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Bipolar disorder (BD) is a brain disorder that results in significant and severe changes in mood, activity, and energy levels, and ability to carry out the routine tasks of daily living. It is also considered one of the most heritable mental health conditions. New research led by scientists at the Broad Institute of MIT and Harvard University has pinpointed a specific gene as a strong risk factor for bipolar disorder and schizophrenia for the first time. Unlike previous genetic links to the disorder, this new gene was found to have a significant effect on bipolar disorder risk. Scientists are hopeful that this discovery will help them develop new treatments for this complex mental health condition. Having a bipolar disorder genetic risk factor, however, does not mean one will develop the condition. There are many other risk factors that play a strong role in its development. New research led by scientists at the Broad Institute of MIT and Harvard University has pinpointed a specific gene as a strong risk factor for bipolar disorder and schizophrenia for the first time.
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Here’s a closer look at bipolar disorder and its genetic underpinnings.

ABOUT BIPOLAR DISORDER

Bipolar disorder (BD), formerly called manic-depressive illness, is characterized by dramatic shifts in mood states and energy levels. However, these shifts are not the normal ups and downs that most people experience. They are more akin to intense emotional states or mood episodes that occur over a distinct period of time—sometimes days or weeks. BD’s mood states are either manic/hypomanic (extreme happiness) or depressive (sad or low mood) and shift in a cyclical pattern, which creates a wide range of symptoms. Yet, people with bipolar disorder commonly have periods of neutral mood too. Manic states can be intensely happy or highly agitated and typically involve a decreased need for sleep, grandiose ideas, or racing thoughts. Depressive states include low mood, loss of interest in activities once found pleasurable, and sometimes, suicidal thoughts (see a more comprehensive list of signs of manic/depressive episodes below). When left untreated, bipolar disorder can greatly impact one’s quality of life. It can cause major problems such as: Bipolar disorder is a serious mental health condition, ranking sixth on the list of the world’s leading causes of disability, according to the World Economic Forum. Close to 6 million U.S. adults are affected by bipolar disorder, but it can affect children and adolescents too. The disorder typically begins in young adulthood (late teens to mid-20s), but it can start earlier in childhood or in mid-life as well.

WHAT CAUSES BIPOLAR DISORDER?

There is no exact cause of bipolar disorder, but experts have identified several risk factors for the condition, including heritable risk factors. You may wonder, is bipolar disorder genetic? Indeed, it is—in part. Having one or more family members with bipolar disorder is a key risk factor and there have been genetic links to BD discovered in recent years, which are discussed below. That said, there are other strong, non-genetic determinants in the development of BD. A history of emotional trauma, high stress, substance abuse, and changes in the structure and function of the brain can all play a role in BD. Additionally, any of the following can factor into the development of BD, according to research:

BIPOLAR DISORDER GENETIC RISK FACTORS

Twin, family, and adoption studies suggest that bipolar disorder has a significant hereditary component. About 15 years ago, researchers found that individuals with a first-degree relative (parent, sibling, or child) with bipolar disorder had a 7 times greater risk of developing the condition than the general population. Indeed, a study involving twins found that the estimated heritability of bipolar disorder is more than 70% without shared family environmental effects. Around the same time, researchers identified 2 genes—ANK3 and CACNA1—associated with bipolar disorder. Since problems with calcium signaling are associated with BD and these two genes contribute to the regulation of calcium, it was believed that they may play a role. However, it is still unclear, according to research. More recently, a study published in the American Journal of Medical Genetics found a number of genetic variations linked to the condition. And just last year, in the research mentioned earlier, scientists identified the first strong genetic link to bipolar disorder, called AKAP11. Still, the discovery of AKAP11 does not reveal too much about genetic risk for the general public. Its greater value may be what it reveals about the roots of BD. Researchers believe this gene may provide clues as to lithium’s effects on the body and open up the discovery of new therapeutic targets. Lithium is one of the most widely used medications for the treatment of BD, although it comes with some undesirable side effects and safety concerns. Though this evidence for genetic risk factors is strong, mental health experts have noted that in clinical practice, a positive family history of bipolar disorder is actually not very common. Of course, this underscores the influence of non-genetic factors in the development of BD.

SIGNS AND SYMPTOMS OF BIPOLAR DISORDER

If you suspect you or a loved one may have bipolar disorder, here are more detailed lists of symptoms for manic and depressive episodes.

Signs of a Manic Episode

Signs of Depressive Episodes

Of course, like so many mental health disorders, BD is not a simple condition or just one thing. Experts recognize at least 4 types of bipolar disorder, including the following: The distinction between each type has to do with the severity of symptoms. For instance, bipolar 1 disorder is viewed as the most severe form of the disorder.

BIPOLAR DISORDER IS HIGHLY TREATABLE

If you recognize the signs of bipolar disorder in yourself or someone you love, reach out to a qualified mental health professional. There’s great hope with BD. The National Institute of Mental Health (NAMI) reports that with proper treatment, 70% to 85% of patients recover. Bipolar disorder and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Bipolar disorder is characterized by extreme mood swings and significant changes in energy and activity levels. Affecting close to 6 million American adults, bipolar disorder involves manic episodes and depressive episodes that shift in a cyclical pattern. These mood changes can appear seemingly out of the blue, however, there is a wide array of things that can trigger an episode or worsen symptoms. Stress is an underlying factor in many of the most common triggers for mood episodes in bipolar disorder, according to research in the Journal of Affective Disorders. The following life events and environmental factors ramp up stress and are common triggers of bipolar episodes. Stress is an underlying factor in many of the most common triggers for mood episodes in bipolar disorder.
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COMMON TRIGGERS OF BIPOLAR EPISODES

Bipolar Trigger #1. Major arguments or breakups

Having bipolar disorder can make it challenging to maintain stable relationships at home, at work, and at school. Symptoms associated with bipolar disorder, such as irritability, risky behavior, and inappropriate behavior can lead to marital conflict or spats with coworkers or classmates. Research suggests that relationship troubles can be so distressing for people with bipolar disorder that it can lead to suicidal ideation. Going through a breakup, separation, or divorce can produce prolonged stress that triggers bipolar episodes.

Bipolar Trigger #2. Drinking and using drugs

Having bipolar disorder raises the chances of self-medicating with drugs or alcohol, leading to a high rate of addiction in people with the condition. According to a 2015 review in the Journal of Affective Disorders, using addictive drugs or alcohol may increase the duration of manic or depressive episodes. In particular, the review concluded that cannabis use may cause or exacerbate manic episodes. In addition, drugs and alcohol cause changes in the brain and in the way the brain functions which may contribute to bipolar disorder.

Bipolar Trigger #3. Antidepressants and other meds

You may be surprised to learn that some medications can trigger bipolar episodes. Research in the journal Bipolar Disorder shows that about 25%-33% of people with bipolar disorder are vulnerable to antidepressant-induced manic episodes. In some people with unipolar depression, treatment with antidepressants increases the risk of a subsequent manic episode, according to a 2015 study in BMJ Open. Other medications that have been associated with manic symptoms include stimulants used to treat ADD/ADHD, thyroid pills, appetite suppressants, and corticosteroids.

Bipolar Trigger #4. Lack of sleep

Disrupted sleep can wreak havoc on mood stability in people with bipolar disorder. Shift work, all-night study sessions, and jet lag can all increase the risk of mood episodes. Failing to get adequate sleep exacerbates the severity of manic and depressive episodes, especially in women, according to a study that spanned 12 years in the International Journal of Epidemiology.

Bipolar Trigger #5. Consuming caffeine

Drinking coffee, energy drinks, or other caffeinated beverages may trigger manic symptoms in people with bipolar disorder, according to a 2021 systematic review. The researchers suggest that because caffeine is a stimulant, it may have a direct impact on moods, alter sleeping patterns, and interfere with the way the body metabolizes medications used to treat the condition.

Bipolar Trigger #6. Death of a loved one

The grief and stress of losing someone can be overwhelming. In some people, this can lead to “funeral mania” or “bereavement mania,” according to research in Frontiers in Psychiatry.

Bipolar Trigger #7. Seasonal weather changes

In some people with bipolar disorder, there is a seasonal pattern associated with mood episodes. A systematic review of scientific studies on seasonality and bipolar disorder found that manic episodes peak in the spring and summer months and depressive episodes are more likely to occur in early winter. Experts suggest that the number of daylight hours, the intensity of sunlight, and altered sleep patterns may contribute to mood changes.

Bipolar Trigger #8. Postpartum

For women with bipolar disorder, the weeks and months after delivering a baby are linked with an increased chance of mood episodes, according to research in Women’s Health. This study cites previous research showing that 50% of women with bipolar disorder experienced a mood episode postpartum. The birth of a child can also impact fathers who have been diagnosed with bipolar disorder. Although there is a scarcity of research on paternity, one study in the American Journal of Lifestyle Medicine found that fathers with bipolar disorder are more likely to experience mania, hypomania, or mixed episodes in the postpartum period compared with the general population.

Bipolar Trigger #9. Hormonal fluctuations

A woman’s menstrual cycle may also play a role in mood episodes. A 2019 review in the British Journal of Pharmacology shows that the hormonal changes associated with premenstrual syndrome (PMS) also affect bipolar disorder symptoms. These hormonal fluctuations are linked to an increase in depressive episodes, a decrease in manic episodes, a worsening of symptoms, and more rapid cycling.

Bipolar Trigger #10. Losing your job

The emotional and financial strain that comes with job loss can increase the chances of a bipolar episode. Unfortunately, bipolar disorder is associated with challenges in the workplace and high rates of unemployment. In fact, nearly 60% of people with bipolar disorder were unemployed, according to a survey by the National Depressive and Manic-Depressive Association.

MANAGING BIPOLAR DISORDER TRIGGERS

Knowing what triggers your bipolar mood episodes is one of the first keys to managing them. Learning stress-reduction techniques and coping skills through psychotherapy can be very beneficial in decreasing triggers. In addition, adopting brain-healthy habits; making sleep a priority; and eliminating alcohol, drugs, and caffeine can help reduce the risk of episodes and decrease their severity. Bipolar disorder, depression, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Euphoric highs. Debilitating lows. The ups and downs of living with bipolar disorder can be so challenging. But is medication the sole solution? Although prescription medication can be helpful and may be necessary in some cases, it is not the only way to address bipolar disorder, which affects roughly 5.7 million Americans. This complex brain disorder—which is associated with dramatic changes in moods, energy, and activity levels—does not have just one single cause. Instead, multiple risk factors contribute to the condition. Addressing these risk factors with nondrug therapies and lifestyle changes can be powerfully effective in managing symptoms of bipolar disorder. Before exploring these natural strategies, it’s necessary to understand the risk factors for bipolar disorder. Note: If you are currently taking medication for bipolar disorder, do not stop taking it without speaking to your healthcare provider first. Non-drug therapies and lifestyle changes can be powerfully effective in managing symptoms of bipolar disorder.
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DO YOU KNOW THE RISK FACTORS FOR BIPOLAR DISORDER?

Researchers have been working for decades to uncover the underlying causes of bipolar disorder and have discovered a variety of physical, emotional, psychiatric, and lifestyle factors that may increase risk. Among them are the following: Looking closely at some of these risk factors has revealed the following methods of treatment that involve no medication at all.

5 NATURAL WAYS TO ADDRESS BIPOLAR DISORDER

1. Trauma and Stress: Relax the Stress Response

Emotional trauma experienced in childhood and periods of extreme stress (such as the death of a loved one, disability, or divorce) trigger the body’s built-in fight-or-flight stress response (also referred to as the hypothalamic-pituitary-adrenal or HPA axis). In normal circumstances, when the stress response is triggered by a threat, real or perceived, the HPA axis ensures a swift response through the release of stress hormones. When the threat has passed, the stress response turns off. Yet studies have shown that trauma and extreme/chronic stress keep the HPA axis turned on. Constant firing of the stress response can cause HPA axis dysfunction, which increases the risk for bipolar disorder and/or bipolar episodes. Research suggests that targeting HPA axis dysfunction is one strategy to improve the outcomes of bipolar disorder, and the following non-drug options are aimed at doing just that. EMDR and CBT for Trauma The stress response and stored memories of trauma can be addressed with therapeutic techniques. Research indicates that cognitive behavioral therapy may help to reduce symptoms of emotional trauma, as well as reverse the underlying biology of the disorder within the brain. Additionally, EMDR (eye movement desensitization and reprocessing), a special psychotherapeutic technique, has been shown in studies to be an effective treatment for people who have been emotionally traumatized. Stress Reduction Of course, stress reduction offers another potential line of treatment as it calms the stress response. The following activities reduce stress markers in the body:

2. Substance Abuse, Mental Health, and Medical Issues: Address Comorbidity

Adding to bipolar disorder’s complexity, it’s common for those affected by it to have co-existing substance abuse problems, mental health issues, or medical problems. Co-occurring conditions can exacerbate manic and depressive episodes. One study examining nearly 400 bipolar cases found as many as 69% abused alcohol and up to 60% abused drugs. Cannabis use was identified in a 2015 review as a risk factor for bipolar disorder that may cause or exacerbate manic episodes. Some medical experts believe that substance abuse can also lead to changes in the brain that may contribute to the development of bipolar disorder. There are numerous mental health disorders that present with bipolar disorder as well. A study in Clinical Psychology found that 62% of those with bipolar disorder also meet the clinical criteria for ADD/ADHD.  Anxiety disorders, panic disorders, obsessive compulsive disorder, social phobias, eating disorders, and some personality disorders are also seen with bipolar disorder. In children and adolescents, bipolar disorder may also co-exist with oppositional defiant disorder and other conduct disorders. Obesity, migraine headaches, irritable bowel syndrome, and asthma are examples of medical issues that are common with bipolar disorder. Address Comorbidities Whether it is substance abuse, another mental health disorder, or a medical issue, bipolar disorder and/or the episodes can be avoided or reduced by properly addressing these co-occurring conditions. Seek the proper professional care and commit to making the lifestyle changes necessary to resolve them.

3. Traumatic Brain Injuries (TBIs)/Concussions: Heal Your Brain

If you’ve had a head injury, you’re at higher risk of developing bipolar disorder, according to a 2016 review. In fact, one study found that people with a prior TBI were 28% more likely to develop bipolar disorder. Heal Your Brain If you’ve been diagnosed with bipolar disorder and have experienced a head injury or suspect you may have had a concussion in the past, have your brain examined. At Amen Clinics, brain SPECT imaging reveals that many people who have been diagnosed with bipolar disorder have signs of undetected traumatic brain injury. Interestingly, head trauma can cause many of the same symptoms seen in bipolar disorder. In either case, healing the brain can be beneficial in decreasing the symptoms. You can help heal your brain and address bipolar disorder symptoms by adopting a brain-healthy lifestyle. This includes healthy nutrition, regulated sleep, moderate exercise, lifestyle changes, nutritional supplements, and helpful forms of therapy, including neurofeedback which has been shown to be beneficial in healing brain injuries in a 2017 study.

4. Sleep Disturbances: Regulate Your Sleep

Disturbed sleep may affect or trigger bipolar episodes. An ongoing study, following 1,100 individuals with bipolar disorder found that a lack of quality rest appears to impact the severity of manic and depressive episodes, particularly in women with the condition. Dysregulation of the sleep/wake cycle (circadian rhythms) can exacerbate manic and depressive episodes in those affected by bipolar disorder as well. Regulate Your Sleep Practicing healthy sleep habits and incorporating methods shown to regulate the sleep/wake cycle are excellent ways to keep bipolar disorder in check. Sleep tips include powering down digital devices at least an hour before bed; keeping the same sleep/wake times; avoiding caffeine and alcohol, which can disturb sleep; listening to a relaxing meditation before bed; keeping your room cool and dark. Supplementing with melatonin can help reset the sleep/wake cycle especially when traveling through different time zones.

5. Gut Health Issues: Support a Healthy Microbiome

A growing body of evidence is showing that mood disorders may be related to changes in the gut microbiome. A recent study following bipolar patients discharged from hospitalization for manic episodes showed a significantly lower incidence or rehospitalization after taking probiotics for 24 weeks than those who did not. Support a Healthy Microbiome Supporting a healthy microbiome by eating plenty of prebiotic foods (inulin fiber-containing foods that feed the good bacteria in your gut such as garlic, leeks, asparagus, and bananas) and fermented foods (foods containing healthy bacteria such as kimchi, yogurt, and kefir) is another way to reduce the risk of bipolar disorder episodes. Taking probiotic supplements can help too, as well as following a brain-healthy diet with loads of vegetables, fruits, nuts, whole grains, and lean meats.

PULL EVERY LEVER

Although there is no cure for bipolar disorder, it is highly treatable and can be managed effectively, especially if every lever of treatment is pulled. Of course, a treatment plan should be tailored to the individual under the care of a medical professional. Bipolar disorder and related mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Sleepless nights—we’ve all had them. Whether you feel like you’re buzzing at night and can’t fall asleep, you toss and turn all night, or you wake up at 2 a.m. and can’t get back to sleep for hours, a lack of sleep can make you feel miserable. If you have chronic insomnia, which affects approximately 1 in 10 adults according to statistics, it’s even worse. Any form of sleep disorder can leave you with a bad mood, anxiety, and brain fog. To get the quality sleep you need, you first have to find out what’s causing your sleep issues. Is it something related to your physical health? Is it due to emotional issues? For many people, sleep problems are connected to both biological issues and psychological conditions. Learn the most common physical and emotional sleep stealers so you can overcome them to sleep better. For many people, sleep problems are connected to both biological issues and psychological conditions.
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PSYCHOLOGICAL CAUSES OF SLEEP PROBLEMS

Sleep issues are more common in people who have psychiatric disorders. Research shows that in more than 50% of cases, insomnia is linked to anxiety, depression, or stress. Some of the more common mental health conditions that are associated with sleep problems include the following:

Depression

Sleep problems are one of the symptoms of major depressive disorder. Depressed people may have trouble falling asleep or staying asleep, or they may feel overly fatigued during the day. Research shows that about 75% percent of people with depression also have insomnia. In some cases, they may sleep too much.

Anxiety

When you’re filled with fear, anxiousness, and worry, it’s no wonder it’s hard to get restful sleep. In fact, a 2020 study in Psychiatry Advisor shows that people with anxiety are 5 times more likely to have sleep disorders or insomnia.

Bipolar Disorder

Sleep disturbances are extremely common in people with bipolar disorder, a condition that is characterized by alternating periods of heightened moods and depressive symptoms. According to a 2016 study on the role of sleep in bipolar disorder, from 69% to 99% of people with the condition experience insomnia or feel a reduced need for sleep during manic episodes. During depressive episodes, disrupted sleep is more common as well as hypersomnia, which affects an estimated 38% to 78% of those with bipolar disorder.

ADD/ADHD

Having attention-deficit disorder (ADD), or attention-deficit hyperactivity disorder (ADHD) as it is more commonly called, increases the likelihood of experiencing sleep issues. Findings from a 2018 study show that 25% to 50% of people with the condition report troubled sleep.

BIOLOGICAL CAUSES OF SLEEP ISSUES

Numerous physical conditions can interfere with a good night’s rest. Some of the most common biological causes of sleep disturbances include the following:

Sleep Apnea

Affecting an estimated 22 million Americans, sleep apnea interrupts breathing for short periods throughout the night, robbing you of restful sleep and leaving you feeling fatigued, forgetful, and unfocused the following day.

Restless Leg Syndrome

One of the most common sleep and movement disorders, this condition causes uncomfortable feelings in the legs and an uncontrollable need to move them to calm those sensations. Affecting an estimated 5% to 10% of adults, this condition typically occurs while a person is at rest and becomes most severe at night during sleep. This makes it difficult to fall asleep and stay asleep.

Thyroid Imbalances

Having thyroid imbalances such as hypothyroidism, which affects about 5% of the US population, or hyperthyroidism, which affects about 1% of Americans, can cause sleep problems. A 2021 study shows that over 66% of people with hyperthyroidism have trouble falling asleep, and those with hypothyroidism have lower sleep duration.

Hormonal Issues

Low levels of progesterone, often seen in women during perimenopause and menopause, are associated with poor sleep. This is often attributed to the hot flashes and night sweats commonly experienced during this time of a woman’s life.

Congestive Heart Failure

Research shows that people with heart failure often experience sleep apnea, leg twitching, or orthopnea (paroxysmal nocturnal dyspnea), which is a shortness of breath that causes periodic awakenings during sleep.

Chronic Pain

When your body aches due to arthritis, headaches, or past injuries, it can lead to long-term sleep deprivation. Unfortunately, the lack of quality sleep increases pain susceptibility, creating a vicious cycle. An estimated 50% to 80% of people living with chronic pain suffer from some form of sleep disruption, according to the Psychiatric Times.

Dementia

Research shows that about 25% of people with dementia experience sleep issues. For example, people with Alzheimer’s disease “sundown,” or rev up at night and wander.

Acid Reflux

Gastroesophageal reflux disease (GERD), also known as acid reflux, affects an estimated 1 in 5 American adults and can interfere with sleep. Experiencing heartburn, indigestion, or vomit rising up in your throat can wake you during the night.

Enlarged Prostate Gland

Having an enlarged prostate gland, also known as benign prostatic hyperplasia, interrupts sleep due to an urgent need to use the restroom multiple times during the night.

Medications and Substances

Certain medications—including stimulants, beta-blockers, and nasal decongestants—and foods, such as caffeine, can contribute to sleep disturbances.

TREATING BIOLOGICAL AND PSYCHOLOGICAL CAUSES OF SLEEP PROBLEMS

To get more restful sleep, it’s important to address any underlying physical or psychiatric issues. Taking care of your overall health and well-being will enhance your sleep, which in turn, will improve your life. Sleep disorders, as well as the mental health issues that contribute to them, can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Bipolar disorder has been making headlines recently as a growing number of celebrities and influencers—including singers Halsey and Bebe Rexha—reveal their diagnoses with the condition that affects nearly 6 million Americans. Despite the increased awareness of the disorder, the condition that used to be called manic-depressive disorder remains shrouded in myths and misinformation. Most people think bipolar disorder is a singular condition with a fixed set of symptoms—manic episodes that alternate with depressive episodes in a cyclical pattern. While that may be true for many people with the disorder, it isn’t so for everyone who has bipolar disorder. In fact, there are multiple types of bipolar disorder and the symptoms experienced depend on which type you have. The most common and most serious forms of the condition are bipolar I and bipolar I. What are the differences between these subtypes of bipolar disorder? To clear up the confusion, this blog will outline the main characteristics of each type.

WHAT IS BIPOLAR I?

Bipolar I is characterized by the presence of mania and may or may not include depressive episodes. During manic episodes, people feel abnormally energized, euphoric, and full of confidence. It is common for people in the throes of a manic episode to come up with lots of grandiose ideas, start several big projects, and skimp on sleep. Common signs of mania include: With mania, behaviors can be so exaggerated that they disrupt daily life. People with bipolar I may impulsively buy expensive items they can’t afford, have sex with a colleague in the office during working hours, or engage in criminal activities. In some instances, mania may be so severe that a person requires hospitalization or suffers severe consequences, such as being injured, attempting suicide, getting arrested, being fired, being suspended from school, and more.

WHAT IS BIPOLAR II?

People with bipolar II typically experience both emotional highs and low moods that can occur in a cyclical pattern. However, the biggest difference between bipolar I and bipolar II is that episodes of elevated moods in bipolar II aren’t as intense as those in bipolar I and don’t reach the level of mania. Mental health experts call these episodes in bipolar II “hypomanic.” The biggest difference between bipolar I and bipolar II is that episodes of elevated moods in bipolar II aren’t as intense as those in bipolar I and don’t reach the level of mania.
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During hypomanic episodes, you may feel a surge of energy, self-esteem, and productivity, but it usually doesn’t prevent you from handling everyday tasks and it isn’t likely to land you in trouble at work, at school, or with the law. People who are experiencing a hypomanic episode may seem like the life of the party—full of ideas, confidence, and high energy.

DEPRESSIVE EPISODES IN BIPOLAR DISORDER

There can be a downside to the manic or hypomanic episodes seen in bipolar I and bipolar II, respectively. These emotional highs may be followed by periods of depression that can last weeks or months. Symptoms of depressive episodes in bipolar disorder include: In both bipolar I and bipolar II, depressive episodes occur more often, are longer in duration, and are more debilitating than manic or hypomanic episodes. Results from a study in the journal Bipolar Disorders show that people with bipolar I spend 3 times as much time in depressive episodes compared with manic periods. For those with bipolar II, nearly 4 times as much time is spent in a depressed mood compared with hypomanic episodes.

GETTING DIAGNOSED WITH BIPOLAR I OR BIPOLAR II

To be diagnosed with bipolar I, a person must have experienced at least I manic episode with or without a depressive episode. For a bipolar II diagnosis, there must be at least one hypomanic episode and one depressive episode. However, because the symptoms of hypomania are more subtle, it can be more challenging to get a definitive diagnosis of bipolar II. What may complicate diagnosis even further is the fact that people struggling with both forms of bipolar disorder typically seek help related to the depression they experience. As a result, people with this condition may be misdiagnosed with major depressive disorder. In fact, research shows that 12% of people with hypomania initially received a diagnosis of depression. People with bipolar disorder may also be misdiagnosed with ADHD or schizophrenia since there is some overlap in symptoms with these conditions. Brain SPECT imaging can be beneficial in getting an accurate diagnosis because it is helpful in identifying brain activity patterns associated with various conditions. SPECT, when included as part of a comprehensive evaluation, can help rule out other possible conditions or causes for symptoms, such as substance abuse.

TREATMENT FOR BIPOLAR DISORDER

There is hope for people who are struggling with either bipolar I or bipolar II. With a clear diagnosis, a targeted treatment plan can put you on a path to manage your condition. The most effective treatment plans for bipolar disorder take a multi-pronged approach and may include psychotherapy, nutritional supplements and medication, lifestyle changes, and more. Bipolar disorder and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Having bipolar disorder can make you wonder who is the real you. Is it the manic you who is full of big ideas and energy? Or is it the depressed you who can barely crawl out of bed in the mornings? Anyone who suffers from this condition knows that dramatic mood swings can make you feel like a different person from day to day. That’s how actress and singer Talia Jackson describes what having bipolar disorder feels like. Best known for her role in Netflix’s Family Reunion, Jackson says one of her biggest issues is “the back and forth of never knowing who I am.” In an episode of Scan My Brain with Dr. Julie Brush, a doctor of naturopathy at Amen Clinics, she says she also struggles with panic attacks, “horrible anxiety,” “awful frustration,” and anger. It’s a lot to cope with. Jackson wanted to have her brain scanned to gain a better understanding of herself and who she is.

IS THERE A BIPOLAR IDENTITY?

Jackson is one of an estimated 4.4% of Americans who will experience bipolar disorder in their lifetime, according to the National Institute of Mental Health. This condition, which used to be called manic-depressive illness, is characterized by extreme changes in mood, energy, activity levels, and the ability to carry out everyday tasks. With bipolar disorder, people often cycle from manic episodes to depressive episodes. Manic episodes are associated with abnormally elevated mood, heightened energy, grandiose ideas, and in some people, delusions, and hallucinations. On the downside, depressive episodes come with persistent negativity, decreased energy, loss of interest in usually pleasurable activities, and in some cases, suicidal thoughts and behaviors. Researchers have noted that this can lead to issues with identity. In a 2020 issue of the Journal of Personality, researchers write: “These experiences confront people with bipolar disorder with a subtler and more chronic struggle related to self and identity.”

THE CONSEQUENCES OF BIPOLAR IDENTITY ISSUES

Along with the challenge to find an identity, people with bipolar disorder also have trouble with self-esteem. The 2020 study mentioned above shows that for those with the condition, self-worth is often linked to goal attainment. This leads to instability in terms of self-esteem, as it rises and falls with perceived successes and failures. A 2009 study in The British Journal of Psychiatry found that over the course of one week, daily self-esteem scores fluctuated more widely among those with bipolar depression compared with healthy controls. A lack of clear self-identity has negative consequences. Findings in the journal Self and Identity show that inconsistencies in self-concept are associated with decreased life satisfaction and a lower sense of well-being. This is further evidenced by the fact that 20-60% of people with bipolar disorder (especially when it goes untreated) attempt suicide at least once in their lifetime, according to a 2019 review in Medicina.

HOW A BIPOLAR DISORDER DIAGNOSIS INFLUENCES IDENTITY

Being diagnosed with bipolar disorder can spark an identity crisis. A diagnosis can make you feel like your life story has suddenly changed, causing you to reevaluate your sense of self. For some people, a diagnosis is a positive step that helps you understand who you are and find effective treatment. For others, it’s a label that invites shame and stigma. Educating yourself about the condition and gaining an understanding that it is a brain-based disorder rather than a character flaw or personal weakness can be beneficial. The brain imaging work at Amen Clinics shows people with bipolar disorder and other mental health issues that their problems are medical, not moral. It also decreases shame and guilt and encourages understanding and forgiveness among family members. Most of all, it elevates hope and provides valuable information to help find the least toxic, most effective treatment plan.

FINDING A BALANCE WITH BIPOLAR DISORDER

With a targeted, comprehensive treatment plan, people with bipolar disorder can find more balance in their lives and a greater sense of self. That’s what Jackson is hoping for. Her SPECT scan, which can be seen in the video of her session at Amen Clinics, showed abnormal activity in various brain regions. Seeing her brain scan helped her understand that her issues have biological roots. “That is so relieving to me, because I know I’m not insane,” the actress says. On the right treatment to improve blood flow and activity levels in the brain, better balance can be achieved. People with bipolar disorder can experience more stable moods, energy levels, and activity patterns, which help lead to a clearer sense of identity and greater self-esteem. Bipolar disorder, anxiety, depression, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Mariah Carey. Bebe Rexha. Russell Brand. Catherine Zeta-Jones. What do these celebrities all have in common? They have all gone public with their diagnoses of bipolar disorder. They are among the nearly 6 million American adults who are affected by the condition, which is characterized by extreme mood swings and significant changes in energy and activity levels. Symptoms of bipolar disorder often emerge in a person’s late teens or early 20s but can also occur later in life. What is it that makes some people more vulnerable to this potentially debilitating disorder that is associated with relationship problems, job performance issues, increased risk of suicide attempts, and a decrease of over 9 years in life expectancy? Researchers have been working for decades to uncover the underlying causes of bipolar disorder and have discovered a variety of physical, emotional, psychiatric, and lifestyle factors that may increase risk. Researchers have been working for decades to uncover the underlying causes of bipolar disorder and have discovered a variety of physical, emotional, psychiatric, and lifestyle factors that may increase risk.
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Before exploring these potential risk factors, it’s important to understand the basics of bipolar disorder and its symptoms.

WHAT IS BIPOLAR DISORDER?

Bipolar disorder is also referred to as bipolar spectrum disorder and was previously known as manic-depressive illness. It is a brain disorder that involves both manic episodes and depressive episodes that shift in a cyclical pattern. Symptoms of manic episodes include: Symptoms of depressive episodes include:

10 POTENTIAL RISK FACTORS FOR BIPOLAR DISORDER

Some of the factors that may increase the risk of bipolar disorder include the following:

1. Genetics

Having a family member with bipolar disorder increases the odds that you may experience it. As early as 2007, researchers had identified 2 genes—ANK3 and CACNA1—associated with bipolar disorder. More recent findings in the American Journal of Medical Genetics shows that numerous genetic variations are likely linked to the condition.

2. Emotional trauma

A 2016 review of scientific studies point to traumatic childhood experiences as a risk factor for bipolar disorder and for more severe outcomes related to the condition. Enduring adverse childhood experiences—such as the death of a parent, sexual abuse, or neglect—have been linked to an earlier age of onset of bipolar symptoms and a higher risk of suicide.

3. Substance abuse

There is a high prevalence of addiction in people with bipolar disorder, which is known as comorbidity or dual diagnosis. It appears that the association is a two-way street. Having bipolar disorder increases the likelihood of self-medicating with substances. Likewise, using drugs or alcohol may contribute to the severity of bipolar symptoms. For example, addictive substances may prolong manic or depressive episodes. Specifically, cannabis use was identified in a 2015 review in the Journal of Affective Disorders as a risk factor for bipolar disorder that may cause or exacerbate manic episodes. Alcohol and drugs are also associated with changes in the brain that may play a role in bipolar disorder.

4. High stress

Periods of extreme stress, such as the death of a loved one, divorce, disability, or other life events may trigger the onset of symptoms. A number of studies have found that when stressful life events occur, the following 6 months are associated with an increased risk of the onset of bipolar symptoms.

5. Infections

Some research has found an association between infections, such as T. gondii, and bipolar disorder, although the scientific evidence is mixed.

6. Medical issues

Obesity, migraine headaches, irritable bowel syndrome, and asthma are also associated with bipolar disorder, but it is unclear if there is a causal relationship. It has been suggested that bipolar disorder and these physical ailments may share inflammation as an underlying factor.

7. Mental health issues

A systematic review of existing research indicates that a number of psychiatric issues—including anxiety disorders, panic disorder, ADD/ADHD, conduct disorders, and aggression—raise the risk of developing bipolar disorder.

8. Traumatic brain injury

If you’ve had a head injury, you have higher odds of developing bipolar disorder, according to a 2016 review of 57 studies on TBI and subsequent psychiatric issues. One of the studies included found that people with a prior TBI were 28% more likely to develop bipolar disorder. Brain SPECT imaging can be beneficial in detecting damage from a TBI.

9. Poor sleep

A lack of quality rest appears to impact the severity of manic and depressive episodes, particularly in women with the condition. This finding comes from a University of Michigan 12-year study on 1,100 individuals with bipolar disorder.

10. Gut health issues

This same research from the University of Michigan also found that people with bipolar disorder who are taking antipsychotic medications have lower levels of certain gut bacteria and less diversity of bacteria. Understanding and treating the various factors that can contribute to bipolar disorder or that increase the severity of bipolar symptoms is one of the keys to managing the condition. Bipolar disorder and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. When someone is experiencing a psychotic episode—seeing people who aren’t there or hearing voices that no one else can—it feels just as concrete as rational thoughts do. A person suffering in this way has lost touch with reality and cannot distinguish what is real from what is not. The term “psychosis” is actually a multifaceted symptom, not a disorder unto itself. It can be part of a lifelong or a temporary psychiatric illness or be a once-in-a-lifetime occurrence. Approximately 3% of the U.S. population will experience a psychotic episode at some point in their lives, and each year about 100,000 young adults or teens will have their first such episode. New research shows these numbers could be increasing due to COVID-19. Approx. 3% of the US population will experience a psychotic episode at some point in their lives, and each year about 100,000 young adults or teens will have their first such episode. These numbers could be increasing due to COVID-19.
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Causes of Psychosis and Psychotic Disorders

The exact causes of psychosis are not known, but there are a number of contributing factors, including:

Cases of Psychosis in COVID-19 Patients

The effects of COVID-19 have been detrimental to many people who have survived the virus, with some struggling for months after the initial onset of symptoms. Increasingly, medical centers in the U.S. and around the world are reporting cases of new-onset psychosis in patients who were infected with COVID-19. And these are not necessarily people who had pre-existing mental health problems or were hospitalized from the illness. Medical centers in the U.S. and around the world are reporting cases of new onset psychosis in patients who were infected with COVID-19.
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One theory about why this could happen involves the body’s own defense system. In order to fight off COVID-19, the immune system goes into overdrive by releasing a flood of immune cells in what is called a “cytokine storm” to attack the invading virus. Unfortunately, one of the consequences of this natural process is significantly increased inflammation which can adversely affect the body and brain. A research study published in the journal, The Lancet, analyzed the medical records of more than 236,379 patients who had COVID-19. They found that 1.4%—or 3,309— of them suffered from some form of psychosis within 6 months of their recovery from the virus. Although most people who get it will not have any unusual symptoms, cases of COVID-related psychosis have been increasingly observed. Another report about 42 cases of psychosis in people stricken with the virus was published in Neuroscience Letters. The doctors who authored the report noted that in many cases, it is difficult to know if their psychotic symptoms were the result of inflammation in the brain, if a person was predisposed to developing a psychotic disorder, or if their symptoms stemmed from other contributing factors such as isolation and stress during the pandemic. Nonetheless, the relatively quick onset of new psychotic symptoms can be very concerning and confusing to the patient and their loved ones.

Symptoms of Psychosis

Psychotic symptoms occur on a spectrum that ranges from mild to severe levels of impairment. These symptoms are often very distressing and can interfere with major domains of functioning, such as interpersonal relationships, work or school, and self-care. They include:

6 Types of Psychotic Disorders

There are several psychiatric conditions that are characterized by psychotic symptoms and these manifest in varying degrees of severity and impairment as well as lengths of time.

1. Schizophrenia

This is the most common and debilitating psychotic disorder. It is a chronic psychiatric condition that is marked by recurrent episodes of delusions, hallucinations, disorganized speech and behavior, and negative psychotic symptoms. Approximately 0.3% to 0.7% of people in the U.S. are diagnosed with this disorder.

2. Schizophreniform Disorder

This condition is like schizophrenia, except the course of symptoms lasts between 1 and 6 months.

3. Schizoaffective Disorder

Someone with this condition will have the same symptoms of schizophrenia and concurrently have a sustained episode of major depression or bipolar.

4. Delusional Disorder

A person with this condition will have delusions that last longer than one month, and there are numerous subtypes that include:

5. Brief Psychotic Disorder

A person with this condition has psychotic symptoms that last one month or less. Although the onset can be anytime in life, first episodes are more common during the mid-30s. If a person has one brief psychotic episode, it’s very possible they’ll have more during their lifetime.

6. Substance-Induced Psychotic Disorder

As the name implies, this is diagnosed when a person has delusions and hallucinations that occur during or after intoxication from a drug (i.e. alcohol, marijuana, opiates, benzodiazepines, cocaine, LSD, and amphetamines) or during withdrawal from the substance(s). Because of the recurrent thought disturbances and breaks from reality, psychotic disorders are among the most challenging mental health conditions to have. Fortunately, treatment with antipsychotic medications (and other meds), along with the support of psychotherapy and case management, is possible for someone who suffers from one of these conditions to keep their symptoms in check. Psychotic symptoms and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Intense emotions. Mood instability. Impulsivity. These are characteristic symptoms of borderline personality disorder… and bipolar disorder. Because they share some overlapping symptoms, these two psychiatric conditions are sometimes confused. Making things even murkier is the fact that they may be co-occurring, meaning a person can have both conditions simultaneously. Research in Dialogues in Clinical Neuroscience shows that approximately 1 in 5 people with borderline personality disorder (BPD) also has bipolar disorder (BD), and about 30% of those with BD were also diagnosed with BPD. But the two disorders are not the same. Here are the basics you need to know about each of them. Intense emotions. Mood instability. Impulsivity. These are characteristic symptoms of borderline personality disorder…and of bipolar disorder. Because they share overlapping symptoms, these two conditions are sometimes confused.
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WHAT IS BORDERLINE PERSONALITY DISORDER?

Borderline personality disorder (BPD) is a type of personality disorder that is associated with instability in moods, emotions, self-image, and relationships. Impulsivity and strong emotional reactions are also common in this condition, which affects an estimated 1.6% to 5.9% of the population. Women account for 75% of those diagnosed with BPD, but experts suggest that the disorder may be underdiagnosed in men. Males who report symptoms of BPD are more likely to be misdiagnosed with issues such as post-traumatic stress disorder (PTSD) or depression.

WHAT IS BIPOLAR DISORDER?

Bipolar disorder is a mood disorder characterized by significant changes in mood, energy, and activity levels that shift in a cyclical pattern. The highs are known as manic episodes while the lows are called depressive episodes. An estimated 6 million American men and women are affected by the condition, which is also seen in kids and teens.

SYMPTOMS OF BORDERLINE PERSONALITY DISORDER

Borderline personality disorder is associated with a wide variety of symptoms, including:

SYMPTOMS OF BIPOLAR DISORDER

People with the condition typically experience a broad range of symptoms. During manic episodes, symptoms may include: During depressive episodes, symptoms may include:

CAUSES OF BORDERLINE PERSONALITY DISORDER AND BIPOLAR DISORDER

Research points to a number of factors that may contribute to the development of BPD or BD, including:

BRAIN IMAGING IN BORDERLINE PERSONALITY DISORDER AND BIPOLAR DISORDER

Brain SPECT imaging, which measures blood flow and activity, reveals abnormal brain activity in people with BPD and/or BD. On brain scans, borderline personality disorder is often associated with abnormal activity in the fear and emotional centers of the brain. In addition, SPECT reveals that mild traumatic brain injuries are a major cause of psychiatric symptoms, including many of the same changes in mood, personality, and behavior that are seen in people with BPD or BD. Brain scans are also helpful in detecting co-existing conditions.

TREATING BORDERLINE PERSONALITY DISORDER AND BIPOLAR DISORDER

There is hope for people who are struggling with BPD and/or BD. With an accurate diagnosis and a comprehensive treatment plan that may include medication (as necessary), nutritional supplements, psychotherapy, and lifestyle changes, people with these conditions can minimize and manage symptoms. Research in Archives of General Psychiatry found that 85% of people who sought treatment for BPD no longer met the criteria for the disorder 10 years later. A pair of studies from 2017 found that enhancing resilience and self-management in bipolar disorder improved treatment success. Borderline personality disorder, bipolar disorder, and other mental health issues can’t wait. During these uncertain times, your mental well-being is more important than ever and waiting until life gets back to “normal” is likely to make your symptoms worsen over time. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Many people think of mental health disorders as isolated conditions. When we hear someone say, “I have depression,” or “My husband has anxiety” it leads us to think that there’s a specific solution for each of these problems that would help people feel better. But it’s not quite that simple. For instance, if someone had only depression, you might think antidepressants would be the simple solution to reduce symptoms and boost their mood and energy. But more than half of depressed patients don’t get the relief they want from taking antidepressants, according to a large study. Similarly, if someone has ADD/ADHD, you might think that prescription stimulants are the easy answer to their issues. But they often aren’t. Why are the standard treatment models ineffective for so many people? Increasingly, physicians and other clinicians recognize that most patients with psychiatric conditions have complex conditions that don’t fit into the tidy categorical boxes described in the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM)—and for a good reason. Many people with mental health issues have an array of symptoms that can occur in a variety of disorders and confound the diagnostic process. Here’s an example of the same symptoms which can be seen in different mental health issues:
Depression Anxiety ADHD Bipolar Disorder TBI
Irritability x x x x
Insomnia x x x x
Poor concentration x x x x x
Impulsivity x x x
Restlessness x x x x x
Behavioral problems x x x

 

Having More Than One Psychiatric Diagnosis is Common

While there are other symptoms that cross diagnostic categories too, recognizing that most mental health problems are not single or simple disorders is helpful in understanding why so many people struggle to get adequate relief of their symptoms. A 2019 research study published in the journal, JAMA Psychiatry, reviewed the mental health history data of more than 5 million people and found that having one mental health disorder increased the risk of having another. This means that comorbidity (having two or more conditions) may actually be more common than having just one. Comorbidity (having two or more mental health conditions) may actually be more common than having just one.
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This means it’s common for people to have multiple conditions at the same time, such as depression and anxiety, ADD/ADHD and depression, panic disorder and bipolar disorder, addiction and anxiety or depression, obsessive compulsive disorder (OCD), and an eating disorder, and so on. Having multiple psychiatric disorders is referred to as dual diagnosis, co-occurring conditions, or co-existing disorders. Treating only one of the conditions will never be adequate. All of the issues need to be treated in order to get well. While it is still not yet known why mental health problems are more complex than originally believed, there are likely some genetic influences and environmental experiences that make some people more vulnerable to them.

Mental Health Disorders Have Multiple Causes

However, what we do know, is that a person’s mental health is directly linked to what’s going on in their brain. During the past 30 years, many people have sought treatment at Amen Clinics after they’ve had several failed attempts to feel better elsewhere. This is largely because of traditional psychiatry’s reliance on the limited DSM symptom-cluster approach to diagnosing their patients. Plus, most psychiatrists don’t use advanced imaging technology, such as SPECT (single-photon-emission-computed-tomography) to actually look at their patients’ brains to assess for the biological underpinnings of their symptoms. Consequently, many people are misdiagnosed and/or inadequately treated because underlying brain problems are missed altogether. Using the example of depression again, to accurately treat a patient, it’s necessary to identify what could be driving a person’s symptoms, since there are several potential causes, including these: Because of this, what works well for one person isn’t necessarily going to work for someone else. There is not a one-size-fits-all treatment for depression—nor for any other psychiatric disorder—because of the complexities that come with each condition as well as the uniqueness of each person’s brain.

A Game-Changing Discovery

Another discovery that helps to explain the problems with treatment response also comes from the extensive brain SPECT imaging work done at Amen Clinics, which now has a database of more than 183,000 patient scans. One of the most important findings is that some of the more common mental health conditions have several identifiable subtypes, which are based on specific brain patterns. The doctors and researchers at Amen Clinics have identified: What makes this work so important is that each of the disorders and their subtypes has different characteristics, which require individualized treatment plans that take into consideration a patient’s symptoms as well as their brain biology and clinical history. Without having SPECT scans as an adjunct tool, it would be much more difficult to accurately diagnose and treat patients. As Dr. Daniel Amen, founder of Amen Clinics, has said, “How do you know unless you look?” By having incorporated such a comprehensive evaluation process for each patient—including the valuable information from the scans—the doctors at Amen Clinics have successfully helped tens of thousands of people finally find relief from symptoms of multiple conditions, so they can live more fulfilling and healthy lives. Complex mental health problems can’t wait. During this ongoing time of uncertainty, your mental well-being is more important than ever. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.