Discussion Guide

ADDENDUM as of 15 May 2023
Discussion Guide for BIPOLAR GENERAL: My Forever War with Mental Illness
By Gregg F. Martin, PhD
Major General, US Army (Retired)

I have written this addendum to facilitate discussion and deeper understanding of the book. It is ideal for book clubs, classes, and other group forums that want to read, discuss, and learn more from this book.

General Questions:
What do you think of the title?
What’s the purpose of the book? What are the main points?
Approximately 20 percent of the global population are afflicted by mental illness (MI) and the other 80 percent are affected. So virtually the entire global population is touched in some way.

Have you or anyone you know been afflicted or affected with bipolar disorder (BD), MI, or another mental/brain condition – either yourself, or by virtue of being family, friend or colleague of someone who is afflicted? Elaborate please.

Who do you identify with in the book? Why?

What are your thoughts on MI going into the book, and then coming out of it?

In what ways did the book change your views on MI, if at all?

Has any part of this story changed your perceptions of MI? If so, what parts, and how?

What were your views on stigma before reading the book? What about after?

How does the book relate to military, veterans, medical professionals and general population?

How has the book made you feel? How does the story/book apply to your life? To the lives of people you know?

What new knowledge has the book given you?

What, if anything, does the book make you want to do? Do you feel motivated to take action?

Does anything in the book surprise you? If yes, what?

I dedicate the book to Maggie, my wife. What role did she play? What role does a spouse or partner play?

In the Acknowledgments, I thank many people. What role did family, friends and colleagues play in helping me to tell my story?

What do you think of General Dempsey’s “Foreword”? What role did he play in my saga?

The “Preface” raises a number of points about me, my mental condition, and my army career. What, if anything, jumps out at you, and/or surprises you?

In the Introduction, I capture my removal from command, the essence of BD, and the effect it has on others. What jumped out at you, surprised you, or provided new knowledge?

Chapter 1: Accidental Soldier covers growing up, the University of Maine, and West Point, a period from 1956 to 1979. What insights did you gain that enable you to understand and know me better? Any surprises? What role did Mom play? Any early signs of BD? Anything else you’d like to mention?

Chapter 2: Cold Warrior is about my very positive Army experiences as a young officer, and meeting and marrying Maggie. What are your impressions of those years, 1980 to 1985, and experiences? Any surprises? Did you learn anything new? Did you detect any troubling signs of future BD?

Chapter 3: Soldier-Scholar and the Pressure of Command covers a 14-year span, from 1986 to 2000. There are a number of diverse sub-plots. What stands out? What surprised you? What new knowledge did you gain?  What, if anything, did you see regarding the growth and development of my BD? Are there any specific examples? What else caught your attention?

Chapter 4: Tragic Foreshadowing is an intense, tragic and traumatic chapter that turned my and my family’s life upside down from 2001 to 2002. What are your thoughts and impressions of this part of my story? What surprised you? What did you learn? How did it make you feel? By the time of this event, I was living quite high on the bipolar spectrum, and in 2003, I would unknowingly surge into BD in Iraq. Why did no one connect any of the dots? What experiences have you had with people afflicted with severe BD or MI? What was it like for you?

Chapter 5: Iraq War Triggers BD describes my share of the war, 2002 to 2004, and its aftermath – a life-changing experience that altered the way I see and feel about nearly everything. What stands out to you in experiencing this chapter? What surprised you? Can you detect a clear onset of BD? How would you describe me before, then during, and then after Iraq? What do you think about my intense, unusual, over-the-top engagement with PT and religion during the war? What do you make of my depressive episode after redeploying from Iraq, back in Germany? Why was it so hard for medical personnel to diagnose my BD, even when I went to them with my medical concerns? Why did my post-Iraq depression in 2004 just “go away”, on its own? Did you learn anything new in this chapter, and did anything surprise you? Is there anything else you’d like to discuss?

Chapter 6: Inner Wars describes and analyzes a tumultuous, intense period from 2005 to 2010 where I served in a number of big, important, complex command positions as a general officer. How did the nature and stress of these jobs exacerbate my BD? What effect did soldier funerals, bureaucratic resistance to change, and the on-going wars in Iraq and Afghanistan have on me? My behavior and thinking grew more extreme; why did no one detect BD? What surprised you? What did you learn? What other points would you like to discuss?

Chapter 7: My Surge into Mania describes how my mania rose ever higher, from 2010 to 2013, taking me nearer to the precipice that would follow. What role did the end of my running career have on this? How would you describe the changes in my behavior? Why did no one recognize or detect that I was manic? In reading this chapter, did these episodes seem like more of the same, or did they mark a clear change in behavior? What surprised you? What did you learn? What else struck you as important?

Chapter 8: Mad Martin describes my life and work in full-blown mania, in the Spring and Summer of 2014. Can you take a guess what it felt like for me? What do you make of the various incidents I detail? What do you think my wife, family, friends and colleagues were thinking? Again, why did no one recognize my BD? What surprised you, and what did you learn? What else?

Chapter 9: Insanity on Steroids describes the intensification of my full-blown mania in 2014. I was unbelievably high on the natural bio-chemicals surging through my brain. I felt way beyond great, had unlimited energy, believed I was on mission directly from God, that I was the smartest person on the planet, and barely slept. I was in a state of insanity, but believed I was Superman. What are your thoughts and feelings as you read this? What, if anything, did you learn, and what surprised you? What other aspects would you like to discuss?

Chapter 10: Grandpa Joe’s Funeral and the NDU “Rebellion” describes the final run-up to my removal from command of NDU, in July 2014. In it, I was rapidly whip-sawing from event to event, euphoric highs to deep and troubling lows, grandiose feelings to feelings of rage and terrifying paranoid delusions, from one powerful emotion to another. I had become unglued, totally. Reports of my behavior were bombarding my bosses in the Pentagon, from students, faculty and staff, yet I saw the criticism as persecution and an attempt by disloyal people to get me fired (which was partly true). My supervisor called me to his Pentagon office and counseled me, yet both he and I were oblivious to the fact that I was suffering from severe, life-threatening MI. And I continued to be unphased. What were some earlier warning signs that had gone unnoticed? What dangerous symptoms of mania were already present? What did you feel as you read this chapter? What surprised you? What did you learn? What else would you like to discuss?

Chapter 11: “Active Shooter?” describes another insane event in July 2014 that was the final straw in my removal from command. How would you assess and describe Chairman Dempsey’s decision to remove me from command and order me to undergo a psychiatric evaluation? Why did the doctors at Walter Reed misdiagnose me three times in July 2014 as being “fit for duty” and not having BD? What is “VIP medicine”, and was it part of the problem? If so, how? Why do I call it a double-edged sword? What surprised you? What are your lessons learned? What other points would you like to discuss?

Chapter 12: “Bipolar Hell” describes my two-year period from 2014 to 2016 – following full-blown mania - of hopeless depression combined with terrifying psychosis, in which I hoped to die, had continuous “passive suicidal ideations”, and was literally in a fight for my life. What are passive suicidal ideations, and why are they so dangerous? Would I have crashed into depression even if I had not been fired from my job at NDU, or would I have continued indefinitely in my manic state? What is “psychosis” and what do you think it’s like? As a general and MIT, West Point and Ranger School graduate, why couldn’t I simply “reason” or “will” myself out of my delusions, hallucinations and depression, and just say, “I’m a smart, tough guy; these are obviously not true; just snap out of it Gregg!”? To what degree were these symptoms “just in my mind”, versus being physiological illness inside the circuitry of my brain? What did you learn in this chapter? What surprised you? What other aspects of bipolar hell would you like to discuss?

Chapter 13: “Broken Brain Club”, from February to September 2016, describes how I broke myself free from the single biggest psychotic factor, which was critical to my recovery. What was that delusion? How and why was I able to break free from the grip of this terrifying and crippling delusion? Why do you think I was happy to enter the VA inpatient program? What elements did I like about it? What were some positive effects of this change of environment and intensified therapy? Describe the contrast between my life at the VA, and life in New Hampshire? What do you make of this contrast? What was the “Boa”? Describe my mother’s views on BD and MI? How do you assess her views? What if the doctors at Walter Reed had not practiced VIP medicine, but had treated me like any lower ranking soldier - putting me in inpatient care and prescribing lithium back in November 2014, and like the VA did in 2016? Could I have avoided two years of bipolar hell? What surprised you in this chapter, and what did you learn? What else would you like to discuss?

Chapter 14: “Taming the Beast” describes the key ingredients of my journey of recovery from September 2016 when the positive effects of lithium took hold, up to the present. What are some of them? How do I protect myself against “triggers”? What effect did and do religion and spirituality play in my BD, and what effect did BD have on my religion and spirituality? To what extent do you believe that BD is a physiological disease of the brain? What is the importance of the five “resets”? Why did Maggie and I move to Florida in 2016, and what effect has it had? Can a person living with BD live a happy, healthy, purposeful life? How? What’s the other common alternative? Finding a medication that works can take years and is arguably the hardest part of BD recovery. Why do so many people with BD resist medication and go off of it? Did anything in this chapter surprise you, and did you learn anything new? What other points would you like to discuss?

Chapter 15: Reflections captures my closing thoughts. How did living on the bipolar spectrum mostly help me, for years, until it didn’t…? Explain how and why I am still living on the bipolar spectrum. Do you consider me “fortunate” regarding my bipolar experience? What were the key elements of my decades-long “self-medication”? How serious are the negative side effects of lithium? On balance, how do those risks compare with the benefits? What is my Life Purpose, or Mission? If a person suspects or feels that they, or a loved one or colleague, may have a mental condition, what should they do? What are the key ingredients of a successful recovery that’s built to last? What are the risks of not following these tenets? How would you characterize the different potential outcomes for a person who is on a successful recovery journey versus someone who is not? Why do I call my journey of recovery a “new life”? Why is it smart to view living with BD in the same light as living with and managing other chronic diseases such as diabetes, cancer, or heart disease, where awareness and self-protection are key? How did my Army service affect my BD, and vice versa, both good and bad? What are bipolar “superpowers”, and what are mine? What are my key conclusions and recommendations, both for civilians and military? Fortunately, I have never been ashamed, embarrassed or self-stigmatized regarding my BD, which is unusual. What accounts for my gratefulness and pride at being a bipolar survivor and thriver? What, if anything, surprised you in this chapter, and what, if anything, did you learn that was new? What else would you like to discuss?

Epilogue. In it, my friend and colleague of many years – Dr. Lenny Wong - delivers a blistering, accurate and frightening synopsis of Maj. Gen Gregg Martin - the “Bipolar General”. What do you make of it? Does anything surprise you? What other points would you like to discuss?

Appendix I: Family Perspectives offers several direct, candid assessments from family members, including my wife Maggie. What do you make of the various perspectives? What surprised you? What did you learn about me that was new? Can you relate to any of the family perspectives? Homework: write testimonials for your own family members, whether you suspect a MI or not. What else would you like to discuss?

About the Author. Is there anything in my bio that surprises you? If so, what? Did you learn anything new about me in the bio?

Concluding thoughts: now that you’ve read, studied and discussed my book, how does it help you? Can you relate in your own struggles, or in those you know and love? What do you think is the bottom line of the book? What is the “so what?” of my book and why does it matter? What’s the key take-away? For those who remain skeptical of the physical reality of MI, even after reading this book: can you clearly articulate why? What is MI’s connection to character? Toughness? Adversity? Willpower? Strength, etc? How do you define illness? What is it about physical illness that “separates” it from MI? What does it mean to be “mentally healthy”? What are the consequences of MI? What are some old-fashioned explanations for MI?

What can and should we do to improve the state of mental health in America and the world? What value is there in other people reading my book? Would you recommend it to others, and if so, why, and how strongly? On a scale of A to F (A being the highest), how would you rate the book?

Thank you for reading, studying and discussing my book. It’s an honor and privilege to share my tumultuous bipolar journey with you, in BIPOLAR GENERAL: My Forever War with Mental Illness.