Strictly Bipolar

Darian Leader mounts a psychoanalytic case against the way bipolar disorder has swelled into a mass diagnosis, and sets out to recover the older clinical category of manic depression that it displaced. He tracks how a rare, structural condition became a broad spectrum applied to children and adults alike, and reads that expansion alongside pharmaceutical marketing and a culture that prizes drive, output and relentless positivity.

Working from Freud, Abraham and Klein, Leader treats mania and melancholia not as chemical noise to be flattened but as organised responses bound up with loss, guilt, debt and a specific relation to an idealised other. He attends to the manic subject's flight of connection, the collapse into dejection, and the peculiar handling of time and speech that runs through both.

For the consulting room, the book argues for listening to what a manic-depressive economy is doing for the patient before reaching for a label, and for distinguishing structure from passing mood.