During the second year of residency in Denver, I was assigned to treat a 15-year-old girl who had been transferred from a medical hospital. She was very active and grandiose; she spoke rapidly, and displayed all of the symptoms which today are part of the definition of Manic Disorder. But times were different in 1975. Back then, only adults were assigned the diagnosis of Manic Disorder, and even among adults, any sign of psychosis gave the individual the diagnosis of schizophrenia. New diagnostic publications were not yet accepted, especially by psychoanalysts. The accurate diagnosis was crucial, since the newly approved use of lithium was an effective treatment for bipolar disorder, although not for schizophrenia.
I interviewed the manic teenager in order to make a video, and it was alive for years. She embarrassed me twice. During the interview I asked her to report similarities, such as the similarity of a dog and a lion; as she compared the two animals, she started to leave the room in order to capture one of the animals. I stopped her. Also, during that video, I asked her about relationships. She then started to sit on my lap because of her feminine feelings for me. I was deeply embarrassed, and for years people laughed at the scene.
My supervisor allowed me to treat the patient with lithium, and she responded perfectly – back to normal.
It was arranged for me to describe the manic patient at a major conference at the University of Colorado Medical Center. I was shocked when the psychoanalysts violently and meanly disagreed with me, and they insisted that the correct diagnosis was schizophrenia (even though the patient had responded well to lithium and had classic bipolar symptoms). These audience members stated that psychoanalytic beliefs determined proper diagnosis, while science did not.
I presented it nationally, and received a much better response from the audience. I got it published in 1978 in a major national child psychiatric journal. My published paper was the fifth one ever published in the country describing manic disorder among teenagers, and my paper was referred to in the most important book written about Bipolar Disorder (authors at Columbia University).