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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.

We cannot imagine cutting off a leg for a broken ankle, but every day another patient hears the false choice between a lifetime of suffering and a diminished life where our capacity to experience high and low states has been cut off. The reason I say it is a false choice is because too many pretend that there are only two choices: remove the highs and lows or not treat it at all. When I challenge the outcomes as unacceptable I often hear that I am advocating the “no treatment” choice, which is a ridiculous assumption. I advocate using the same tools along with new tools while collecting evidence of their efficacy for better outcomes. I believe we need a new paradigm altogether. I call it IN Order-based instead of disorder-based.

Please note that I am fully supportive of the evidence-based model of vigorously studying and debating the efficacy of tools. While corporate interests are skewing studies toward pharmaceutical approaches, I am in full agreement that we need to scientifically assess each tool to make sure the evidence supports its use. My issue is the lack of debate about outcomes. For the most part, the outcome is assumed to be removal of symptoms. It is almost universally assumed that the disorder is that we have highs and lows. There is little willingness to consider that we can have them without them being in disorder.

Perhaps the problem is the pain is so great that we are willing to jump at the solution without considering our options. It may be that people in authority are giving us a false choice comparable to cutting off our leg or suffering from a broken ankle for the rest of our lives. It is funny how the people most advocating evidence-based treatment are the ones unwilling to consider evidence that refutes their claim that we have to cut out our highs and lows to remove the disorder. Worse yet are the doctors mixing multiple drugs with no evidence at all of their efficacy while hypocritically deriding other options as not being evidence-based (http://www.psychiatrist.com/brainstorms/br6510.pdf).

There are a growing number of people who are achieving Bipolar IN Order instead of staying in disorder. We have learned to remove the disorder without cutting a part of ourselves away. We are fully bipolar, but we are not in disorder. We still have highs and lows, but they do not affect our ability to choose how to respond to the increased flow of energy and information associated with the bipolar condition.

We use the same tools that were used to achieve lesser results and have added more advanced tools to the toolbox. We have developed a program of assessments, tools, and realistic plans that have worked for many people, while recognizing that each individual will create their own plans from the template. Evidence is growing that we can achieve results that the “illness” model refuses to consider.

“Since it is believed impossible to thrive in depression, mania, hallucination, and delusion, we are not taught how to thrive. We are instead taught only how to avoid the symptoms and live in fear that they might some day return.”
- Bipolar In Order

If you really believe in science, you need to consider the evidence of our outcomes. IN Order-based does not mean treatment-free; It means that we consider evidence that is based on better outcomes instead of dogmatic belief in removal of highs and lows as the only possible solution. Once you see the outcomes that we are already producing, you will find the argument for cutting out our capacity for a wider range of experience as preposterous as the argument for removing a leg because of a broken ankle.

What evidence can you share of living with Bipolar IN Order?

I have heard many people postulate that Steve is bipolar, so I thought the stunt would get his attention. The book cover was easy for people to mistake as him and with his name on it the legal team would be wondering what it was about. The crazy idea was that they would show it to him and he would contact me because of it. He has been a hero to me and at the time I was obsessed like so many with finding examples of famous people who were bipolar.

The recent announcement that Steve Jobs is stepping down reminded me of my old fantasy. Back then I was convinced that his success was a result of being bipolar and it was proof that we have advantage, which is partly why I named the book The Bipolar Advantage. He may be bipolar, but the fantasy really says more about where I was at the time than anything else. Like so many others, I needed to find things that made up for the horrors of the condition. If we could just survive all of the terrible things about mania and depression, perhaps we could gain something from having been through it.

My evidence was pretty flimsy though (as was the premise itself, I have since found reasons that bipolar is an advantage DURING mania and depression, not in spite of it). Steve is said to be mercurial – I was mercurial = bipolar. Steve is creative – I want to be creative = bipolar. Steve works very hard – I do when I am manic = bipolar… Looking back it was delusion combined with grasping at straws. We take hearsay evidence and filter it through our own desires to see what we hope to see. Does anyone have any strong evidence for or against the notion that Steve is bipolar?

Although it would be interesting to learn that Steve Jobs is bipolar, what does it matter? Does it change my day-to-day life with my own bipolar condition? Perhaps yes, if it inspires me to work harder on becoming a better person. If it leads to making excuses for my behavior because Steve Jobs didn’t address his own flaws, I would be better off paying attention to other things.

Although Steve is one of my heroes for what he has accomplished with Apple, from a Bipolar IN Order perspective there are far greater examples to look up to. My greater heroes are those who changed themselves into better people no matter what hardships they faced. I can see some of that in Steve as a result of facing cancer and that is what I admire about him the most, but there are countless examples throughout the world of people making real changes in their behaviors. What we need as heroes are bipolar people who have done the same.

Are you a bipolar hero? What changes have you made in your behavior that made you a better person? Are you using bipolar as an excuse for bad behavior, or are you using it to gain insight that leads to becoming a better person? Who do you know that has made the effort to grow towards Bipolar IN Order?

Photo by Ben Stanfield, available under a Creative Commons attribution license.

Companies can and do prosper during times of economic turmoil. What do GE, Disney, HP, Microsoft, and Apple have in common? They were all startups during steep declines in the U.S. economy. GE started during the panic of 1873, Disney started during the recession of 1923-24, HP began during the Great Depression, and Bill Gates and Paul Allen founded Microsoft during the recession of 1975. Even today, while the economy is in the worst down period since the Great Depression, Apple is thriving. All these companies realized that they had an advantage by adopting a different mindset, a different way of seeing the crisis. Instead of succumbing to the situation, they saw it as an opportunity to innovate and grow.

Those of us who have changed our mental condition from bipolar disorder to bipolar IN order have something important to share. We have found strength in what was at one time a debilitating weakness. We have learned how to function in all states, including the extremes of mania and depression. The insights we have and the tools that we use can help our companies to function better in both boom and bust times. We can inspire everyone to move forward instead of being crippled by fear and doubt.

It is times like these that call for a different kind of leader. We need someone who understands bipolar and can inspire us all. We need a bipolar president.

Dr. Nassir Ghaemi is a professor of psychiatry at Tufts University School of Medicine and the director of the Mood Disorders Program at Tufts Medical Center in Boston. He serves on the faculty of Harvard University’s Medical School, and has degrees in history, philosophy and public health. His new book comes to the same conclusion.

In A FIRST-RATE MADNESS: Uncovering the Links Between Leadership and Mental Illness, Dr. Ghaemi argues that the very qualities associated with mood disorders have produced brilliant leadership under the toughest circumstances. He focuses on those leading during very turbulent periods and he identifies four key elements essential to crisis leadership: realism, empathy, creativity, and resilience. All, he posits, can be directly enhanced by mental illness: empathy and realism by depression, creativity by mania, and resilience by both.

Dr. Ghaemi looks at the careers and personal plights of figures like Sherman, Lincoln, Churchill, John F. Kennedy, Mahatma Gandhi, and Martin Luther King, Jr,. What Ghaemi uncovers is that our great heroes were neither “normal” nor were they special in the sense of being better, or more perfect, than the rest of us. They often suffered from mental illness, but these afflictions actually proved beneficial by boosting the very traits they needed to excel as leaders during hard times. In the case of Lincoln and Winston Churchill, depressive realism and empathy helped these men tackle both personal and tremendous national challenges. For General Sherman and Ted Turner, mania proved a catalyst for the design and execution of some of their most creative and successful strategies. Depression built resilience in King and Gandhi.

Expanding on his thesis, Dr. Ghaemi also explains why exceedingly sane men like General George McClellan and Neville Chamberlain failed to rise to the challenges of their times. Though many considered these men were excellent peacetime leaders, during crises – when empathy, creativity, realism and resilience are called for – their mental health proved a severe liability. A lifetime without the cyclical troubles of mood disorders, Ghaemi explains, can leave one ill equipped to endure dire straits. He also clarifies which kinds of insanity – like psychosis – make for despotism and ineptitude, sometimes on a grand scale.

Similar to my own work with Bipolar Advantage, Dr. Ghaemi encourages us to rethink our view of mental illness as a purely negative phenomenon. Those of us who have done the work to change our bipolar condition from disorder to IN order can be tremendous assets to society instead of burdens. We may also hold the key for turning this mess around. As Dr. Ghaemi concludes, “We should not be seeking leaders who are like us – our leaders should be different from the norm and posses the qualities that come naturally to those persons with mental illnesses.”

From early childhood, we have been taking tests to assess our understanding of the world. These tests have had a profound impact on us in ways that we are often unaware. They have created a world view that places too much importance on passing the test and not enough on learning more about ourselves. In some ways, the tests themselves have gotten in the way of what the goal was in the first place.

I have been wearing glasses for almost thirty years. Every year or so I take a new exam to make sure my prescription is still the same. The test seems simple enough: the clinician shows me letters at different sizes and asks me to identify what letters I see. Anyone who has a driver’s license has taken a similar test as has anyone who wears glasses or contact lenses.

A few years ago I discovered a major breakthrough that has completely changed my life. It has brought my life into focus in many ways. I share it with you in hope that it will help you to see better too.

We are not supposed to pass the test.

I know this goes against a lifetime of training. At least in the US, our entire culture says the opposite. Our education system has been so corrupted by it that we focus completely on tests instead of learning how to think. We have been so programmed to believe in passing that it has become a subconscious need. It spills over into so much of life that we don’t even see the adverse effect it has on our very ability to see.

During an eye exam, the clinician asks us what letter we see and, without noticing, we guess the answer. We are subconsciously focusing on passing the test. We think we are helping to identify the best lens so that we can see better, but instead are sabotaging the exam in subtle ways. We end up with an assessment that is relatively accurate, but miss the subtle difference between the one that would literally help us to see more clearly and the one that is just a little better than our old prescription.

The next time you take an eye exam, try it my way. Focus on failing the test instead of passing it. Each time the clinician asks what letter you see, say it is not clear enough. When it gets better, say “that one is better, but still not good enough. Is there a better one we can try?” Don’t focus on passing the test of getting the correct answer; focus on getting the best prescription you possibly can. You will be amazed how much better you see when you get your new glasses.

What does this have to do with bipolar? I have asked thousands of bipolar people if they lie to their doctors and therapists; most say that they either lie outright or leave important information out. We call it “presenting well.” We are subconsciously (or consciously) trying to pass the test. We have been trained to seek the approval of the tester so much that we present the answers that we think are going to pass instead of what is true for us. We present a different person than who we really are. Instead of a clear assessment, we end up treating an imaginary person in ways that may be detrimental to our real needs.

Think about the eye exam the next time you are with your doctor or therapist. Remember it is in subtle ways that we try to pass the exam. When explaining how you handled a particular stress or other event, try to say “that way is better, but still not good enough. Is there a better way we can try?” Instead of focusing on how you passed the test, use the time to find a better solution for the next time you face similar circumstances.

The great thing about the eye exam is that the results are immediate. If you get new glasses during your exam visit, you will notice the difference as soon as you put them on. It takes much longer with bipolar, but the results can be even more dramatic; you can learn to see bipolar in a whole new way.

image by John Forward

I imagine many people would expect this article to be a rant on how people without bipolar disorder have no idea how bad we have it. I am sorry. It is not. It is for those who already know how bad it can be. They may not know the half of it, either.

I often joke that depression is so terrible that we sometimes wish we were dead and we act so badly during mania that everyone else wishes we were. It is good for a laugh, because we all know it has some truth in it. The horrible symptoms of depression and mania that can occur when an individual is in a disordered state are well known. They include physical, mental, emotional, spiritual, social and career/financial dysfunction.

Funded massively by the pharmaceutical industry, partly because it is one of their biggest profit centers, there have been countless studies about bipolar disorder and how to move people from crisis through managed stage to recovery. There are many who argue over the choice of tools to address depression and bipolar, but nearly everyone agrees on one thing: depression and bipolar are horrible mental illnesses that need to be removed from our lives. They don’t know the half of it.

I know bipolar disorder well. I had my first full-blown manic episode 46 years ago and my first major depressive episode 10 years after that. I am all too familiar with the devastation wreaked on my own life and those around me that both the manic and depressive sides of bipolar disorder contributed to. It nearly cost me my life.

Although it takes a great deal of understanding to get from crisis through managed stage and eventually to recovery, we can never know all there is to know about bipolar disorder. Even if we did, we would not know the half of it.

In the conclusion of the largest study to date, the National Institute of Mental Health said, “According to the researchers, these results indicate that in spite of modern, evidence-based treatment, bipolar disorder remains a highly recurrent, predominantly depressive illness.” This is why in spite of achieving recovery, bipolar disorder is believed to be a life-long condition. They don’t know the half of it.

After 35 years of suffering interspersed with good times, I set out to find a better way. When I made it my career to understand bipolar about 10 years ago, I gathered people with depression and bipolar together with family, friends, doctors, therapists and others who were also looking for better answers. After talking with thousands of people, I came to realize that I didn’t know the half of it, either.

Having achieved the recovery that everyone was saying was the best I could do, I found myself unwilling to accept a diminished life living in fear that the next crisis was only a bad night’s sleep away. If I was going to put so much effort into trying to keep bipolar suppressed, I wondered what would happen if I put the effort into understanding the other half that I hoped was there.

Many of us continue to explore what works to achieve recovery, but also how we might use the same tools to get beyond it. In the process, we have discovered new ways of using existing tools, and we have created new ones that are much more powerful. We found that there is another half to the bipolar experience, where our understanding helps us remove the suffering while we gain the ability to function completely in all states, from the highest high to the deepest low. I call it “Bipolar IN Order” (as opposed to bipolar disorder).

Over the years we have refined the tools and strategies to help others make “Bipolar IN Order” a reality in their lives. With each new success, we gain a deeper understanding of how to assess people to determine where they are on the path from crisis through managed stage to recovery (bipolar disorder), as well as through the three stages beyond that: freedom, stability and self-mastery (“Bipolar IN Order”). We have also learned that tools are stage-specific. Some tools are used differently according to the stage, while other tools only apply to more advanced stages and should not be used while in disorder.

It took almost 10 years, but we did prove that “Bipolar IN Order” is real in our own lives and now have a community of people who have successfully made the transition from bipolar disorder to “Bipolar IN Order.” We can now challenge the paradigm that claims that bipolar is an illness. Bipolar disorder is a horrible mental illness, but “Bipolar IN Order” is a healthy state.

Bipolar itself is not a brain dysfunction but the ability to experience a range of energy and emotion that is wider than “normal” people. The range is not the problem; it is the lack of understanding and inability to choose how to react to it that causes so many of us to find ourselves in disorder. When they are only taught the disordered half, they see it as an illness and struggle with the vicious cycle of crisis and recovery. When they are taught how to get “Bipolar IN Order,” their suffering ends, and they discover that bipolar is an advantage in their lives that they would never give up.

If all you know is bipolar disorder, it is time to find out about “Bipolar IN Order.” You will soon be using a new phrase about bipolar: “not half bad.”

Last winter, I went through one of the deepest depressions of my life. It was very intense physically, mentally, emotionally, and spiritually. It was a beautiful experience, but that is for another article. The physical aspect is what I want to focus on here.

My physical experience this time was far more intense than any other depression. I was in tremendous pain throughout my body, but especially in my digestive track and chest. I was also completely drained of energy. It took a tremendous act of will just to get out of bed. It was so intense that I found myself reviewing my life in search of any other time that I had similar experiences.

In looking back I was reminded of two previous experiences where I felt so wiped out: my childhood rheumatic fever (a serious heart condition) and my heart attack. I became concerned that perhaps I was having more than just a depression and went to my doctor for tests.

I explained that I was depressed and was concerned with my physical health along with my reasoning for it. My doctor ordered a bunch of blood tests and sent me on my way. The blood tests all turned up fine, so I let it go for a while, but on further reflection decided that perhaps checking my heart made sense.

In the mean time I had switched doctors because it was my first experience with my doctor since moving and I didn’t feel there was a good fit. (I am talking about general practitioners here, not psychiatrists.) When I went for my appointment with the new doctor I clearly looked the part of a depressed person and made no effort to hide it. I related the whole story (as much as brief time would allow) along with my heart history and expected her to schedule an EKG.

What I got instead was a shock: she told me that I was depressed (shocking enough since I had already said it) and asked how many more tests do we have to do before I accept that my problem was just depression. I had to argue forcefully that my heart history is reason enough for prudence and that if it turns out that my heart is fine I have no problem accepting that it is “just” depression.

It was my wife Ellen who encouraged me to make sure I was not more than “just” depressed. She saw that I was physically far worse than what was normal for my deep depressions. Without her I might have blown it off myself. I cannot blame only the doctor for it since it made me realize that I too blame depression for issues that could have been something else.

If I had died from a heart condition would it have been another statistic that proves depressives have shorter lives? How many “real” conditions do we not address because we (and our doctors) blame it on depression instead of checking it out? Has anything like this happened to you?

Another issue, of course, is the side effects of medications, but that too is for another article.

1. Cassano P, Fava M. Depression and public health: an overview. J Psychosom Res. 2002;53(4):849–57. doi:10.1016/S0022-3999(02)00304-5. PMID 12377293.↑
2. Rush AJ. The varied clinical presentations of major depressive disorder. The Journal of clinical psychiatry. 2007;68(Supplement 8):4–10. PMID 17640152.↑
3. Alboni P, Favaron E, Paparella N, Sciammarella M, Pedaci M. Is there an association between depression and cardiovascular mortality or sudden death?. Journal of cardiovascular medicine (Hagerstown, Md.). 2008;9(4):356–62. PMID 18334889.↑

I watched almost 100 people drive into walls and other cars and asked 25 of them what they thought was the reason for so many crashes. Almost to a person, it was the fault of the car. Although they sat in seats that were identical to those in a race car, they said it was too twitchy, loose in the corners, and was nothing like driving a real car.

I was ready to conclude that the game was not very good when a man came along who drove incredibly fast without crashing at all. I asked him his secret and he said that he had taken driving lessons at a race track and practiced often in a real race car. He concluded that the game was very realistic and those who thought otherwise were trying to compare it to a normal car. He said the problem is they don’t know how to drive and the game is not at fault.

If you took the same 100 people to a race track they would all end up in a wreck. It would be pretty absurd to conclude that it is the fault of the car, but most people make a similar conclusion about bipolar and get upset when someone like myself challenges the assumptions. We blame the vehicle (in this case the brain) and “prove” it is defective because it works different from “normal” people.

I have been teaching people to drive while bipolar (figuratively) for about ten years now, and see a huge difference in those who have had training and practice compared to those who continue to blame the condition for the way they handle it. Like the skilled race car driver, my conclusion is lack of training is the problem, not the condition.

“Wait a minute,” you might say, “we have all kinds of training for depression and bipolar.” If you think about it, the only training we have is how to put on the brakes and park our brains in the garage. The current standard of care as defined by the National Institute of Mental Health (NIMH) is to minimize symptoms with the ultimate goal of removing them altogether.

The NIMH did a multi-year study called STEP-BD. Included in their research was an analysis of recovery “defined as having only two symptoms of the disorder for a period of at least 8 weeks, during the 2-year follow-up period.”¹ Although very specific as regards time range and number of symptoms, you will find that no matter where you look, the definition of recovery has removal of symptoms as a central element.

There are countless studies that “prove” bipolar and depression are illnesses, but none of them have studied people who know how to drive. The conclusions are on par with the people who think the video game is at fault. They take people with no training for anything but making it go away and watch them drive off a cliff.

Dr. Larry Davidson, one of the foremost authorities of recovery in the mental health field, defines recovery as: “being ‘in’ recovery—even while they remain disabled;” “being ‘in’ recovery despite the presence of an enduring mental illness;” and “the ability to live a fulfilling and productive life despite a disability.”² We are being sold a solution that says “make the best of a horrible situation” when some of us have found the game to be perfectly fine.

Unfortunately, the STEP-BD study mentioned earlier concludes with, “according to the researchers, these results indicate that in spite of modern, evidence-based treatment, bipolar disorder remains a highly recurrent, predominantly depressive illness.” “Recovery” is not a permanent condition; it is a temporary condition with a high probability that the symptoms will return, precipitating another Crisis.

The STEP-BD study proves that it does not work, yet they conclude that “this finding may indicate that complete symptomatic remission, i.e, the absence of all symptoms, should be the goal of treatment, as it is in non-bipolar, major depression.” Albert Einstein said that the definition of insanity is doing the same thing over and over again and expecting different results. It is amazing that modern day researchers are living up to Einstein’s definition while looking for a solution to the problem of mental illness.

It is time for us to acknowledge that some of us have learned how to drive WHILE bipolar and start focusing on what we do instead of trying to make it go away. In what ways have you been able to drive while bipolar or depressed where you used to crash? What have you done to learn to drive during high and low periods instead of making them go away?

References

1. Perlis RH, Ostacher MJ, Patel J, Marangell LB, Zhang H, Wisniewski SR, Ketter TA, Miklowitz DJ, Otto M, Gyulai L, Reilly-Harrington N, Nierenberg A, Sachs GS, & Thase M, Predictors of recurrence in bipolar disorder: Primary outcomes from the Systematic Treatment Enhancement Program for Bipolar disorder (STEP-BD). The American Journal of Psychiatry (2006), 163:2, 217-224 – http://www.nimh.nih.gov/science-news/2006/early-findings-from-largest-nimh-funded-research-program-on-bipolar-disorder-begin-to-build-evidence-base-on-best-treatment-options.shtml↑
2. Larry Davidson PhD, “Remission and Recovery in Schizophrenia: Practitioner and Patient Perspectives,” and  ”Personal Accounts: Us and Them;” along with his book “Living Outside Mental Illness: Qualitative Studies of Recovery in Schizophrenia.”↑

Photo by wlodi, available under a Creative Commons attribution license.

She asked if I was referencing the movie called Black Swan and I have not seen it yet, so I do not know if it is related at all to Karl Popper’s concept from the 1930s that I was referencing. Have you seen it? Does it mention Popper? Should I see it either way?

Popper suggested that if you observe only white swans, you are using inductive reasoning to extrapolate that all swans are white. This was falsified when black swans were discovered by the English naturalist John Latham in 1790. Science was forced to change the hypothesis that all swans are white by the new evidence.

Almost a year ago, Jonah Lehrer wrote an article called “Depressions Upside” in the New York Times. I was very interested in the response to it because I expected him to get attacked for challenging the prevailing beliefs about depression. A particular response stuck with me to this day and happens to be from someone who writes occasionally on PsychCentral, Dr. Ronald Pies:

“I have seen many hundreds, if not thousands, of patients [with depression] over the past 30 years. I have never had one–no, not one–say to me, ‘Gosh, Doctor, there are some real 
benefits to all this depression!’”

Dr. Pies made the classic white swan mistake – inducing from his limited experience that all depressives are like the ones he has seen. A few days later he wrote an article called “The Myth of Depression’s Upside” right here on PsychCentral.

My sense at the time was that the emotions of the debate were way too high for me to challenge such notions, but the White Swan of Depression stuck with me ever since. Over the years I have run into the same argument many times and have tried various ways of challenging it, only to be met with complete refusal to even consider the fact that I find depression to be beautiful and among the most valuable experiences of my life. Instead of recognizing the black swan right in front of them, people make the strangest accusations and deny the possibility entirely.

A frequent critique of my work is that I do not represent all bipolar people. I never said that I do; only that my existence contradicts the paradigm that too many hold so rigidly. It is amazing how many people get so upset they accuse me of insisting that everyone is like me. That would be like saying that all swans are black, which is not at all what I was saying.

In the previous three books I was saying that if I could accomplish Bipolar In Order or Depression In Order, then perhaps others can too and we need to change the definition of what is possible to accommodate the new evidence. What I share in my new work are other people’s success stories along with a well defined path for others to follow, which is why the woman in Santa Rosa remarked about how my message has changed.

What is most interesting about Dr. Pies argument is that I meet many people who feel the way I do, or at least in ways that contradict the notion that there are no “real 
benefits to all this depression.” It seems that we attract people according to what we believe. If you believe it is not possible to see value in depression and therefor do not teach people how to, you spend 30 years with people who share your beliefs.

I run into people who see value all the time. I also have taught many who at first reacted as strongly as any that I am completely wrong, yet now say that depression has become a beautiful and valuable part of their lives too.

I have not met Dr. Pies, but have read much of his work and find him fascinating. Without this one point of contention I would not have been exposed to his insights, many of which I find valuable and I have learned much from him. His work is brilliant and a major contribution to our understanding. I also find him to be very open-minded and interested in things that would lead me to believe that once he met a black swan he would embrace it as strongly as the notion that we don’t exist. I hope that we do meet some day and in some small way I help him to learn something new too.

What is also interesting is that I agree with Dr. Pies about the myths that he pointed out and his specific critiques about studies that Jonah Lehrer sited in his article. They are not at all what I am talking about when I say depression has value. There are at least two distinct kinds of value in depression (including deep clinical depression); the value of learning something from having been through it, and the value of being in it in the moment. I am interested in both and cherish each new example I find.

If you share your story of how you see value in depression it might help others to believe in the possibility too. Please share your thoughts in the comments. If you think that we black swans do not exist, please share your thoughts too. Exploring both sides can help us all to understand better.

I have been working on more thorough assessment programs for my new book and think that I have found a breakthrough. Through the assessments I have it traced to the exact moment that it happens. I wonder if you can help me verify my research with your own experiences and share your ideas on how to improve upon it?

As soon as we are diagnosed, everyone else becomes perfect! All of their flaws are instantly wiped clean and every relationship problem is blamed on our illness. Now that we are deemed crazy, our behaviors are purely a result of our illness and have nothing to do with the behaviors of those around us. Has this happened to you too?

What really brought it out was when I started testing assessments designed for friends and family members. I originally thought that such an assessment would be a way for them to help us to see things about ourselves that we could not. I had already been testing a self-assessment tool that is much more refined than the simple ones you usually find on the internet and thought that the questions for friends and family would be similar, but from a different point of view. The questions revolved around what they noticed about the bipolar person. I hoped involving those around us in the assessment would bring up things that even the doctors were missing.

The tests proved much more insightful than I had expected. I found the assessors were often blind to their own roles in the problem. They had become perfect and saw everything as an issue for the bipolar person to address, but none of their own role in their problems. It made me change the assessment in fundamental ways.

The assessment now asks the friends and family members about their own issues first. Only after that do the questions target the bipolar person. This minor change made the friends and family assessment the powerful tool that I was hoping for.

But it can be much better. With your help we can come up with questions to ask that will help us all to grow. What do you think we should be asking our friends and family that will help us to gain insight about our own condition while helping them to be more aware of their own?