Perception plays a vital role in the diagnosis of bipolar illness. Symptoms are perceived through the categories of psychiatric medicine at a given moment in history, categories which are continually shifting and being named or renamed.

Worries about the power of a doctor's suggestions to influence and shape his patient's mind, whether they are made under hypnosis or not, are still with us.

Every sickness has an alien quality, a feeling of invasion and loss of control that is evident in the language we use about it.

When I taught writing classes to psychiatric patients, I met people whose stories of manic highs and immobilizing lows appeared to be textbook descriptions of classic bipolar disorder. I met other patients who had been diagnosed with myriad disorders. No doctor seemed to agree about what they actually suffered from.

Every time the DSM prepares for a new edition, there are countless groups lobbying to get their particular mental illness recognized by the diagnostic manual. Surely, this is a social and cultural phenomenon.

The history of fiction is about family - an inexhaustible subject for literature. We are creatures driven by emotions that are on high display in intimate relations - inside the family.