The Lithium Saga

The following piece first appeared in my Depression and Bipolar Weekly:

The use of lithium as an effective treatment for bipolar disorder was discovered in 1948 by the Australian John Cade MD. It would be nice to say that a whole new era immediately opened up for bipolars, but the unfortunate truth is that lithium only became commonly available for treatment in the US in the mid-seventies.

The lithium saga is told in Frank Mondimore MD's new book, "Bipolar Disorder: A Guide for Patients and Families" (Johns Hopkins University Press). While Dr Mondimore reveals nothing new here, his retelling provides a bitter object lesson object lesson for all of us. The psychiatric profession back in the fifties and sixties was stuck in its Freudian couch phase, and bipolar was regarded as some form of extreme personality disorder rather than a biological malfunction of the brain.

That is, if the shrinks bothered with diagnostic criteria at all. In the name of rooting out childhood traumas, undiagnosis or misdiagnosis was the order of the day. Meanwhile, in Europe, a Danish psychiatrist, Morgans Shou, took up the cause of lithium, but it wasn't until 1970 that his work was given respectability in a British medical journal. The major hurdles had been cleared. A new day was about to dawn.

MEANWHILE OVER AT ANOTHER BOOK

Many of you probably read Katharine Graham's memoir, "A Personal History", when it came out two years ago. Ms Graham is best known as the publisher of the Washington Post, the paper that revealed the Watergate scandal that brought down Richard Nixon.

She was also married to Phil Graham, the brilliant and charismatic Harvard Law graduate, and close confidante of both JFK and LBJ. Phil Graham was also bipolar. As Kathryn Graham describes it, Phil's psychiatrist didn't believe in medications. Why would he? This was the fifties and sixties now. By the time he was diagnosed it was already too late. His condition had deteriorated to the point where he was engaging in erratic behavior and making a spectacle of himself in public. In the end, he had to take extended leaves from running the family newspaper, sometimes in the hospital, sometimes out at their estate in the rural areas outside Washington DC.

So it happened one fine day that Katharine heard a gun go off in the other room. In spite of having everything he had to live for, Phil Graham's brain had convinced him otherwise. And now no one on earth could help him

Keep in mind that lithium had been discovered as being effective in the

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