Further reading for Lord and Master
Background medical information
This page is a spoiler for the novel. Don't read any further unless you've already read the book and are looking for more information about a medical issue raised in the book. Scroll down past the spoiler space for further information.
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Bipolar disorder in the book
Where to find more information about bipolar disorder
Bipolar disorder in the book
Steven has bipolar II disorder. As shown in the novel, this is characterised by relatively mild mood swings compared to Type 1 or "classic" bipolar disorder; with hypomania rather than full-blown manic episodes, and a major depressive episode perhaps once a decade. The most common pattern has occasional hypomanic and dysthymic (mild depression) episodes that last for weeks or months at a time; but some people have cyclothymia, with frequent mild episodes lasting only days or even hours. It's also possible for people to have a mixed mood state, with symptoms of both depression and hypomania. Steven is cyclothymic and rapid-cycling, with several short episodes every year.
Because the mood swings are relatively mild, bipolar II doesn't usually have the flamboyant symptoms that people associate with the phrase "manic depression" until quite late on. Unless someone has a severe case, initially the only obvious symptom is the major depressive episode every ten years or so, which is usually severe enough to need treatment. It's common for sufferers to remain undiagnosed for years, or to be misdiagnosed as having unipolar depression. People at the mild end of the spectrum often function perfectly well without treatment most of the time, only needing medication during the major depressive episode. However, misdiagnosis can still be a problem even in people who don't normally need treatment, because people with bipolar disorder who are treated with certain antidepressants are at risk of switching from depression into hypomania or mania unless they have accompanying mood stabilisers.
Where to find more information about bipolar disorder
If you've come to this page because you recognised yourself or a friend or family member in Steven, and are now wondering where to find more information, I would suggest you start with the National Institutes of Health section on bipolar disorder:
http://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml
This covers both Type 1 and Type 2 bipolar disorder. The introduction page of the main coverage is here:
http://www.nimh.nih.gov/health/publications/bipolar-disorder/introduction.shtml
or you can find the whole thing on a single page here:
http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-publication.shtml
A psychiatrist who wrote to me after reading the book also suggests these sites:
"I suggest www.healthyminds.org (the american psychiatric association's public info site) and www.wpanet.org (the world psychiatric association which also has a public info section) for dsm4tr - diagnostic criteria fit for public consumption. I also recommend www.nami.org (national alliance on mental illness) for advocacy as well as info."
Bipolar disorder is not curable, but it is treatable. If you are worried, it's well worth reading these resources and seeking further advice if necessary.
Return to main background information page.