1) You have a brain/body disorder - - it is NOT your fault; if you were suffering from any other "physical illness" - - would you blame yourself?

2) Your chance of improvement or recovery will increase if you obtain the correct diagnosis and, thence, treatment. If you have been seeing the same professional(s) for a long time without significant relief - - seek a consultation with a new doctor - - even if this new person ends up agreeing with the previous diagnosis and treatment plan. Confidence in the treatment you are receiving enhances your likely outcome.

3) Do not take too seriously the suggestions for alternative treatments which are based on anecdotal data. (e.g.: Your friend Joe says he took Vitamin "Q" and Nutrient "X" and his depression went away.) In the absence of scrupulous scientific studies, such statements cannot be considered to be valid. People improve from all sorts of medical conditions without any intervention; the placebo effect also can cause people to go into remission.

4) Compliance - - No treatment regimen can be effective if the person refuses to follow the regimen as directed by hir doctor. There are people who refuse to take their lithium or antidepressant, complaining "it's not natural." Why so many mood disorder patients concentrate on the word natural is interesting - - after all cyanide and arsenic are natural! In fact, lithium is "natural" - - appearing on the periodic table of elements. Some persons take their meds but not as directed - - rather, only when they feel like it. The efficacy of most drugs depends on blood levels which should be relatively constant. Intermittent medication taking can defeat the intended results.

5) Stigma I - - The reaction of society to your disorder. Responses to all "mental illnesses" used to be absolutely horrible! Now, there has been some improvement, due to some education of the public,  via television, magazines, and public people "coming out of the closet". (e.g. authors William Styron, Art Buchwald, actors Margot Kidder, Dick Cavett, and Washington Post publisher Katharine Graham - - who also went public when her husband Philip committed suicide due to manic depression... and the list goes on and on!  Special credit is due to Dr. Kay Jamison, who is pre-eminent in the field of mood disorders. In her memoir she juxtaposes her important scientific work with an exploration of her having lived with an exploration of her having lived with manic-depressive illness for over thirty years.)

Knowledge defeats stigma. Ambiguity scares; facts remove fears.

[To be continued in the Winter issue.]