AspectRain

Over this past year, which has been remarkably busy and provided many oppertunities to learn more about the complexities of the human body and it’s failings, I have been diagnosed with two new diseases:  Lupus, and Bipolar.  I mentioned Lupus briefly in a past article, and may go into at a later date.  For now, I’m more interested in exploring the modern definition of Bipolar, since I’ve been discovering that most of the books and reference materials available, even from the most reliable sources, are out of date.  I don’t want to talk "psycho-babble" or go into how to live with it, but am going to focus strictly on the science of this disease.

So that we may start on equal footing, Bipolar Disorder is "a serious brain illness. It is also called manic-depressive illness. People with bipolar disorder go through unusual mood changes. Sometimes they feel very happy and ‘up,’ and are much more active than usual. This is called mania. And sometimes people with bipolar disorder feel very sad and ‘down,’ and are much less active. This is called depression. Bipolar disorder can also cause changes in energy and behavior" (NIMH ).  It is believed to be caused by genetic and enviromental factors, and associated with hormonal inbalances and inbalances in neurotransmitters, notably  glutamate, dopamine, and serotonin.

It should not be confused with the ups and downs that people experience regularly - the swings are dramatic, the emotions and energy shifts intense, so much so that they can result in the destruction of relationships, the loss of jobs, reckless behavior, and self-harm.  Those with Bipolar Disorder are, according to a study done in 2005, 10-20% more likely to commit suicide than the general public.

I have found that it is difficult for many people to take this disorder seriously without having experienced it, either firsthand or through a close friend or family member.  Psychiatric illnesses in general are (not uncommonly) considered narcissistic as their core, an excuse of bad behavior or self-involvement.  I have heard such responses to my recent diagnosis as "Oh, everyone’s bipolar now and then," "You just need an outlet for your creativity," as well as the suggestion to start volunteer work so I’d feel part of something important.

The greatest challenge to the Neuro-Psychiatric research community has been finding a way to diagnose mental illnesses such as bipolar, schizophrenia, borderline personality disorder, attention deficit disorder, clinical depression, and other such "invisible demons" of the psyche, in a way that is clear-cut and pure science.  Not just to advance the technology, but also to have hard evidence at hand to tell medical insurance companies, "See these test results?  See these scans?  This is a real medical disease, so cough up the f*ing money and cover it!"  Don’t you love it when science is on your side?

Right now, diagnosis is based primarily on observed behavior, the patient’s self-reported experiences, and the reports of family members or friends.  Though this sort of evidence may not be considered solidly scientific, a well-trained psychiatrist can discern the difference between the various emotional and mental illnesses, as well as validate whether the patient is just seeking drugs.  The rate of misdiagnosis has dropped signifigantly as these disorders have become better understood in the past couple decades and doctors are increasinly well-educated - this is also why it seems  sometimes that "everyone has it."  We have not yet reached the point of stability after a new (or better understood) disease is given more accurate methods of diagnosing.  There is always what appears to be a "boom" of newly-diagnosed patients, leading to the suspicion that the disorder is invalid, an excuse for patients and a moneymaking scam for pharmascutical companies.

The need for a medical method of proving their existance has become very important, to reduce the stigma attached to them, to gain these "invisible diseases" the attention they deserve in the scientific community, and to ensure resources and aid for patients.

How to catch an invisible demon?  The technology that has been available to us could do nothing but exclude other possibilities - test for "hypo- or hyperthyroidism, metabolic disturbance, a systemic infection or chronic disease, and syphilis or HIV infection. An EEG may be used to exclude epilepsy, and a CT scan of the head to exclude brain lesions" (Wikipedia ).

Very recently, some new research has shed new light on our brains.  As we have understood it, our brain functions via neurons, who send their information by electronic impulse.  We could test and scan these little buggers by tracking the electricity.  About 15% of our brain is made of these neurons.  A larger portion are cells called Glia.

"The four main functions of glial cells are to surround neurons and hold them in place, to supply nutrients and oxygen to neurons, to insulate one neuron from another, and to destroy pathogens and remove dead neurons" (Wikipedia ).  Essentially, they were the domestic servants of the neurons, keeping house and acting as packing material.  Subserviant to neurons, supporting them in their transmissions, the scientific community dismissed them for over a century.

Yet in the past decade, scientists have found a new way to scan the brain that proves the glian cells are communicating information on their own without electricity, bypassing the neurons entirely. Not only that, but they have the power to control the impulses traveling through the neural network.

Thank Einstein for some of this - or his brain, anyhow.  Neuroanatomist Marian Deamond was one of the fortunate scientists whose team recieved part of this late genius’s brain, that had been preserved and hoarded since his death. She wanted to see if he had more neurons that the average brain, something to clue us in to what made him different and brilliant.

Her study showed that the neurons in his brain were the same as the rest of us.  However, the non-neuronal cells were numbering twice as much as average, especially in the parietal cortex, "where abstract concepts, visual imagery, and complex thinking take place" (Fields, R. Douglas. The Other Brain , 2009, pg 7).  It was a great bafflement as to how this "bubblewrap" of the brain could possibly be involved with mental function.

"Imagine the implications.  Electrical activity in the brain conveys our perceptions, experiences, thoughts, and moods.  Glial cells perform such diverse functions in our nervous system that a vast range of brain functions might be influence by glia if they could sense nerve impulse activity.  Everything from immune system responses to infections, to insulating axons, to wiring up and rewiring the brain, to recovery from brain disease and injury might be influenced by impulse activity actng through glia" (Fields, pg 24).

Let’s not understate this:  The importance in researching glia is as vital as that for stem cells, and the potential in benefits to humanity just as great.

By using a new technique, calicum imaging, we are now finally able to learn more about glia.  In studies that have shocked the scientific world, image scans are now able to show without a doubt that there are signifigant structural differences in the brains of those with psyiatric diseases, including, but not limited to, Bipolar Disorder.  Studies suggest that an imbalance in glian cells could be the cause of mental diseases and epilepsy.  Too much, and it causes seizures.  Too little, and chronic depression, schizophrenia, bipolar, and so forth will develop.  "Now it is also known that patients suffering from bipolar disorder have fewer glia in the regions of the brain handling mood" (Fields, pg 155).

I recommend that if you wish to understand the brain chemistry in further detail, Field’s book is the place to begin, being the most current compiled literature I’ve found.

Some additional new information that has come to light:  For one, in the largest study ever done on the matter, a strong family connection was found, suggesting a genetic link between schizophrenia and bipolar (WebMD, Salynn Boyles, Jan 2009 ).  This means that should one family member have either disorder, the other family members are at increased risk.

At the end of 2009, another study confirmed that genetic link, adding new fodder to the arguement that the two may be different sides to the same coin.  They call the gene involved ABCA13 (The Med Guru, Dec 2009 ).  Scientists are also finding that many mental illnesses, including autism, may be connected by a mutation on human chromosome 16.

"’This type of genetic variation is called copy number variation,’ Sebat explains. ‘It means that instead of having differences in sequence, you have a deletion or a duplication of a whole gene or genomic region. It’s not a mutation; it’s extra copies of a gene. So the dosage of the gene changes, rather than the sequence.’

Specifically, Sebat and his team found that a duplication in copy number variation predisposes someone to schizophrenia and bipolar disorder - and a decrease in CNV is associated with autism " (EmpowHer, Dec 2009 ).

I looked forward to the future of these studies, which will help us understand mental illnesses in their purely physiological form, and hopefully find a medical cure.  In the meantime, buck up, and don’t stop taking your meds.