necessary? | p. 144 |
The Psychiatrist-Psychotherapist: An Extinct Species? | p. 145 |
12. Treatment Approaches in Bipolar Disorder | p. 147 |
Therapeutic Results as a Guide to Treatment | p. 147 |
A Few Principles of Treatment | p. 150 |
Part III Variations, Causes, and Connections | p. 157 |
13. Bipolar Disorder in Children and Adolescents | p. 159 |
Symptoms of Pediatric Bipolar Disorder | p. 160 |
Bipolar Disorder and ADHD | p. 161 |
Treatment and Prognosis | p. 162 |
14. Women with Bipolar Disorder: Special Considerations | p. 165 |
Premenstrual Syndromes | p. 165 |
Symptom Differences in Women | p. 167 |
Postpartum Mood Disorders and Family Planning | p. 168 |
15. Alcoholism and Drug Abuse | p. 170 |
Bipolar Bings | p. 170 |
Effect, Cause, or Association? | p. 173 |
Use or Abuse? | p. 174 |
A Deadly Combination | p. 175 |
16. Seasonal Affective Disorder and Chronobiology | p. 177 |
Biological Clocks | p. 179 |
Seasonal Affective Disorder | p. 183 |
The Sleep Cycle and Bipolar Disorder | p. 187 |
17. The Genetics of Bipolar Disorder | p. 191 |
Genes, Chromosomes, and DNA | p. 191 |
Genetic Diseases | p. 193 |
What We Know | p. 195 |
The Search Continues | p. 195 |
18. Bipolar Biology | p. 197 |
"Medical" Mood Disorders | p. 197 |
Post-stroke Mood Disorders | p. 199 |
Mood Disorders Due to Hormonal Problems | p. 202 |
Picturing Bipolar Disorder in the Brain | p. 204 |
Viruses and Bipolar Disorder | p. 206 |
19. Bipolar Disorder and Creativity | p. 209 |
Part IV Getting Better and Staying Well | p. 217 |
20. Living with Bipolar Disorder | p. 219 |
Confront and Accept the Illness | p. 219 |
Practice Mood Hygiene | p. 222 |
Build Your Support System | p. 228 |
Don't Be a "Bipolar Victim" | p. 230 |
21. Planning for Emergencies | p. 232 |
Know Whom to Call for Help | p. 235 |
Insurance Issues | p. 236 |
Safety Issues and Hospitalization | p. 238 |
22. The Role of the Family | p. 240 |
Recognizing Symptoms | p. 240 |
Involuntary Treatment and Other Legal Issues | p. 244 |
More on Safety | p. 247 |
Getting Support | p. 248 |
23. Looking Ahead | p. 250 |
Resources | p. 253 |
Suggested Reading | p. 253 |
Support and Advocacy Organizations | p. 254 |
Internet Resources | p. 255 |
Notes | p. 257 |
Index | p. 273 |