By Admin | September 23, 2008
Are you working on a book right now?
And may I ask what it is?
It is a book called Nothing Was The Same. It is a follow-up to an earlier book I wrote called An Unquiet Mind.
So you are writing your second memoir?
You wrote An Unquiet Mind in 1995. Do you ever wish you hadn’t written it?
I have had my regrets. I think overall that it was the right thing to do.
Why did you decide to write your memoir?
Why? Because people don’t talk about it. You know, people in the professions have these illnesses, have psychiatric illnesses.
People in medicine, my colleagues, my students have depression and bipolar illness and they live in a climate of fear and concern about hospital privileges and licenses.
These are illnesses like any other illnesses and the trouble is people don’t talk about them that way and so I felt that you that i should.
Does it bother you when you are out speaking or in a social situation and people come up and tell you their stories or a story of one of their loved ones.
Well, I think it is a very common illness and I think people don’t have the kind of opportunity to talk about that and in an ideal world they should.
So, I always try and listen because I think it is very hard for people to have. It is a devastating illness to have. It is devastating for family members.
I think I have been very fortunate. I have been very fortunate to have wonderful family and colleagues and I respond very well to medication.
So, I feel like I’ve been lucky. So, if I can do something to help people I try and do it. I don’t always succeed but I try.
Are you practicing clinically as a therapist right now?
No, not right now. It was one of the things that I gave up. It was one of the major decisions I had to make before I wrote my book. You know, I see patients in consultation, but that’s it.
Do you miss it?
Of course, I miss it terribly. I had great patients. I loved my patients. I loved clinical work. I spent twenty years practicing. And, it’s a part of the way you think. It’s a part of the way you see the world. I miss it, sure.
Was An Unquiet Mind the most difficult book for you to write?
The suicide book was a very difficult book to write in the sense of the subject matter. It is very hard to get up every day to read and write about suicide.
Are you distressed about all these kids on the college campuses shooting the other kids.
Why is that happening?
Suicide overwhelmingly is linked to psychiatric illness. The major causes of suicide are depression and bipolar illness. So, that’s why people tend to kill themselves.
Do you think it is more prevalent now?
No, I see that the suicide rate has gone down over the last twenty years.
Why is that?
Does acupuncture work for bipolar disease?
There is no evidence that it does. It doesn’t mean that it doesn’t. There is no evidence.
The treatments that have been demonstrated from a scientific point of view are lithium and a variety of anti-convulsive medications. Mood-stabilizing drugs.
Yeah. As a matter of fact I just gave a lecture this morning to public health students at Hopkins about that issue.
It doesn’t do you any good to have really great medications that work – there are quite a few medications that work – if people won’t take them.
And, one of the big advances in bipolar illness in the last maybe 15 years or so, is that there are now ten or fifteen studies showing the combination of psychotherapy and medication is more effective than medication alone. Psychotherapy alone for bipolar illness doesn’t work.
But the combination is good. People, particularly when they are young, don’t take their medication and psychotherapy is something where people can deal with the issue of not wanting to take a medication.
How do you find a good therapist? What is the key to a successful therapy? Trust?
Someone who is competent. I think in my own field, which is the study of bipolar illness, which is a very serious illness which tends to get worse over time if it is not aggressively and well-treated, you want a doctor who knows what he or she is doing.
You want a doctor knows about the natural course of the illness, the neurobiology, the medications, the psychotherapy. You want a doctor who knows alot. You don’t want somebody… I mean empathy is important, of course, but you shouldn’t have to make an either or decision.
You want a doctor who is informed and up on the literature, who is empathetic and who knows what to do. Not everybody needs psychotherapy by any stretch.
But, there is a tendency I think to downplay the importance of psychotherapy because bipolar is such a clearly genetic illness and the primary treatment is clearly medical.
But, I would argue and I think alot of people who treat the illness would argue that actually it is one of those places where psychotherapy has actually saved lives. It doesn’t just make the quality of life better. It saves lives.
When you were a clinical psychologist, did you specialize in bipolar? If somebody came to you for marriage counseling would you see them?
I was pretty specialized in mood disorders. I ran a mood disorders clinic.an affective disorders clinic, at UCLA for many years. So, the patients that we saw were patients with depression and life trauma.
Do you think that because you had that disease it made you a better clinician, a better therapist, a better healer?
Not necessarily. I don’t really buy that argument. Say, if I had Hodgkins’ disease, I wouldn’t choose my doctor on the basis of whether he or she had Hodgkins disease. I would choose on the basis of what they knew.
I think it certainly affected, I hope in a good way but probably not always by a stretch, my research, my teaching and my advocacy. Because, I think I am more impatient.
I focus alot on suicide. I focus somewhat more on the positive elements of the illness. I think I probably have a different focus and interest than somebody who doesn’t have the illness.
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