Book Review: Bipolar, Not So Much: Understanding Your Mood Swings and Depression

Bipolar, Not So Much: Understanding Your Mood Swings and Depression, by Chris Aiken, MD, & James Phelps, MD, W. W. Norton & Company, New York, NY, ISBN: 978-0393711745, 2017, 368 pages, $22.95 Hardcover.

    Bipolar, Not so Much, by Chris Aiken, MD, and James Phelps, MD, is aimed at those who experience, and those who treat, depressions and the range of manias in the middle of the mood spectrum—more than unipolar, but not fully bipolar. Bipolar disorder, despite its current vogue in the vernacular, may be one of the most misunderstood and difficult-to-diagnose disorders we currently encounter. Its varied presentation, the tendency to present for treatment primarily at the extremes of either side of mood, the deep and common misunderstandings of mania and hypomania, and the overlap of symptoms with many other disorders make an accurate diagnosis of bipolar disorder as difficult as it is important.

    The idea of a mood disorder spectrum, as described by the authors, makes important headway toward the DSM’s stated but not yet realized goal of moving away from a categorical and toward a dimensional model of mood, key to accurately identifying where a person lies on the mood spectrum, which has vital implications for successful treatment.

    Of particular note is the authors’ clarification of mania and hypomania, which addresses the commonly accepted but less commonly seen “classic” model of mania, the euphoric, confident, grandiose “high” of a mania that people are reluctant to let go of, so eagerly watched for by less experienced clinicians. Aiken and Phelps describe the restless, agitated, distressed, and anxious side of mania, often tinged with aggression and paranoia, that my colleagues and I in community mental health see far more often than the classic mania or sunny hypomania intake clinicians often screen for.

    The authors give many more diagnostic tips and tools. Presented primarily to help clients gain an understanding of their place on the mood spectrum, these tools have already found their way into my own thinking and practice. The book is aimed primarily at clients, but the level of writing and scholarship is such that students, beginning social workers, and even seasoned ones will find much of value. The research is quite current, and the authors are advancing the body of knowledge, with a great deal of valuable “practice-based evidence” drawn from their treatment of those on the mood spectrum.

    Early chapters serve to define the disorder and educate the reader, with later chapters presenting clear and effective strategies and tools for managing it, including chapters on sleep, exercise, diet, and therapies. Much of the book discusses medication, and although I found the information both useful and interesting, there is a dizzying plenty of it. This, and the high level of the writing, make the work appropriate for the more sophisticated lay reader. However, the tone is hopeful and encouraging, imbued with compassion and leavened with humor when appropriate.

    Overall, this book is accessible to the person who experiences these conditions, but with enough depth and rigor to be engaging and valuable to clinicians. I have recommended it to several colleagues, will prescribe it to several clients, and have awarded it precious space on my clinical shelves.

Reviewed by Jodon English, ACSW, BA, clinician, Enki Health and Research Systems.