Your book on Bipolar Disorder (recommended to me by DR MODE OF ARLINGTON VA) is the best I have ever read; by far the most detailed, with supporting studies cited and practical suggestions. I have the 2006 2nd Edition, and am still mining it for info and ideas. I HOPE YOU WILL CONSIDER WRITING A NEW EDITION.

I wonder if you still feel the same about ECT? To sum up–that it is a good avenue, effective, and certainly not a last resort. I have had trouble finding doctors who perform this procedure. Also, can you direct me to reliable sources and practitioners of TRANSCRANIAL MAGNETIC STIMULATION? You noted that it is promising, and easier to do than ECT. I realize you probably can’t name names, but wanted to ask.

I was diagnosed with bipolar disorder in 1992, at age 42, when I had a manic episode. I was also addicted to xanax and alcohol. Happily I’m sober and off addictive meds. I haven’t had a full blown manic episode since, though I’ve had inklings of it’s onset. I didn’t see anything in your book about ADULT ONSET bipolar. By far my major ongoing symptom is depression, not uncommon as you note.

I recently learned of two natural supplements claimed to be helpful in the treatment of the disorder. I realize naturopathic recommendations re this disorder are unproven thus far. Certainly I know meds are the gold standard, and I will stay on them. However, I wondered if you knew of these supplements and about the veracity of their effectiveness: INOSITOL and EMPower Plus. The source of this info is Scott Shannon, MD. He has other suggestions as well, presented in a recent lecture.

Not to worry–I would never go off my meds–but I’m always interested in new findings (with that grain of salt).

I would also like to mention SEVERAL BOOKS of a more philosophical nature recommended in Wes Burgess’ book on the disorder (a book not of the depth and detail as yours, but an easy read for me when I was with Churchhill’s black dog. The books include Krishnamurti’s Commentaries on Living and Zen and the Art of Motorcycle Maintenance (there were others). It’s about acceptance and WHAT IS IS (hackneyed phrase but says it). This reading has helped me. Burgess also recommends Wittgenstein’s Zettel, which I haven’t started yet. Burgess mentions “objective positivism,” something I plan to research. These books remind me to be aware of and commit to not being so driven by my emotions, to let go of the circular thoughts and negativism (admittedly I’m not always successful). To stand outside myself and my disorder and “SEE” my symptoms for what they are–expressions of the disorder–not my total self.

Dr. Mode thinks very highly of you, and I miss him. (I moved to Alpine, WY).

Thank you for your work. I look forward to more books from you.

Sincerely, Barb Loder Alpine, Wyoming

At the present time, there is no known “work-up” of the brain–that is, no blood test or scan–that can diagnose clinical depression. It appears that the brain abnormalities that underlie clinical depression are at the microscopic level. The only way to know whether an antidepressant will help a person is for them to try it.

Also, only about 50% of individuals will have a good response to the first antidepressant they take. Fortunately, there are now over twenty different antidepressants available.

The field of neuroscience has moved away from the idea that low levels of chemical messengers (neurotransmitters) are the cause of mood disorders. Rather, cell growth and neuronal plasticity appear to be the important factors. See the entry titled “How Antidepressants Work - I.”

The strategy I use in treating this problem is to maximize the mood stabilizing factors while eliminating the mood destabilizing ones: this means that antidepressants usually need to be the first to go!)

Here - In this comment - I will try to Deal with the biological one ..

Feelings of depression are caused by a chemical change that affects
how the brain functions.

A normally functioning brain is a giant messaging system that controls
everything from your heartbeat, to walking, to your emotions. The
brain is made up of billions of components with called “nerve cells”
or “neurons” . These nerve cells send and receive messages from the
rest of all your body, using brain chemicals “neurotransmitters” .

These chemicals in the human brain are responsible for our emotional
state. Depression happens when these chemical messages are not
correctly send or received between brain cells, which affect the
communication.

(i. e., A telephone): If your telephone has a weak signal, you can’t
hear the person on the other end. so it is disabled or unclear

It has been proposed that even the people who already suffering
depression, have a way to treat it passed on the biological side, This
way is the “Medications” .
The main role of the “Medications” Is to fortify weak signals by
raising the levels of certain neurotransmitters . which guarantee that
the brain’s messages are submitted loud and clear.

…More information and Related Topics at My Blog!
http://no4depression.blogspot.com/