Evidence-Based Treatment for Bipolar Disorder: Is the Evidence Based on the Wrong Outcome?
My ankle was broken during a hockey game when I was sixteen. The pain was so intense that by the time I got to the hospital an hour later I couldn’t bear it any longer.
If the doctor had given me a choice between suffering from the pain or cutting my leg off at the knee I would have chosen the amputation. I would still be paying for the mistake if he told me the best evidence calls for amputation and gave me no other option other than suffering for the rest of my life.
This sounds absurd. But, what if the pain was in my head? According to a recent article in the BBC News Magazine (http://www.bbc.co.uk/news/magazine-15629160), they did something even worse in the 1950s – they amputated part of people’s brains.
They lobotomized people with depression and bipolar (and other issues) because it was the best evidence-based treatment at the time. From the article, “But from the mid-1950s, it rapidly fell out of favour, partly because of poor results and partly because of the introduction of the first wave of effective psychiatric drugs.” Chemical lobotomies became the evidence-based treatment of the day.
Today’s evidence-based treatments are so much more humane. Or are they? The tools are more refined, but the goal of treatment is the same: cut off the part that is broken. We are no longer poking ice picks into people’s eye sockets, but are still trying to accomplish similar outcomes.




When my first book The Bipolar Advantage came out, I almost made a version of it replacing my name with Steve Jobs to send to him. The two of us looked so alike at the time that even Apple employees would come up to me and ask if I was a Steve when I dressed like him.

There was a demo of a video car racing game at the mall the other day and I became fascinated by the reactions of the people who were trying it out. I stayed around for a couple of hours and did an informal study of the phenomenon.
I noticed it when I was first diagnosed, but have been watching the phenomenon ever since. I have seen it happen in so many people that it might be true in three quarters of the cases. What is even more amazing is how fast it happens. Bipolar may be the fastest path to perfection known to man!
