What is Bipolar Disorder?
What Are We Doing?
With support from our Rising Star Awards program, cutting-edge research is being done to help bipolar disorder patients.
Dr. Jean-Martin Beaulieu’s research is revealing molecular mechanisms to target for safer alternatives to current medications.
Dr. Colleen McClung is discovering precise gene targets to develop treatments to stabilize mania more effectively.
Dr. Jun Li’s identification of bipolar disorder’s genetic roots is opening doors to novel treatment development.
SIGNS, SYMPTOMS, CAUSES AND THE PURSUIT OF A CURE
Signs of Bipolar Disorder
A person suffering from bipolar disorder goes between highs and lows that can be extreme. If someone you know has bipolar disorder, you may notice a range of signs depending on what type of the disorder is present, and whether they’re experiencing a manic or depressive episode.
Signs someone is experiencing a manic episode
- Fast speech
- Sleeping less
- High energy level
- Impulsive decisions that may have negative consequences (e.g. betting large amounts of money or quitting their job)
- Sudden increase in self-confidence
Although mania is not always easy to spot. Those with hypomania may experience mild symptoms that don’t interfere with daily life.
Signs someone is experiencing a depressive episode
- Sleeping too much or too little
- Changes in eating habits
- Loss of interest in hobbies
- Frequent crying
- Slow speech
Other signs of bipolar disorder
In addition to the mania and depression common in bipolar disorder, other signs to watch for include:
Bipolar disorder often requires treatment to get better. If you notice signs of the disorder in your loved one, encourage them to talk to their doctor about possible treatment options.
Symptoms of Bipolar Disorder
Someone with bipolar disorder suffers from a chronically unbalanced mood, cycling from state to state. These states include mania, depression, mixed bipolar symptoms, and psychosis.
Manic bipolar disorder symptoms
Mania is a mood state in which someone cannot slow down. A state of mild mania or hypomania can be pleasurable and highly productive — in fact, some people with bipolar disorder even report that they like it.
However, full-blown mania can put someone at risk of damaging their physical health and their relationships.
Someone experiencing mania may:
- Feel either euphoric or highly irritable
- Run on boundless energy
- Think and talk at a “mile a minute” and often leap from idea to idea
- Entertain inflated ideas about one’s abilities and make plans accordingly
- Make impulsive choices
- Exercise an assertive, confident sex drive
Depressive bipolar disorder symptoms
The symptoms of bipolar depression are akin to those of major depression.
Bipolar depression can cause such symptoms as:
- Preoccupation with feelings of sadness, guilt, and/or hopelessness
- Loss of energy and motivation
- Loss of self-esteem
- Loss of interest in previously pleasurable activities
- Disturbance in sleep pattern such as sleeping either too much or too little
- Disturbance in appetite such as eating either too much or too little
- Physical pains and perceived ailments that resist treatment
- In prolonged instances, thoughts of suicide
Mixed bipolar disorder symptoms
Someone experiencing a mixed bipolar episode may feel simultaneously energized and debilitated.
As Marya Hornbacher vividly describes it: “Everything is moving at a shrieking pitch, and my thoughts turn black and bloody. This hell is garish, sharp, and cuts at my brain.” Many with bipolar disorder report this state as the most excruciating part of the disease.
Psychotic bipolar disorder symptoms
If someone’s illness progresses far enough, psychosis may arise.
Someone with bipolar psychosis may hallucinate (perceiving products of their own fantasies as real), or experience delusions (believing things to be true that are demonstrably false). Psychosis can be a terrifying experience.
Types of Bipolar Disorder
- Bipolar Disorder Type I Includes the “highest” manic episodes or mixed episodes (sometimes both), usually major depressive episodes, and possible psychosis.
- Bipolar Disorder Type II The less extreme form alternates states of hypomania and major depression.
- Cyclothymia The less severe mood disorder alternates hypomania and mild depression with neither progressing into full-blown episodes.
Help for bipolar disorder
Fortunately, if bipolar disorder is recognized early enough, it can be treated and managed well. In fact, many people who live with bipolar disorder spend much of their lives symptom-free.
If you experience feelings like these and they disrupt your life on an ongoing basis, know that there is help available. Doctors and mental health professionals can treat your illness.
Causes of Bipolar Disorder
Doctors generally accept the theory that a mix of interacting genetic defects and stressors from one’s environment causes bipolar disorder.
The brain is subject to many biological processes governed by numerous different genes and outside influences. As a result, a complex brain illness such as bipolar disorder can have many contributing factors.
Genetic defects are the primary contributing factor to Bipolar Disorder. It was first noticed over a century ago that the risk of developing bipolar disorder runs in families.1 Studies now show that if a first degree relative such as a parent has the disorder, an individual has a 10x’s greater risk of developing Bipolar Disorder. This means they would have an 8.7% chance.
Do genes play a big role?
How can we know if this increase is due to genetic heritability or early life environment? Studies of twins who grow up together comparing the frequency with which pairs of identical twins share the disease vs. the frequency for pairs of fraternal twins have helped to show what part of this illness comes from genes and what part from experience.
The key thing that makes these studies work is that identical twins share 100% of their genes while fraternal twins share only half their genes. Therefore, a greater sharing of bipolar disorder among identical twins would indicate that genes are a greater influence than family environment. In fact, such studies have found a much greater chance (around 65%) that identical twins will share the disorder, versus around a 5-20% chance for fraternal twins. Thus, these results place a greater weight on genes than environment.
This conclusion also plays out in studies of families adopting children. First-degree adoptive relatives of people with bipolar showed about the same risk of developing the disease as did the general population further showing early family environment as a minimal factor. In general, studies have placed the genetic heritability of bipolar disorder at 60-85%.
Exactly which mixes of genes can lead to bipolar disorder still remains to be discovered. Over a dozen major genes have so far been implicated through association studies. Using an innovative approach to analyze the genomes of 90 individuals in 30 families, Johnson & Johnson / One Mind Rising Star Award winner Dr. Jun Li has recently identified 6 of these candidate genes.
Much more research is underway. For example, Johnson & Johnson/One Mind Rising Star Award winner Dr. Colleen McClung is isolating the specific genes in the brain whose proteins can be inhibited for therapeutic benefit. Her research may soon lead to the availability of safer mood stabilizing drugs.
Likewise, One Mind / Johnson & Johnson Rising Star Dr. Jean-Martin Beaulieu has discovered a biochemical reaction in the brain which he intends to target in testing novel small-molecule therapies. In theory, these compounds will stabilize mood as effectively as lithium with minimal side effects.
Common roots for other brain diseases
Did you know that some bipolar risk genes can also influence the development of schizophrenia and vice versa? Several studies have shown that the two diseases are closely genetically related. In fact, a 2009 study of Swedish families demonstrates that the genetic risk factors for bipolar disorder and schizophrenia overlap by 63%.2
In relation, a 2013 NIMH-funded study identified several genes each of which plays a role in the development of each of 5 common psychiatric diseases, including bipolar disorder, schizophrenia, major depressive disorder, autism and ADHD.3
Does substance abuse have an effect?
Much attention has been given to the frequent mixing of substance abuse with bipolar disorder as a potential influence in the onset of symptoms. One review of research data shows that bipolar patients who abuse drugs develop symptoms earlier and experience a rockier course of illness than those who do not.4
Whether this correlation implies a cause one way or another is not yet known though — perhaps drugs worsen symptoms or, alternatively, worse symptoms induce a stronger desire to self-medicate. Further research is required.
Life experiences a factor
As you might expect, many studies indicate that life experiences influence bipolar symptoms. Evidence abounds that stressful life events may in fact bring on manic, hypomanic, or depressive episodes by disturbing the sufferer’s sleep-wake cycles — and, in turn, their brain chemistry.
For example, striving to do well on final exams has been shown to produce manic or hypomanic episodes in many bipolar students. Other studies have shown that one’s current family relationships are strongly influential; living with more emotionally expressive or more critical family members can cause more frequent relapses and longer recovery times.
There is also considerable evidence that a certain cognitive style (i.e. a strong goal orientation, perfectionism and self-criticality) compounds the risk of symptom onset under stress.
Fortunately, cognitive behavioral therapy has been shown to improve wellness and reduce bipolar symptoms. Additionally, the nurturing and enjoyment of supportive family and social relationships can help maintain mental health and stability as various studies clearly show.5
For more information and help for bipolar and other mood disorders, please visit Depression and Bipolar Support Alliance.
According to the NIMH, around 51 million people worldwide are currently suffering from bipolar disorder. Although current medical treatments can help, troublesome side effects and incomplete therapeutic effects mean that they are not nearly good enough to cure the disease outright. People with bipolar disorder deserve better. At the One Mind, we believe cures for bipolar disorder are not just necessary but possible, and we are committed to financially supporting the journey to discovering them.
One Mind-funded scientists are already accomplishing encouraging progress toward cures. Dr. Colleen McClung’s research has revealed that two specific drugs which inhibit genes governing bipolar symptoms reverse manic-like behaviors in mouse models of bipolar disorder. Likewise, Dr. Jean-Martin Beaulieu is investigating a biochemical reaction in the brain which can be putatively targeted to replicate the therapeutic effect of lithium but with much lesser (or perhaps no) side effects.
“Brain diseases really get to the heart of who we are as human beings,” says One Mind funded scientist Dr. Vikaas Sohal. “How we feel, and how we relate to the world and to other people. So, of course we want to help everybody function as best they can.”
Learn more about One Mind-funded bipolar disorder research.