The Bipolar Handbook: Real-Life Questions With Up-to-Date Answers by Wes Burgess

December 1, 2006

Bipolar disorder is often seen as a perplexing illness by patients and clinicians alike. In recent years, there has been a growing appreciation in psychiatric circles of the disorder's prevalence. This increased attention has filtered its way down to the general public, which, in turn, has produced sometimes sensationalistic media portrayals of manic depression, a number of speculative books about historic figures and noted artists who purportedly had the illness, and an array of self-help books marketed to individuals (and their families) afflicted with the disorder.

Bipolar disorder is often seen as a perplexing illness by patients and clinicians alike. In recent years, there has been a growing appreciation in psychiatric circles of the disorder's prevalence. This increased attention has filtered its way down to the general public, which, in turn, has produced sometimes sensationalistic media portrayals of manic depression, a number of speculative books about historic figures and noted artists who purportedly had the illness, and an array of self-help books marketed to individuals (and their families) afflicted with the disorder. Unfortunately, the information that is readily gleaned from these sources is often incomplete at best and inaccurate or misleading at worst.

In a book titled The Bipolar Handbook: Real-Life Questions With Up-to-Date Answers, Dr Wes Burgess attempts to correct a number of the common misconceptions about the disorder. Based on his many years of experience in treating patients with bipolar disorder, Burgess has compiled a comprehensive list of frequently asked questions from patients, their families, and their colleagues. Each question is categorized by topic area and is then succinctly addressed. A perusal of the table of contents quickly demonstrates the diversity of topics this book covers, including diagnosis and symptom presentation, effective medical and psychological treatments, healthy lifestyle choices, career and relationship issues, concerns specific to women with bipolar disorder, and the impact of the illness on family members and how they can help. In addition, the author provides readers with a list of reliable resources on bipolar disorder, as well as helpful recommendations for finding qualified treatment providers.

I would be comfortable recommending this book to patients and their families. It is appropriate for those in whom the disorder has been newly diagnosed, but it is also useful for patients who have had the illness for years. Furthermore, the book would make a particularly excellent adjunct to treatment, albeit with a few caveats. Although the information provided in the book generally appears accurate, some psychiatrists may be uncomfortable with Burgess' strong admonitions against the use of antidepressants as an adjunct to mood stabilizers in almost all cases because of their potential for triggering manic episodes.

In addition, some may find Burgess' definition of bipolar disorder to be a bit overly inclusive. The book provides readers with detailed information on how to recognize even subtle bipolar symptoms, which the author notes are frequently misdiagnosed as other problems (eg, unipolar depression, attention-deficit/hyperactivity disorder, schizophrenia). On the other hand, Burgess does not properly acknowledge the instances when bipolar disorder itself (especially bipolar II) is misdiagnosed, also leading to incorrect and perhaps harmful treatments. However, these and other potential concerns can be diminished if clinicians provide patients and their families with opportunities to discuss the book and to ask any questions that may arise.

Overall, Dr Burgess has written a welcome addition to the emerging self-help and educational literature on bipolar disorder-a disabling and potentially life-threatening condition.

As with most books in its genre, The Bipolar Handbook: Real-Life Questions With Up-to-Date Answers is likely to be optimally effective when integrated with the treatments already being provided by experienced psychiatrists and therapists.

Dr Gaudiano is an assistant professor (research) in the department of psychiatry and human behavior at Brown Medical School in Providence, RI.