Antibiotics Linked to Manic Episodes

Have you ever taken an antibiotic and felt more manic? There might be a reason for that.

 

antibiotics

Credit to flickr.com user Iqbal Osman. Used with permission under a Creative Commons license.

Researchers have found a link–not cause and effect, mind, just a link–between antibiotics and manic episodes in people with mental disorders. Robert Yolken and a research team at John Hopkins University reviewed medical records of patients treated for mania, major depression, bipolar disorder, and schizophrenia at the Sheppard Pratt, a psychiatric hospital in Baltimore. The scientists also surveyed over five hundred controls–people without mental disorders–about their antibiotic use.

 

What they found is shocking. In the manic patients, 7.7 percent were taking antibiotics, compared to 1.3 percent of the controls. This is a more than a fivefold increase in the odds of being in the mania group. However, only 4 percent of the people hospitalized for bipolar depression and 3 percent of the people hospitalized for schizophrenia were taking antibiotics.

Yolken’s team examined whether the place of infection, such as the mouth, skin, or respiratory system correlated with hospitalization, and determined that the site of the infection didn’t seem to matter.

There are several ways that antibiotic use could impact psychiatric symptoms. The infection itself could lead to inflammation. Or the antibiotic could kill off good bacteria, which could also lead to inflammation.

The research team is conducting more studies to see how this link works. For example, one study is examining whether suppressing inflammation in the gut will reduce the recurrence of manic episodes.

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Dans les souliers d’un bipolaire // In the shoes of a bipolar

Stephane, of Espoir Bipolaire, a new French blog, has kindly shared a guest post with us titled “In the Shoes of a Bipolar.” Stephane is translating some of the Bipolar Parent’s posts into French, such as 4 Ways to Educate Someone About Mental Illnesses. Scroll down to the bottom of this post for the English translation!

Espoir BIPOLAIRE

English version at the end of the post

Dans les souliers d’un bipolaire

Des chaussures, il y en plein l’Histoire, avec un grand « H » comme on dit. Le saviez-vous ? La mère de Charlemagne, traditionnellement appelée « Berthe au grand pied », avait un pied plus long que l’autre, ce qui l’obligeait à acheter deux paires de chaussures de taille différente. Imelda Marcos, la femme du dictateur Philippin des années 80 possédait plus de 3000 paires de chaussures, toutes achetées au frais de l’état. Il y en a aussi dans les petites histoires. Vous aimiez certainement les contes de votre enfance ! Le Petit Poucet était brave et se sortait du pétrin avec les bottes de 7 lieues du géant. Grâce à elles, il entre au service du roi, accumule les richesses et met sa famille à l’abri du besoin.

Tant de chaussures me direz-vous ! Mais le choix des chaussures à porter n’est pas…

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Why Should You Chart Your Moods if You Have Bipolar Disorder?

chart

Credit to flickr.com user Selbe Lynn. Used with permission under a Creative Commons license.

Mood charts can be valuable tools if used properly. The charts provide a quick reference guide to how your moods and medications affect your daily life.

Among other things, they can track:

  1. The date.
  2. Mood scale.  All mood charts intended to track the effects of bipolar disorder have a mood scale, with most ranging from -3 (low mood) to +3 (elevated mood). 0 is the baseline, indicating “normal” or stable mood. You record the most intense mood at the end of the day by placing a dot or an “X” in the appropriate box. If you suffered from both mania and depression, you would mark two dots or “X”s. This gives you an easy graph to track exactly what moods you’ve experienced, providing both a way to examine patterns in your moods, and an early warning system for potential mood episodes.
  3. Weight. The chart I recommend, used by the National Institutes of Mental Health, recommends that you weigh yourself on the 14th and 28th of each month. This makes it easy to track whether your medications are packing on the pounds, or if your diet is actually working.
  4. Menstrual cycles. Premenstrual syndrome symptoms can interfere with mood, weight, and cause irritability. It’s a good idea to know when a dip in your mood is due to a visit from Aunt Flo.
  5. Sleep. Most mood charts have spaces to mark down how many hours of sleep you received the night prior. A lack of sleep might be a warning about a manic episode.
  6. Medications. Usually, mood charts also encourage you to write down your medicines, the dosage, and whether or not you’ve taken them. This can help you actually take your medication on time.
  7. Alcohol and drug use.
  8. Anxiety and irritability.
  9. Notes. These are records of life stressors or therapy sessions. These notes can be a brief mood diary.

But why should a person chart their moods, if the above list wasn’t enough? There are several reasons:

  1. Simplification. Your mood is affected by a great number of things, among them sleep, medication, and life stressors. Because there are so many factors involved, it is easier to chart than to keep a diary, or remember everything between doctor’s visits. The best part is that you can take your charts with you to psychiatrist and therapist visits!
  2. Keeping track of patterns.  A quick visual guide enables you to easily see patterns in your moods, and warn for potential mood episodes before problems develop. If you track your moods and keep notes, you can identify your own personal triggers for episodes.
  3. Empirical data. A mood chart definitively shows the effects medication, exercise, and sleep has on your mood. Collected over a period of time, the data makes it easier to pick out specific reasons behind your mood changes rather than just relying on feelings.
  4. Social Security disability evidence. Because mood charts can show exactly how intense your mood swings are, you can use them to demonstrate how your episodes interfere with your day-to-day life.

Mood swings from bipolar disorder–from the grandiose highs of mania to the deep despair of depression–can be intense and unpredictable. Using a mood chart is an easy way to learn potential triggers to mood episodes, understand the impact of medication, and keep track of other factors such as weight and sleep. Charting your moods can help bring order to an irregular disorder.

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Bipolar Disorder is Toxic–Literally

neurons

Credit to flickr.com user Anders Sandberg. Used with permission under a Creative Commons license.

Apparently the blood of people with bipolar disorder is toxic to their brains. Let me explain.

Bipolar disorder, also known as manic-depressive illness, is a brain disorder characterized by changes in mood and energy levels, affecting a sufferer’s ability to function. People affected by the disorder endure periods of both mania–with elevated mood, irritability, and rapid thoughts–and depression.

Lately, researchers have begun classifying patients as early or late-stage. Early-stage patients have dealt with fewer mood episodes; late-stage patients have dealt with more frequent and more severe episodes.

A recent study compared neurons exposed to blood serum from bipolar patients to neurons exposed to blood serum from healthy controls. Researchers Fabio Klamt and Flávio Kapczinski found that the first neurons suffered a significant loss in the density of neurites, which estimate the number of brain connections. However, neurons exposed to serum from early-stage bipolar disorder patients showed no difference in neurite density compared to the healthy controls’. The scientists also found that, except for those neurons exposed to serum from patients at very late stages of the disease, the number of neurons weren’t that different between samples.

Previous studies have shown that people with bipolar disorder have lower neurotrophins–proteins that promote brain growth. Also lowered is the early-growth response 3 (EGR3), a protein which helps the brain cope with stressors such as environmental changes and overstimulation. In addition, another study showed that bipolar patients have abnormally low levels of chemokines–proteins that signal other cells, so reactions to stimuli are slower.

So, what does that all mean? In short: researchers have found definitive proof that the blood of people with bipolar disorder is toxic to their brains. The more mood episodes a person has, the fewer brain connections he or she will create, and the slower their brains will grow. People in later stages of the disease also produce more cells which impair the brain’s ability to deal with environmental changes, inflammation, and stress.

Further studies will concentrate on creating drugs which can offset the toxicity of the bipolar patients’ blood.

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Antibodies That Cause Encephalitis Linked to Psychosis

antibodies

Credit to flickr user Parthiv Haldipur. Used with permission under a Creative Commons license.

Psychosis, a break from reality, is a common feature of bipolar disorder. People can suffer delusions, hallucinations, depression, anxiety, and incoherent speech. The breaks are especially dangerous for postpartum women, who may harm their infants. The causes of psychosis are varied, ranging from mental illnesses such as schizophrenia or bipolar disorder, to sleep deprivation, substance abuse, or prescription drugs.

But new research has linked psychosis to antibodies that cause encephalitis, a life-threatening disease which inflames the brain. There is hope that removing these antibodies will treat psychosis just as much as doing so treats encephalitis. Some of the antibodies act against a nerve cell protein called NMDAR, or the NMDA receptor.

Belinda R. Lennox, a psychiatry professor at the University of Oxford in the United Kingdom, led a team of researchers who conducted a study on 228 people with first-episode psychosis. The scientists drew blood from the patients within the first six weeks of treatment. They also collected blood from a group of healthy people and used that as the control group for the study.

Seven–three percent–of the patients with first-episode psychosis presented with NMDAR antibodies. None of the controls did. A previous study from 2015 found that children experiencing their first episode of psychosis also had antibodies relating to the NMDAR.

The good news is that, Lennox and her team, using an experimental immunotherapy that targets the antibodies, successfully treated patients with psychosis, and helped them recover function after their episodes.

Three percent may not be much, but it’s three percent more of people who may be able to be treated with immunosuppressant therapies. This is a significant minority, one that shows promise. Lennox and her team plan to conduct a randomized, controlled trial of immune treatment in people with psychosis in 2017.

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Can Blueberry Extract Help Prevent Postpartum Blues?

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Credit to flickr.com user ___steph___. Used with permission under a Creative Commons license.

Postpartum blues, a range of sad emotions that peak five days after giving birth, is often seen as a precursor for postpartum depression. But a recent study in the Proceedings of the National Academy of Sciences (PNAS) shows that dietary supplements, including blueberry extract, may lessen the effect of postpartum blues, and possibly prevent postpartum depression.

Researchers believe that postpartum blues are controlled by hormones, and the changes that occur in them after birth. In the postpartum period, estrogen and progesterone drop severely, which may contribute to depression. Postpartum depression is also coupled with an elevation in the enzyme monoamine oxidase A (MAO-A), which regulates neurotransmitters in the brain.

During the study, scientists gave a group of 20 women a dietary supplement containing L-tyrosine and L-tryptophan–both thought to help balance postpartum MAO-A activity–blueberry juice, and blueberry extract. The levels of tryptophan and tyrosine in breastmilk were not affected by this dietary supplement. The blueberries were added to help the chemicals cross the blood-brain barrier.

A control group of 21 women were not given a supplement, which may mean that the results of the study may be challenged by the placebo effect. But it’s difficult to argue with the results: on the Visual Analog Scale, a commonly-used measure of pain, the group that did not receive the supplement had scores of a thousand times higher than those women that received the supplement. On the Profile of Mood States, the control group showed a significant increase in depressive symptoms, but the women who received the supplement experienced a decrease in the same symptoms. The moods of the women taking the supplement were improved three-fold.

Even though the study did not have a placebo trial, the results speak for themselves. The supplement doesn’t have any negative effects, so researchers plan to have better studies, with bigger sample sizes and placebos. If the chemicals and blueberry juice and extract can  indeed decrease depressive symptoms this greatly, there’s no reason to not give women these supplements. What a great scientific advance!

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Substance Abuse and Bipolar Disorder

alcohol

Credit to flickr.com user Zhao. Used with permission under a Creative Commons license.

Sometimes, the symptoms of bipolar disorder–including periods of elevated mood, depression, and irritability–are too difficult to deal with. Often, people turn to drugs and alcohol to try to cope.

“Some people attempt to treat symptoms of their mental illness with substances, but substance abuse can activate or prolong symptoms,” Marissa Krick, a writer for DrugRehab.com, said in an email.

Krick cited studies saying that up to 60 percent of people who suffer from bipolar disorder confess that they’ve also abused drugs or alcohol. People who suffer symptoms of acute mania or bipolar II disorder are significantly more likely to abuse benzodiazepine and alcohol than people who suffer from depression, according to the Zurich Cohort Study. In addition, a history of substance abuse complicates recovery from acute manic states.

The writers at DrugRehab.com have penned an extensive report on substance abuse in conjunction with bipolar disorder. It’s worth a read. According to the report, “Substance abuse makes symptoms of bipolar disorder worse and decreases the benefits of standard treatment. People tend to take longer to recover, spend more time in health facilities and be more likely to contemplate suicide when they misuse substances during treatment.”

But there is hope. Rehabilitation facilities can treat both substance abuse and bipolar disorder concurrently. Treatment for substance abuse starts with a detoxification process, whereas treatment for bipolar disorder involves medication and behavioral therapy. Patients going through drug or alcohol withdrawal are kept as comfortable as possible.

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Bipolar Disorder in Women

Bipolar disorder, a mood disorder in which sufferers cycle between manic and depressive states, affects 2.6 percent of the adult population in the United States. While men and women are equally affected, the illness manifests differently across the sexes.

Compared with men, women with the disorder are more likely to experience depressive episodes, mixed states–in which manic and depressive symptoms occur at the same time–and rapid cycling. Rapid cycling is the occurrence of four or more mood episodes in an annual period. Around three times as many women as men experience rapid cycling. Women are also more likely to be diagnosed with bipolar II, which has depressive and hypomanic–which are less intense than manic–episodes. Research demonstrates that thyroid imbalances may play a part in these differences, which, again, are more common in women than men.

women

Credit to flickr.com user Mical Koralewski. Used with permission under a Creative Commons license.

Bipolar disorder often develops later in women than men, who are often diagnosed around age 25. Women are often misdiagnosed with unipolar depression, and men are often misdiagnosed with schizophrenia. Anxiety is often comorbid with diagnoses of bipolar disorder in women rather than men, and eating disorders are more likely to appear during depressive episodes of women’s than men’s. Men are shown to have higher rates of substance abuse and gambling addiction than women.

Symptoms of bipolar disorder worsen during perimenopause, menopause, and after childbirth–all linked to fluctuating levels of estrogen and other hormones. Women with premenstrual dysphoric disorder (PMDD) have a greater risk of developing bipolar I. Fifty percent of women with bipolar disorder will experience a mood episode within four weeks after childbirth. About twenty-five percent will go through postpartum psychosis, and a further twenty-five percent will suffer from postpartum depression.

Women and men are very different in the ways in which their bipolar disorder manifests. The menstrual cycle and its hormones plays a part in the worsening of symptoms. Women’s comorbid disorders necessitate different treatments than men.

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PNWA Conference Report

 

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The Pacific Northwest Writers’ Association conference tag, with a black finalist’s ribbon outlined in gold. Protected under a Creative Commons license.

From Thursday, July 20th through Sunday, July 23rd, I attended the 2017 Pacific Northwest Writers’ Association’s conference. It was a meeting of writers of all genres, from memoir to middle grade to fantasy. I participated in the PNWA literary contest back in February with chapters five and six of my memoir, Committed, and placed as a finalist. I also judged the science fiction category, reading up and making comments on 280 pages of others’ works.

The conference was an absolute blast. I made several contacts who I will gladly call friends, and attended classes to improve my craft and ability to market my book. I was overwhelmed at first by what’s required to market my book, according to the experts–Facebook and Twitter parties, and blogs with over 120,000 followers–but I quickly rallied to learn about how to structure author websites, how to research facts properly for memoirs, and how to edit my book properly. I pitched to nine agents/editors, and received requests for a partial manuscript from five of them.

The highlight of the conference was a woman named Maria (pronounced Maraya) Philips, and how she showed her faith in my memoir. Now, I didn’t know this woman from Adam before the conference, but she is the marketing manager at PNWA and taught two classes. She heard my pitch, and immediately spoke with an editor, Lynn Price, of Behler Publications. Maria later caught me in the hallway and said, “Lynn Price is expecting you!”

What a shock! Unfortunately, Ms. Price ultimately rejected my manuscript, but to have someone enjoy my story enough to use their clout with an editor was supremely satisfying. I thank Maria for her faith in me, and recommend the conference for networking opportunities for anyone in the Seattle area.

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App to Detect Onset of Mania In Development by Sane Australia

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Credit to flickr user Christian Hornick. Used with permission under a Creative Commons license.

Mania, which can include irritability, hyperactivity, over-spending, and promiscuity, is often devastating to people who suffer from bipolar disorder. Unless the bipolar sufferer knows themselves and their disease very well, oncoming manic episodes can’t be detected. And occasionally, patients even ignore or deny their symptoms. Sane Australia, a mental health organization, is testing an app that will detect the onset of manic episodes.

The app works by monitoring the bipolar person’s interactions with their digital devices. Over time, this data can be compared with touchstones of stability in the person’s life. If instable patterns–such as not sleeping for days on end–arise, then the bipolar sufferer and a trusted confidant or medical professional are notified by the app so they can take action to prevent the episode from getting worse. The data can also be shown to psychiatrists working with the bipolar person to demonstrate patterns of behavior and create treatment plans in response.

Sane Australia is hosting a three-month non-clinical trial in July with 400 people–200 with bipolar and 200 people close to them–to determine if the app actually works. Initially, the app, funded by Gandel Philanthropy, will only be available on Android smartphones, but the company plans to release it on tablets, laptops, and other devices.

Eventually, the company plans to address the onset of depression as well as the onset of manic episodes. They hope to analyze data gathered by a large user base, which will give them bellweathers of instability across a population of bipolar sufferers.

This app, if it works, is a promising addition to a bipolar patient’s arsenal to prevent their disorder from consuming their life. According to the app’s website, “Destructive mania is often detected too late to take preventative action.” If manic episodes can be found early, then medical professionals and careers can respond quickly, and head off the worst of the symptoms.

The app is scheduled for release in the Australian market sometime in 2018.

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