Category Archives: Bipolar

Mental Health Awareness

Mental Health AwarnessPhysical health problems, such as cancer, diabetes, and other heart diseases, there is a vast knowledge of preventions and early intervention. People are fully aware of the cures, medications, and treatments available for so.  For example, in the area of cardiovascular disease, there is widespread knowledge about modifiable risk factors like smoking and exercise, people know the value of screening and treatment for hypertension and high cholesterol, many people have the first aid skills to apply cardiopulmonary resuscitation in an emergency, and some would know the warning signs of a stroke and the need to call an ambulance immediately.

But as far as mental health is concerned, the knowledge in the public has generally lagged behind the major physical diseases despite their high prevalence. Surveys of the many countries showed the lifetime prevalence rates of 18 % to 36 % (Kessler et al., 2009). Every year, millions of people are diagnosed with various mental health conditions such as depression, anxiety, schizophrenia, bipolar disorder, epilepsy, etc. Mental illnesses affect about 20% of the adult population, 45% of teenagers and 15% of children each year.  This high prevalence means that either the person is affected by a mental disorder or has close contact with other people who are. Despite the high exposure to mental disorders in the population, unfortunately, the stigma and misunderstanding associated with mental illness are also widespread. Only half of those who are affected with such condition receive treatment. The untreated ones become prone to other health issues contributing higher medical expenses, poorer performance in their respective fields, fewer opportunities and increased risk of suicide.

Although this perception of mental illness has improved over the past decades, studies show that stigma against mental illness is still powerful. Due to the current rates of occurrence, it has become necessary that everyone should be well aware of the conditions and symptoms and must be skilled to take action to improve community mental health. The community must be educated to fight stigma and provide support.

Medications for Bipolar Disorder

Bipolar Disorder 2018Bipolar Disorder, also known as manic depression, is a mental disorder which causes periods of abnormally elevated mood (i.e., Mania) or the periods of depression. It affects approximately 1% of the global population and the stats are increasing day by day. Hence, it is an active area of research.

The causes are not clearly understood, but both environmental factors (such as child abuse, long-term stress, addictions, etc.) and the genetic factors play a role. Even the genes with the small effect are involved. The neurological conditions such traumatic brain injury may also lead to bipolar disorder, but it’s not very common.

The treatment commonly includes the psychotherapy (such as Cognitive Behavioral Therapy) as well as the Medications. Medications are an essential part of the treatment for Bipolar Disorder. This helps to keep the periods or the moods in balance enabling the person to live a normal life. They do not cure the disorder but helps to stabilize the condition.  Numbers of medication used to treat Bipolar Disorder. Some of them help to fight the manic episodes and others prevent the episodes of depression.

  • Mood Stabilizers: They are used for long-term mood stabilization but are unable to quickly treat acute bipolar depression. The examples include lithium, and the anticonvulsants like carbamazepine, lamotrigine, and valproic acid. By far, lithium is the most effective medication of all. They treat bipolar depressions, acute manic episodes and prevent relapses. It also reduces the suicidal risk and deaths in people with bipolar disorder.
  • Antipsychotics: Also known as neuroleptics, or major tranquilizers, principally they are used in conditions of Schizophrenia and Bipolar Disorder. They are effective for the short-term treatment of both manic and depressive episodes of the bipolar and hence, are considered to be more superior to the lithium and other anticonvulsants. Olanzapine is an example of an antipsychotic drug. Now doctors prescribe new antipsychotic drugs including Aripiprazole (Abilify), Quetiapine fumarate (Seroquel), Ziprasidone (Geodon), Lurasidone (Latuda), Asenapine (Saphris), Cariprazine (Vraylar), Olanzapine (Zyprexa).
  • Medication for Bipolar Depression or Antidepressant drugs: In the treatment of bipolar disorder, antidepressants are not prescribed to use alone as they may trigger the manic episode. It is usually prescribed along with a mood stabilizer or antipsychotic drug.
  • Others: Several other medications such as anti-anxiety medication, sleep medications, benzodiazepines, omega 3 fatty acids may have some beneficial effects in certain conditions.
  • Side Effects: Like any other drug, bipolar medications also have some side effects and the symptoms vary depending on the medication. They include nausea, tremors, hair loss, weight gain, liver damage, kidney damage, diarrhea, skin problems, and several other conditions.
  • Recommendations: As the medications for bipolar are very powerful drugs, it should always be taken according to the doctor’s recommendation for the given period of time. The abrupt withdraw of medicine without Doctor’s approval can be very dangerous.

Understanding the aspects of Psychiatric Disorders

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Understanding the aspects of Psychiatric Disorders

The recent acknowledgment of the worldwide importance of mental disorders has put psychiatry firmly on the international health agenda. The World Health Organization has evaluated that neuropsychiatric disorders and suicide account for 12.7% of the worldwide burden of illness. Major bipolar affective disorder, depression, schizophrenia, alcohol misuse, and obsessive-compulsive disorder account for five of the 10 leading causes of disability in underdeveloped and developing countries. In developed countries, dementia is the third most common neuropsychiatric disorder. Few aspects for the better understanding are given below.

Psychiatric stigmatization is the inappropriate and erroneous association of mental illness with something disgraceful or shameful. Stigma generates a hidden burden and results in barriers to mental health care, reluctance to seek appropriate care, delay in return to wellbeing, and discrimination in the allocation of resources. Stigmatising attitudes are found universally and can be deeply entrenched. There are two important factors to reduce the burden of stigma:

  • Personnel awareness, and
  • Availability of effective treatments

Due to advancements in psychiatric research, today we have various effective treatments for the major brain disorders; the key to changing attitudes is education. But still today, people disagree on the symptoms of the disorders and ignore their mental health.

  • Neurobiological aspects of post-traumatic stress disorder

The traumatic stresses such as combat, sexual assault, car crash, or intensive cancer treatment, cause pervasive distress in almost anyone and triggers the post-traumatic stress disorder. The disorder arises because of the various emotional challenges during the trauma, resulting in a delayed and protracted response.

  • Cost-effectiveness of atypical antipsychotics

Atypical antipsychotics (clozapine, risperidone, olanzapine, amisulpride, and quetiapine) are the newer generation of drugs that produce fewer extrapyramidal side effects than conventional antipsychotics such as chlorpromazine. Generally, their effect is similar to the conventional ones, although few of them are shown to be more effective, for example- clozapine in the treatment of schizophrenia. Because atypical antipsychotic drugs are better tolerated, it is often suggested that they should become the first-line treatment for schizophrenia. However, as the newer drugs can be up to 30 times more expensive than the older drugs, such a change has major cost implications. If atypical drugs are truly associated with greater patient benefits then it is reasonable to expect them to be cost-effective. Unfortunately, economic evaluations often fail to take full account of direct and indirect costs and exclude subjects who discontinue treatment.

Cannabis use- an independent risk factor for bipolar symptoms in young adults

Cannabis has been using as a mind-altering drug from the Prehistoric times. Even today, it is a popular recreational drug around the world, only behind tobacco, alcohol, and caffeine. It is commonly known as Marijuana and is the most commonly used illicit drug in youth all over the world.1

It is known that the psychoactive effects of Cannabis have three phases:

  • Primary psychoactive effect- relaxed state of euphoria because of the compound, tetrahydrocannabinol.
  • Secondary psychoactive effect- introspection, higher-order thinking, the philosophical thinking among the cases of anxiety and paranoia.
  • Tertiary psychoactive effect- increased heart rate and hunger, due to the chemical compound 11-OH-THC, the metabolite of THC produced in the liver.

It is found that the use of cannabis by adolescent results in hypomanic episodes (elevated mood) and sleep deprivation which are usually considered as symptoms of bipolar disorder and it greatly affects the daily life. Many more concerns such as memory and cognition problems and schizophrenia have been observed in young people.

The researchers analyzed data from the Avon Longitudinal Study of Parents and Children found that the use of cannabis during the teenage results in the hypomanic symptoms in the later years.

With the frequent use of Cannabis, Cannabinoid receptors (CB1) are distributed throughout the brain and gets active in neurotransmitter release and concentrations across the nervous system. It alters the genetic expression of neural development and endocannabinoid system leading to a series of neurochemical and neurostructural aberrations which results in poorer emotional outcomes and hypomania in adulthood.

Cannabis use in youthful individuals is common and related to psychiatric disorders. Be that as it may, the imminent interfaces between cannabis use and bipolar disorder side effects have rarely been investigated.”

Cannabis is one of the foremost commonly utilized unlawful substances of abuse in western countries. Problematic utilize within the common population is as high as 9.5% within the United States, whereas 2.6% of the UK population report having been cannabis subordinate within the last year.

Potential Advance in turning around impacts of Alzheimers:

The Possibility that anticipating and regarding Alzheimer’s ailment could be as simple as wearing specific eye wear that conveys quick gleams of light. Since the main instance of Alzheimer’s illness was recognized more than 100 years prior, the quantity of individuals with the infection in the United States has developed to more than 5 million and is relied upon to increment. Analysts have gained significant ground in describing the atomic and protein brokenness that happens in Alzheimer’s ailment, yet none of the present FDA-endorsed medicines can turn around, stop, or even back off its movement

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Its trademark pathology are beta-amyloid proteins that bunch together and shape lethal plaques outside of cells, and unusual tau proteins that cluster together and frame poisonous tangles inside cells. The most longstanding hypothesis of Alzheimer’s infection places that beta-amyloid protein variations from the norm drive the tau protein anomalies. Thus, these drive different markers of cerebrum brokenness of Alzheimer’s ailment, for example, neuroinflammation and cell passing. Generally, the demise of cells and neurotransmitters (parts of cells that permit correspondence with each other) are likely in charge of dementia, an essential piece of the ailment. Indeed, even before beta-amyloid groups into plaques, in any case, certain parts of beta-amyloid are delivered at too high a level and bother mind work.

A few analysts have discovered proof that amyloid levels might be raised in individuals for a long time, maybe even decades, previously manifestations end up clear. The moderate movement of the sickness may imply that cerebrum brokenness has just advanced too far when indications are distinguished for medications to be viable. This is one reason a noteworthy focal point of research is to discover organic markers — ideally noninvasive — that could enable clinicians to identify the most punctual phases of Alzheimer’s sickness before across the board and irreversible harm happens.

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The adequacy of the light flicker treatment in the mice proposes that, if these discoveries can be effectively meant people. Maybe somebody with an expanded hazard for Alzheimer’s ailment could consider doing this treatment preventively.

Normal Painkillers Triple Dangerous Reactions in Dementia and Alzheimers

Normal utilization of painkillers ‘could cut Alzheimer’s hazard by a quarter. The standard utilization of ibuprofen, headache medicine and other non-steroidal calming drugs lessens the danger of building up the infection. Individuals to begin taking once again the-counter torment solutions for avoid dementia. There are likewise reactions, for example, an expanded shot of dying, which should be considered. Likewise, it isn’t known how the medications secure the mind. Nonetheless, the SALA drugs, which incorporate the normally utilized medications diclofenac and ibuprofen, were not any more compelling than the other non-SALAs, for example, naproxen or headache medicine.

Dementia Pain

A painkiller normally utilized by individuals living with dementia could aggravate manifestations, as per analysts who discovered it was connected to an expansion in dangerous reactions including sedation and disarray. The painkiller buprenorphine is an opioid that is accessible in a few structures, including as a fix that conveys the medication through the skin. It is thought to bring about less symptoms than morphine, with the additional advantage that it can be given to individuals who experience issues gulping. In the UK there around 850,000 individuals living with dementia; in Norway, somewhere in the range of 10% and 15% of individuals with dementia are recommended the buprenorphine fix.Effects of pain killer

The result reveal that, contrasted and those given the fake treatment fix, those utilizing the buprenorphine fix were 24 times more prone to drop out of the preliminary, in the wake of considering factors including age, sex, agony and dejection. They were additionally more prone to have an undesirable reaction

 

Bipolar disorder with substance use disorders.

blog image bipolarSubstance use in persons with bipolar disorder (BPD) is known to have high  risk of hospitalization and suicide. Two third of persons with bipolar disorder (BPD) have substance use disorders and out of that more than 50% are alcohol dependent. Of those who have substance use disorders more than one third of them are poly substance disorder patients.). Usage Alcohol and Khat are the poly substance use disorder in more than one third of patients and in nicotine and khat use disorders. Study identified that they are three common substance use disorder in bipolar disorder are alcohol, khat and nicotine use disorders. According to different studies 50%-60% of persons with bipolar disorder (BPD) are alcohol dependent .According to most studies addiction to alcohol is the most common form of substance abuse in people with bipolar disorder. Based on  different evidences up to 50% of persons with bipolar disorder have khat use disorder which  occurs together with other substance use disorders including alcohol, nicotine and cannabis.  Researchers also identified that of bipolar disorder patients up to 40% them have alcohol use disorders and up to 1.5% have cannabis use disorders. Substance  use disorder mainly observed in males, younger, separate and divorce and among patients with illiterate. Evidences indicated that substance abuse can make treatment for bipolar disorder (BPD) less effective. Substance use disorders with bipolar disorder are known to have difficult treatment and increase the hospital stay. And people who abuse drugs are less likely to follow their treatment plan.

ARBD- Alcohol-related brain damage diagnosis and What are the Links between Alcohol and Dementia?

Alcohol related Brain Damage is a mind issue caused by consistently drinking excessively liquor more than quite a long while. A few people routinely drink significantly more elevated amounts than the suggested furthest reaches of liquor. The second way that liquor abuse prompts ARBD is by causing thiamine insufficiency. Liquor related mind harm can’t be dependably analyzed except if the individual has quit drinking liquor for a little while, to empower the indications of liquor inebriationand withdrawal to determine. A man’s evaluation for suspected ARBD takes after comprehensively an indistinguishable stride from for dementia. The specialist will do a full physical examination and take a definite history from the individual and somebody who knows them well if conceivable. A mind output may likewise be required. This may preclude other conceivable reasons for side effects (eg stroke, drain, tumor).

Dementia

ARBD and Alzheimer’s illness have comparative side effects since they both influence the cholinergic framework, which assumes a critical part in memory. While analysts presently comprehend that Alzheimer’s, Disease isn’t caused by ARBD, the two prompt comparative impacts by lessening the mind in certain comparative ways. Individuals who have a type of dementia, regardless of whether caused by liquor utilize scatter or not, are probably going to endure more genuine memory misfortune on the off chance that they devour liquor. To a limited extent, this is caused by responses between dementia prescriptions, different drugs for different sicknesses, and liquor. It can likewise be caused by liquor itself, particularly in the later phases of dementia. Senior natives who knocked back the firewater two times every month were 147 percent will probably encounter subjective decrease and 146 percent more prone to have more memory issues contrasted with the individuals who did not drink.  ARBD should be diagnosed if the individual has disabled memory, considering or thinking which is sufficiently terrible to influence everyday life, together with an ongoing history of quite a loDementia Conference - 2018ng while of liquor abuse. If their condition keeps on exacerbating, they might be determined to have a type of dementia, for example, Alzheimer’s ailment. As indicated by the side effects, the specialist may analyze Wernicke-Korsakoff disorder, Korsakoff’s alcoholic psychosis, alcoholic dementia, liquor amnestic disorder, incessant alcoholic mind disorder or another condition.

Mutations in ANT1 gene causes risk of Bipolar Disorder

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Mutations or changes in DNA structure i.e., ANT1  causes a risk of bipolar disorder is due to serotonin and mitochondrial signalling in the brain involve in bipolar disorder. There is a connection between levels of the mitochondrial dysfunction and serotonin had not been identified. Other study reported that mitochondrial dysfunction affects the activity of serotonergic neurons in mice with mutations of ANT1 and other research suggest that mitochondrial dysfunction can alter activity of serotonergic neurons in bipolar disorder

On average of 20% of patients observed with mitochondrial disease having bipolar disorder, a major psychiatric disease characterized by manic and depressive episodes. Altering serotonin function might be involved in bipolar disorder because drugs that target serotonin levels can effectively treat the condition. The study started by identifying mutations or changes in DNA structure i.e., ANT1  in patients with bipolar disorder. When Compared with non-mutant mice and mutant mice, the mitochondria in these knockout mice unable to retain calcium and had leaked pores. The ANT1-mutant mice contain elevated serotonin turnover in their brains. Due to this hyper-serotonergic state causes the loss of the ANT1 gene and the resulting dysfunctional mitochondria. Enhanced serotonergic activity may then further impair mitochondria cycle.

Reduction of Serotonergic neurons was found in a brain area called the dorsal raphe, which is also observed in Parkinson’s disease–another condition that may show in mitochondrial dysfunction. So, mutations in ANT1  does not cause bipolar disorder, but I sows high risk. This research highly helpful for the mitochondrial dysfunction and helps to reduce bipolar disorder more effectively than present available serotonin-targeting drugs.

Psychosis and the brain

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Psychosis is a symptom of some of mental health issues, along with schizophrenia and psychotic depression. Characterised with the aid of hallucinations and delusions, psychosis is a hard situation to recognize, deal with, and, importantly, expect. Those who present with psychotic signs and symptoms do no longer always pass directly to broaden acute psychosis. But, it is difficult to expect whose symptoms will continue and worsen. People can and do get over acute psychosis, but timing is fundamental. The earlier remedy starts, the better the outcome is in all likelihood to be. For that reason, locating a manner to catch the ones at maximum danger of developing acute psychosis is critical. Brain folds cortex.

Earlier work has mounted that psychosis is, at the least in part, because of faulty communique among components of the mind. Current imaging has made it feasible to visualize those damaged pathways. but, in spite of upgrades in information, a way to distinguish individuals whose situation will enhance to acute psychosis has remained elusive.

Different researches have searched for changes in the extent of local gray matter inside the brain. Even though changes in people with psychosis had been measured, it appears that evidently they could arise previous to psychosis starting, all through onset, or after psychosis has begun. This makes its power of prediction particularly weak. Recently, researchers revisited this problem. They centred at the gross anatomy of the mind. Mainly, they had been interested in the folds on the surface of the brain, or the cortex.

The improvement of these convoluted lumps and bumps on the cortex is referred to as gyrification. The folds are referred to as gyri, and the troughs in-between are referred to as sulci. The manner of gyrification is finished in the first 2 years of existence and, from then on, the structures continue to be incredibly constant.

The researchers targeted their research on the interaction between the gyri; they were on the hunt for any measurable impairments or changes in verbal exchange in high-danger people. They hoped to locate enough variations in cortical communication to make the early prognosis of psychosis a opportunity.

For the examine, they assessed the brains of over 160 members. These had been 44 healthful controls, 38 folks that had skilled their first psychotic episode, and seventy nine individuals who have been at high hazard of developing acute psychosis. Of the seventy nine excessive-danger individuals, 16 went directly to expand acute psychosis.