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Bipolar Episodes Cause Brain Damage?


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#1 Luna-

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Posted 26 January 2012 - 09:57 PM

My pdoc says that BP episodes cause brain damage. I wasn't diagnosed till 47 and had repeated depressive episodes with the manic and hypomanic going by, undiagnosed (never saw a pdoc when feeling great).

Now I am quite sure I have cognitive deterioration. My memory has gone to hell. Information doesn't stick like it used to. My thinking is slowed down and I have trouble grasping some concepts that I know I used to know. I don't feel drugged, I feel stupid.

Has this been caused by bipolar? I'm now 50; I know I have aged but surely this cognitive decline isn't just due to ageing? I've heard APs cause brain damage. Is that true? I feel caught between a rock and a hard place. I long to go off my meds, especially Geodon, but I am too afraid to do so. I can't afford to get stupider, I already have trouble at work.

What do bipolar episodes actually do to the brain? Is my stupidity just going to get worse?
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#2 amyra

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Posted 27 January 2012 - 06:07 AM

My pdoc says the same. I don't believe it. I think it's just the effects of the meds. Nobody wants to admit that though, because they have to be on these drugs for the rest of their life. I don't know how it can ever be proven that manic episodes destroy the brain. It's more likely that the massive medication dosage to bring people back to reality is the culprit. Manic episodes in my theory bring together the dream makers and the conscious mind while awake to create a very confusing delusion filled experience. I would say it improves the functionality of the brain.
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#3 Her

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Posted 27 January 2012 - 07:49 AM

Study suggests bipolar disorder may cause progressive brain damage

And here is the paper from which that article drew its information:

http://ajp.psychiatr...6207#Discussion

Take your meds, people. If you find you're having intolerable side effects on one med, find another. Don't throw the baby out with the bathwater.
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#4 notfred

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Posted 27 January 2012 - 08:20 AM

Meds are actually neuroprotective and some grow new brain tissue.
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#5 dymphna

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Posted 27 January 2012 - 08:53 AM

My pdoc says the same. I don't believe it. I think it's just the effects of the meds. Nobody wants to admit that though, because they have to be on these drugs for the rest of their life. I don't know how it can ever be proven that manic episodes destroy the brain. It's more likely that the massive medication dosage to bring people back to reality is the culprit. Manic episodes in my theory bring together the dream makers and the conscious mind while awake to create a very confusing delusion filled experience. I would say it improves the functionality of the brain.


I regret to inform you that you are incorrect in your assumptions.


Do the epilepsies, pain syndromes, and affective disorders share common kindling-like mechanisms?

Since seizures are the paradigmatic behavioral manifestation of kindling, some types of pharmacological seizures, such as those induced by the local anesthetics cocaine and lidocaine, and some epileptic syndromes, are most likely homologously modeled by kindling. However, since non-epileptiform syndromes, such as recurrent episodes of affective illness and some pain syndromes possess non-homogenous elements of kindling-like evolution, some of the principles involved in kindling progression may, nonetheless, be pertinent to the understanding and treatment of these syndromes.



Now read it backwards. As in, "recurrent episodes of affective illness possess elements of kindling-like evolution, some epileptic syndromes are most likely homologously modeled by kindling, and seizures are the paradigmatic behavioral manifestation of kindling."

And kindling is what fries the neurons of your brain.



Bipolar Disorder and Epilepsy: A Bidirectional Relation? Neurobiological Underpinnings, Current Hypotheses, and Future Research Directions


Biochemical, structural, and functional abnormalities in primary bipolar disorder could also occur secondary to seizure disorders. The kindling paradigm, invoked as a model for understanding seizure disorders, has also been applied to the episodic nature of bipolar disorder.

[...]

All these lines of research appear to be converging on a richer understanding of neurobiological underpinnings between bipolar disorder and epilepsy. Mania, which is the other side of the coin in affective disorders, may represent a privileged window into the neurobiology of mood regulation and the neurobiology of epilepsy itself.



e.g. One big-ass continuum. Today's untreated mania may morph into tomorrow's seizure disorder (not like I'm speaking from experience or anything...) Or, to put it more simply:

The status of the sensitization/kindling hypothesis of bipolar disorder

Kindling refers to repeated, intermittent, subthreshold stimulation that evokes increasingly widespread biochemical and physiologic manifestations culminating in a progression of behavioral abnormalities, and eventually full-blown seizures, which if sufficiently repeated, become spontaneous.



And amyra, if your manic theory is what you truly believe, why are you here? We don't sling that crap here.


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#6 LovelyThoughts

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Posted 27 January 2012 - 09:13 AM

Luna-
It might be a little of both. I began noticing a sort of memory loss when I hit 40-like I KNEW the word I was looking for but couldnt get it to my tounge. So frustrating.
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#7 bipolar librarian

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Posted 27 January 2012 - 02:44 PM

I began noticing a sort of memory loss when I hit 40-like I KNEW the word I was looking for but couldnt get it to my tounge. So frustrating.


Menopause is also notorious for causing brain fog.

The AAP sedation makes me foggy at times, but so does crushing depression.

MRIs showing loss of brain cells are a great way of showing how untreated MI damages the brain.... I see everyone else pointed to the relevant studies on this point.

Have you been evaluated for alternate causes of the cognitive problems? My temptation is to blame my meds for everything from a hangnail to heart failure, because I STILL struggle with taking them!

I have a friend who had to retire early because of cognitive problems brought on by a brain injury years ago. She has developed a lot of systems -- calendars, notes to herself, etc. -- to cope with it, and she does remarkably well. You may want to look at coping strategies.
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#8 martasi2

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Posted 27 January 2012 - 08:12 PM

Now I am quite sure I have cognitive deterioration. My memory has gone to hell. Information doesn't stick like it used to. My thinking is slowed down and I have trouble grasping some concepts that I know I used to know. I don't feel drugged, I feel stupid.


Does your PDoc think you have brain damage from untreated BP? Is this his answer to your concerns about your cognitive and memory decline? I think you need to clarify this with him. If he said this to encourage you to stay on medication, that's one thing. But his answer didn't help you. IMO, he should be willing to address cognitive and memory problems and suggest solutions - whether caused by meds or not. If your work is suffering, that's another reason to discuss with him. Does he think you should just "live with it" and risk losing your job?

Also consider your hypothyroidism. I don't know if thyroid hormone interacts w/Lamictal or any of your meds to decrease the amount of thyroid you're getting, but you might need to have your dose adjusted. Something else to ask your PDoc.

Your meds could be part of the problem, but there are lots of meds for BP, and you might do better on something else or need to adjust what you're taking. If you want to stop the Geodon, is it due to questions about AAPs and brain damage? Again -- something else to discuss with your psychiatrist. You have to advocate for yourself, and it's a lot of work.
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#9 3jane

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Posted 27 January 2012 - 11:53 PM

Wow, thats kind of scary. I'm only 21, been having bipolar symptoms since 16/17... my memory is definitely lacking more than it used to, I have more trouble typing sentences (I'll randomly capitalize, punctuate, etc.), and there seems to be a disconnect between my brain and my mouth. I trip over my words waaaay more than I used to.
I mean, my memory and speech have always been lightly lame... was that a portent of my bipolar yet to come, or did bipolar just make what I already have worse? Is that even possible in such a relatively short span of time?

On that note, is there any link between Synaesthesia and other mental illness?
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#10 dymphna

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Posted 28 January 2012 - 12:53 AM

Wow, thats kind of scary. I'm only 21, been having bipolar symptoms since 16/17... my memory is definitely lacking more than it used to, I have more trouble typing sentences (I'll randomly capitalize, punctuate, etc.), and there seems to be a disconnect between my brain and my mouth. I trip over my words waaaay more than I used to.
I mean, my memory and speech have always been lightly lame... was that a portent of my bipolar yet to come, or did bipolar just make what I already have worse? Is that even possible in such a relatively short span of time?

[b]On that note, is there any link between Synaesthesia and other mental illness?[b]


Synesthesia is just a thang. Usually genetic, rarely associated with temporal lobe seizures. It falls under the umbrella of "the brain is a great big place, and when it comes right down to it, we really don't know jack." Kind of like how in the Autism / Asperger spectrum we can see the inheritence lines (sometimes), but the why? Bubkus.

But no, not a mental "illness".


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#11 3jane

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Posted 28 January 2012 - 01:08 AM

Whoops, didn't mean to insinuate Syn was a mental illness. Should've written "synaesthesia and other.. something." Is there a term for anything that affects you mentally, illness/disorder or not? I probably know it but I just can't come up with the right word. Whatever that word is, that's what I meant.
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#12 dymphna

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Posted 28 January 2012 - 01:21 AM

Whoops, didn't mean to insinuate Syn was a mental illness. Should've written "synaesthesia and other.. something." Is there a term for anything that affects you mentally, illness/disorder or not? I probably know it but I just can't come up with the right word. Whatever that word is, that's what I meant.


Here is a good explanation - synesthesia doesn't really correspond to anything else out there.

http://www.livescien...hear-color.html

D
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Yes, my name really is Dymphna.

 

I'm not a doctor, nurse, pharmacist, or therapist.

I can find you an answer and I won't blow smoke up your ass.

 

St. Dymphna is the Patron for brain maladies.

 

I'm the Enforcer.

 

eqnmrt.jpg

 


#13 3jane

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Posted 28 January 2012 - 01:32 AM


Whoops, didn't mean to insinuate Syn was a mental illness. Should've written "synaesthesia and other.. something." Is there a term for anything that affects you mentally, illness/disorder or not? I probably know it but I just can't come up with the right word. Whatever that word is, that's what I meant.


Here is a good explanation - synesthesia doesn't really correspond to anything else out there.

http://www.livescien...hear-color.html

D

Thanks. I was discussing my Schizoaffective with a curious friend when he brought up my Synaesthesia, and it's been stuck to the back of my brain ever since.
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#14 Luna-

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Posted 28 January 2012 - 08:45 AM

Thanks for the replies and discussion.

Bipolar is progressive? Is that also true for medicated bipolar?

In reply to people who’ve commented:

Menopause causing brain fog – I’m not menopausal yet – you mean that’s still COMING? That's a daunting prospect.

Are specific classes of meds more neuroprotective than others? What about the AAPs?

I haven’t been evaluated for other reasons for the cognitive problems – I haven’t told anyone but my pdoc She says it’s the untreated bipolar. She says that to make me keep taking the meds, I think. I have blamed the medications because some of them sure did make it worse. I was a zombie on lithium, likewise on Seroquel. My brain feels numb on SSRIs.

I don’t think I am in danger of being fired but work is a daily struggle. I process very slowly. When I am anxious, which is a lot of the time, my brain freezes and nothing gets processed. I spend a lot of time trying hard to appear as if everything is normal and cover up for what I can’t remember or for when I am having anxiety attacks. I think I have them fooled. It sucks.

I’m actually not keen to switch any meds. I am in remission on what I am on now. Would love to decrease doses but when my pdoc said I could lower the Geodon, I did, and my anxiety went through the roof. So I went back.

I’ve read stuff about it being the AAPs that cause the brain damage, not the illness. Some of it is very convincing. Makes me waver when I read it. It haunts me. I guess you can use stats to prove anything. I also worry about long-term S/Es.

I’ve had thyroid function tests recently. They’re fine. Surely my pdoc would have told me about interactions of my cocktail with thyroxine? I sure hope so.

I will just have to accept the grim truth: I have brain damage. I cope. I cover up. I talk less in case I reveal my stupidity. I compensate by writing lots of things down.

Sorry about the ramble – the discussion is interesting.
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#15 bipolar librarian

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Posted 28 January 2012 - 11:11 AM

I haven’t been evaluated for other reasons for the cognitive problems – I haven’t told anyone but my pdoc She says it’s the untreated bipolar. She says that to make me keep taking the meds, I think. I have blamed the medications because some of them sure did make it worse. I was a zombie on lithium, likewise on Seroquel. My brain feels numb on SSRIs.


Some meds do, certainly, and it's worth it to look for the right cocktail. Untreated bipolar makes me pretty spacey, though.

I don’t think I am in danger of being fired but work is a daily struggle. I process very slowly. When I am anxious, which is a lot of the time, my brain freezes and nothing gets processed. I spend a lot of time trying hard to appear as if everything is normal and cover up for what I can’t remember or for when I am having anxiety attacks. I think I have them fooled. It sucks.


Have you discussed this issue with your tdoc? I'm going out on a limb here, but you may be doing better than you think at work. At least that was my experience. I had sort of the "imposter syndrome" thing going on quite often, but have learned that despite my ups and downs, they're more pleased with me than I thought. Would I like to be more productive? Sure, but I do what I can.

I’ve read stuff about it being the AAPs that cause the brain damage, not the illness. Some of it is very convincing. Makes me waver when I read it. It haunts me. I guess you can use stats to prove anything. I also worry about long-term S/Es.


Where are you reading these? I can find you convincing arguments for almost anything on the internet -- but not necessarily valid ones. I've thought of writing blog posts on "my breakfast, and why it will kill me," since I can go online and find evidence that animal products will kill me, fruit will kill me, grains will kill me, too much protein, too much fat, too much carbs, too LITTLE of any of these... whichever direction, I'm apparently screwed.

If you're finding this on naturopathy type sites, they often have a very strong anti-med bias. Not everything that is "natural" is good. It's perfectly natural to lose half your children before the age of 5 due to disease.

I’ve had thyroid function tests recently. They’re fine. Surely my pdoc would have told me about interactions of my cocktail with thyroxine? I sure hope so.


It's not so much a drug-drug interaction (like benzos + booze = bad) but more of a potential co-morbid condition. Psycheducation.org has a good discussion of thyroid in bipolar here. A good thing to know, if your levels keep coming up "normal" is that there is some dispute as to where normal is. Some say TSH should be .5 - 4.5, others .3 - 3. For a couple of years, I was gaining weight, fuzzy-headed, felt like I was moving through mud, going through gallons of hand cream & conditioner -- all classic hypothyroid symptoms -- but because I kept testing under 4.5, I was told I was fine. I felt like hell, and as it turned out, my thyroid WAS going on the fritz (Hashimoto's thyroiditis, later got thyroid cancer, now have no thyroid.) If you are testing on the high side of normal and having hypothyroid symptoms, you may want to talk to an endocrinologist.

Edited by bipolar librarian, 28 January 2012 - 11:11 AM.

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#16 PlatformDblSuede

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Posted 28 January 2012 - 09:42 PM

From the time I graduated high school (at 18) to the time I eventually dropped out of graduate school altogether (at 25), I'd lost about two standard deviations off my IQ. I was completely batshit insane and unmedicated the whole time. I started meds a year ago, at 27. and my cognitive function is actually slowly returning. Just my experience.
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#17 Luna-

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Posted 29 January 2012 - 05:55 AM

Lots of food for thought, thank you, bl.

Some meds do, certainly, and it's worth it to look for the right cocktail. Untreated bipolar makes me pretty spacey, though.

I’m pretty sure I was doing ok cognitively before the big 2-year breakdown about a year ago. I had several episodes, back-to-back at that time. Was it those episodes that fried my brain? Before then I was only on venlafaxine for MDD, for many years. So it’s hard to tell if it’s the BP or the meds. (Hence the topic.)

Have you discussed this issue with your tdoc? I'm going out on a limb here, but you may be doing better than you think at work.

Not in therapy anymore – stable now. I suppose you could be right. But I have a colleague who jumps on me if I make the slightest mistake, which I do from time to time. The boss is absolutely fine. I am just easily intimidated, is all. And I can FEEL my thinking is slowed down. Everyone else works faster and gets through more work than me.

Anyone read “The Brain That Changes Itself” on neuroplasticity? Good book and at least hopeful for those of us with fried brains. It maintains we can recover from neuronal loss. I sit at lunch doing crossword puzzles to try and exercise my brain and recover some words I knew the meaning of, but now can’t remember. It's slow-going, though.

Where are you reading these?

Yeah, it’s from anti-med sites with a Jungian approach to MI. They cite lots of studies.
Like I said, I am easily intimidated.

It's not so much a drug-drug interaction (like benzos + booze = bad) but more of a potential co-morbid condition. Psycheducation.org has a good discussion of thyroid in bipolar here. A good thing to know, if your levels keep coming up "normal" is that there is some dispute as to where normal is. Some say TSH should be .5 - 4.5, others .3 - 3. For a couple of years, I was gaining weight, fuzzy-headed, felt like I was moving through mud, going through gallons of hand cream & conditioner -- all classic hypothyroid symptoms -- but because I kept testing under 4.5, I was told I was fine. I felt like hell, and as it turned out, my thyroid WAS going on the fritz (Hashimoto's thyroiditis, later got thyroid cancer, now have no thyroid.) If you are testing on the high side of normal and having hypothyroid symptoms, you may want to talk to an endocrinologist.

Thanks for the information. My TSH was 0.35. My T4 was 24, just one above normal. I’m not hypo. My TSH always tests low – once it was 0.03. Wouldn’t that suggest I am over-supplementing? My pdoc didn’t comment on the last round of tests, so I just assumed it was fine and that she wasn’t concerned. I’ll be sure to ask in March when I see her again.


I'm still curious as to whether medicated BP is also progressive or if the meds halt that progression?

Edited by Luna-, 29 January 2012 - 05:58 AM.

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#18 bergsonisme

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Posted 29 January 2012 - 03:25 PM

One sentence-summary: epistemology is destiny


Bipolar is progressive? Is that also true for medicated bipolar?


There's such a thing as the "kindling hypothesis" or "kindling model" of bipolar disorder, named after the kindling phenomenon in epilepsy. Things are more clear-cut in epilepsy, although I'm bound to oversimplify this for lack of personal experience: kindling in epilepsy means that every seizure episode will lower the threshold for abnormal brain activity to trigger more seizures. It doesn't mean epilepsy's progressive or degenerative: if you never seize you don't kindle. Thus teh meds.

As for bipolar, this is a far more controversial issue, and not for lack of confirmatory data. Kindling in BP was first postulated by one dr. Post in the 1980s, and there is still plenty of recent literature that will point to endogenous worsening of untreated bipolar.

BUT, and herein lies the rub, one that is extremely hard to sort out from RCT data. Kindling is a model of the dynamics of seizure thresholds, yet we don't have a clear definition of thresholds or even what stands in for "seizure" in the analogy. Thus, all the comparisons between bipolar and epilepsy. (This is not unlike comparing nose bleeds to intestinal bleeds. Plenty of gross jokes were omitted here for the benefit for of the reader.)

The wider problem is that RCT is a grossly inadequate model for any areas of medicine that involve anything systemic. The double-blind RCT is supposed to zero out placebo effects but it confines us to horrible selection bias. Illness X is defined by criteria Y so we want intervention Z that for a random sample of people fitting criteria Y, symptoms of X are diminished in some form. Do you see how criteria Y basically determine the outcome of the study? Give a sample of 50 men and 50 women a birth control pill, and measure "fertility" later. No better than even odds. Now look at this problem in reverse: Topamax is consistently shown to be no more effective than placebo for BP, but I promise that it's possible to conceive criteria for "BP, Topamax reactive" that exclude out all the Topamax non-responders. Also, banish Topamax non-responders from the exclusive Bipolar Club. Maybe we can get them a PD dx for insurance purposes.

Is syntaxfree being just hypergraphic for hipergraphia's sake? Yes, but also consider that any study that claims anything of BP is as sensitive to selection bias -- the criteria for inclusion -- as the Topamax studies. And we all know how some people fare great on Topamax and some just don't. Why would a study about brain damage be free of these? And what does this all have to do with epilepsy?

One last hypothetical study: a random sample of self-identified bipolars in the 25-35-y.o. range will take an IQ test on a wednesday afternoon. I promise you the IQ scores will be lower. The top of the crop will be at work. I'm not even saying people are unemployed because they're not smart, I'm just saying smart people have a higher probability of being employed, so restricting your sample to the unemployed pushes the expected mean down.
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#19 Mr_West

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Posted 29 January 2012 - 03:57 PM

Thanks for the information. My TSH was 0.35. My T4 was 24, just one above normal. I’m not hypo. My TSH always tests low – once it was 0.03. Wouldn’t that suggest I am over-supplementing? My pdoc didn’t comment on the last round of tests, so I just assumed it was fine and that she wasn’t concerned. I’ll be sure to ask in March when I see her again.

I'm still curious as to whether medicated BP is also progressive or if the meds halt that progression?


If your T3 and T4 are normal to high, your TSH is going to be low. All TSH tell your thyroid to do is make more T3/T4. If you have enough floating around you dont need more TSH.
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#20 Luna-

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Posted 30 January 2012 - 09:02 AM

I agree with you about the selection criteria determining the study. Studies that use MRI imaging to show loss of grey matter in bipolars as compared with non-bipolars are pretty convincing, though. What is that if not brain damage?

Talking of kindling and progressiveness of unmedicated bipolar - is it possible for BP2 to develop into BP1 if untreated? I'm pretty sure that is what happened to me. Back in the early 80s when I first started to show symptoms, BP2 hadn't been invented yet. You were either full-blown manic in which case you were BP (there was only 1), or you were some flavour of depressed (endogenous, reactive or atypical). My ups never got dx'ed and the downs were treated with ADs and the BP probably kindled merrily over the next 25-odd years until I had a manic episode that landed me in the locked section in hospital (in one hell of a good mood!) - and earned me the BP1 dx.

Is anything known about BP2 kindling/progressing to BP1 if left untreated?
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#21 bergsonisme

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Posted 30 January 2012 - 09:19 PM

I agree with you about the selection criteria determining the study. Studies that use MRI imaging to show loss of grey matter in bipolars as compared with non-bipolars are pretty convincing, though. What is that if not brain damage?


Busy bipolar executive, artists, celebrities, that won't consent to a study that, if leaked, may compromise their careers. Actually, one should expect most time-intensive outpatient RCT studies to have a strong bias against high-functioning individuals.

Of course, there are statistical methods to correct at least partially for this bias. In econometrics one common method are Heckman regressions, which comprise a proposed equation to model participation/nonparticipation of relevant samples yielding a correction term for your main regression (which may just be a comparison in means if you run a regression without controls). It's just that you need to develop protocols for the use of endogenous selection models and medical researchers are lazy, particularly because RCT is supposed to be the end-of-history re: scientific methodology.

But really, to stay on the Heckman regression model (which may not be adequate as-is for medical research, but something similar should), the selection equation involves knowing something about patients ex ante: what are the characteristics of high-functioning, likely to stay out of time-consuming studies individuals that can be measured across the sample? And this we don't know, because we don't even know what the question is.
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#22 bergsonisme

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Posted 30 January 2012 - 09:23 PM

Re: bp2 to bp1, the standard classification works for me. I have manic ramp-ups that eventually dissolve into mixed states after some upper threshold of hypomania, rather than evolving into big time crazyhood. You possibly had a mild case of bp1 that worsened over time.

Edited by syntaxfree, 30 January 2012 - 09:25 PM.

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#23 Mr_West

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Posted 31 January 2012 - 01:26 AM

because RCT is supposed to be the end-of-history re: scientific methodology.


Also, the good biostatisticians work for the drug companies hedging for the possibility of a revision of the declaration of Helsinki applying to the FDA approval process. In that case placebo controlled studies would be on the outs and non-inferiority studies would be the norm (already the case for some cancers and epilepsy in many cases). Also in the United States the people who pay for a lot of prescriptions, the state medicaid programs and the PBMs are on an evidence based medicine kick, so anything to slow new drugs would have someone on their side in legislative areanas (not that generic manufacterers don't routinely get hit up with fines for price fixing and manipulation).

On another point mentioned in this thread I did move from BP II to BP I, but that also involved moving from my early twenties to my mid twenties.
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#24 bergsonisme

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Posted 31 January 2012 - 03:18 AM

Well -- although non-inferiority studies may be somewhat more sensitive towards drugs that only work for subtypes of the population (Topamax is an issue that infected my whole philosophy of science), it's also something that would keep stuff like Depakote away from approval.

That said, it's still an RCT, it's just the question that was changed. RCTs make sense for experiments that can be repeated, and you can't really repeat an RCT because you can never exactly sample from the same population -- because we don't know what "the population is". I mean, the whole apparatus of statistical inference in random samples presupposes repeatability -- p-values mean squat diddly doo if you can't assume repeatability. And then we have the frakking decline effect, precisely because in the absence of a solid "data generating process" (i.e. a model of why the drugs would work for the things we find that they do, something that we don't have a clue for bipolar) these p-values are stochastic in and of themselves and publication bias selects for the different results over time.

What's the alternative here? Longitudinal studies, even if for budgeting/organization issues they become naturalistic, non-systematic studies. The difference between bipolar, schizophrenia and dementia was discovered on naturalistic observation; Darwin discovered evolution on naturalistic observation. Kindling, IIRC, was postulated on naturalistic observation of inpatients. And we must still correct for inpatient, low-functioning outpatient and high-functioning outpatient.

What am I doing, reinventing psychiatric research methods on an internet forum? Of course researchers know about it. But there's such thing as the McNamara fallacy -- I'm an economist and I see it at work all the time. "Well, if we don't assume bidders in an auction have independent private valuations and don't know anything about the private valuations of other bidders, we don't have a model". But of course bidders have some measure of knowledge of what something is, particularly when they're bidding for government contracts that are easily comparable to private contracts. The same happens in medicine -- "well, of course we need to assume away the selection biases, otherwise we don't have a model". Guess what -- you don't have a model.

For future reference, the McNamara fallacy:

The first step is to measure whatever can be easily measured.
This is OK as far as it goes.

The second step is to disregard that which can?t be easily measured or to give it an arbitrary quantitative value.
This is artificial and misleading.

The third step is to presume that what can?t be measured easily really isn't important.
This is blindness.

The fourth step is to say that what can't be easily measured really doesn't exist.
This is suicide.


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#25 dymphna

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Posted 31 January 2012 - 06:45 AM

Syntax,

When you're on, you are just ON.


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#26 In_Remission_Moodrider

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Posted 02 February 2012 - 06:49 PM

Syntax, once again I kneel in the long shadow of your edit. Sublime. I was undiagnosed for over ten years with my first Dx being an “existential crisis”. The Rx?... an avalanche of antidepressants that sent me into a nasty manic / dysphonic crisis for about 18 months. 6 years later I'm Dx’d BP2 / MDD. I'm 39. After an enjoyable 2 week hypomanic interlude last month I was explaining to my Pdoc and GP that I felt like I was now living with a head injury. Many things I was once expert in I'm now unable to even comprehend – it’s like part of my memory is being slowly erased, it can’t retain even the simplest things & the part of my mind that processes information has become randomly selective and keeps me idling in a state of anxiety whilst I wait to see what it will let me do. My Pdoc says this is most likely due the depressive state that always follows my mania screwing me up. Whilst it probably does have something to do with it he wants be to back out of work for a while. The truth of the matter is I couldn’t do less if my life depended on it. This may well cost me my career. Sadly, I know theres damage and I know its slowly getting worse.... the price of survival I suppose.

sorry bout the grammer / spelling etc - posting this has emptied my tank.

Edited by Moodrider, 02 February 2012 - 06:54 PM.


#27 In_Remission_mommymeltdown

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Posted 02 February 2012 - 07:11 PM

I would never say its your age ... but its probably your age! I think the meds that people take with this stuff slows your mind down, and just being over like 35 slows your mind down. I have noticed in the last 2 years (I turned 40 this year) that things that I used to think about would come to me in a few minutes and now it takes me HOURS. Also stress can make your mind slow. I don't believe it causes brain damage any more than age and parenting does!

#28 Asimov

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Posted 23 May 2012 - 08:22 PM

...This does not help me feel much better about the fact that I've felt like I've been getting stupider over the past few years. (I'm not 30 yet.)
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#29 jsonx

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Posted 18 June 2012 - 05:04 PM

My pdoc says the same. I don't believe it. I think it's just the effects of the meds. Nobody wants to admit that though, because they have to be on these drugs for the rest of their life. I don't know how it can ever be proven that manic episodes destroy the brain. It's more likely that the massive medication dosage to bring people back to reality is the culprit. Manic episodes in my theory bring together the dream makers and the conscious mind while awake to create a very confusing delusion filled experience. I would say it improves the functionality of the brain.



I totally agree with you @amyra. I know so much great bipolar people and i don't think they used lithium or other drugs and of course their brains was working much more different and better than other people. Some of them: Michelangelo di Lodovico Buonarroti Simoni, Ludwig van Beethoven, Leo Nikolayevitch Tolstoy. And they produced great works until their end of life.
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#30 dymphna

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Posted 19 June 2012 - 01:01 AM


My pdoc says the same. I don't believe it. I think it's just the effects of the meds. Nobody wants to admit that though, because they have to be on these drugs for the rest of their life. I don't know how it can ever be proven that manic episodes destroy the brain. It's more likely that the massive medication dosage to bring people back to reality is the culprit. Manic episodes in my theory bring together the dream makers and the conscious mind while awake to create a very confusing delusion filled experience. I would say it improves the functionality of the brain.



I totally agree with you @amyra. I know so much great bipolar people and i don't think they used lithium or other drugs and of course their brains was working much more different and better than other people. Some of them: Michelangelo di Lodovico Buonarroti Simoni, Ludwig van Beethoven, Leo Nikolayevitch Tolstoy. And they produced great works until their end of life.


No, most of them used alcohol, absinthe, cocaine - what was available at the time. Many people also "took in the waters", which was a euphemism for drinking or bathing in mineral water that we now know to be lithiated.


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