Kay Redfield Jamison has devoted her career to studying bipolar disorder, the mental illness that boomerangs its sufferers between crippling depression and hyperactive mania.

She does much of her research by looking in the mirror.

Dr. Jamison, a psychiatry professor at Johns Hopkins University in Baltimore, has had bipolar disease for more than 30 years and wrote a landmark autobiography, "An Unquiet Mind," in 1995.

She will be one of the featured speakers this week at the Eighth International Conference on Bipolar Disorder, being held Thursday through Saturday at the David L. Lawrence Convention Center.

The conference is one of the premier research gatherings on bipolar disease, which used to be called manic-depressive illness, and is expected to draw at least 800 scientists from around the world.

"Within a month of signing my appointment papers to become an assistant professor of psychiatry at the University of California, Los Angeles," she wrote in her book, "I was well on my way to madness; it was 1974, and I was 28 years old.

"Within three months I was manic beyond recognition and just beginning a long, costly battle against a medication that I would, in a few years' time, be strongly encouraging others to take. My illness, and my struggles against the drug that ultimately saved my life and restored my sanity, had been years in the making."

The drug she was referring to is lithium, a mood stabilizer that is still the gold standard for treatment of bipolar disease. Dr. Jamison still takes it, although she keeps the amount low because a full dose makes her feel "emotionally blunted and cognitively slowed," she said in a telephone interview last week.

She will be speaking Friday as part of a session on suicide, which is a particular risk for people with bipolar disease.

Her talk will deal with writings by famous authors who are believed to have suffered from bipolar disease and either killed themselves, attempted suicide or led risk-taking lives, such as poets Anne Sexton and Sylvia Plath, short story writer Edgar Allan Poe and poet Lord Byron.

They all may have been afflicted by "mixed states," which can be described as an agitated depression or a bitter form of mania, she said, and even though they were not scientists, "I do think if you look at the great writers they've had the capacity to put into words what these agitations felt like, and how destructive they were."

The conference also will feature sessions on brain imaging, how the disease affects thinking ability, new treatments and clinical trials and bipolar disease in adolescents, among several other topics.

Most experts now agree that patients with bipolar disease need lithium or some other mood stabilizing drug to keep them from cycling between depression and mania.

But antidepressant drugs may not do much good, and could even cause harm, said Dr. Holly Swartz, a psychiatry professor at UPMC's Western Psychiatric Institute and Clinic.

If a doctor gives antidepressants to a bipolar patient, thinking he has depression, the mood boost from the drug could send the person into a manic state, Dr. Swartz said.

Even when the person is already on lithium, antidepressants may not provide much additional benefit, at least one large study has shown.

There is a type of treatment, however, that is demonstrably better than antidepressants -- psychotherapy -- according to Dr. Swartz.

Not just any talk therapy will do, though, Dr. Swartz said. Studies that UPMC and others have done show that there are three newer types of psychotherapy that are particularly effective against bipolar disease.

One is cognitive behavioral therapy, which is designed to change people's distorted thinking about their situation. "So a patient who is depressed might think, 'I'm a bad person, and everybody hates me and that's why I have no friends,' " and the therapist will work to get him to see the error of those ideas.

The second approach is family-focused therapy, which is used when the patient has a "significant other" such as a committed partner or a parent. "It really focuses on helping the family member understand bipolar disorder and it teaches more effective communication" between the two people.

The final effective therapy, and the one with the deepest Pittsburgh roots, is interpersonal and social rhythm therapy, she said.

It is based on the fact that people with bipolar disease have disturbed circadian rhythms, the 24-hour biological cycle that governs sleep patterns, hormones, temperature and energy levels.

Bipolar patients often have erratic sleeping times, meals and other daily activities, and they are hypersensitive to any disruptions in their circadian cycle, Dr. Swartz said.

A typical traveler, for instance, may suffer one or two days of jet lag if he travels across a couple time zones, but for a bipolar patient, "what's likely to happen is they can't get their clocks back on track and they'll develop a manic episode."

The interpersonal and social rhythms therapy tries to establish regular, reliable daily activities for such patients.

It might start by giving the person a two-hour window for getting out of bed each morning -- say, 10 a.m. to noon -- and then use other social relationships to enforce that, such as having friends make wake-up calls or meet the person at Starbucks at an appointed time.

"We say that patients with bipolar disorder need to have supranormal rhythms," Dr. Swartz said, and she often compares them to people with diabetes, who must be especially careful to eat and take medication at regular times.

In one large study at 17 sites around the nation, including Pittsburgh, patients who got one of the three therapies described above went into remission much faster than those who were placed in conventional psychotherapy, she said.

Now the challenge is finding enough resources to train front-line psychotherapists, "who are often social workers in mental health clinics," in these rigorous techniques. "It takes money, and our mental health system doesn't have a lot of money," she said.

For additional information about University of Pittsburgh research on bipolar disorder or to participate in a research study, call 412-246-5566 or see www.depressionprevention.info.