Bipolar disorder driven by combination of biological mechanisms and interactive external influences, finds study
December 26, 2017 0 Comments
Bipolar disorder, formerly known as manic depression, is characterized by intense and unusual changes in mood, energy and activity levels that affect an individual’s ability to perform everyday tasks. Such changes in mood and energy levels are much greater in intensity than those typically experienced by people. While attempting to identify the possible causes of bipolar disorder, most researchers agree that the illness is a result of several different factors.
A recent, long-term study of over 1,100 research volunteers – of which more than 730 had bipolar disorder and 277 did not – showed that the development of bipolar disorder cannot be attributed to a single genetic change, chemical imbalance or life event. The researchers from the University of Michigan’s (U-M) Heinz C. Prechter Bipolar Research Program (Prechter Program) collected and analyzed thousands of data points on volunteers’ medical histories, heredities, emotions, temperaments, life experiences, motivations, diets, sleep patterns and thought patterns, over a period of 12 years.
The findings, published in the International Journal of Epidemiology in December 2017, indicated that each individual’s experience of bipolar disorder was different from the others. However, all these experiences were classified into seven classes of phenotypes, labeled “phenoclasses.” The findings were used to develop a framework which may be helpful for patients, doctors and other researchers.
Lead author Melvin G. McInnis, head of the Prechter Program at the U-M Depression Center, said, “There are many routes to this disease, and many routes through it.” According to him, the development of bipolar disorder was driven by a combination of biological mechanisms and interactive external influences.
Rate of bipolar symptoms among teens similar to adults
Past research funded by the National Institute of Mental Health (NIMH) showed that 2.2 percent and 2.5 percent teens aged 13-18 met the criteria for bipolar disorder in a given year and in their lifetime, respectively. This was nearly as high as the prevalence among adults. The incidence increased with age – nearly 2 percent of younger teens and 3.1 percent of older teens experienced symptoms of the disorder.
It is widely believed that bipolar disorder first appears in youth. Bipolar disorder during adolescence can also co-occur with other problems like anxiety disorders, attention deficit hyperactivity disorder (ADHD) and substance abuse. The Prechter Program study results substantiated these findings/beliefs as study participants, on average, experienced their first depressive or manic episode at 17 years and many had other mental disorders.
Besides the standard measures used by doctors to diagnose and monitor bipolar disorder, the six other phenoclasses defined by the researchers included:
- Cognitive changes (thinking, reasoning, processing emotions)
- Psychological aspects (temperament, personality)
- Motivated behaviors (substance use/abuse)
- Life experiences (family, intimacy, trauma)
- Sleep patterns/circadian rhythms
- Monitoring changes in patients’ symptoms and their responses to treatment
Some key findings particularly relevant to adolescents
Although volunteers comprised adults aged 38 years on an average, some key findings may be particularly relevant to adolescents with bipolar disorder, compared to those without the condition:
- Three-and-a-half times higher likelihood of experiencing migraine headaches
- Eating disorders, anxiety disorders, alcohol-related issues and metabolic syndrome
- Elevated history of childhood trauma
- Changes in self-control and attention
- Diets comprising higher levels of saturated fats
- Association between certain fat molecule levels in the bloodstream and mood or intensity of symptoms
- Poor sleep (associated with higher severity of depression and mania in females but not males)
The researchers also found lower levels of a key type of gut bacteria and a lower variety of gut microbes among people taking antipsychotic medicines. Bipolar disorder patients, particularly males, with personalities bearing a strong neurotic propensity were more likely to have severe illnesses. Other key findings related to genetic variations, cellular aspects and features of speech patterns.
Managing bipolar disorder
According to McGinnis, although bipolar disorder tends to run in families, it cannot be attributed to a single gene. The researchers hope that the new framework will change the approach toward understanding, measuring and assessing bipolar disorder and other complex illnesses.
White River Academy, a leading therapeutic boarding school for boys aged 12 to 17 years, offers a multi-faceted approach for treating bipolar disorder in teens at its state-of-the-art center in Utah. Call at our 24/7 helpline or chat online with our experts to know more about the best treatment for teen bipolar disorder.