This past week, we were discussing bipolar disorder. From this broader topic, our group spent quite a bit of time discussing whether or not it should be considered a real disease, is it over diagnosed, and is it a “cop out” diagnosis. It is very difficult to determine any of these without first looking at the background effects it has on neurological function inside the brains of those affected and treatment.
Bipolar disorder is diagnosed as individuals that experience extreme swings in mood, with the manic stage lasting at least a week and the depressive stage lasting at least two. That means you extremely moody significant other who switches from hot to cold over the course of the same day are most likely not bipolar. Individuals with bipolar disorder go from periods of depression to periods of “manic” activity, and the effects are very difficult for them to carry on in day-to-day functions. This is where the diagnosis gets tricky. According to the “go-to” diagnostic book (cinder brick is more like it!), the DSM-IV, there are so many aspects of the manic stage and depressive stage that most people would be hard pressed to not find themselves having two or three conditions of each.
At this point, you are probably wondering what happens in the brain? What goes wrong? The research is there, and while our class probably only scratched at the surface, it was enough to make my head spin! One of the main causes we found in our readings was oxidative stress. Oxidative stress is when our bodies produce too many free radicals and are unable to balance the system with antioxidants. This is not something as simple to fix as drinking more pomegranate juice and eating more spinach. Oxidative stress is more like a domino effect. When one domino falls, the rest don’t just stand there and deflect the falling domino, but rather fall in a chain reaction. The cascades that follow include affecting the secretions of our immune system called cytokines. Wait, immune system? Yup, you read that right. These inflammatory cytokines can have a prolific effect in increasing our manic moods and our depressive moods. In unaffected people, you can kind of see this in the effect of the “runners high.” So how do we cure the progression of this disorder?
There are many current treatments for bipolar disorder, one of the most common being lithium. Why lithium? Turns out that sufferers tend to have a sodium concentration inside their 2-5 times higher than everyone else. Lithium was originally intended to help replace some of that sodium with another element that does not have such a significant factor in regulating out bodies. The only problem was that in order to actually be effective, we needed to consume 10 times the concentration of sodium, and our cells would burst under that high of a concentration. Think of it this way, in your coin purse you have quarters, nickels, dimes, and pennies. We are going to call the quarters the sodium and the nickels the lithium. Since we are trying to flush out the quarters (sodium), we are going to replace each quarter with five nickels (lithium). It doesn’t take a much time to realize that pretty quickly you run out of space and your coins begin to spill over everywhere. So why do we still prescribe lithium? Lithium, actually in smaller doses does a remarkable job! It has significant therapeutic properties, and it is believed that it has the ability to target the affected (higher concentration) cells first and leave our “normal” cells be.
That’s a lot of science, and not a whole lot of discussing. Rather than give you the answer to our debate, how about some thought provoking questions – the ones that started our discussion. Does the increasing trend in diagnosis correlate with the change in how we treat our children? Is the “everyone is awesome for participating” attitude at fault? Think back to when you were a teen; is the prevalence of diagnosis higher? If so, why? When do people get diagnosed, is it because they’re trying to justify something or their actions? And if you really want to poke the bear, is bipolar disorder real?
Bipolar Disorder – What is it?
