Tag Archives: euthymic

New Research On The Aetiology Of Bipolar Disorder.

John D. Pettigrew and Steven M. Miller argue that the underlying pathophysiology for Bipolar Disorder remains elusive, the disorder being strongly heritable but acknowledging that genetics are complicated. Pettigrew and Miller use the term inter-hemispheric switching which looks at trait-dependent biological markers associated with bipolar disorder. Proposing that bipolar disorder is the product of genetic propensity of slow inter-hemispheric switching mechanisms which can become ‘stuck’ in one particular state. Pettigrew and Miller state that slower switches are more ‘sticky’ in contrast to faster switches, hypothesising that the clinical manifestations of bipolar disorder can possibly be explained by hemispheric activation, which could be caught on the right (depression) or the left (mania). The research is based on rates of perceptual alteration in binocular rivalries that appears to be slower in bipolar disorder subjects who are in euthymic states in contrast to the normal controls.

portable_mood_by_alephunky-d5c536zThe research data showed that bipolar disorder patients clustered on the tail end of the distribution indicating a slower alternation rate. The Rivalry Alternation Rates: Bipolar Affective Disorder (n = 18) vs  Non-Clinical Controls (n = 49). Subsequently the euthymic state of the bipolar subjects at the time of testing suggests that slower rivalry rates can be a trait marker for bipolar disorder. Limitations of this study are related to subjects that have unipolar depression who demonstrated slower rivalry rates, although these subjects were to a lesser extent in contrast to bipolar subjects. The model of “bipolar disorder slow switches are ‘sticky’ switches because the intrinsic channel abnormalities that cause the slow oscillation rate also make the switch more likely to be held down in one state by external synaptic inputs”. A neuronal sensitivity with bipolar disorder argues that it would “lead to increased hemispheric output (in response to a stressor) and might therefore increase the likelihood that the switch will be held down (‘stuck’) on the side favouring that hemisphere”.

Pettigrew and Miller propose that the data suggests that bipolar patients have an increased ‘stickiness’ due to reduced intrinsic currents and greater extrinsic synaptic inputs from stressors, resulting in the patients being ‘stuck’ in a depressive or manic episode as a consequence of a stressor. The research proposes that the wide variety of data is indicative of hemispheric asymmetries of mood and mood disorders. Overall the results of the tests in inter-hemispheric switching might also be applicable to understanding the physiological rhythms of mood, cognitive style and other aspects of human brain function. Pettigrew and Miller outline that there have been reports that creativity is enhanced in subjects with mood disorders and also their relatives in contrast to the general population.  The controversial reports of increased creativity raise the potential for an understanding of the consequences associated with slower inter-hemispheric switching and the rhythms of cognitive style that could reveal neural mechanisms of human creativity.

Please note: this is not an academic essay merely a series of different research I found interesting.

Related/interesting sources:

Altshuler, L., Suppes, T., Black, D., Nolen, W., Leverich, G., Keck, P., Frye, M., Kupka, R., McElroy, S., Grunze, H., Kitchen, C. and Post, R. (2006). Lower Switch Rate in Depressed Patients With Bipolar II Than Bipolar I Disorder Treated Adjunctively With Second-Generation Antidepressants. AJP, 163(2), pp.313-315.

Bost-Baxter, E. (2013). ECT in Bipolar Disorder: Incidence of Switch from Depression to Hypomania or Mania. Journal of Depression & Anxiety, 01(05).

Bottlender, R., Sato, T., Kleindienst, N., Strauß, A. and Möller, H. (2004). Mixed depressive features predict maniform switch during treatment of depression in bipolar I disorder. Journal of Affective Disorders, 78(2), pp.149-152.

Buckley, P. (2012). The Neurobiology of the Switch Process in Bipolar Disorder: A Review. Yearbook of Psychiatry and Applied Mental Health, 2012, pp.388-392.

Calabrese, J. (2001). Drug-induced switch rates and their impact in bipolar disorder. European Neuropsychopharmacology, 11, pp.S95-S96.

Goldberg, J. (2010). Substance Abuse and Switch From Depression to Mania in Bipolar Disorder. AJP, 167(7), pp.868-869.

Kauer-Sant’Anna, M. and Yatham, L. (2007). Comment on “antidepressant treatment-emergent switch in bipolar disorder: a prospective case-control study of outcome”. Rev. Bras. Psiquiatr., 29(1), pp.86-87.

Koszewska, I. (1995). P-2-65 Pharmacotherapy in depression during switch from depression to mania in patients with bipolar affective disorder (BD). European Neuropsychopharmacology, 5(3), p.296.

Niitsu, T., Fabbri, C. and Serretti, A. (2014). P.2.d.031 Predictors for manic switch at depressive episodes in bipolar disorder: the Systematic Treatment Enhancement Program for Bipolar Disorder. European Neuropsychopharmacology, 24, pp.S431-S432.

Pettigrew, J. and Miller, S. (1998). A ‘sticky’ interhemispheric switch in bipolar disorder?. Proceedings of the Royal Society B: Biological Sciences, 265(1411), pp.2141-2148.

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The Sobriety Of My Mind.

It’s becoming more and more tedious, the constant unchangeable level of emotion. I want my creative passionate highs and my long nightly social jaunts back. My apparently ‘euthymic’ stage is getting tiresome, the appeal of sexual debauchery is so high, the appeal of reckless driving is growing more attractive, not in a fundamentally hypomanic way, I miss the old highs. My mind has become sober and is craving its old haunts. I want to enjoy the trappings of my former life. It’s as if my old life has been put on ice and I’m currently experiencing the oxygen withdrawals and the hypothermic low temperature when I usually enjoy the heat.

An ornate clock with the words Time to Heal on its face

I realize that when my stable ‘sober’ mind reappears it will have a lot of explaining to do, but I’m stable now and I’m bored, I’m bored of myself. I’m starting to recognize that I like who I am regardless of a mental health diagnosis, my ups and downs serve to reiterate and make me value the better times, I believe people can’t experience true happiness without first experience true sadness. I’m sitting at home twiddling my thumbs thinking “so what comes next?!” I’m not happy or sad, just an in-between irritating state. How is this normalcy?! I’m not even on anti-depressants, yet it feels like the atmosphere has a monotonous ambiance, with a dreary lacklustre song playing on repeat in the background. Not to mention my current feelings of asexuality, I’m like a vegetable that has a gender but lacks the incentive to do anything (had two very nice men ask me on dates, refused both with a nonchalant response, I just couldn’t be bothered).

I’m aware that this sounds like anhedonia (a symptom of depression,  loss of interest in previously rewarding or enjoyable activities) but I’m not depressed, I haven’t been crying, I’ve been participating in a modicum of social activities, yet it’s just different.

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