Daily Archives: September 21, 2016

The Risk

There is a building ideology within the mental health community that the approach of life-long medication is outdated. Medications are better utilized in crisis or times of visible active disease. Thankfully, bipolar often expresses itself within cycles, one of those cycles being something like ‘remission’, in other words, where I am right now. However I […]

Life Ain’t Fair, But Who Said it Was?

I haven’t had a drink or taken an illicit drug since December 8, 2003. I’m grateful for my sobriety. I don’t remember much during the time just before and just after my sobriety date, but I do remember well the night I attended my first Alcoholics Anonymous meeting. I immediately knew I was in the right place and I cried…

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Happy International Day of Peace

“Peace is a daily, a weekly, a monthly process, gradually changing opinions, slowly eroding old barriers, quietly building new structures.”  – John F. Kennedy Today, September 21st, is the International Day of Peace, which was established by the United Nations General … Continue reading

Immune Disorders Tied to Mental Illness?

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Wow! This is my pet hypothesis, that mental illness is caused by immunological factors, and may even be an auto-immune disease. Well here, ladies and gentlemen, a bone marrow transplant cures mice of compulsively pulling out their hair!

Compulsive hair pulling is akin to obsessive compulsive disorder and changing the mice’s immune system (bone marrow transplant) stops them from pulling out their hair.

Please can I get a bone marrow transplant? Please?

http://psychcentral.com/news/2010/06/01/immune-disorders-tied-to-mental-illness/14171.html

A provocative study using genetically altered mice finds a cause-and-effect link between the immune system and a psychiatric disorder.

Mario Capecchi, a Nobel Prize-winning geneticist, discovered that bone marrow transplants cure mutant mice who pull out their hair compulsively.

The study provides the first cause-and-effect link between immune system cells and mental illness, and points toward eventual new psychiatric treatments.

“We’re showing there is a direct relationship between a psychiatric disorder and the immune system, specifically cells named microglia that are derived from bone marrow” and are found in the brain, says Capecchi.

“There’s been an inference. But nobody has previously made a direct connection between the two.”

The findings – published in the journal Cell – should inspire researchers “to think about potential new immune-based therapies for psychiatric disorders,” says Capecchi, a 2007 Nobel laureate in physiology or medicine.

Capecchi and colleagues showed that pathological grooming and hair-pulling in mice – a disorder similar to trichotillomania (trick-o-til-o-MAY-nee-ah) in humans – is caused by a mutant Hoxb8 gene that results in defective microglia, which are immune system cells that originate in bone marrow and migrate from blood to the brain.

Microglia defend the brain and spinal cord, attacking and engulfing infectious agents.

Mice with pathological grooming appear to groom normally, but do so too often and for too long, leading to hair removal and self-inflicted skin wounds. The disease of pulling out head or body hair is common in humans; studies in seven international communities found trichotillomania affecting 1.9 to 2.5 of every 100 people.

In the key experiment, geneticist Shau-Kwaun Chen, Capecchi and colleagues transplanted bone marrow from normal mice into 10 mice that had a mutant Hoxb8 gene and compulsively pulled out their own chest, stomach and side fur.

As the transplant took hold during ensuing months, grooming behavior became normal, four mice recovered completely and the other six showed extensive hair growth and healing of wounds.

“A lot of people are going to find it amazing,” says Capecchi. “That’s the surprise: bone marrow can correct a behavioral defect.”

Nevertheless, “I’m not proposing we should do bone marrow transplants for any psychiatric disorder” in humans, he says.

Bone marrow transplants are expensive, and the risks and complications are so severe they generally are used only to treat life-threatening illnesses, including certain cancers and disabling autoimmune diseases such as lupus.

Capecchi says that mice with the mutant gene that causes pathological grooming now can be used to study the surprising connections between the immune system’s microglia cells and mental illness – and ultimately to produce new treatments.

“We think it’s a very good model for obsessive-compulsive disorder,” he says.

Source: University of Utah Health Sciences


Stuck at the dysfunction junction

Growing up, I always thought I had an incredibly dysfunctional family. And, by my own definition I did. I had a BFF in middle school and just loved her parents. The way they interacted with their children. The way they hugged them and gushed about how much my friend was loved. Their soft compassionate demeanor towards me. EVERTHING. I wanted to be their daughter.
My folks were distant, emotionally detached. Quick to punish and spank with anything handy…belt, wooden spoon, fly swatter. Sent off to my room to “think about what I did.” Never a follow up question regarding my thoughts. Never reassurance it was still okay, i was okay. Not much love floating in the airwaves. I was a shy awkward young girl who could use some guidance, but none was available. When I mustered up all my bravery and asked for some help, i was quickly shut down. Up went the wall!
My husband has helped me to break down the wall and communicate my feelings. Some days i can do this, some days i simply can’t. Either the words don’t come, i don’t know the words, or I’m afraid of the words I should be saying. Throw my therapist in the mix and we are working on it!
On his side of the family, big mean derogatory words can come barreling at you seemingly out of nowhere. Or you get the silent treatment. The in laws reside in Western NY, which you would think would be a blessing. It is, but it really isn’t. Distance can kill any kind of relationship, even if you work at it. When there is no consistent communication, the ship can go down in a hurry. My mother in law is the only tether to the sinking ship. We hang on, get bounced around and ejected over and over by his brother. But, his frail mother who sits slumped over in her wheelchair waits for my husband’s phone call twice per day.
Just in the last few days, she has been too weak to manipulate the cell phone. Too weak to eat and not terribly responsive. When you are 3000 miles away and the only link is an old flip phone its hard to know what’s happening. We find ourselves having to rely on the brother for information as he is power of attorney and the ungrateful boots on the ground in NY. The word “strained” keeps popping up in my mind to describe the relationship of these two men, but it really doesn’t do it justice.
Last year i stood my ground after i visited and had a subsequent hospitalization. I was out of work for 3 months. I am a highly sensitive being with bipolar I, some situations i just cannot handle. I delicately told my husband the environment was not good for me and my mental health. He agreed and declared I never have to go there again. Not realistic.
So here I am. mother in Law not doing well. Brother in law sparing with his medical information. Husband terrified if he doesn’t jump now he may never have a positive interaction with his mother again. what a freakin dilemma. How do i be of support to him and validate my own struggles with the family. Honor my own mental health. Be a doting wife full of empathy and love. How?

Today Has Been Toturous

I didn’t sleep very well last night, I wasn’t able to get past REM before I would be woken up by something or somebody.  Then all today I had bottom issues. The stress of tomorrow and Thursday is really playing havoc on my body.

I’m so fucking stressed I seldom have a moment where I can relax.

I hate things that you HAVE TO DO!

I had forgotten just how bad my anxiety could get until this past week. At least it is keeping my mind off the depression which is still rearing it’s ugly head.

Blech.


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.


Irritable Depression

img_0546Depression, the irritable kind is when one is quick to anger and quick to tears. Unfortunately this is the kind that I often have, where I get so angry and even rageful, and then the tears, yes the tears come. Julie Fast’s blog is the first place where I learned this was a thing. I wrote about it, see here: https://bipolar1blog.com/2016/08/20/mean-bipolar-downswings-check-yourself-before-you-wreck-yourself/

Now here is an article that describes Irritable depression as a subcategory of depression. It’s not bad enough to feel bad, but on top of it all is the anger and then the dissolution into tears. I get a very short fuse, things that would normally not set me off, do. It is one of the lease fun things that one can experience.

For me, the treatment is to increase my dose of Seroquel, let’s say fro 50 mg to 75 mg and then possibly to 100 mg.

Currently I am on 100 mg of Seroquel and 900 mg of lithium daily. And this seems to be controlling my mood quite well. Of course anxiety, though somewhat controlled by Seroquel, sometimes gets beyond me.

Some of my friends have asked if their or their loved ones’ symptoms of anger, tears and depression are depression. Well, here’s the answer, yes they are.

https://www.elementsbehavioralhealth.com/depression/irritable-depression-when-sadness-feels-like-anger/

Ever feel so frustrated and pent up that even the slightest thing seems like it could set you off? On the verge of rage, but is it truly rage or is it a different emotion – one that defies words but combines anger, frustration, sadness, anxiety, “stressed out” and edginess? Irritability can feel like emotional sandpaper under your skin and once it is in full swing, everything, from a partner’s kind words to your dog’s whine, seems to make it worse.

Typically when we think of depression, we think of the classic symptoms: sadness, low energy, insomnia, appetite changes, and so on. Sometimes, however, depression presents with a slightly different constellation of symptoms, especially in children and young adults. In fact, in children, sadness might not even be present and irritability alone can lead to a diagnosis of depression. The notion of an irritable or agitated depression has been around in mental health treatment for decades, but is not yet supported by the formal diagnostic process for adults.

Diagnostic Criteria

Currently, the basic criteria required to diagnose depression must include at least five of the following symptoms, and must include either sadness or loss of interest as one of the five:

  • Sadness, “the blues,” low mood, feeling glum, bummed out, or down for no clear reason.
  • No longer being interest in doing things that previously were compelling or interesting. In some cases, this escalates into a complete loss of interest in doing anything at all, and withdrawing from social activity. In other cases, the activity continues but pleasure/enjoyment ceases.
  • Appetite changes that result in weight changes: increases or decreases may be part of depression, but only significant weight loss is noted as diagnostic criterion.
  • Changes in sleep patterns: oversleeping (can’t get out of bed, sleeping excessive number of hours) or inability to sleep.
  • Feeling tired, washed out, and exhausted despite sleeping.
  • An increase in fidgety, purposeless movement such as pacing, nail biting, or chewing the insides of your mouth or a complete absence of such movements (the technical term for this is psychomotor agitation or retardation).
  • Excessive guilt and feeling worthless.
  • Difficulty concentrating, feeling overwhelmed or unable to complete basic mental or physical tasks; feeling unable to do “normal” activities such as driving, food shopping, answering emails, etc.
  • Thoughts of death, thoughts of suicide, plans of suicide, or attempting suicide.

In adults, a sad mood must be present to diagnose depression. In children, this is not so. The first criteria, sadness or a low mood, need not be present in children if the dominant mood state is irritable. However, in May 2013, a new revision of the Diagnostic and Statistical Manual (DSM) will be released and some changes in understanding depression and irritability in both adults and children are expected.

Irritable Subtype?

Much has been written about diagnosing depression, and the age exclusion regarding irritability. Studies show that many depressed adults report significant irritability, yet this symptom alone is not sufficient for the diagnosis of depression. Some researchers and clinicians have been arguing for the inclusion of an irritable subcategory of Major Depressive Disorder to help identify, diagnose, and treat this group of depression sufferers. As the DSM heads for its fifth revision, the inclusion of an irritable subtype of major depression may become a reality.

What is Irritability?

Quick to anger and quick to tears, most of us know when we are irritable, or more poignantly, we know when those around us are irritable. When children are irritable, they are easily frustrated, have a “short fuse” and may be more prone to acting out behaviorally. Adults also show irritability by becoming easily angered or frustrated, allowing small annoyances to take on inappropriate significance, or having trouble filtering out a sharp word or impatient sigh.

In terms of diagnosing a psychiatric illness such as depression, though, clarity and precision are important. Reflect for a moment upon the overlap among feelings of anger, aggression, hostility, and irritability: if irritability is to be featured more prominently in the diagnosis of depression, then it becomes increasingly important to have a clear and precise understanding of this emotion.

Irritability is already seen as a diagnostic indicator in several psychiatric disorders, including mania, ADHD, PTSD, and substance abuse. However, researchers note that the definition of this term within the DSM IV is lacking precision. Some researchers have advocated for removing irritability as a criteria from a number of diagnoses, and instead creating a working definition of “dysfunctional anger.” Whatever it ends up being called, the addition of a mood state other than sadness being key in the diagnosis of depression in some cases is a positive step forward in helping those with this type of depression gain better access to treatment.