Why Am I Up, Why Am I Down?: Understanding Bipolar Disorder

Why Am I Up, Why Am I Down?: Understanding Bipolar Disorder

by Roger Granet
Why Am I Up, Why Am I Down?: Understanding Bipolar Disorder

Why Am I Up, Why Am I Down?: Understanding Bipolar Disorder

by Roger Granet

Paperback(Mass Market Paperback - Reprint)

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Overview

Violent mood swings...suicidal feelings...unpredictable behavior...

Is your life a roller coaster of highs and lows? Do your moods vacillate between profound sadness and euphoria?

If so, you may be suffering from bipolar disorder, a complex illness that involves the mood centers of the brain and affects as many as two million Americans. Since bipolar disorder is often misdiagnosed as major depression, an accurate diagnosis is crucial to understanding and managing this often chronic condition. Now this sensitive, authoritative guide explains the challenging nature of bipolar disorder and how to get the right kind of treatment to minimize or prevent future episodes of this devastating illness. Find out:

What causes bipolar disorder and who is at risk
The symptoms of both manic and depressive episodes and their common triggers
How to get the very specific kind of help you need and why early diagnosis is your best bet for successful treatment
The latest facts on successfully managing bipolar disorder...why alternative therapies such as meditation and hypnotherapy can actually be dangerous to bipolar sufferers...plus news from the front lines of research

Product Details

ISBN-13: 9780440234654
Publisher: Random House Publishing Group
Publication date: 08/10/1999
Series: Laurel-Leaf Bks.
Edition description: Reprint
Pages: 256
Sales rank: 1,004,779
Product dimensions: 4.21(w) x 6.90(h) x 0.70(d)

About the Author

Roger Granet, M.D., F.A.P.A., has practiced psychiatry for twenty years, focusing much of his work on mood and anxiety disorders. He is clinical professor of psychiatry at Weill Medical College of Cornell University, lecturer in psychiatry at Columbia University College of Physicians and Surgeons, consulting psychiatrist at Memorial Sloan-Kettering Cancer Center, attending psychiatrist at New York Presbyterian Hospital-Cornell Division, and director of consultation-liaison psychiatry at Morristown Memorial Hospital. The author of numerous medical journal articles and textbook chapters and series editor for the Dell Mental Health Guides, Dr. Granet has also written essays in The New York Times, two collections of poetry, and four popular books on psychiatry: Why Am I Up, Why Am I Down?: Understanding Bipolar Disorder; If You Think You Have Panic Disorder; If You Think You Have Depression; and Is It Alzheimer's? Dr. Granet is married, with two children. He maintains a private practice in Morristown, New Jersey.

Elizabeth Ferber is a graduate of Barnard College and has a master's degree from New York University. She is an award-winning author of eight previous books including May the Circle Be Unbroken, The Vegetarian Life, and Diabetes. As a journalist, she has written dozens of articles for a variety of national publications including The New York Times, The Washington Post, and New York magazine.

Read an Excerpt

Bipolar Disorder: Definitions and Overview

It often feels as if we live in a world of endless contradictions.  The more we work, the more money we make, yet ironically, the less time we have to enjoy it. Another classic example, according to Pentagon officials, is that the more bombs we build, the safer we will ostensibly be. How do we handle these and life's other fundamental contradictions? We pay attention to events around us, we continue with our daily tasks, and we simply hope for the best. When it comes to life's inherent contradictions, the world of mental illness is no exception, claiming as its own a disease that truly embodies the meaning of the word "opposite": The disease is bipolar disorder, formerly and more commonly known as manic-depressive illness. Bipolar disorder can be likened to the painted face of a circus clown: at once robustly joyous and at other times profoundly sad.

The clown analogy, which is commonly used when describing bipolar disorder, is an apt one, but it does not begin to address the complexity of the illness. The disease is perhaps one of the most mysterious and understudied illnesses in the field of mental health. It is estimated that 11 to 15 million Americans suffer from some form of mood disorder, whether it be major depressive disorder, dysthymic disorder, bipolar I disorder, bipolar II disorder, or cyclothymic disorder. Of the afflicted, at least 2 million people, or 0.4 to 1.6 percent of the population in the United States, experience the "highs" and "lows" of bipolar disorder.


Bipolar disorder is differentiated from other forms of depression by its periods of intense mania and/or hypomania. Sufferers experience black and hopeless moods of depression, but also euphoric feelings of hypomania and often psychotic periods of mania. In between episodes of depression and mania, patients may experience periods of balanced moods, where they feel relatively normal or "euthymic." A person may, for example, be manic for three to six months, euthymic for six months after that, and then depressed for six to nine months. As we come to understand more about this illness that takes its toll on spousal, familial, and other interpersonal relationships, we know that far more people have lived with bipolar disorder than was formerly thought. A devastating reality of bipolar disorder is that fewer than one-third of those who have the illness are ever treated for it. For a host of complex reasons, bipolar disorder is often misdiagnosed or simply goes undetected, sometimes at the expense of the sufferer's life. We do know that at least 15 percent of those who have bipolar disorder take their own lives, that men who suffer from the illness are more likely to commit suicide than women, and that these people take their own lives most often during a depressive episode.

Often, describing just the technical aspects of a disease like bipolar disorder tells only half of the story. Without personal anecdotes and case studies the material can seem dry, removed, and not terribly relevant. This is why, throughout the book, we will be presenting stories and histories of individuals coping with the disease.

Has bipolar disorder existed for a long time?

One of the great mysteries of bipolar disorder is its etiology, or cause. We will explore this subject at greater length in chapter 3, but it may help to address some of the issues here. There is a substantial amount of evidence that mood disorders, including bipolar, have existed since antiquity. Many ancient documents, including the Old Testament story of King Saul and Ajax's suicide in Homer's Iliad, describe serious depressive episodes. Even the father of medicine, the Greek physician Hippocrates, noted both mania and melancholia when discussing certain mental abnormalities. The alternating moods of bipolar disorder were not formally recorded until about the mid-nineteenth century, when two French doctors, Jules Falret and Jules G.F. Baillarger, noted that several patients showed both depressed and manic symptoms over a period of time. It was not until 1882 that the German psychiatrist Karl Kahlbaum coined the term cyclothymia, which describes depression and mania as parts of the same disease. In 1899, psychiatrist Emil Kraepelin, using the knowledge of his French and German predecessors, established a criterion for a manic-depressive psychosis that psychiatrists still use for diagnosing bipolar I today.

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