This latest publication on Bipolar Disorder (BD) is written specifically for teens and young adults with the condition. It contains 7 chapters, in addition to the introduction, which starts with a neat description of the symptoms from the point of view of the person experiencing the disorder. This makes it very accessible and reveals a high degree of insight on the part of the authors.
Chapter one deals with the basics and explains depression and mania, again in plain English style with informative case vignettes. Perhaps the weakness was the all too inclusive definition of moods which, like all vague all encompassing definitions, end up defining very little. Today the affective sciences have very competent definitions and distinctions between terms like affect, emotion, mood, feelings and so on (e.g., see work by James Gross at Stanford University, Richard Davidson at Wisconsin University, etc).
Chapter two focuses on how to get help and what young people can expect from professionals. I liked the fact that the authors offered examples of useful questions to ask of various professionals as well as the type of questions young people will in all likelihood be asked by those same professionals.
Chapter three is crucial and I'm glad they dedicated a whole chapter to the issue of accepting the illness, as this has a decisive initial role in commitment to therapy. They illustrated this with Ashley's moving story and her fears of revealing her diagnosis to the wider world, and her all too well known pattern of discontinuing medication.
Chapter four is about tools; "you don't have to be a passive passenger being swept down the bipolar river" is an evocative sentence which the authors used to introduce the key elements they believe are integral to a successful recovery. These key elements can be captured by the four S's of bipolar stability, namely, creating a structured life, managing stress, getting a good sleep, and learning to self-monitor. I think this chapter deftly explains these factors which are common to almost all psychological approaches to psychotherapy for BD, and can indeed be found in any text dealing with the bipolar condition.
Chapter five addresses the issue of whether it is convenient or not to let others know about the illness and stipulates that total secrecy is probably not good at all, while exercising some discretion about who we confide in is also a good measure. The issue of a "helping team" is emphasized.
In chapter six one can clearly see that the book has been written for young people. "Managing your independence" focuses on academic over commitment in college, dealing with ample opportunities for experimenting with drugs, alcohol and excessive partying, and the issues of psychiatric and psychological continuity.
Finally, chapter seven, "Looking forward", addresses the painful reality that sometimes long term academic and professional goals might not be achieved and how the reality of BD sometimes forces young people to re-think important plans in life. Finding the fine line between being too fatalistic and overly optimistic appears to be a challenge. Focusing on the strengths rather than on pathologizing the individual, the authors propose, will help in finding the optimal middle ground. And even if things don't go well, 'picking yourself up' appears to be a skill required to enjoy quality of life if you have BD.
Overall, this is a good book and I have already found myself recommending it to some of my BD clients and some of my university students. One of the highlights of the book is the vignettes. They are clear, relevant, and at times very moving. This will maximize the possibilities of getting throughto young people as I'm sure they relate much more effectively when the emphasis is on experiences. Fortunately, the academic accuracy has not been sacrificed in the name of accessibility and the important findings in the expert literature are also covered, namely, importance of medication and therapy, key helpers, early symptom monitoring, cautionary notes about sleep deprivation, alcohol abuse, need for emergency plans, and others.
In terms of format, at times the authors used terms and annoying acronyms more common in the USA which will be a little cryptic for others. However, these minor offenses occurred rather infrequently so we can certainly forgive them. Their laudable effort in putting across such a complex and much needed message in an accessible yet rigorous manner is to be commended.
© 2011 Rodrigo Becerra
Dr Rodrigo Becerra, Lecturer in Psychology, School of Psychology and Social Science, Faculty of Computing, Health and Science, Edith Cowan University, Perth, Australia