Bipolar Disorder, and Society's Response Re "My So-Called Bipolar Life," by Jamie Stiehm (Op-Ed, Jan. 18): Stories of bipolar disorder, like Ms. Stiehm's, resonate with the public and the media. This year, the television series "Homeland" won a Golden Globe award for best TV drama. Two years ago, "Next to Normal," a play about a mother with bipolar disorder, won the 2010 Pulitzer Prize for Drama. Untreated, bipolar disorder can lead to wildly euphoric and manic behavior as well as depressive, suicidal phases. These behaviors not only fascinate but also repel; fear of mental illness leads to debilitating stigma for the mentally ill. As these stories demonstrate, the entertainment industry, like the media, can play an important role in increasing public awareness of mental disorders, enabling our society to better understand and diminish the stigma associated with mental illness. The writer is chairman of the department of psychiatry at Columbia University College of Physicians and Surgeons. I was glad to read Jamie Stiehm's article, which shines a spotlight on recovery from mental illness. Glad, that is, until nearly the end, where Ms. Stiehm calls electroconvulsive therapy "extremely effective." In reality, E.C.T. can cause permanent amnesia and permanent deficits in cognitive abilities. The Food and Drug Administration continues to classify E.C.T. equipment in its high-risk Class III category - which comprises only 10 percent of medical devices - despite repeated pressure from E.C.T. equipment makers to reclassify it into the lower-risk Class II. According to Mental Health America, some researchers recommend that E.C.T. be used only as a last resort because of its risks. Many people believe that they have been helped by E.C.T., so we do not promote a ban, only the opportunity for truly informed consent so that people can weigh the risks and potential benefits before agreeing to the procedure. SUSAN ROGERS Director, National Mental Health Consumers" Self-Help Clearinghouse Philadelphia, Jan. 18, 2012 Jamie Stiehm correctly states that electroconvulsive therapy is a very effective antidepressant treatment. Many people fail to understand that severe depression (either unipolar or bipolar) is a serious medical illness; when the patient is suicidal, it may be a medical emergency. E.C.T. works when antidepressant medications don't, and it works more quickly. Modern E.C.T. has evolved into a safe and comfortable procedure that can be done on an outpatient basis. Thanks to Ms. Stiehm for helping destigmatize not only bipolar disorder but also E.C.T. CHARLES H. KELLNER Director, E.C.T. Service Mount Sinai Medical Center New York, Jan. 18, 2012