World Bipolar Day


Once again, it is World Bipolar Day. We don’t celebrate the fact that we have bipolar disorder, we celebrate the fact that we are strong enough to live with it. So to all my fellow people who live with this illness, I celebrate you, your strength, your tenacity and determination to survive and even thrive with this illness. I have hope that with all the research that is going on, there will be better and better treatments available for us, until hopefully one day, the treatments will work so well that we won’t even be aware that we have this illness!

Until that day, we will band together, support each other, and write, write, write our blogposts to learn, blow off steam, inform, educate, offer support.

Congratulations fellow people with bipolar d/o, congratulations on your strength and determination!

Why nutritional psychiatry is the future of mental health treatment

Blueberries

Very interesting and may be so helpful.

Below is a direct quote from the article below. I wonder why we are not told to add vitamin and mineral as well as OTC anti-inflammatory supplementation to out diets and medicine regimen? It would be worth it to try it, if it doesn’t help, ok, but imagine it does help! I am going to ask my psychiatrist about all of these and if they have any adverse reactions with the medications I’m on. That’s would be the best way to go here. Wishing us all the best of physical and mental health.

“It is now known that many mental health conditions are caused by inflammation in the brain which ultimately causes our brain cells to die. This inflammatory response starts in our gut and is associated with a lack of nutrients from our food such as magnesium, omega-3 fatty acids, probiotics, vitamins and minerals that are all essential for the optimum functioning of our bodies. Recent research has shown that food supplements such as zinc, magnesium, omega 3, and vitamins B and D3 can help improve people’s mood, relieve anxiety and depression and improve the mental capacity of people with Alzheimer’s. Magnesium is one of most important minerals for optimal health, yet many people are lacking in it. One study found that a daily magnesium citrate supplement led to a significant improvement in depression and anxiety, regardless of age, gender or severity of depression. Improvement did not continue when the supplement was stopped. Omega-3 fatty acids are another nutrient that is critical for the development and function of the central nervous system – and a lack has been associated with low mood, cognitive decline and poor comprehension. Research has shown that supplements like zinc, magnesium and vitamins B and D can improve the mental capacity of people with Alzheimer’s. Shutterstock The role of probiotics – the beneficial live bacteria in your digestive system – in improving mental health has also been explored by psychiatrists and nutritionists, who found that taking them daily was associated with a significant reduction in depression and anxiety. Vitamin B complex and zinc are other supplements found to reduce the symptoms of anxiety and depression. Hope for the future? These over-the-counter” supplements are widely available in supermarkets, chemists and online health food stores, although the cost and quality may vary. For people who have not responded to prescription drugs or who cannot tolerate the side effects, nutritional intervention can offer hope for the future. There is currently much debate over the effectiveness of antidepressants. The use of food supplements offer an alternative approach that has the potential to make a significant difference to the mental health of all age groups.”

 

http://theconversation.com/why-nutritional-psychiatry-is-the-future-of-mental-health-treatment-92545

A lack of essential nutrients is known to contribute to the onset of poor mental health in people suffering from anxiety and depression, bipolar disorder, schizophrenia and ADHD. Nutritional psychiatry is a growing discipline that focuses on the use of food and supplements to provide these essential nutrients as part of an integrated or alternative treatment for mental health disorders. But nutritional approaches for these debilitating conditions are not widely accepted by mainstream medicine. Treatment options tend to be limited to official National Institute for Care Excellence (NICE) guidelines which recommend talking therapies and antidepressants. Use of antidepressants Antidepressant use has more than doubled in recent years. In England 64.7m prescriptions were issued for antidepressants in 2016 at a cost of £266.6m. This is an increase of 3.7m on the number of items prescribed in 2015 and more than double than the 31m issued in 2006. A recent Oxford University study found that antidepressants were more effective in treating depression than placebo. The study was led by Dr Andrea Cipriani who claimed that depression is under treated. Cipriani maintains that antidepressants are effective and a further 1m prescriptions should be issued to people in the UK. This approach suggests that poor mental health caused by social conditions is viewed as easily treated by simply dispensing drugs. But antidepressants are shunned by people whom they could help because of the social stigma associated with mental ill-health which leads to discrimination and exclusion. Prescriptions for 64.7m items of antidepressants were dispensed in England in 2016, the highest level recorded by the NHS. Shutterstock More worrying is the increase in the use of antidepressants by children and young people. In Scotland, 5,572 children under 18 were prescribed antidepressants for anxiety and depression in 2016. This figure has more than doubled since 2009/2010. But according to British psychopharmacologist Professor David Healy, 29 clinical trials of antidepressant use in young people found no benefits at all. These trials revealed that instead of relieving symptoms of anxiety and depression, antidepressants caused children and young people to feel suicidal. Healy also challenges their safety and effectiveness in adults. He believes that antidepressants are over-prescribed and that there is little evidence that they are safe for long-term use. Antidepressants are said to create dependency, have unpleasant side effects and cannot be relied upon to always relieve symptoms. Nutrition and poor mental health In developed countries such as the UK we eat a greater variety of foodstuffs than ever before – but it doesn’t follow that we are well nourished. In fact, many people do not eat enough nutrients that are essential for good brain health, opting for a diet of heavily processed food containing artificial additives and sugar. The link between poor mental health and nutritional deficiencies has long been recognised by nutritionists working in the complementary health sector. However, psychiatrists are only now becoming increasingly aware of the benefits of using nutritional approaches to mental health, calling for their peers to support and research this new field of treatment. It is now known that many mental health conditions are caused by inflammation in the brain which ultimately causes our brain cells to die. This inflammatory response starts in our gut and is associated with a lack of nutrients from our food such as magnesium, omega-3 fatty acids, probiotics, vitamins and minerals that are all essential for the optimum functioning of our bodies. Recent research has shown that food supplements such as zinc, magnesium, omega 3, and vitamins B and D3 can help improve people’s mood, relieve anxiety and depression and improve the mental capacity of people with Alzheimer’s. Magnesium is one of most important minerals for optimal health, yet many people are lacking in it. One study found that a daily magnesium citrate supplement led to a significant improvement in depression and anxiety, regardless of age, gender or severity of depression. Improvement did not continue when the supplement was stopped. Omega-3 fatty acids are another nutrient that is critical for the development and function of the central nervous system – and a lack has been associated with low mood, cognitive decline and poor comprehension. Research has shown that supplements like zinc, magnesium and vitamins B and D can improve the mental capacity of people with Alzheimer’s. Shutterstock The role of probiotics – the beneficial live bacteria in your digestive system – in improving mental health has also been explored by psychiatrists and nutritionists, who found that taking them daily was associated with a significant reduction in depression and anxiety. Vitamin B complex and zinc are other supplements found to reduce the symptoms of anxiety and depression. Hope for the future? These over-the-counter” supplements are widely available in supermarkets, chemists and online health food stores, although the cost and quality may vary. For people who have not responded to prescription drugs or who cannot tolerate the side effects, nutritional intervention can offer hope for the future. There is currently much debate over the effectiveness of antidepressants. The use of food supplements offer an alternative approach that has the potential to make a significant difference to the mental health of all age groups. The emerging scientific evidence suggests that there should be a bigger role for nutritional psychiatry in mental health within conventional health services. If the burden of mental ill health is to be reduced, GPs and psychiatrists need to be aware of the connection between food, inflammation and mental illness. Medical education has traditionally excluded nutritional knowledge and its association with disease. This has led to a situation where very few doctors in the UK have a proper understanding of the importance of nutrition. Nutritional interventions are thought to have little evidence to support their use to prevent or maintain well-being and so are left to dietitians, rather than doctors, to advise on. But as the evidence mounts up, it is time for medical education to take nutrition seriously so that GPs and psychiatrists of the future know as much about its role in good health as they do about anatomy and physiology. The state of our mental health could depend on it.

Bipolar risk boosted by accumulation of rare versions of genes

https://www.sciencenews.org/article/bipolar-risk-boosted-accumulation-rare-versions-genes

kb_bipolar_graph_freeRISING RISK  People with bipolar disorder are more likely than others to have several rare versions of genes that control how much nerve cells fire. Width of the shapes in the graph indicate how many people in each group had a given number of rare gene types.

A buildup of rare versions of genes that control the activity of nerve cells in the brain increases a person’s risk for bipolar disorder, researchers suggest in a paper posted online the week of February 16 inProceedings of the National Academy of Sciences.

“There are many different variants in many different genes that contribute to the genetic risk,” says coauthor Jared Roach, a geneticist at the Institute for Systems Biology in Seattle. “We think that most people with bipolar disorder will have inherited several of these risk variants.

Neurosurgeon studying if deep brain stimulation can help with bipolar disorder

Although I am not at all unresponsive to medication, I would love to try this technique of deep brain stimulation (DBS) to see if it would repair/heal/rejuvenate the brain structures that are thought to be responsible for bipolar disorder. In this study, it is thought the cingulum bundle (which is a fiber tract in the brain that connects different parts of the gray matter in the frontal area of the brain) may not be “strong” as in normal people. The brain’s frontal area is involved in decision making and problem solving and is smaller in people with bipolar disorder (BPD). So strengthening the connections in the frontal cortex of the brain should have a beneficial effect on people with bipolar disorder. This study is being done to see if DBS will help people who have BPD.

http://www.eurekalert.org/pub_releases/2016-05/uhcm-nsi052616.php

Many patients are often unresponsive to medications

CLEVELAND — Jennifer Sweet, MD, a neurosurgeon at University Hospitals Case Medical Center, recently opened a clinical research study to learn if there is a structural target in the brain for patients suffering from bipolar disorder and whether deep brain stimulation (DBS) can bring them relief.

Participants are being recruited through the UH Mood Disorders Program, which treats about 1,000 patients annually with bipolar disorder.

Bipolar disorder is associated with episodes of mood swings ranging from depressive lows to manic highs. Each of these cycles can last for weeks or months. It is among the leading causes of disability in young adults worldwide, according to Dr. Sweet, who is also an Assistant Professor of Neurosurgery at Case Western Reserve University School of Medicine.

While many patients respond to medications, most do not have complete control of cycling, and others have little or no response. It is hoped that DBS can help such non-responsive patients, or perhaps down the line even patients whose response to drugs become less effective over time.

Dr. Sweet’s study has two parts that will continue for at least three years. In the first part, currently underway and continuing through this year, she actively is enrolling 10 bipolar type I patients who do not respond to medications, 10 bipolar type I patients who do respond to treatment, and 10 healthy volunteers.

Participants will get a specialized type of MRI with diffusion-weighted imaging sequences, which can see how water molecules spread through the brain to create three dimensional maps of neurons in their brains. Dr. Sweet and her team will look for “connectivity” differences in structures among the different groups of participants.

“There are no obvious structural abnormalities in bipolar patients that can be seen with conventional MRI, but perhaps we can show that while Point A is still connected to Point B in bipolar patients, this connection or wiring is not functioning properly. Maybe the ‘cables’ aren’t as strong as in healthy controls,” said Dr. Sweet.

The biologic cables she refers to compose a fiber tract in the brain call the cingulum bundle that connects different parts of the gray matter in the frontal area of the brain.

According to the National Institute of Mental Health Web site, one MRI study found that the brain’s frontal area in adults with bipolar disorder tends to be smaller and function less well compared to adults without bipolar disorder. This area of the brain is involved in “executive” functions such as solving problems and making decisions.

Pinpointing differences in the structure of the cables may give neurosurgeons a new target for treating the disorder through DBS.

Once the first part of the study is complete, Dr. Sweet’s group will then recruit six of the bipolar participants who are unresponsive to medications and in whom structural imaging showed abnormal connectivity, to undergo a randomized, double-blinded pilot study to evaluate the safety and efficacy of DBS.

The participants will undergo DBS surgery, researchers and participants will both be blinded to the state of the stimulator. Prior to, during, and after the study, patients will be provided routine clinical and research care by the UH Mood Disorders Program.

“Bipolar disorder is so debilitating for many of the people who have it, and it strikes at a younger age, so it is a disease with which patients must contend throughout their lives. If DBS works, it will offer hope for patients, especially those who get no relief from medications,” said Dr. Sweet.

The study is currently funded by the National Institutes of Health to the Case Western Reserve University School of Medicine.

Deep brain stimulation (DBS) has been approved by the FDA for treating the symptoms of Parkinson’s disease and essential tremor, and it is FDA approved under the Humanitarian Device Exemption for the treatment of dystonia and obsessive-compulsive disorder. Researchers also are exploring whether DBS can help improve life for patients with other disorders, such as unipolar depression, bipolar depression, and memory loss, among other diseases.

Beneath the Surface: Exploring Mental Illness.

DSCN0356Mental illness, it’s invisible. There are no bandages, no casts, no crutches, no external wounds. How do you know someone is suffering from one? We, the afflicted, talk about feeling bad, talk about our depression and anxiety woes. You, our friends, look at us with bewildered eyes. You think to yourself “This person is all put together, she has makeup on, is dressed well, there are no signs of illness. I don’t understand.”

It’s not easy to explain mental illness to people who don’t have it. You can’t show them anything that is broken, or any flulike symptoms, or anything visible at all.

The key is listening, trying to understand where your mentally ill friend is coming from, what your mentally ill friend feels like, what they are trying to explain to you. And many will not even explain anything, because of the stigma, because they don’t want to appear “crazy” or abnormal.

Yes it’s confusing. I’ve had bipolar disorder since 1985, and sometimes it’s still confusing for me, so don’t anyone beat themselves over this. Basically the only empirical thing you have to gauge mental illness by is behavior. For example, in mania, people talk a lot, have very high energy, don’t sleep much, may have delusions of grandeur, may have a lot of anxiety. In depression, they have no energy, may sleep a lot, or not, are in a downcast mood, hopeless, and may also have a lot of anxiety. Paradoxically, in hypomania (the stage before going into full blown mania), we can actually get a lot accomplished, we are energetic, focused, not over the edge yet. This might be considered the “industrious” phase of bipolar disorder.

So the way your friend is behaving, a departure from their normal self, is a clue to their mental illness. What they are saying and how they’re saying it is as well. Are they being grandiose, talking non stop, switching from subject to subject (flight of ideas,) these are all clues.

In schizophrenia, people can have auditory hallucinations, where they hear voices, that’s definitely a clue, if they tell you, if they are aware that this is happening and admit to it… Yet most of the time, looking at a mentally ill person, you’d never know anything was wrong at all. It’s all below the surface, in their brain. Just like in a sea, where the water looks still and calm but a savage riptide is flowing under the surface.

Signs and signals, feelings and observations, those are clues to understanding mental illness. Just being an observant and understanding friend who listens and tries to comprehend what is being said and shown to them, that my friends is what is needed to understand the illusive nature of mental illness.

Lithium Beats Newer Meds for Bipolar Disorder

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I’ve been on Lithium since 1986, (except for a disastrous period between 2001 – 2008) so this comes as no surprise for me. I am now on 600 mg Lithium Carbonate ER per day and 100 mg Seroquel daily. My mood is stable, my symptoms are totally under control. I don’t feel flat, I still feel things, still have sadness and happiness. I have been stable for one and a half years, a record for me, as I used to cycle at least a couple of times a year. This is attributable to Lithium of course, but also to the fact that I am no longer on an SSRI (Zoloft), which causes people who have bipolar disorder to cycle and have mixed phases, which is exactly what I was experiencing. Mixed phases, hmm, the best way to describe them is you experience mania and depression symptoms at the same time, also with a huge amount of anxiety. Not fun! So not being on Zoloft and yes being on Lithium has been the best thing for me as far as mood stability is concerned. I admit, the scary depth of feelings led me to be more creative as in writing poems, stories, etc. But I gladly give that up for relative peace of mind. I don’t care if I never write “creative” poems that have much too much emotion in them (mostly sadness and anxiety,) I choose to be stable mood wise, I’d rather not visit those dark, frightening dungeons where bipolar monsters live.

PS

Lithium can affect your kidneys, so regular tests are needed to ascertain that the kidneys are woking well. Also, it can affect your thyroid, cause hypothyroid, so again testing is needed to make sure that your thyroid is fine. My thyroid stopped working a few years ago, we thought it was because of the lithium, but it is in fact Hashimoto’s thyroiditis, which is an autoimmune disease, whereby your own immune system basically kills your thyroid, so now I take Synthroid, synthetic thyroid hormone, to replace what my thyroid no longer makes.

http://www.webmd.com/bipolar-disorder/news/20160512/lithium-beats-newer-meds-for-bipolar-disorder-study-finds

Lower rates of self-harm, accidental injury seen

By Dennis Thompson

THURSDAY, May 12, 2016 (HealthDay News) — Lithium outperforms newer mood stabilizers in the treatment of bipolar disorder, a new study has found.

Patients taking lithium had lower rates of self-harm and unintentional injury compared to those taking other bipolar drugs, such as valproate (Depacon, Depakote), olanzapine (Zyprexa) or quetiapine (Seroquel), said lead researcher Joseph Hayes. He is a fellow of psychiatry at University College London.

“This is important because people with bipolar disorder are 15 times more likely to die by suicide and six times more likely to die by accidental injury than the general population,” Hayes explained.

People taking one of the alternative mood stabilizers were 40 percent more likely to harm themselves compared to patients on lithium, Hayes and his colleagues found.

And people on valproate or quetiapine were 32 percent to 34 percent more likely to fall victim to unintentional injury, most likely while experiencing a manic episode, the researchers said.

“Lithium still is the gold standard for the treatment of bipolar. We really haven’t had a medication that surpasses lithium, as far as we know,” said Dr. Raphael Braga. He is physician-in-charge of the Center for Treatment and Research of Bipolar Disorder at Zucker Hillside Hospital in Glen Oaks, N.Y., and was not involved with the study.

Hayes noted that lithium has been used for more than half a century to treat bipolar disorder, but it’s still not clear how the drug stabilizes a person’s mood.

Bipolar disorder, which used to be called manic depression, is characterized by extreme mood swings ranging from emotional highs to depressive lows.

The researchers undertook their study following evidence reviews and studies that suggested lithium might be better than newer medications at preventing suicide and self-harm.

These studies have contended that lithium achieves these results by reducing symptoms such as depression, aggression, risk-taking and impulsive behavior, according to background notes in the study.

Lithium can be hard on the body, the study authors said, increasing a person’s risk of kidney and thyroid disease, but even that may have a positive side in bipolar patients. Because patients must be closely monitored for side effects, they are in more frequent contact with doctors who can pick up on emotional problems that lead to suicide, the researchers contend.

To compare lithium against newer medications, Hayes and his colleagues collected medical data on nearly 6,700 people diagnosed as bipolar and prescribed only one of the drugs — lithium, valproate, olanzapine or quetiapine.

The investigators found that people on lithium were less likely to harm themselves, either intentionally or by accident.

The suicide rate was lower in the lithium group, but too few suicides occurred to allow accurate risk estimates, the study authors said.

The findings were published online May 11 in the journal JAMA Psychiatry.

Lithium can cause kidney disease and hypothyroidism (underactive thyroid gland), Braga and Hayes said.
Doctors need to carefully weigh benefits versus harm when prescribing lithium to people with kidney or thyroid problems, and “if these are severe, it should be avoided,” Hayes said. “Lithium [also] needs to be reviewed on an individual patient basis before pregnancy.”

Braga said psychiatrists often require patients taking lithium to undergo lab tests every three to six months, to make sure their kidney function hasn’t been compromised.

Even with this, lithium is much cheaper than the other medications in the study, Braga said. Hayes noted a 2008 study that found lithium was nearly $500 cheaper per month compared with olanzapine.

“Lithium is a great drug,” Braga said. “It’s definitely a drug every clinician should think about when prescribing for bipolar disorder.”