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?
The Hidden Neurological Disorder
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.
Breaking Down the Vicious Cycles of Bipolar Disorder
Bipolar disorder, also known as manic depressive illness, is a mental disorder characterized by extreme unusual shifts in energy, mood, and activity levels, impacting the ability to carry out day-to-day tasks. Although it is not a neurodegenerative disease like other previous topics discussed, bipolar disorder is neuroprogressive. Tissue damage and structural changes occur in areas involved in mood regulation increase the risk of recurrence of episodes and reduce the effectiveness of treatment. Several factors have been identified to contribute to the neuroprogression in BPD. First, let’s break down the symptoms and diagnosis of this disorder.
Symptoms
Bipolar disorder is characterized by extreme manic and depressive mood episodes. Cycles between manic and depressive episodes vary in frequency and severity from one individual to another.
Manic episode symptoms: mood changes consisting of a long period of feeling overly happy or outgoing mood or extreme irritability (hypomania), talking very fast, jumping from one idea to another, racing thoughts, easily distracted, increase in activities such as taking on a variety of new projects all at once, overly restless, sleeping little, unrealistic belief in one’s ability, impulsive behavior, engaging in pleasurable, high-risk behaviors
Depression episode symptoms: extended period of feeling sad or hopeless, loss of interest in previously enjoyed activities, including sex, problems in concentration, memory, and decision-making, restless/irritable, changes in eating, sleeping, or other habits, thoughts of death or suicide, including suicide attempts
Diagnosis
The onset of bipolar disorder occurs due to genetic influences, stress, and other factors such as substance abuse. Someone with a bipolar family member is at an increased risk for developing the disorder, but onset is not guaranteed. Bipolar disorder usually develops in early adulthood, with half of all cases starting before age 25. Bipolar disorder worsens if left undiagnosed and untreated. Unfortunately, bipolar disorder is often misdiagnosed as ADHD or major depression due to similar symptoms, and by the time it is properly diagnosed, manic and depressive cycles are much more severe and difficult to treat. Here is a brief overview of the different bipolar diagnoses according to the DSM (Diagnostic and Statistical Manual of Mental Disorders):
Bipolar I: manic or mixed episodes persisting for at least 7 days or severe manic symptoms that require hospitalization, depressive episodes also occur, persisting for at least 2 weeks
Bipolar II: pattern of hypomania episodes and depressive episodes, but no full-blown manic episodes as observed in Bipolar I
Bipolar Disorder Not Otherwise Specified (BP-NOS): symptoms of illness exist and are out of the person’s normal behavior but do not fit criteria for Bipolar I or II
Cyclothymia: mild form of BPD, episodes of hypomania and mild depression present for at least 2 years, symptoms do not meet requirements for any type of BPD
Rapid-cycling: 4 or more episodes of mania, hypomania, mixed states, or depression within one year, more common for those with first bipolar episode onset at a younger age
Neuroprogression of Bipolar Disorder
The underlying mechanisms behind the progression of the disease remain largely a mystery. However, recent findings have identified structural changes and factors involved in the neuropathology. Grey matter loss in the anterior cingulate cortex of the brain has been observed in those with Bipolar disorder, particularly the anterior limbic regions. These areas of the brain are associated with cognitive functions including executive control, emotional processing, reward anticipation, and decision-making.
Recent research has identified inflammation and oxidative stress as factors involved in the neuropathology of BPD. These factors are also present in neurodegenerative diseases such as Alzheimer’s disease. Excess levels of dopamine, a neurotransmitter involved in reward behavior, and glutamate, an excitatory transmitter, are present in BPD brains. Excess levels of dopamine and glutamate lead to an increase of calcium in the cell, causing oxidative stress, which damages neurons.
Increased levels of cytokines, pro-inflammatory molecules involved in immune responses, have also been observed in those with BPD. When the brain becomes inflamed, it activates cytokines, which increase the number of oxidative species in the brain. Oxidative species damage the cell and eventually lead to cell death. Although increased cytokine levels have been identified, their exact link between the inflammation process and bipolar disorder is still unknown.
Treatment
Bipolar disorder is treated with a variety of medications, usually a combination of mood stabilizers and antidepressants. The most effective mood stabilizer is Lithium, which helps control manic symptoms. Though not much is known as to why Lithium is so effective, it has been suggested to protect against inflammation and oxidative stress. Antidepressants are used to treat the depressive symptoms of BPD, but unfortunately can increase the risk of developing rapid-cycling symptoms. This is why they are often required to be given in conjunction with mood stabilizers like Lithium. Finding the appropriate dosage of both mood stabilizers and antidepressants to treat bipolar disorder is a difficult and painstaking process, often requiring many adjustments to medication and dosages before finding one that best controls the cycles. More research is needed to further investigate the role of inflammation and oxidative stress in the pathology of Bipolar Disorder. With a better understanding of the underlying mechanisms of bipolar disorder, we can create more effective treatment plans and stop the vicious cycles for good.
Bipolar Disorder, more than just Mood Swings
Bipolar disorder, often associated with characters such as Dr. Jekyll and Mr. Hyde, is a very real and serious disorder. Because it is a mood disorder, it can be dismissed by some as “mood swings” or someone being temperamental while in reality, bipolar disorder has biomedical groundings and can be diagnosed quantitatively using biomarkers. Like so many of the diseases or disorders previously mentioned on this blog, bipolar disorder can be caused by inflammation or oxidative stress in the brain. This shared etiology really shows not only how fragile the human brain is, but how diverse its functions are and what can go wrong when those functions are disturbed.
If inflammation and oxidative stress are what bipolar disorder shares with some of the other neurological diseases discussed on this blog then neurodegeneration is where bipolar disorder differs. With other diseases, like Parkinson’s or ALS, show massive neuronal cell death, bipolar disorder doesn’t really follow that path. You might see more glial cell death instead of actual neuron death, which could be what makes bipolar disorder not life-threatening like the Parkinson’s or ALS. Despite this distinction, bipolar disorder is still a serious and debilitating disease and the advances in diagnosis and treatment of this disorder are welcome by the many people it affects.
My Cousin, Bipolar Disorder, and the Stereotypes of Mental Illness
Bipolar disorder is a disease that most people in the general public have heard about but had little experience with. For me, it is a disease that I find extremely interesting, and I attribute that interest to actually knowing someone who suffers with bipolar disorder. One of my cousins is both schizophrenic and bipolar, and seeing how she has been affected by these mental illnesses is very eye-opening. Most of the symptoms that you see when you are with her are the “schizophrenic side” but when you compare interactions with her at different times (like Christmas vs. Fourth of July) it is sometimes evident of her “bipolar side,” as well. My cousin is someone who suffers greatly from these diseases of the mind; she is unable to have a job and must live in a community that does not allow for complete independence. The medications that she takes also take some of the “life” out of her and have caused additional health problems. It is heartbreaking to think about what her life could have been like, had she not been diagnosed with these disorders. Mental illness is something that has a very negative connotation in today’s society because it is a disease that cannot be “seen”. There are no effects on mobility like Parkinson’s or ALS. It is much harder to ask for help for something like depression or bipolar disorder because it can be embarrassing for the patient. It is for this reason that we should continue research on bipolar disorder (and other mental illnesses) to determine exactly what is happening in the brain and why.
Bipolar disorder (BD) is more than just mood swings. The mania and depression associated with the disorder can drastically alter a person’s life. There are multiple pathways in the brain that are altered/triggered in BD. First, excess dopamine is associated with BD, and when it reacts with an enzyme called monoamine oxidase, the dopamine is broken down. This breakdown causes reactive oxidative species (ROS) to be created. ROS are harmful because they cause the mitochondria of our cells to become stressed, and oxidative stress ultimately results in apoptosis, or cell death. Too much glutamate in the body can also be seen in BD. Excess glutamate causes excitotoxicity, generation of ROS, and cell apoptosis. Finally, inflammation in the brain is a very large part of BD. When there is inflammation, receptors called TNF-alpha and IL-6 receptors are activated. Activation eventually leads to apoptosis and neurodegeneration through ROS and oxidative stress as seen in the other pathways.
Treatment for BD is difficult because there are two opposing extremes to treat. Too much “control” of the depression can elevate manic symptoms, while treating the mania can result in depressive symptoms. It is a delicate balance, and patients with BD are often on a cocktail of drugs to maintain that balance. Lithium is one drug that proves to be very effective at treating BD, but the mechanism behind how it works is unknown. Much of today’s research involves finding out how lithium can control BD in the hopes that understanding that pathway can help us understand what is exactly causing BD.
Bipolar disorder is difficult to live with, but not impossible. Unlike my cousin, many people are able to hold jobs and have families while they are diagnosed with BD. But in addition to having the difficulties and symptoms of BD, they also must deal with the negative stereotypes associated with mental illness. Just because someone requires pharmaceuticals or therapy to stabilize their mood does not make them less of a person. As a society we should not be so quick to judge those with bipolar disorder, or any mental illness for that matter. Eliminate the stigma associated with BD, and others may be less afraid to seek help.
The Complex Organ We Call The Brain
The brain is a mysterious part of our bodies, and we have yet to explore all its depths. It is made up of complex networks of billions of neurons, which control all the mechanisms and functions within the body. Because we do not completely understand the brain’s entirety, it makes it hard to learn about neurological diseases and even harder to diagnosis them. Recently, these disorders have become major points of focus for researchers and they have been able to shed some light on what is going on in the brain. These new understandings have allowed for treatments and therapeutic options to be discovered for many neurological diseases. Bipolar Disorder is one disease that has become an interest to many and in the last decade researchers have been trying to explain what is going wrong in people with the disorder. The disease is characterized with manic and depressive mental states. However, a person with Bipolar Disorder can have varying amounts of these states and activities during them. During the manic phase, the individual can experience high self-esteem, risk-taking behavior, and excessive energy, making sleep negligible. On the contrary, the depressive state consists of changes in appetite, sleep, interests, and suicidal thoughts and/or actions. These states are in constant fluctuation, making it hard for a person to live a normal life. Individuals are normally diagnosed in their early twenties, but can have symptoms years before an actual diagnosis.
For many years, not much was known about Bipolar Disorder or the medications that help to treat it. Recent studies have suggested that it is a complex disease, with many contributing factors. These factors include over activation of glutamate receptors, also known as excitotoxicity, oxidative stress, and inflammation of the brain. Many of these symptoms are also common in other neurological disorders such as Parkinson’s disease, Alzheimer’s disease, and traumatic brain injury. In Bipolar Disorder, when the brain becomes inflamed it activates a cytokine pathway, which is a cell signaling molecule usually involved in the immune response. In Bipolar Disorder it is not exactly known what activates these pathways. However, these pathways have been shown to increase the number of oxidative species in the brain; we normally refer to these as free radicals. These radicals further damage the cell’s ability to effectively perform, eventually leading to cell death. Not much is known about why the brain in these victims becomes inflamed, but this inflammation is also seen in concussions, and may be the result of an injury to the brain causing these effects.
With many other disorders having similar characteristics, it makes it hard to diagnosis Bipolar Disorder. The argument has become whether or not these diseases are over or under diagnosed. Because so little is known about disorders affecting the brain, many times people do not know what is going wrong until years after the initial symptoms first started. At that point, much of the damage that has occurred is irreversible. Many factors can contribute to delayed diagnosis, such as the age at which people are diagnosed, ruling out other diseases, and substance abuse. For the most part, the age at which people are diagnosed is a time when many things are going on in these individuals’ lives. They are most likely graduating high school, going to college, getting jobs, and some are starting families. The stress of these life events can make it seem like nothing is wrong and that the manic and depressive episodes are simply the person trying to deal with the fast pace of life. Also, years before diagnoses, many individuals are in there teens, trying to find their individuality, going through puberty, and so forth. These episodes can then seem like the average rebellious teenager and it is not until years later, after a diagnosis, that these people begin to see what was influencing their behaviors years ago. People diagnosed with Bipolar Disorder also many times abuse drugs and/or alcohol. This can make it hard for anyone around them, as well as themselves, to be able to understand what is going on with their mental state. They are already not thinking clearly and have thrown in another factor, such as these substances, making everything much more complex. All of these factors go on to further complicate the already complex neurological disease.
After looking at all these factors, we still have much more to learn about the brain. The brain is so intricate, making problems within the brain just as complicated. Until we can better understand the depths of the brain, there is no saying how well we are diagnosing and treating these disorders. Once we are able to reach these depths in understanding, there is no telling the numerous amount of treatments, maybe even cures, that could be possible for neurological diseases like Bipolar Disorder.
References:
http://www.sciencedirect.com/science/article/pii/S0149763410001545#sthash.ATLQszpz.dpuf
Understanding the Highs and Lows of Bipolar Disorder
Bipolar disorder (BD) is a mental disorder known for its manic and depressive episodes. Unlike our previous topics, it is not neurodegenerative, but it is neuroprogressive. When I think about BD, I think of massive mood swings from the highest of highs and the lowest of lows. I think of chemicals imbalances in the areas of the brain that control mood. I don’t think of structural changes occurring in the brain that mark this as a neurological disorder. Even more than that, I don’t picture a brain that shares dysfunctional pathways with all of our other neurodegenerative disorders such as inflammation, excitotoxity, and oxidative stress. Bipolar disorder can be extremely hard to diagnose even with the new DSMV guidelines. The median age for BD is 25, a time when people are finishing school or entering the job force – in general, a very high stress times. It is not hard to imagine stress causing individuals to enter into a depressive or manic state depending on their coping mechanisms. It may take years to accurately diagnose. Especially in teenagers, who are commonly misdiagnosed with other psychological disorders such as ADD/ADHD and depression.
The neuroprogressive aspect of the BD makes it vital to try to accurately diagnose the disorder in the earliest stages. Brains with the disorder exhibit a loss in grey matter in the anterior limbic region responsible for executive control and emotional reasoning. However, the highest amount of grey matter loss occurs in the anterior cingulate cortex (ACC), which controls emotional responses and other cognitive functions. An individual with BD has the world working against them in manner ways. First of all, there needs to be a special combination of genetic factors, stressors, and aggravating factors, such a substance abuse, which illicit the disorder. The sum of all these factors manifests in manic and depressive episodes characteristic of the disease. As the time between episodes decreases, the severity of each one increases while the responsiveness to therapies decreases. Ultimately, BD leads to issues with cognition and mood modulation. Inflammation, oxidative stress and neurotrophic factors were focused on in this week’s paper. What makes certain brain mechanisms go awry? The paper suggests that is a lack of compensatory mechanisms within a BD patient.
There is no one drug therapy for BD, so patients end up taking a cocktail of medications that target both the mania and depression. One treatment seems to target many of the pathways suggested in the paper that contribute to BD pathology. Lithium has shown to decrease reactive oxidative species (ROS), increase BDNF – a protein which functions in cell growth, differentiation, survival – and inhibits proteins involved in the apoptotic pathway such as GSKα and caspase. In addition, lithium treatments increase mitochondrial expression of complex I, decreasing mitochondrial dysfunction and contribution to oxidative stress, and restores cytokine levels therefore decreasing inflammation. Aspirin is also used to decrease inflammation and ROS, and acts as an antidepressant.
As this week’s paper shows, there is a lot more happening in the brain of a patient with BD that what we see. Bipolar leads to increased mood and cognitive impairment because of the snowball effect of increased episodes in areas of the brain involved in mood regulation and higher order thinking. Treatments need to target the specific pathways that run awry. It is usually hard to target one pathway or one area of the brain for treatment. Remarkably, lithium seems to target a combination of pathways. As a society, we have a stigma around psychological disorders which puts anyone with one in a negative light. This stems from an ignorance of what is happening to people with such disorders. Bipolar disorder, as discussed, has so much more happening in the brain than chemical imbalances. I hope that people may do more research on BD and other psychological disorders so we can show more empathy and less judgment towards those with diagnoses of depression or BD.
We Are All Doomed
The pessimistic conclusion I have come to after about 2 months of studying various neurological diseases is that we are all doomed.
OK, not really… but sort of…
There are so many things that can go wrong in the brain that it seems something will go wrong in everyone’s brain… eventually.
The topic of the week in our neurochemistry class was bipolar disorder, BD (also called manic depressive disorder). BD is a neurological disease that affects about 5.7 adult Americans and has an average onset age of 25 (http://www.dbsalliance.org/site/PageServer?pagename=education_statistics_bipolar_disorder). BD is a neuroprogressive disease and thus worsens with age, but unlike some other neuroprogressive diseases like Alzheimer’s and Parkinson’s, aging is not a huge risk factor. So what makes BD different from other neurological diseases? That was the question we tried to explore.
Like other diseases we have discussed, BD has many, many contributing factors….
-Excessive dopamine neurotransmission contributes to the manic side of BD by way of increasing oxidative stress in the neurons.
-Similarly, increased glutamate levels are involved with BD by way of increasing excitotoxicity in the cells which causes a damaging calcium influx.
-Inflammation around the neurons may contribute to the depressive side of BD as it is usually associated with depression.
-Oxidative energy generation is involved in BD; increased in mania and decreased in depression.
-Oxidative stress in the mitochondria of the neurons leads to mitochondrial dysfunction and can create free radicals that damage the cells.
BD can be treated with medications including anti-seizure medications and lithium.
So what makes BD distinct from other neurological diseases? Many of the listed factors in the diseases are almost exact repeats of the things that go wrong with Alzheimer’s and Parkinson’s and ALS. The article we discussed does not really give a clear answer about the distinguishing characteristics of BD. It could be that it mainly depends on the types of neurons and locations of such neurons that are affected. It could also depend on when the neurons are damaged. Since BD has an earlier onset age and starts usually during development of the brain and AD and PD start much later in life, this factor could distinguish the diseases.
Regardless of the exact distinguishing factors, BD in severe cases is a debilitating disease that has similar characteristics to other neuroprogressive diseases. With every passing week, I am convinced that the brain is a delicate organ requiring the utmost balance in all of its processes, and with enough time… it is likely we will all get a neurological disease…. Let’s hope that is just me being pessimistic.
Article Reference: http://www.sciencedirect.com/science/article/pii/S0149763410001545
A Look into Bipolar
Mental illnesses have been more of a focus in medicine in the last decade because of the increased number of diagnosis. Bipolar otherwise known as manic-depressive disorder is one of the mental illnesses that have been a part of this. The average onset age is twenty years old. There have been instances juvenile bipolar too. Research is beginning to look at the effect of bipolar on children.
Bipolar is a disorder characterized by a manic and depressive state. Manic stage symptoms include higher self-esteem, little need for sleep, constant talking, racing thoughts, easily distracted, psychomotor agitation, and pursuit of pleasure with a high danger risk. Some of the depressive state symptoms are lack of interest, changes in appetite, changes in sleep habits, lack of energy, feelings of self-doubt, cognitive difficulties, and suicidal thoughts or actions.
It is a multifactorial disorder that includes inflammation, dopamine excitotoxicity, glutamate excitotoxicity, mitochondrial dysfunction, and oxidative stress. When the brain becomes inflamed, a cytokine pathway is initiated. These cytokines activate certain receptors, which increase the number of reactive oxidative species (ROS). These ROS are toxic to the brain and can cause dysfunction. Glutamate excitotxoicty causes a similar problem that leads to ROS being released. An increase in dopamine causes the manic state. This also leads to oxidative stress from ROS. These are just a few of the possible routes that can cause bipolar.
The most popular drug to treat the symptoms of bipolar is lithium. It reduces the oxidative stress caused by the pathways discussed above. It is a favorite because it can treat the manic and depressive symptoms. Patients with bipolar can be given valproate too, which also reduces oxidative stress. Many scientists are researching the mechanism of the drugs, since we don’t know the exact cause of bipolar.
I have a personal connection to bipolar disorder. One of my relatives has it. She had to drop out of school because she couldn’t handle it on her own. I’ve witnessed both parts of her illness. During the manic stage, she becomes very active. She will deep clean her house or go on biking and hiking trips. The depressive state is the worst. She sleeps at weird hours of the day. She becomes very quiet and stays indoors all day. It’s like she loses hope. It’s very difficult to watch someone you love suffer. Mental illness research needs to continue and expand because it affects so many people.
Sources:
https://moodle.cord.edu/pluginfile.php/390935/mod_resource/content/2/bipolar.pdf
http://neurochemistry2014.pbworks.com/w/page/88342886/Pathways%20underlying%20neuroprogression%20in%20bipolar%20disorders%20and%20neurotrophic%20factors
http://www.medscape.org/viewarticle/560302
Maybe We All Have a Mental Disorder
Bipolar disorder (BD) is a mental disease characterized by swings from a manic state to a depressed state. Although each individual is affected in a unique way, these swings typically occur every couple weeks, with the depressive state generally remaining for a more significant period of time. Although much more research needs to be done, scientists have begun to identify some of the potential neurological pathways that may be responsible for the drastic mood swings seen in those affected by BD. Although neurological degeneration is not one of the tell-tale signs of the disorder like many other neurological diseases, it has been suggested that excessive transmission of neurotransmitters such as dopamine and glutamate can set up conditions that lead to oxidative stress and cell death. Inflammation in the brain has also been identified as one of the main problems that can contribute to BD. At this point scientists are looking at mood stabilizers such as lithium, valproate, carbamazepine, and lamotrigine to treat BD, which may also help alleviate some of the problems caused by oxidative stress and inflammation.
Yet while research looks at drugs to treat BD, counseling services are still a great option for treatment of those with BD, especially for the depressive state. Unfortunately our society has placed such a negative stigma on counseling that at times you have to wonder if the benefit of the service is worth the scrutiny from society that comes along with it. We automatically characterize anyone going to a counselor as having a mental disease, something that can’t necessarily be treated with pharmaceuticals, or as being a crazy person. But what is a mental disease anyway? It seems as though anything that deviates from what society considers normal and balanced emotionally or behaviorally is now termed as such. And although I can’t say that having balance is a bad thing, I want to encourage everyone to be a little more understanding of those that seek out counseling as a way to feel relaxed and in control. Don’t get caught up in the labeling game that is played with mental disorders and deviations from “normal”. Personally, I can’t say that I’ve ever met someone who has their emotional and behavioral balance always in check. And if that’s the case, maybe we all have a mental disorder.