What Causes Bipolar Disorder?
The answer to this question has never been entirely clear. But it is getting better.
Indeed, if you ask "what causes depression?", the answer is getting pretty good; and right now, it appears that this answer also applies to bipolar depression.
But that leaves mania. However, new research is beginning to shed more light on this. I just revised the essay on this subject on my website to reflect that new research. The bottom line: first, there is clearly a genetic component, but instead of one gene, there clearly are many that can be part of the problem, which is one reason why there are so many different versions of bipolar disorder. Secondly, at least one of the genes involved is part of the biological clock, the mechanism of which is now understood to a remarkable degree. Third, new research has revealed clues about the basic differences between the brains of people with bipolar disorder and those who do not have this illness.
If bipolar disorder can be so lethal sometimes, why is it still around? Why hasn't evolution selected it out long ago? Some speculations on this are offered at the end of the Web essay linked above.
Dr. PhelpsLabels: Bipolar disorder, cause, depression, mania
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7 Comments:
Psycheducation.org is the most important 'one-stop' resource I've find to date to help me get a handle on a very difficult subject: I spent the better part of summer '06 reading almost everything there.
Forgive me if you've possibly discussed this before, but I wonder if you could write sometime about the PROGRESSION of bipolar disorder. I often wonder how it is that a healthy, socially well-adjusted child can seem to do well for many years, go through adolescence and young adulthood relatively unscathed, yet experience a depression so severe, strange (and psychotic) in one's early 30's, to warrant (10 years after that) a diagnosis of Bipolar Depression? Is it possible to have a 'normal' childhood/adolescence/young adulthood, without any severe disturbances, but undergo such a great change later in life?
Your thoughts on this would be very much valued. Thank you.
Good idea. I'll send that up shortly. Thanks for the compliments and the encouragement.
Jim Phelps
I would like to challenge the notion that Mania is bad.
The ramifications of mania may be bad but they may be the inevitable effect of an underlying process of a brain healing itself. If one accepts that depression is the result of, or cause of neurodegeneration. One should also be willing to accept that mania is the result of neurogenesis.
Dr.'s Ralph Hoffman and Andrew Chambers have done some work in neural network modelling that is highly suggestive that neurogenesis would produce a 'noisy' network. This disrupted network would allow for better represented cell assemblies outside of(but innervated by) the hippo-campus to, perhaps, have undue influence in behaviour.
The stability of the areas of the brain that regulate the evolutionary necessities of survival / harm avoidance and reproduction would therefore be more influential in shaping behaviour (mania / psychosis).
I invite you to look at the work done by Hongjun Song. My interpretation of it is that new neurons, quickly like to integrate with existing assembly's. While at the same time, there intergration increases the plasticity of the targeted assemblies, following Hebbian principles.
Not based on any direct science but as a matter of opinion, I would also suggest that during this period, there is a 'race' for neurons to mature. The better connected and differentiated a neuron becomes, the healthier it will be. But during this time, the reactions to potentiating factors will be heightened, drive behaviours.
What this might mean is that shoring up the depressive side, and not being overly aggresive on the manic side (prophalixs) might produce better outcomes.
Dr. Song's papers are available at...
http://neuroscience.jhu.edu/HongjunSongRecentPapers.php
Thank you for the references. I looked at Dr. Song's list.
If I understand you correctly, you are suggesting that mania must in some way be a product of neurogenesis (inasmuch as it is rather the opposite of depression, which we now know is a function of neuro-atrophy, at least in longer episodes of depression). Certainly that basic presumption has some intuitive appeal.
If mania really is in some way a form of neurogenesis, then -- if I follow you -- must it not be potentially a good thing?
Two thoughts on that: first, we still do not really have direct evidence that mania is a form of neurogenesis. It makes sense to think of it that way, but I'll bet it will turn out to be much more complicated than that.
Secondly, and most important: mania is incredibly destructive when you look at what happens to people's lives. I will just caution you to be careful with this idea of mania as being somehow a good thing. You would only have to broach that idea on a website devoted to bipolar disorder to hear loud and clear how awful mania can be sometimes.
In the first phase of mania, before it becomes too extreme, I grant you there is a period in which people become remarkably productive and can sometimes use their often very unique intelligence to its maximum. If only things would stop there. Unfortunately, they rarely do, and what happens thereafter can be so devastating that you would not dare to breathe this idea of mania as a good thing in the company of someone who has been through it. The definitive reference on this is a book by Kay Jamison, An Unquiet Mind. Might be worth a look.
Thank you for your comment.
JP
You are understanding me correctly in so much as mania being a product of neurogenesis. I did preface that, with the distinction between being physically positive but with potentially negative consequences. Inevitable perhaps, but not positive.
The idea is based, in part, on the work of Dr.'s Hoffman and Chambers. I will dig up some links for you. And elaborate further.
Best,
Glen
And also, as far as not having a bad episode until later in life -
you can't always tell the difference between normal behavior and Bipolar until you are in your 30's.
As a kid, people dismiss behavior as "growing pains" ADD, immaturity/childish impetuousness or temper tantrums, or crazy college years when people stay up all night partying or cramming for exams, or your early 20s when you might be working really hard to get ahead at work or changing jobs frequently while exploring different fields, dating around, etc. It's when you can't stop these behaviors even if you wanted to when you get older. Then you can tell if the behaviors you had as a child, teen and 20-something were manic or regular. Regular people grow out of such things. Manic people slowly grow worse.
The term "mania" brings to mind someone "out of control." I am not sure that I have bipolar although I think I may. My "mania" is just that I get more talkative, irritable, and bossy with more energy. The negative aspect of this for me has been that under stress, I'm quit several jobs (or tangled with the wrong people).
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