Many degenerative disorders such as Parkinson’s disease or ALS show very distinct physical and mental symptoms that others can directly see. Bipolar disorder however, is slightly different. It is obvious to many that diseases such as Parkinson’s are debilitating, however this is not as evident in those who have bipolar disorder. The effects can be seen by those that are close to those affected, however in general, bipolar patients are forced to hide their disease in order to function normally in society. There are several different neurological causes that have been hypothesized however there is still more that has to be examined. Likewise, there are current treatments, however they are not particularly effective, fixing only one side of the issue and making bipolar patients feel somewhat empty.
What Characterizes Bipolar disorder?
Bipolar disorder is a manic-depressive illness that is characterized by long periods of depression, followed by long periods of mania. That is, patients go through prolonged periods of highs and lows, which tend to get more polarized over time.
Pathways Causing Bipolar Disorder
Several different pathways have been identified as potential causes of bipolar disorder. The dopaminergic system has been seen to be overactive in the manic stage and almost non-existent in the depressive stage. The glutamatergic system is also unregulated in bipolar disorders. Excess levels of glutamate have been shown to lead to excitotoxicity. Another culprit in the disorder is excessive inflammation. This inflammation is characterized by cytokine cascades which lead to cellular immune responses. This is also a primary cause of depression, thus a characteristic of the depressive state. And finally, like most other neurological disorders, high levels of oxidative stress and mitochondrial disfunction have been observed in bipolar disorder. Brain energy generation is increased in mania and decreased in depression.
Treatment Options
Current treatments of bipolar disorder target the intensive manic stage that patients experience, by administering mood stabilizers which inhibit dopamine. Many of these drugs are similar to the drugs that are used to treat psychosis, again, showing how much is unknown about the disease as a whole. However, several different neuroprotective strategies may prove to be effective treatments for bipolar disorder. N-acetyl cysteine is a precursor to a free radical scavenger. This may sound menacing, however it is essentially just a specific antioxidant (ones that we hear about in green tea or veggies). It has shown to modulate glutamate levels, thus crossing off one of the causes of the disease. Anti-inflammatory medications have also been shown to lessen the depressive stage of bipolar disorder. Drugs such as celecoxib or even aspirin have been shown to induce these anti-inflammatory benefits. Omega-3 fatty acids have also shown decrease the prevalence of nerve disorders. This occurs due to anti-inflammatory benefits as well as an increase of BDNF that occurs with an increase of Omega-3 fatty acid consumption. Finally, statins have shown anti-inflammatory and anti-oxidative properties which, as previously mentioned, are beneficial for bipolar disorder treatment.
There is still much that must be done now to better understand and treat bipolar disorders, however until that point, there must be greater public acceptance and understanding for those that are currently going through and suffering the highs and lows of the disorder.
The Hidden Neurological Disorder
