Bipolar Disorder: Well, They Say Opposites Attract…
It is human nature to display a range of emotions. As a college student, it is unwise to approach me in the morning immediately after I wake up because you will get the reaction of an unhappy, angry bear that has just woken from his slumber. But after a hot shower and some breakfast, I will be cheery and as friendly as ever. By the end of the school day, I will be antsy and anticipating the end of the day. When supper rolls around, I will be conversational and looking to ask how your day has been. Then darkness will set in, and I will be in a state of great focus until I can study no longer and must lie down to sleep.
These general changes in mood occur nearly every day; each person has his or her own individual manner and range of emotions. While these emotions are triggered by external events and internal thoughts, they are largely controllable based upon our own willpower, but most evidently, we are capable of recognizing these varying emotional states in which we might find ourselves.
On the other hand, there exists a commonly known disease called bipolar disorder. Although there is still much we do not know about bipolar disorder, we have classified it as one of many psychological disorders that can afflict our personality and behavior. Specifically, bipolar disorder is usually clinically diagnosed by the uncontrollable presence of varying emotional phases between which the patient cycles. These two phases include a manic phase where passion, energy, and goal-driven actions are intense and brilliant. Everything is over-the-top, and productivity can reach an incredible maximum. But, the manic phase tends to be somewhat short-lived; most patients with bipolar disorder spend the majority of their time in another state: the depressive phase.
In the depressive phase, one can imagine how this might look. If you simply imagine all associated factors with regular clinical depression, that about sums up the depressive phase of bipolar disorder. Oftentimes, patients with bipolar disorder understand that their brains chemically cycle between these two phases, but the transition between the two is not often as simple as flipping an on/off switch. And still, even if the patient recognizes that they are in the center of a certain cycle, they are powerless in attempting to act in a way that might counter the symptoms. For instance, if you had bipolar disorder and you recognized that you were at the peak of a manic phase after organizing your entire house in an hour, you could not simply tell yourself to “calm down” and relax to depress the manic phase because the chemical signaling in the brain cannot be overridden by your conscious thought. Similarly, telling yourself to be happy or to go for a walk in the park during a depressive phase simply will not magically transition you into a neutral or manic state.
Thankfully, there has been much research into the topic, and while I mentioned previously that there is still a large amount that we do not know, some light has been shed in relation to the disease. Originally, the focus in bipolar disorder was on a class of molecules called monoamines, but recently, new ideas have especially indicated the importance of inflammation, oxidative stress, and even some other common cellular processes.
Inflammation is generally characterized as an immune response which occurs through the use of molecules called cytokines. When a tissue is disturbed, (trauma, heat, infection, etc.) these cytokines are released, and they act as “targets” that attract white blood cells to the area. The white blood cells are part of your body’s immune response that can trigger inflammation and removal of infectious or problematic agents in your cells. Normally, this process is excellent and works to keep you healthy, but in patients with bipolar disorder, inflammation in the brain has been linked with their emotional phasic symptoms. Unfortunately, the cause of how inflammation is related to bipolar disorder is still unknown.
Oxidative stress is a very broad category that is usually associated with a cellular machine called mitochondria. Mitochondria are thought of as the “energy factories” of your cells, and just like any power plant or factory functions, they typically generate wastes while producing the energy that we need. In the same respect, mitochondria produce waste called reactive oxygen species. While reactive oxygen species are important in producing energy, if we have too many of them, they end up being toxic to many other functions in your cells and can cause other parts of the cells to become dysfunctional. I am sure you have heard of “antioxidants” in foods such as tomatoes or vegetables, but you may have not known that antioxidants are important because they get rid of these excess reactive oxygen species. Like inflammation, patients with bipolar disorder typically have irregular function of mitochondria, and therefore have problems with reactive oxygen species which lead to oxidative stress, but again, unfortunately, we have not yet uncovered exactly how oxidative stress is linked to the symptoms of bipolar disorder.
The crazy thing is that things like inflammation and oxidative stress are commonly found in a whole variety of psychological and neurological disorders such as Alzheimer’s disease, Parkinson’s disease, schizophrenia, and even have a link in head trauma like concussions! So then, the big question that scientists are working on answering is how many of these same irregularities that can occur in the brain will lead to the variety of vastly different clinical diseases. Clearly, there must be something different, otherwise the diseases would be the exact same. It will be very interesting to see within the coming years if we can tease out the subtle differences and begin to understand exactly what causes each of these separate diseases. Once we know this, I believe it will open floodgates for treating the true roots of these problems. Think of it this way: “If you have a leaky pipe, you can continue to plug and patch small cracks, but the best way to stop the flooding would be to simply turn off the water altogether…”
Final thoughts on bipolar disorder written by Steven Dotzler
Bipolar Disorder: Well, They Say Opposites Attract…
