Matt Wilsey

Causes and Treatment of Bipolar Disorder

Someone who is bipolar has a disorder that causes changes in mood, energy,

activity levels and the ability to carry out everyday tasks. Two major symptoms of

bipolar disorder are depression and mania. Millions of people suffer from bipolar

disorders in the united states and there are many believed causes of the condition.

There are many possible causes to bipolar disorder but there are also many forms of

treatment.

The brain has many chemical processes that make it function including what

is called calcium signaling. Michael J. Berridge wrote an article called Calcium

signaling and psychiatric disease: bipolar disorder and schizophrenia where he

describes the purpose of calcium signaling as Neurons have highly developed

Ca2+ signaling systems responsible for regulating many neural functions such as

the generation of brain rhythms, information processing and the changes in

synaptic plasticity that underpins learning and memory (Berridge). Berridge also

says The Ca2+ signaling pathway is a key component of the mechanisms

responsible for regulating neuronal excitability, information processing and

cognition (Berridge), which means the process is important for regulating

emotions. Without calcium signaling, a person would have trouble controlling

emotions and doing daily tasks. Changes in neuronal signaling mechanismscan be

connected to many diseases and Berridge backs it up with dysregulation of the

Ca2+ signaling pathway has been implicated in the development of some of the

major psychiatric diseases such as bipolar disorder (BPD) and schizophrenia

(Berridge). A lack of regulation can cause the inability to control emotions, and the

ability to perform day to day tasks, and has direct correlation with bipolar disorder.

A possible treatment for bipolar disorder is a L-type calcium channel (LTCC)

antagonist which can regulate calcium signals. The use of LTCC antagonists has

been used in bipolar treatment for over 30 years and could be still relevant; in an

article for Molecular Psychiatry titled A systematic review of calcium channel

antagonists in bipolar disorder and some considerations for their future

development the author talks about the possible future use of the drug Interest in

this class of drugs has been rekindled by the discovery that LTCC genes are part of

the genetic aetiology of bipolar disorder and related phenotypes (Molecular

Psychiatry). This type of treatment may look promising but it appears treatment for

people with bipolar disorder is a case by case solution and what works for some

doesnt work for others. One issue with bipolar disorder is depression and treatment

for that can very. Antidepressant drugs are common use but are not always

accepted as the best treatment. In an article written by John R Geddes and David J

Miklowitz for the journal The Lancet titled Treatment of bipolar disorder they say

considerable uncertainty and controversy remains about the use of antidepressant

drugs in the management of depressive episodes (Geddes and Miklowitz). Another

symptom of bipolar disorder that needs treatment on its own is mania. Mania is a

state of heightened energy which is the opposite to depression, and those in a

manic state can be more susceptible to emotions like anger. While taking

antidepressants help with depression, many believe they heighten mania, but some

researchers argue against that claim. In an article in the journal titled American

Journal of Psychiatry titled Monotherapy Antidepressant Treatment is Not

Associated with Mania in Bipolar I Disorder the writer says the risk of mania for
patients taking antidepressants long-term compared with those not taking

antidepressants was actually reduced by 32% (American Journal of Psychiatry).

According to the American Journal of Psychiatry antidepressants have no effect on

heightened mania and antipsychotic drugs have no effect on depression. Geddes

and Miklowitz say antipsychotic drugs are an effective treatment for mania but fail

to help with depression (Geddes and Miklowitz). The perfect treatment for someone

suffering from bipolar disorder is not known but Geddes and Miklowitz say Long-

term maintenance and possibly acute stabilisation of depression can be enhanced

by the combination of psychosocial treatments with drugs (Geddes and Miklowitz).

One of the most common treatments for bipolar disorder is Lithium drugs. In an

article in the journal CNS drugs titled Potential Mechanisms of Action of Lithium in

Bipolar Disorder the writer talks about the uses of lithium drugs by saying

numerous studies report that lithium is effective in the treatment of acute mania

while also saying evidence for its efficacy in depression is modest (CNS Drugs).

While lithium drugs seem to help with mania, it still does not prove to completely

help with depression. A combination of multiple treatments where there is

something for each issue could work for people who are bipolar and appears to be

their best option.

The bipolar disorder has many possible treatments but none are a solid

solution. Patients usually are prescribed lithium drugs, antidepressants, or

antipsychotics which tend to help one of the many issues being bipolar causes.

There is no medicine that can treat all of the symptoms so patients often have to

take multiple kinds of treatment. An issue with finding a solid solution is not

knowing exactly what causes the disorder and there are many reasons why

someone can be diagnosed as being bipolar.

 References

Berridge, M.J. Cell Tissue Res (2014) 357: 477. doi:10.1007/s00441-014-1806-

Cipriani, A., K. Saunders, M-J Attenburrow, J. Stefaniak, P. Panchal, S.

Stockton, T. A. Lane, E. M. Tunbridge, J. R. Geddes, and P. J. Harrison. "A Systematic

Review of Calcium Channel Antagonists in Bipolar Disorder and Some

Considerations for Their Future Development." Molecular Psychiatry 21.10 (2016):

1324-332. Web. 20 Apr. 2017.

Geddes, John R., and David J. Miklowitz. "Treatment of Bipolar Disorder." The

Lancet 381.9878 (2013): 1672-682. Sciencedirect.com. Web. 20 Apr. 2017.

Malhi, G.S., Tanious, M., Das, P. et al. CNS Drugs (2013) 27: 135.

doi:10.1007/s40263-013-0039-0

"Monotherapy Antidepressant Treatment is Not Associated With Mania in

Bipolar I Disorder." American Journal of Psychiatry, 172(6), p. 586