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April 5, 2004

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Medside Manner
Congratulations to Vanessa Grigoriadis for her “Are You Bipolar?” article [March 8]. As a psychiatrist who is trained in psychopharmacology and psychoanalysis, I’m troubled by trendy diagnoses and medications as an end in themselves. The fact that Ms. Grigoriadis had the courage to sit down with an “organic” therapist and examine issues in her life is an encouraging note to us all not to jump to easy, externalized solutions.
—Scott C. Schwartz, Manhattan

Headstart
If we bang our head against the wall and experience an immediate headache, the medical model gladly prescribes a pill to ease the pain. Therapy—the process of understanding our emotions and learning from them—instead teaches us to listen to the headache and try to discover the reason we banged our head against the wall in the first place. In most cases, depression is the result of distorted perceptions and wrong decisions. Tragically, Vanessa Grigoriadis and others endure years of pill-popping before they discover the motivations behind their emotions and learn that they have another choice.
—William E. Ward, Montvale, N.J.

Just Say No
Perhaps it’s not a coincidence that a remake of The Stepford Wives will be released soon. As drug companies and compliant psychopharmacologists attempt to turn us into a nation of detached automatons, maybe someone will recognize the satirical parallel. I breathed a sigh of relief when Vanessa Grigoriadis acknowledged that “without meds, there was no madness—there were only other relationships, other challenges, and other ways of growing.” There’s hope for the (unmedicated) human race yet.
—Malerie Yolen-Cohen, Stamford, Conn.

The Series
i’m sure bipolar disorder exists, but the expanding definition is clearly a way for drug companies and the psychiatric profession to extend their reach. Through personal family experience, I have seen the profession define the normal ups and downs of the maturing process as a pathology. On the continuum of bipolar I, II, III, etc., I’m certain that someday I will be defined as bipolar VII, since I am sometimes more upbeat than at other times, while a totally comatose person will be bipolar IX.
—Jerry Gindele, Pittsburgh, Pa.

Mood Lighting
Kudos to Vanessa Grigoriadis for her cover story on the vagaries of bipolar disorder and especially the challenges of diagnosis in modern urban settings. Strangely, though diagnosis traditionally drives treatment decisions, the reverse may hold true for bipolar II disorder—namely, response to medication may enlighten diagnosis. Psychiatrists are increasingly familiar with depressed patients who are unresponsive to the usual antidepressant medications. Mood stabilizers like Lamictal and lithium may help bring both dramatic improvement and diagnostic clarity.
—Brian P. Lipton, M.D., Manhattan

Lucky on Lithium
Although I found Vanessa Grigoriadis’s article interesting and informative, I was dismayed to see that the moral of the story seemed to be Don’t take medication. Perhaps medication was not right for Ms. Grigoriadis, but not all of us have the luxury of treating our illnesses in an “organic fashion.” I consider myself very lucky to have found a psychiatrist—not a psychopharmacologist or therapist—who correctly diagnosed my symptoms and placed me on the appropriate medication.
—Ellen Gordon, Manhattan

Cure-Aid
I am bipolar and do not anticipate that I will ever stop being bipolar—this illness is something I will merely have to contend with for the rest of my life. I will always have ups and downs, but so many smart, wonderful, brilliant people like me who genuinely suffer from bipolar disorder have been given a second chance in life through the medications and treatment available today.
—J.F., Brooklyn

Daily Dose
While I commend Vanessa Grigoriadis for raising consciousness about bipolar disorder, I think it’s important for diagnosed patients to follow their doctors’ orders and stay on a regimen of medication. Through my work with bipolar disorder, I’ve heard from literally hundreds of sufferers about frightening tales of going off medication. It’s almost always a recipe for disaster.
—Andy Behrman, Los Angeles, Calif.

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