Bipolar Disorder

From Science Online

1 What is Bipolar Disorder
2 Symptoms of Bipolar Disorder
3 Biochemistry
4 Treatments
5 Refrences

What is Bipolar Disorder

Bipolar disorder, also known as manic-depressive illness, in it's simplest form causes dramatic emotional shifts from dangerous highs to dangerous lows. The individual cycles can last as long as months, separating them from the everyday good/bad moods. It is also much more severe and can hinder everyday activities and relationships. It is much more common then people think affecting about 3/100 adults in the U.S. Usually the symptoms of bipolar disorder begin to show during the teenage years and progressively get worse if left without treatment. Rarely is it recognized as an illness and it can go on for years before it is properly diagnosed.

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Symptoms of Bipolar Disorder

Bipolar disorder symptoms fall under four main categories ranging from severe mania to severe depression.

Manic phase- includes feelings of heightened energy, creativity and euphoria however it quickly can get out of control which can lead to reckless and harmful behavior.

             Symptoms: feeling unusually 'high' or extremely irritable
                       impared judgement-acting recklessly, spending spress
                       racing thoughts- fast talking
                       usually includes abuse of drugs particuraly cocaine, alcohol or sleeping meds
                       denial that anything is wrong
        *it is considered manic if it occures with three or more symptoms everyday for a week or longer.

Bipolar depression-resembles major depression however people with bipolar depression usually also have low energy, talk slowly, sleep a lot, and in severe cases lose contact with reality.

              Symptoms: feeling hopeless, sad, empty
                        fatigue, loss of energy, unintended weight change
                        memory problems, chronic pain not caused by injury
                        thoughts of death or suicide
        *it is considered depressive episode if there are five or more symptoms for most of the day, every day for over two weeks of longer

~A mild to moderate level of mania is hypomania-hypomania includes feelings of good function and enhanced productivity but can quickly lead to severe mania if not recognized and treated

~Many of these various episodes include psycotic symptoms including

                     hallucinations
                     delusions (usually of grandeur)

~there are two forms

     * Bipolar I disorder which involves reoccuring mania and depression
     * Bipolar II disorder which is milder symptoms

If there are multiple symptoms in one week or year then it is called rapid-cycling bipoolar disorder.

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Biochemistry

        ~This protein is the protein prolactin. This is relevant to Bipolar disorder because it is the protein that releases dopamine, one of the probable causes, in the brain. 
        ~The PDB ID for this protein is 1rw5. 
        ~Five A-Helices and no B-sheeets

Although the exact cause of bipolar disorder is still being debated some researched speculated causes as to the pathophysiology of bipolar disorder are dysregulated protein kinase c distribution and actication or abnormal receptor-G protein coupling. This theory has many steps but starts with abnormalities in the phosphoinositide (PI) signaling system. This system whose receptors include seratonin results in the formation of two second messengers, diacylglycerol and 1,4,5-tris phosphate (IP3). This IP3 increases the calcium stores and the diacylglyverol stimulates PKC. An abnormal release of the diacylglyverol can be caused by an alteration in the effector, PLC. Protein Kinase C is in the family of phosphotransferases that help to regulate many cellular functions.It can be activated by diacylglycerol because of an increase in the affinity for Ca2+ (calcium)in the Kiase C protein. Once the Kinase C is activated it results in a translocation of the PKC in the brain, which means that the PKC goes from the cytosol to the cellular membranes. In the membranes of the cells, receptors for the activated C-kinase attach to the regulatory domain of the protein. These activated C-kinase receptors (called RACKs) increase the activity of PKC by . These RACKs anchor the PKC to the membranes and the increase in the ability of RACK to anchor PKC to the membrane, the stronger the associated PKC activity and translocation. The mechanism that causes an increase RACK/PKC especially in the bipolar disorder patients brains is not yet known however it has been proven that they bind at mazimum capacity when CA2+ and diacylglycerol are present. High levels of free Ca2+ were found in cells of bipolar disorder subjects. This could be caused by an increased level of inositol 1,4,5-trisphosphate. This theory has been proven correct due to the experiments run by injecting lithium into the brains of infected BD subjects. This lithium seems to compete with the RACKs to bind with the PKC's causing a decrease in their translocation and a decrese of their activity.

Another theory is that this abnormalities may be related to genetic changes. In addition many people believe that bipolar disorder or at least a tendency to develop it is passed along in genes and many scientists are researching how the genes and which genes are likely to stimulate the bipolar disorder symptoms.

another intersting tidbit is that people who have bipolar disorder usually also have abnormal thyroid function and usually need some sort of thyroid medicaiton in addition to the bipolar medication

None of these theories have been concreted and there is still a lot of research going on currently about the exact happenings of this disease. It seems to have many causes and there are also different levels during manic attacks of bipolar disorder which seem to be able to be triggered by high stress or hormone levels in the brain.

This is your brain on bipolar disorder manic and depression!

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Treatments

Bipolar disorder treatments have proven very effective for people will all ranges of symptoms. The medicine is generally perscribed by a psychiatrist. The medications are generally 'mood stabilizers.'

 Some of the major medications are 
       -Lithium- the first medicine approved for treatment, it aids in precenting the reaccurance of manic episodes
       -Anticonvulsant medication (valproate or carbamazepine- used for extreme cases of manic disorder

Treatment using antidepressent medication susually heighten the symptoms or turn them into rapid cycling symptoms

~some side effects can include weight gain, nausea, tremors, anxiety or hair loss

For people who also are plagued with psychococial symptoms there are many treatments including

       *cognitive behavioral therapy-helps change and recognize negative thought and behavior
       *family therapy-helps to council and relieve stress the person might be feeling in the home
       *Interpersonal therapy- helps to improve relationships and to establish a regular routine to keep the stress levels low

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