More Bipolar Myths Debunked

Hello everyone! I hope I'm finding you in good spirits today. I wanted to cover some more myths about bipolar disorder that society perpetuates. When individuals fall prey to these myths patients are not as compliant with treatment and they do not work as diligently to recover, family members may often distance themselves and offer less-than-optimal support, and mental health professionals negatively impact progress by failing to motivate their patients and by not engaging in comprehensive treatment. Todays information comes from the BP magazine and the Depression and Bipolar Support Alliance (DBSA).

Myth: There's no cure for bipolar
Reality: There may be no cure in theory, but there are many strategies to use to successfully manage your life. The fact is that there’s no cure for life itself. When difficult situations arise, you either confront them or seek help from others. The same is true in dealing with bipolar disorder.


Myth: Bipolar disorder is all in your head.
Reality: Conditions like bipolar disorder are real, biological medical conditions that can be diagnosed and treated. There are many outspoken individuals who have made a career of misinforming the public about the true nature of bipolar disorder. While they argue that the illness cannot exist because the exact biological defect has not been discovered, they fail to recognize that the same is true for high fever, yet it is no less an ailment. A wide variety of medical tests including brain scans (MRIs, CTs) reveal the difference between a bipolar brain and a normal, healthy one. To ignore or distort the science behind bipolar disorder is simply irresponsible.


Myth: Bipolar disorder is a personal problem not a societal problem.
Reality: Bipolar disorder is everyone’s problem. In fact, the impact bipolar disorder has on society is shown in the following statistics:

• Bipolar disorder is the sixth leading cause of disability worldwide with more than 5.7 million people affected. (World Health Organization)
• People living with bipolar disorder spend as much as one-fourth of their adult lives in the hospital, live one-fourth of their adult lives disabled, and lose as many as 14 years of cumulative productivity. Bipolar disorder results in 9.2 years reduction in estimated life span, and as many as one in five living with bipolar disorder commits suicide. (National Institute of Mental Health)
• The unemployment rate for people with severe and persistent mental disorders, including bipolar, is close to 90 percent. (U.S. Surgeon General Report on Mental Health, 1999)
• Bipolar disorder costs the U.S. economy $45 billion annually. (Wyatt and Henter, 1995)
• The combined indirect and related costs of mental illnesses like bipolar disorder, including costs of lost productivity, lost earnings, and societal costs, are estimated to total $148 billion. (National Institute of Mental Health, 1999)

Indeed, society pays a huge price, both financially and in terms of human suffering.


Myth: Medications that treat mood disorders are habit-forming. They can change a person’s personality. A person can’t be “clean and sober” while taking medication.
Reality: When properly prescribed and used, medications are not addictive and do not change a person’s true personality. Medications help a person’s mood become more stable and even. They are not “happy pills” and should not be compared to street drugs. They do not cloud a person’s judgment or give a false sense of courage.


Myth: I haven’t found the right medication yet.
Reality: There’s more to recovery than finding the right medication. Today, in an increasingly scientific-based psychiatric community, it can be difficult to remember that drugs are not a panacea. Medication does nothing to change a person’s underlying assumptions, false beliefs, or negative thinking. A prescription does not teach anyone effective behaviors nor can it generate positive reinforcers. Finding the right medication that yields results with minimal side effects is an essential ingredient in recovery, but it alone is not the answer.


Myth: People with bipolar are dangerous.
Reality: Research shows that people with mental illness do not commit significantly more violent acts than people in the general population. However, people with mental illness are twice as likely to be victims of violence.


Myth: People with bipolar disorder shouldn't have children.
Reality: People who have been treated for mood disorders can parent as well as anyone else. They are also more likely to recognize symptoms, treat their children early and understand their children’s struggles if their children have mood disorders. Personally, I am not going to have bilogical children because I would never wish this disroder on anyone.


Myth: People with depression or bipolar disorder are not stable enough to hold positions of authority in fields like law enforcement or government.
Reality: People with mood disorders can and do hold positions of authority

everywhere. When properly treated, a person’s mood disorder does not have to affect job performance. Persoanlly, I have tried to reenter the workforce and was not able to. My symptoms are too severe to allow me to enter the workforce. I also have a long unexplainable gap in my work history.

 

 

I hope some of these debunked myths have been brought more to light for you and you can share this information with friends who are unfamilar with the disorder. Education is the key. The more people know about bipolar, the less stigma there will be. Have a wonderful day!

Brain Damage and Bipolar

Hello Everyone, I hope I'm finding you in good spirits! Today I wanted to explore the possibility of bipolar disorder causing brain damage. I know personally I can't recall much of my college courses. There are gaps in my memory. My case manager form the local mental health authority told me she's pretty sure manic episodes cause permanent damage in the brain. That's why the doctors try to keep us level on meds. Since she didn't seem too sure I decided to do some looking myself. Here's what I found:

Bipolar disorder does in fact cause damage to the brain. A study by researchers at the San Francisco VA Medical Center indicates that people with bipolar disorder may suffer progressive brain damage. 

“For the first time, our study supports the idea that there may be on-going damage to certain regions of the brain as the illness progresses,” said the study’s lead author Raymond Deicken, MD. Deicken is the medical director of the Psychiatric Partial Hospital Program at the San Francisco VA Medical Center and UCSF associate professor of psychiatry."

The study appears in the May issue of the American Journal of Psychiatry.

"Researchers determined chemical signatures of different brain structures in these two groups using proton magnetic resonance spectroscopy. One finding focused on the level of an amino acid called N-acetylaspartate, or NAA, in the hippocampus, which is made up of a right and left half and is part of a complex of neural circuits in the brain that regulate emotion and memory.
 
The study found significantly lower concentrations of NAA in the right hippocampus of males with bipolar disorder when compared to the control group. They also found that for the right hippocampus, bipolar patients who had the disease the longest had the lowest levels of the amino acid. This association between length of illness and NAA appears to be confined to certain brain regions since it was not found in previous studies that involved the frontal lobe and thalamus.

NAA is the second most abundant amino acid-next to glutamate-present in brain tissue. It is a biochemical indicator of the presence of neurons and axons, plays an important role in the synthesis of neuronal proteins, and is a precursor of myelin, which acts as insulation around neurons in the brain.

“Low NAA is an indication that the integrity of neurons and/or axons has been compromised in some way, either by damage, loss or dysfunction,” Deicken said. The decrease of hippocampal NAA over time in the test subjects indicates a progressive nature of this disease. Decreasing levels of NAA are also seen in neurodegenerative diseases like Alzheimer’s disease, Parkinson’s disease, and multiple sclerosis.

According to Deicken, the findings also confirm the important role of the hippocampus in bipolar disorder. Brain imaging studies of patients suffering from major depression have demonstrated smaller hippocampi. Given that bipolar disorder also affects mood and emotion, it is not surprising that this study provides evidence for hippocampal damage or dysfunction in the disorder.  The hippocampus is also important from a therapeutic standpoint since it is one of two brain regions where new neuronal growth, or neurogenesis, can occur, offering hope for reversal of damage.
NAA measurements may also help us to understand how medications work in bipolar disorder.

Additional authors of the study include Robert Feiwell, MD, UCSF assistant clinical professor of radiology; Brain Soher, PhD, SFVAMC Magnetic Resonance Unit; Mary P. Pegues, MSW, and Susan Anzalone, BA, research associates, SFVAMC Psychiatry Service. Deicken’s research was supported by the National Institute of Mental Health and a Stanley Foundation Research Award from the National Alliance for the Mentally Ill." Source



Stephen M. Stahl, M.D., Ph.D. suggests neurons may be damaged by the very process of ferrying angry, malfunctioning chemical and electrical events. As symptoms are shipped about the brain, they may leave behind weakened or sinking neurons due to the triggering of neuronal death by apoptosis or necrosis. Some symptoms may be associated with the fading away of neurons by a quiet process of designer cell death called apoptosis. Other symptoms may be associated with excitotoxic neuronal explosions due to chemical failure and, ultimately, messy necrosis. He too suggests staying on medication to prevent future damage. Source


"A lengthy review article by Carrie Bearden PhD et al of the University of Pennsylvania published in Bipolar Disorders cites "findings of persistent neuropsychological deficits" in long-term bipolar patients, even when tested in symptom-free states. The relationship between these deficits and length of illness led the authors to suggest that "episodes of depression and mania may exact damage to learning and memory systems." An article by FC Murphy PhD and BJ Sahakian PhD of Cambridge University in the British Journal of Psychiatry draws a similar conclusion: "The balance of evidence ... supports a hypothesis of residual cognitive impairments."

Father Time appears to be a major factor. Dr Bearden et al cite a study that found that chronic, multiple-episode patients exhibited more severe cognitive impairment than younger patients or patients who remit, and that these impairments were not restricted to their affective episodes. The same study found 40 percent of the patients were rapid-cyclers. Another study found that of 25 patients initially hospitalized with mania with no signs of cognitive impairment, one third showed significant cognitive impairment five to seven years later.

Also, it appears that our current bipolar medications actually repair and protect brain cells, which is one of the better arguments for staying compliant. Further research in this area may produce new drugs with enhanced neuroprotective properties." Source


Here are some more useful links with study abstracts:
Increased excitotoxicity and neuroinflammatory markers in postmortem frontal cortex from bipolar disorder patients

Acute mania is accompanied by elevated glutamate/glutamine levels within the left dorsolateral prefrontal cortex.

Frontal lobe function in bipolar disorder: A multichannel near-infrared spectroscopy study


It looks like we do have some damage occuring after all. Just one more reason to stay on our meds instead of seeking that manic high. What are your thoughts?