Ghaemi's methodology is twofold: on the one hand, he applies philosophical ideas, such as utilitarian versus duty-based ethical models, to psychiatric practice. On the other hand, he subjects clinical psychiatric phenomena, such as psychosis or the Kraepelin nosology, to a conceptual analysis that is philosophically informed. This book will be of interest to professionals and students in psychiatry, as well as psychologists, social workers, philosophers, and general readers who are interested in understanding the field of psychiatry and its practices at a conceptual level.
S. Nassir Ghaemi, M.D., M.P.H., is director of the Bipolar Disorder Research Program at Emory University School of Medicine.
Too often depression as disease is mistreated or not treated at all. Ghaemi warns against the "pretenders" who confuse our understanding of depressionâ€”both those who deny disease and those who use psychiatric diagnosis "pragmatically" or unscientifically. But experiencing sadness, even depression, can also have benefits. Ghaemi asserts that we can create a "narrative of ourselves such that we know and accept who we are," leading to a deeper, lasting level of contentment and a more satisfying personal and public life.
Depression is complex, and we need guides to help us understand it, guides who comprehend it existentially as part of normal human experience and clinically as sometimes needing the right kind of treatment, including medications. Ghaemi discusses these guides in detail, thinkers like Viktor Frankl, Rollo May, Karl Jaspers, and Leston Havens, among others.
On Depression combines examples from philosophy and the history of medicine with psychiatric principles informed by the author's clinical experience with people who struggle with mental illness. He has seen great achievements arise from great suffering and feels that understanding depression can provide important insights into happiness.-- Michael Trimble, M.D., Institute of Neurology, London
Bipolar Depression first introduces a hierarchical model for diagnosis to allow the clinician to distinguish between bipolar and unipolar depression, addressing problems of misdiagnosis and overdiagnosis as well as differentiating attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder. Early chapters review the neurobiology and genetics of this highly heritable condition, presenting studies of neurotransmitter function and brain imaging studies and documenting the susceptibility of specific chromosomes as loci for bipolar disorder. Other chapters address the particular issues of bipolar depression in children, for whom a diagnosis is especially problematic, and suicide, focusing on the need for assessment during both acute and maintenance treatment with interventions appropriate to a patient's symptoms and history. Bipolar Depression offers critiques of specific treatment approaches: Lithium and antiepileptic drugs: featuring a review of the most recent research on the use of lithium, in which higher doses are shown to be effective, plus coverage of lamotrigine, valproic acid, carbamazepine, oxcarbazepine, and topiramate. Antidepressants: offering new perspectives on a complex field, including a discussion of the randomized clinical trial literature and observational studies on their use, and citing cautions regarding side effects. Antipsychotics: evaluating the difference between first- and second-generation medications and discussing their role in controlling acute depressions. Novel approaches to treatment: including the use of atypical neuroleptics, electroconvulsive therapy, transcranial magnetic stimulation, vagus nerve stimulation, ketogenic diet, omega-3 fatty acids, myo-inositol, and dopamine agonists. Psychological interventions: focusing on the inclusion of cognitive-behavioral therapy or interpersonal social rhythm therapy for nonmelancholic depressions in patients who had previously received psychoeducation.
Despite the past decade's advances in practice and research, there remains much room for progress in understanding and treating bipolar depression. This book blazes a trail toward that goal, opening new doors in recognizing differences between bipolar and unipolar forms of depression while offering both researchers and clinicians key insights into this troubling illness.