Hi Robin,
I'm sorry that I did not see your post until now. I'm afraid I lose track very easily!
Sorry to hear that your brother has had to deal with such a painful mental illness. There is mental illness in my family, too. One of my stepkids has severe, treatment resistant anorexia nervosa with OCD, for instance. There are others who suffer in the family but this particular condition is potentially fatal so it will suffice to let you know that I do understand the pain of mental illness in the sufferer and the family. We look to psychiatry for help and treatment. I am not about to throw out any babies with the bathwater.
Nevertheless, psychopharmacology which has done so much for your brother is a distinct specialty within psychiatry. Most psychiatrists know little about pharmachology or knew little in the past. With the emphasis on drug therapy now, I'm sure that is changing. I have grave concerns about the overuse of psychotropic med.s, though. It seems that everyone is on SSRIs these days despite the fact that one of the known side effects of this class of drug is suicidal ideation and suicide. I know that those with insufficient serotonin have been helped and that's wonderful but those with sufficient serotonin have been badly damaged and that's not so wonderful.
There can be a dangerous tendency to a kind of blinkered orthodoxy in this profession. For instance, I know a young man who has a long standing diagnosis of paranoid schizophrenia. He does well on anti-psychotic medication. However, he began seeing a new psychiatrist who had been trained with an emphasis on personality disorders and his diagnosis was changed to Borderline and he was advised to discontinue, after a taper, his medication. He as spent the last several years on and off anti-psychotic medication and in and out of a psychotic state because his psychiatrist, as a result of his training, sees personality disorders everywhere he looks.
In psychiatry, more so than in any other branch of medicine, we really are at the mercy of the beliefs of the practitioner. I'm so glad your brother, and others with bipolar disorder, are able to be treated successfully for their illness now. I hope my child may enjoy the same relief one day. I look forward to the day when psychiatric illnesses are better understood so that they may be treated with more science and less dogma. Until that time, I hope all are treated with care, compassion and humility.
All the best to you and yours,
Koan