Let me start by acknowledging what is well known: Manic Depression or Bipolar disorder can be a devastating illness. Affecting at least 1% of the population, it can, untreated, result in suicide, ruined careers and devastated families. Bipolar disorder is often accompanied by alcohol and drug abuse and addiction, criminal and even violent behavior. I acknowledge this, because I do not want to make light of the burden this illness places on people’s lives, their families and communities.

On the other hand, the history of the world has been influenced very significantly by people with manic depression (see my website www.wholepsychiatry.com for details)-from actors and actresses (Patty Duke, Jim Carey and Robin Williams) to Politicians (Winston Churchill, Theodore Roosevelt) to astronauts (Buzz Aldren), media mogels (Ted Turner) and perhaps even well known religious figures.

It seems clear that for at least some people with Bipolar disorder, there is an increased sense of spirituality, creativity, and accomplishment. It may be that having bipolar disorder holds great potential, if one is able to master or effectively channel the energies, which are periodically available, to some higher task. This would of course presume the ability to abstain from harmful drugs and alcohol, to have good character, and at least some supportive relationships and community networks.

It might be helpful to consider a reconceptualization. Perhaps instead of it being a disorder, we can think of people with bipolarity as having access to unusual potency. This potency will find a way to be outstanding-either in a destructive way, or in a constructive way. If such a choice is presented to the person, perhaps it can open some doors.

I will be discussing this and other aspects of bipolar disorder on Wednesday, August 4th @ 12PM Eastern time in my free virtual teleconference.

Women have twice the frequency of depression as men, and are more vulnerable to many psychiatric disorders between puberty and menopause. Menopause and the post partum are time of high vulnerability for women. Women are more likely to be hospitalized or jailed in the days just before menstruation begins. Transdermal estrogen has been proven in three studies to have antidepressant effects (as opposed to oral estradiol). These facts, and others, beg for our attention to the role of female hormones in mental health. When one adds the concerns raised by the woman’s health initiative study of over 160,000 women on synthetic estrogens, one can easily be left in a state of confusion.
What to do?

First, write down a complete history of your mental health and hormonal events. This means looking at mental health symptoms just before and during puberty, in the days before your period, in response to pregnancy and birth control pills, after any female surgeries, and around menopause. What were your symptoms, did they get better or did some get worse? Include your family history of female (ovarian, uterine, breast) cancers, male cancers (prostate), and cardiovascular disease.

Next if you are still menstruating, track your symptoms and your cycle for three months. Some studies suggest that 50% of women who think they have PMS, do not. Whether that statistic is correct or not, you need to make an accurate correlation.

Finally, work with your doctor to check your FSH, LH, estradiol and progesterone in both the follicular (first 10-12 days) and luteal (days 18-24) parts of your cycle. If you can arrange for continuous salivary monitoring of estradiol and progesterone (less reliable) during that same cycle, you will get a very nice picture of what your hormones are doing in relation to your symptoms. In a simplistic way–estrogen tends to be activating, and progesterone is like the drug Valium—calming in small doses, sedating and depressing in large doses. If you want to be really comprehensive, you can test your genetics (CYP450 1B1 and COMT) and estrogen metabolism to determine whether you can improve your protection against female cancers by eating crucifers, or whether these veggies might increase your risk for making ‘bad’ estrogens.

In addition, look at other hormones (adrenal and thyroid) that influence the female hormone cycle to round out the picture.

All this and more will be discussed in my upcoming complimentary Lunch and Learn teleconference May 5th, at 12:00.