Incisive guide to bipolar disorder | |
Fast facts: Bipolar disorder. Guy Goodwin and Gary Sachs. Oxford: Health Press, 2004 (99pp). ISBN 1 903734 50 9. |
At first blush,
a book from a series called Fast facts does not evoke enthusiasm — suggesting, rather, an uninspired commercial opportunism. However, this small volume is pleasingly pithy, erudite and accessible, as well as being helpfully informative. Goodwin and Sachs are eminent in the field of bipolar disorder, representing research groups from both sides of the Atlantic (Oxford and Harvard, respectively). The dominant style, however, is that quintessentially English amalgam of droll understatement and incisive intellectual directness. The authors are unabashed apologists for the scientific method in clinical medicine, while at the same time compassionate clinicians: “We believe that the medical model is useful in diagnosing bipolar disorder — indeed, we cannot see a viable or reliable alternative.” The richness of their clinical experience is apparent in their accounts of the condition, referring, for example, to the “mischievous state of elation” that characterises milder presentations of mania. When discussing the somewhat dry issue of aetiology, they engagingly describe the interplay of genetic vulnerability and life-event precipitants: “Triggers have the same relationship to the real causes of severe bipolar disorder as a spark has to gunpowder.” It is the sharp observations and commentary that make this volume distinctive. One striking instance is their discussion of the controversial issue of childhood bipolar disorder, which is being diagnosed at alarmingly high rates in the US: “It represents another of the ways in which practice in North America is different from that in most other parts of the world …. It is still possible for the sceptic to say that this is diagnosis inflation.” Bipolar disorder is a condition that is tentatively emerging from the shadows of shame, misunderstanding and fear. Thoughtful volumes such as this are a critical component of the process of destigmatisation.
Philip B Mitchell
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