Janusz Rybakowski: The Faces of Manic-Depressive Illness


Hector Warnes’ comment on Donald Klein’s comment


           Professor Klein's outline of Professor Rybakowski's book leaves him unimpressed from the outset, particularly Professor Klein's comments on Lithium. Quite the contrary, I found Rybakowski's contributions to Lithium research quite impressive and most of them were published in English journals (e.g., references given in his book numbered 218, 220, 222, 227, 229, 230, 232, 233, 236 and 237).  Reference number 236 on the Prophylactic Lithium response and polymorphism of the Brain-derived neurotrophic factor; reference number 218 comparing Lithium with Valproate; and reference number 220 comparing the two generations of mood stabilizers are outstanding.  

           Professor Klein  comments on two chapters: 7 and 13. On Chapter 7, I would agree that Professor Rybakowski did not cover all the neurobiological  issues of bipolar disorders. There is a book edited by Maarten Reith, Cerebral Signal Transduction. From First to Fourth Messengers, as well as several animal and human  research reports on the brain-derived neurotrophic factor and its relationship with corticoids in severe depression and so on that were left out.

           Regarding chapter 13,  Professor Klein in my opinion misunderstood it.  These were not Professor Rybakowski’s own observations; he was quoting several American authors on the social impact of bipolarity, depression, alcohol or addicting drugs on American culture. It has become known that there is a relationship between bipolarity and creativity. Professor Rybakowski attempted to bring together the nosological, social and  cultural. From this perspective creativity might be therapeutic for some forms of depression or hypomanic states.

           I would not agree that the chapter is “glib,” in the sense of shallow, or flippant.

           Reading the references listed by Professor Rybakowski, I would refer Professor Klein to reference number 293 (Williams RS. Cheng L. Mudge AW et al. 2002) which answers one of his last questions.  Professor Rybakowski also cites an early paper of R S. Duman written in collaboration with Monteggia (2006).

           Rybakowski addresses the molecular and cellular theory of depression, citing in reference number 71 the research of Duman,  Heninger and Nestler (1997)  on the subject.



Duman RS, Heninger GR, Nestler EJ. A molecular and cellular theory of depression. Arch Gen Psychiatry. 1997;54(7):597-606.

Duman RS, Monteggia LM. A neurotrophic model for stress-related mood disorders. Biol Psychiatry. 2006; 59(12):1116-27.

Klein D. Donald F. Klein’s comments. Janusz Rybakowski: The Faces of Manic-Depressive Illness. inhn.org.books. January 10, 2019.

Williams RS, Cheng L, Mudge AW, Harwood AJ. A common mechanism of action for three mood-stabilizing drugs. Nature. 2002; 417(6886):292-5.


August 22, 2019