bipolar parent

How to Make a Dopamenu to Give Your Brain the Stimulation it Desperately Needs

This post appeared on the International Bipolar Foundation’s website, here.

Have you ever found yourself doom scrolling the internet, desperately seeking stimulation for your depressed brain but being too tired to think of a healthy way to do that?

When we’re depressed, our brains have trouble focusing on “boring” tasks. We just can’t do them, and our brains seek stimulation.

But we often look for that easy dopamine (the “happy” chemical) hit, like scrolling social media, which ends up not feeling great when we do so for hours.

So what’s one way to stimulate the chronically understimulated depressed brain?

Make a Dopamenu.

This YouTube video by How to ADHD called “How to Give Your Brain the Stimulation it Needs” walks you through the process of making a Dopamenu, which can be done in the following four steps:

  • Design your menu.
  • Omit anything unrealistic.
  • Prep your ingredients.
  • Advertise

I’ll walk you through these in more detail below.

1. Design your Menu

The first step is designing your menu. Eric Tivers, an ADHD expert who has ADHD himself, recommends figuring out both what excites you and what makes you feel rotten after indulging in them for too long.

The video recommends breaking the menu down into the following sections:

  • Entrées – Activities that you can do every day that make you feel alive. My entrées involve taking a bath, planning a fanfiction with friends, eating a meal with my family, taking a brisk walk, or cross-stitching.
  • Desserts – Your “go-to”s when you’re bored and seeking a fast dopamine hit that doesn’t really satisfy you. Mine include eating Cheetos or drinking a Mountain Dew, staying in bed in the morning, and doom scrolling the internet.
  • Appetizers – Things that give you a “quick burst” of happiness. Mine include eating some cheese and bell peppers, sitting in the sun, and drinking a cup of tea.
  • Sides – Things you add to the other items on the menu to help you enjoy them more. Mine include listening to music and warm socks/comfortable clothing.
  • Specials – These are the big dopamine hits – expensive or inconvenient things that are not meant to be frequent. Mine include a trip to the local arcade to play the Dance Dance Revolution machine, baking a cake, and buying a new video game.

The video author goes on to say that desserts are not completely off-limits; you can still partake in desserts, but they shouldn’t be your main source of “nutrition” re: dopamine hits.

2. Omit anything unrealistic

The video author’s next step is to omit anything unrealistic from the entire list.

This is half a dreams list and half a goals list. I’d recommend listing things you can actually do; going on a vacation in a pandemic as a special may be out of the realm of comfort for some people, as well as too expensive.

So fluff up your list as much as possible and then cut, cut, cut.

3. Prep your ingredients

The author says to prepare to do items on your Dopamenu ahead of time as much as possible to make the processx smooth.

For example, I prepped a cross-stitch kit–fabric, needles, thread, an embroidery hoop, and scissors kept in a gallon-size Ziploc bag–and placed it in the backpack I take everywhere so I can cross-stitch at a moment’s notice. Any time I’m sitting down unoccupied and in need of precious relaxation, out comes the cross-stitch kit.

The author also says to create barriers to your go-tos so you don’t use them as often. When I need to unplug from the internet, I uninstall Discord, a chatting application, on my phone, and during my day-to-day life, I tell myself I can’t check Discord until I’ve done something productive.

Increasing the number of steps to my go-tos and decreasing the number of steps to more satisfying things on the menu has certainly helped me, and it can help you too.

4. Advertise

The next step is to make your menu pleasing to use. Advertise!

You can add descriptions to the items, design a pretty background, and/or make it humorous and therefore fun to read. When you create something beautiful to look at, it’s exciting to use!

After you prettify your Dopamenu, then place it in places where you’ll see it every day. I keep mine on my phone, but I’m planning to print a copy and post it on the door to my bedroom. That way, every time I go to lie down in my bed for the purpose of doom scrolling on my phone, I can find a better activity to engage my brain.

Final Thoughts

Making a Dopamenu is a simple way to take a look at your daily habits and start doing better ones. If your brain is continually unsatisfied, you may end up depressed, where seeking stimulation becomes even harder.

It takes energy to think of things that give you energy. Cut out the planning.

Make a Dopamenu today.

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bipolar parent

How to Shield Your Children from the Effects of Your Bipolar Disorder

A version of this post appeared on the International Bipolar Foundation website.

As a parent with bipolar disorder, you might worry about the effects of your unchecked mental illness on your loved ones, especially your children. The devastating mood swings of bipolar disorder–ranging from manic “highs” to depressive “lows” and everything in between–can cause instability for your kids. One example, a 2014 study, showed teenaged children of parents with bipolar disorder are more susceptible to risky sexual behavior and emotional problems than young adults who do not have parents with bipolar disorder. As has been seen in many other cases, dysfunction in the home causes dysfunction in the child. This is equally true in cases of children with parents who suffer from mental illness, like bipolar disorder.

children
A picture of four cheerful kids with brown skin. Credit to flickr.com user Adam Lai. Used with permission under a Creative Commons license.

But there is good news. You can learn how to shield your children from the effects of your psychiatric condition. How? Let’s dig in.

Treat Your Disorder Properly

One of the most effective ways to shield your children from your bipolar disorder is to treat the disease properly. Try to eat a healthy diet and work exercise into your life. Adequate sleep is another requirement to keep you healthy and keep things from spiraling out of control. Make sure you get your forty winks, and if you have trouble, talk to your doctor. Taking medication regularly and working through emotional problems through therapy will help you manage your disorder and aid you in positively impacting your kids.

If your disorder is treatment-resistant, don’t give up hope. Dyane Harwood, author of Birth of a New Brain: Healing From Postpartum Bipolar Disorder, thought she’d exhausted all of her options to treat her bipolar depression, including electroconvulsive therapy. Then her doctor prescribed a monoamine oxidase inhibitor (MAOI). The drug worked, and Harwood is now engaged with her children and husband, living life the way she wants to.

Get Help

Bipolar in the family needs a whole family solution. The entire household needs to learn coping skills to handle a parent’s disorder. Ask your therapist for ways to teach your partner and children to deal with the ups and downs of your bipolar disorder. If your children start showing symptoms of emotional problems, such as anxiety, phobias, or intolerance to frustration, find a child behavioral psychologist or a therapist willing to see children. Make a list of the symptoms you’ve seen in your kids, and be sure to include your family history as well.

Cultivate a Support Network

One aspect of getting help is relying on a support system of healthy adults. They can spot you when you’re feeling too up or too down. They can offer your children a more stable environment during manic or depressive episodes by taking the children to a different place, like your friends’ homes, or coming over to yours. Your kids need adults they can consistently rely on, even if you can’t provide that reliability sometimes. Try to develop that support if you don’t have it. When you are well, cultivate reciprocal friendships with other adults you can trust with your children. Easier said than done, of course, but try to be a reliable source of childcare for your parent friends, so they will pitch in when you need them.

Prepare Your Kids

Shielding your kids from bipolar disorder doesn’t mean hiding the illness from them. Preparing your children to accept what’s happening around them can be difficult, but it is worthwhile. Communication with your children is crucial when managing their understanding of bipolar disorder. You might think explaining your disease to them is wrong. There’s an instinct to hide uncomfortable situations from your children, but kids are intuitive. They will know if someone in the family is suffering, even if they can’t put their finger on why. If the problem isn’t explained to them, they may assume the worst, even to the point where they think it’s their fault. Letting your children know up front what to expect if you’re suffering from a mood episode will help your kids roll with the punches. Keep the explanation simple, and be ready to revisit the conversation anytime your children have questions.

When explaining your bipolar disorder to your children, stress that this disease is not your kids’ fault. Also stress that taking care of a parent suffering from mental illness is not their job. They will probably appreciate your candor and feel more secure in their relationship with you and their place in the world. If things don’t go well, talk to your therapist for ways to help your children understand bipolar disorder and their relationship with you as a parent with a mental illness.

If your older children are concerned about developing bipolar disorder themselves, tell your preteens honestly that they are not destined to have the disease. Studies put the inheritance rate at about 30% with a single parent affected by bipolar disorder, and around 60% for both. You don’t need to quote the statistics to a younger child, but a teen might be interested. Because of the instinct to hide uncomfortable situations from your children, you might want to keep this from your children. But knowing even uncomfortable statistics, like the 30%, is better than the unknown.

Final Thoughts

When you suffer from mental illness, taking care of yourself is a tall order. Taking care of a child as a parent with bipolar disorder adds additional complications, but it’s worth it. You can shield your children from bipolar disorder in several ways. Make sure that you treat your disease with professional help. Cultivate a support system. And it’s paramount that you communicate with your children about your disorder, so they know what to expect and what their place is.

You can do this.

bipolar parent

How Specific Gene Variants May Raise Bipolar Disorder Risk

cpgv level
In this data visualization, each horizontal line is an individual. Those with bipolar disorder were more likely to be on the lower end of the CPG2 protein expression scale, and more likely to have gene variants that reduced expression. Credit: Rathje, Nedivi, et. al.

A new study by researchers at The Picower Institute for Learning and Memory at MIT finds that the protein CPG2 is significantly less abundant in the brains of people with bipolar disorder (BD) and shows how specific mutations in the SYNE1 gene that encodes the protein undermine its expression and its function in neurons.

Led by Elly Nedivi, professor in MIT’s departments of Biology and Brain and Cognitive Sciences, and former postdoc Mette Rathje, the study goes beyond merely reporting associations between genetic variations and psychiatric disease. Instead, the team’s analysis and experiments show how a set of genetic differences in patients with bipolar disorder can lead to specific physiological dysfunction for neural circuit connections, or synapses, in the brain.
The mechanistic detail and specificity of the findings provide new and potentially important information for developing novel treatment strategies and for improving diagnostics, Nedivi said.

“It’s a rare situation where people have been able to link mutations genetically associated with increased risk of a mental health disorder to the underlying cellular dysfunction,” said Nedivi, senior author of the study online in Molecular Psychiatry. “For bipolar disorder this might be the one and only.”

The researchers are not suggesting that the CPG2-related variations in SYNE1 are “the cause” of bipolar disorder, but rather that they likely contribute significantly to susceptibility to the disease. Notably, they found that sometimes combinations of the variants, rather than single genetic differences, were required for significant dysfunction to become apparent in laboratory models.

“Our data fit a genetic architecture of BD, likely involving clusters of both regulatory and protein-coding variants, whose combined contribution to phenotype is an important piece of a puzzle containing other risk and protective factors influencing BD susceptibility,” the authors wrote.

CPG2 in the Bipolar Brain

During years of fundamental studies of synapses, Nedivi discovered CPG2, a protein expressed in response to neural activity, that helps regulate the number of receptors for the neurotransmitter glutamate at excitatory synapses. Regulation of glutamate receptor numbers is a key mechanism for modulating the strength of connections in brain circuits. When genetic studies identified SYNE1 as a risk gene specific to bipolar disorder, Nedivi’s team recognized the opportunity to shed light into the cellular mechanisms of this devastating neuropsychiatric disorder typified by recurring episodes of mania and depression.

For the new study, Rathje led the charge to investigate how CPG2 may be different in people with the disease. To do that, she collected samples of postmortem brain tissue from six brain banks. The samples included tissue from people who had been diagnosed with bipolar disorder, people who had neuropsychiatric disorders with comorbid symptoms such as depression or schizophrenia, and people who did not have any of those illnesses. Only in samples from people with bipolar disorder was CPG2 significantly lower. Other key synaptic proteins were not uniquely lower in bipolar patients.

“Our findings show a specific correlation between low CPG2 levels and incidence of BD that is not shared with schizophrenia or major depression patients,” the authors wrote.

From there they used deep-sequencing techniques on the same brain samples to look for genetic variations in the SYNE1 regions of BD patients with reduced CPG2 levels. They specifically looked at ones located in regions of the gene that could regulate expression of CPG2 and therefore its abundance.
Meanwhile, they also combed through genomic databases to identify genetic variants in regions of the gene that code CPG2. Those mutations could adversely affect how the protein is built and functions.

Examining Effects

The researchers then conducted a series of experiments to test the physiological consequences of both the regulatory and protein coding variants found in BD patients.

To test effects of non-coding variants on CPG2 expression, they cloned the CPG2 promoter regions from the human SYNE1 gene and attached them to a ‘reporter’ that would measure how effective they were in directing protein expression in cultured neurons. They then compared these to the same regions cloned from BD patients that contained specific variants individually or in combination. Some did not affect the neurons’ ability to express CPG2 but some did profoundly. In two cases, pairs of variants (but neither of them individually), also reduced CPG2 expression.

Previously Nedivi’s lab showed that human CPG2 can be used to replace rat CPG2 in culture neurons, and that it works the same way to regulate glutamate receptor levels. Using this assay they tested which of the coding variants might cause problems with CPG2’s cellular function. They found specific culprits that either reduced the ability of CPG2 to locate in the “spines” that house excitatory synapses or that decreased the proper cycling of glutamate receptors within synapses.

The findings show how genetic variations associated with BD disrupt the levels and function of a protein crucial to synaptic activity and therefore the health of neural connections. It remains to be shown how these cellular deficits manifest as biopolar disorder.

Nedivi’s lab plans further studies including assessing behavioral implications of difference-making variants in lab animals. Another is to take a deeper look at how variants affect glutamate receptor cycling and whether there are ways to fix it. Finally, she said, she wants to continue investigating human samples to gain a more comprehensive view of how specific combinations of CPG2-affecting variants relate to disease risk and manifestation.

Materials provided by Picower Institute at MIT.

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bipolar parent

America Has Highest Rate of Bipolar Disorder Diagnoses in 11-Nation Study

Bipolar disorder, a disease characterized by “highs” (called mania) and “lows” (called depression), does not discriminate. It affects men and women equally, has been affecting children more and more, and appears to have a roughly similar incidence across all ethnic, racial, and socioeconomic groups. About 2.4% of people around the world are diagnosed with bipolar disorder in their lifetimes.

According to a new 11-nation study conducted by researchers around the world, the United States has the highest incidence of bipolar disorder, at 4.4%. India has the lowest rate at 0.1%, followed by Japan at 0.7%. Lower-income nations typically demonstrated lower rates. Colombia, a lower-income nation, bucked the trend with a incidence of 2.6%.

But why does the U.S. experience the highest bipolar rate among all 11 nations studied? Let’s dig in.

Wealth

Wealth may play a role. Individuals in higher-income nations were more likely to be diagnosed than those in lower-income nations. The exception is Japan, with an incidence rate of 0.7%.

Unfortunately, the U.S. also has the largest worldwide gap between the rich and the poor. The economic stressors are greater than in other Western societies. This means there are more psychological stressors among the poor of America, which may lead to substance abuse and fragmentation of the family.

Immigrant Melting Pot

Genetics may also contribute in the rate of bipolar disorder in different countries. Studies have confirmed that the condition sometimes runs in families, and that the lifetime chance of an identical twin of a bipolar twin developing the disorder is about 40% to 70%. So the genetic makeup of a country may affect the rate.

But what about immigrants? America is known as the “melting pot” of the world, due to all the immigrants that come here. Among people who have emigrated, the actual expression of bipolar disorder is the same as it is in the population that those people have left. However, what’s interesting to note is that, in those cases, their children tend to have higher rates of mental illnesses, including bipolar disorder, by a factor of as much as tenfold.

Social scientists suspect that the lack of extended family and cultural systems may result in higher incidences of bipolar disorder, as environmental stressors play a factor in the development of the disease. With a lack of familial support, immigrants have less of a buffer in terms of a social network, especially when they first arrive.

And immigrants seeking a new life in America might be more risk-taking than people who stay in their home countries. The immigrant belief that they can find success here takes a certain mindset of grandiosity and other symptoms of hypomania, which may be more common among people who suffer from bipolar disorder.

Stigma

map.jpg
A stylized map of South America. Credit to flickr.com user Stuart Rankin. Used with permission under a Creative Commons license.

Stigma also plays a part in the incidence rate of bipolar disorder among different countries. Fewer than half of those suffering from the disorder sought help for it. And only a quarter of those in low-income countries were treated by a mental health professional for bipolar disorder.

Some cultures are reluctant to talk about psychiatric things. Lower-income nations experience higher rates of stigma. Fewer people are willing to come forward with their struggle with mental illnesses, which leads to a lower perceived rate of bipolar disorder.

Cultural awareness of mental illnesses also contributes to the problem of stigma. Americans are fairly aware of bipolar disorder as a disease, whereas the symptoms of the condition may be missed or ignored in lower-income nations. This leads to lower rates of diagnosis.

The Bottom Line

No matter where people live, bipolar disorder causes serious impairment among those who suffer from it. People need to be less afraid about seeking help for their mental illnesses. Educating individuals about the disease may help combat stigma. Greater awareness among cultures will only help people get much-needed treatment.

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