Bipolar Disorder For Dummies. Joe Kraynak

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      ✔ Stressful life events: Studies of people with bipolar disorder have found a number of abnormalities in the biological systems that regulate the body’s response to various types of stress. Interactions between these vulnerable systems and environmental stress more than likely play an important role in both the development and progression of bipolar disorder. Acute life events have been found to occur more frequently before mood episodes in people with bipolar disorder.

      ✔ Early life stress: That same interaction between impaired stress response systems and stress may occur many years before the development of bipolar disorder. Studies suggest that early childhood trauma is associated with a higher risk of bipolar disorder in adulthood.

      ✔ Substances: Alcohol and/or drug abuse often accompanies bipolar disorder. Some of this may be self-medication – using substances to dull pain and discomfort in the short run. However, substance abuse and bipolar disorder may have overlapping genetic risk factors, so that rather than being a behavioral response to the illness, these conditions may develop alongside one another. Some evidence even suggests that the use of alcohol and drugs may increase the risk of developing bipolar disorder, which raises the question of whether early intervention with drug and alcohol use can help reduce the likelihood of ever having that first mood episode. Tobacco use is also being looked at as possibly interacting negatively with genetic vulnerabilities to bipolar disorder.

      ✔ Nutrition: Although no research points to specific nutritional triggers for bipolar disorder, people with bipolar disorder have higher rates of illnesses such as cardiovascular disease and type 2 diabetes. These conditions create their own stress and physical damage. Healthful nutrition is an important part of limiting the development and progression of these conditions, which can reduce their negative effects.

      ✔ Infection: Studies have suggested that maternal infections, particularly with the flu virus, during pregnancy are associated with higher rates of bipolar disorder I in adulthood. The overlap of the infection with genetic risk factors may be a contributing factor to some people’s bipolar disorder. Some research shows a higher rate of infection with toxoplasmosis (a parasite found in cat feces) in people with bipolar disorder, and the current thinking is that the infection interacts in some way with the genetic risk factors to cause psychiatric symptoms.

      ✔ Sleep/circadian rhythms: Researchers have identified a strong relationship between bipolar disorder and sleep problems. A number of different genetic variations may contribute to these difficulties. Some data suggests that sleep deprivation can be a trigger for mania, and because people with bipolar disorder are already poor sleepers, they’re at much higher risk of sleep deprivation. Sleeplessness creates a vicious negative spiral with bipolar, causing sleeplessness and sleeplessness contributing to bipolar. Sleep management is important in trying to hinder the progression of bipolar disorder.

      ✔ Hormones: Hormones are mood modulators and may contribute to mood symptoms and patterns. Research suggests that they interact with the genetically vulnerable brain and body systems in people with bipolar disorder to influence the onset and progression of their illness. Women are particularly vulnerable to this effect because of their frequent hormone shifts throughout their lives. Hormonal transition times such as the onset of puberty, pregnancy, and menopause are vulnerable periods for mood episodes (refer to Chapter 10 for more discussion).

      Was it the drugs, the genetic predisposition, or the trauma? Likely, all of the above.

      My parents, Marcia and Martino, were impoverished, had two kids, and were using illicit drugs. I was born premature and addicted. Each had manic depression, now called bipolar disorder.

      They coped with their mental battles by using drugs and alcohol. They would leave my brother Jordache and me unattended, lying in our own filth, screaming, barely clothed, to score. They left us just one too many times. On that day, at a seedy motel, the clerk heard our cries and called the police, and we were then taken into child protective services. It was a gift, our first.

      Clearly Jordache and I were predisposed to bipolar disorder. The question remains, did we have a chance? How much did neglect, malnutrition, and abandonment have to do with my condition? How much did the drugs in my system, in utero, contribute to the eventual onset of bipolar disorder?

      After Jordache and I were placed into foster care, he developed bronchitis and died. Feeling even more abandoned, I developed a detachment disorder, which would follow me into adulthood. Even today, I battle with anxiety, detachment disorder, and abandonment issues on top of bipolar disorder.

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