Mountains and Valleys: The Roller Coaster that is Bipolar Disorder.

Bipolar Disorder.  What is it?  You may have a preconceived notion, like I did, that it is when you can turn on a dime and change moods from hyperactive to depressed in the blink of an eye.  Well that was what I thought before this weeks discussion.  Bipolar is a disorder characterized by extreme mood swings that can last from a few days, to weeks, to even years.  There are 4 main types of bipolar; I, II, cyclothymic and rapid cycling.  Bipolar I is where you have 1 or more manic episodes with depressive moods not required for diagnosis.  Bipolar II is having no manic, 1 or more hypomanic episodes and 1 or more major depressive episodes.  Cyclothymic bipolar is classified as having 1 or more hypomanic with periods of depressive moods that do not fall into the category of major depression. Rapid cycling is applied to all the previous categories and refers to having 4 or more major mood swings in any given year.  Bipolar is usually fairly hard to diagnose because of all the coinciding complications that can go along with bipolar, such as; social phobia, OCD, ADHD and anxiety disorder.
The first thing we discussed was the hypothesis we thought should be researched in order to find a way of treating bipolar.  The one that I thought should be researched the most was the myo-inositol depletion pathway, which describes the mechanism that Lithium has on the inositol pathway in the brain.  Lithium is the most widely used drug for the treatment of bipolar even though the exact mechanism is not entirely known at this time, which is why I think that this hypothesis should be researched the most.  What is hypothesized is that Lithium inhibits a protein in the brain, inositol-monophosphotase, which converts the inositol-monophosphates into myo-inositol, thus the name myo-inositol depletion hypothesis.
The next thing we discussed was that in pregnant women, whether or not you treat the disorder, the mother has a higher likelihood of  abusing drugs, smoking, and being overweight and the child has an increased risk of being born with complications that could be detrimental to its health.  In untreated mothers, the children were also shown to be at risk of being born with small heads and low blood sugar.  Now the question was do we treat the disorder and have the child live with the effects of the drug or do we not treat it and have the child deal with complications that arise from not treating.  A saying from a mental health expert, Dr. Salvatore Gentile, says that the issue is not whether or not to treat the disorder, it is how to treat the disorder in respect to pregnant women with bipolar disorder.  I agree with this statement because once we know how to treat bipolar without posing significant risk to pregnant women’s children, the question of whether or not to treat them becomes irrelevant.  However, until research shows what the exact change is that occurs in people with bipolar, a cure will be hard to come by and the question of whether or not to treat it will stay relevant.
The final thing we discussed was the statistic that out of 7.7 million Americans that suffer from schizophrenia and bipolar, approximately 40% of schizophrenics and 51% of bipolar people are untreated in any given year. The question posed was why are so many people not getting treated?  I think that one of the main reasons is that the medication that can be used has some serious side effects and that most people would rather suffer from the adverse effects of schizophrenia and bipolar disorder than risk having to deal with the side effects of the drugs.  I think that until bipolar is “figured out” and a drug that targets the main cause of it has been developed, I think that the statistic will remain high and a lot of people will go on untreated.
That is all for the bipolar week of discussion.  Next week is all about Obesity and all the details that entail.