Bipolar or Bi-Winning?

By Tyger Latham, Psy.D.


Charlie Sheen’s very public unravelling recently had many people questioning whether the actor may be experiencing some type of manic break.  After months of tabloid drama, the Two and Half Men star went on ABC’s Good Morning America and spoke candidly about his erratic behavior.  He described himself as a “total freaking rock star from Mars” and in almost the same breath, referred to himself as a “Vatican assassin warlock.”  Sheen was also honest about his drug use, stating at one point that he had abused drugs, including “a drug called Charlie Sheen.” 

It’s hard to say for sure whether Sheen is bipolar.  Such diagnoses should only be made after reviewing a patient’s full medical history and ruling out other possible medical explanations.  With that said, Sheen is certainly exhibiting many of the symptoms we commonly associate with the disorder.  When asked if he was bipolar, Sheen responded, “What does that mean?  I’m bi-WINNING.”  And truth be told, he might be right.  There are several health conditions that often mirror the symptoms associated with mania.  It’s not unheard of for individuals with similar drug histories such as Sheen’s to undergo drug-induced psychoses; likewise, withdrawal from many drugs can look a lot like mania.  Whatever Sheen is dealing with, however, one thing is clear: the guy needs help.

Bipolar Disorder is a disorder often misunderstood but frequently associated with creative individuals like Charlie Sheen.  In her book, Touched with Fire, Kay Jamison, Ph.D. has suggested that many artistic geniuses have suffered from bipolar disorder and argues the mood swings associated with the disorder are in fact an important component of these artists’ creativity.

There have been quite a few Hollywood celebrities over the years believed to be bipolar.  Marilyn Monroe, for example, was known to have struggled with erratic mood swings, leading some to speculate she might have had the condition.  The American actresses Carrie Fischer and Linda Hamilton have also publicly acknowledged their struggles with the disorder.  Linda Hamilton, known for her commanding performance in the Terminator movie saga, revealed she was diagnosed only after 10 years of “amazing brilliant” highs and lows that felt “like falling into a manhole and not being able to climb out no matter what.”  She says she now has the disorder under control and reports her quality of life has improved dramatically.     

Likewise, there have been several prominent artists and writers known to have suffered from the condition.  Vincent van Gogh often wrote to his brother, Theo, that his artistic output often fluctuated with his mood.  When his spirits were up, van Gogh reported being able to paint with fervor; when down he described being paralyzed with fear.  The poet Emily Dickinson is another artist believed to have been bipolar.  In a study published in the American Journal of Psychiatry, John McDermott, MD examined Dickinson’s writing and persuasively concluded that the poet’s productivity closely correlated with her significant mood swings.

So, what are the signs a person might be bipolar?  Bipolar is not a diagnosis to be made lightly; however, here are a few of the most common symptoms associated with the disorder:

1. Great mood. The disorder is associated with highs and lows and it is the highs that are the hallmark.  Mania is more than just feeling good; it is almost always associated with poor reality testing and grandiosity.

2. Inability to complete tasks. Starting and never completing tasks, particularly ones that are overly ambitious, is another hallmark of the disorder.  People who are manic often go from one unrealistic project to another, never completing any of them.

3. DepressionThe flip-side of mania is depression and when people “come down” from their mania, they can sometimes experience bouts of depression that are every bit as intense.

4. Irritability. Some people with bipolar suffer from what is referred to as “mixed mania,” in which they experience symptoms of mania and depression at the same time, often resulting in intense irritability.

5. Rapid speech. “Pressured speech” is one of the most common symptoms of the disorder.  If you have ever sat with a bipolar individual, you will discover quickly that it is nearly impossible to get a word in edgewise.

6. Alcohol and/or drug use. About half of all bipolar individuals are believed to have a substance abuse problem.  In many cases, alcohol and drugs are used. 

7. Erratic behavior. When manic, people often exhibit an inflated sense of self-worth, causing them at times to become impulsive.

8. Irregular sleep. People who are manic often have less need for sleep.  In fact, establishing a regular sleep schedule is one of the first things doctors recommend for bipolar patients.

9. Flight of ideas. Bipolar individuals often complain of having racing thoughts that they cannot slow down.

If you suspect you or someone you know is bipolar there is help.  People who suffer from this disorder often respond well to medication.  In my experience, this disorder is definitely manageable because of its generally positive response to mood stabilizers such as lithium.  In addition, it is important people with the disorder maintain a healthy lifestyle of eating properly, sleeping, and exercise.  Finally, seeing a therapist, one who is knowledgeable and trained in mood disorders such as bipolar, can be beneficial in helping a person manage their symptoms.

Source Psychology Today

For Some, Food ‘Addiction’ Similar to Substance Abuse

By RICK NAUERT PHD


People with eating behaviors that resemble addiction appear to have greater neural activity in certain regions of the brain similar to that of substance abusers, including a heightened response in reward circuitry to food cues — more powerful cravings, in other words.

In a study posted online that will appear in the August print issue of Archives of General Psychiatry, researchers used functional magnetic resonance imaging (fMRI) to study the response of 48 healthy young women in response to cues signaling impending delivery of a highly palatable food (chocolate milkshake) vs. a tasteless control solution; and consumption of a chocolate milkshake vs. a tasteless solution.

The women ranged from lean to obese and had been recruited for a healthy weight maintenance trial. Their eating behavior was assessed using a food addiction scale developed by lead author Ashley Gearhardt, a doctoral student at Yale University.

“Similar patterns of neural activation are implicated in addictive-like eating behavior and substance abuse and dependence,” Gearhardt noted in the study.”Food and drug use both result in dopamine release in mesolimbic regions [of the brain] and the degree of release correlates with subjective reward from both food and drug use.”

Gearhardt and colleagues found that participants with higher food addiction scores showed more activity in brain areas linked with craving. “These findings support the theory that compulsive food consumption may be driven in part by an enhanced anticipation of the rewarding properties of food,” the authors write. “Similarly, addicted individuals are more likely to be physiologically, psychologically, and behaviorally reactive to substance-related cues.”

The researchers said that if certain foods are addictive for some people, that could explain in part why they find it so hard to lose weight and keep it off.

While researchers have speculated that an addictive process may be involved in obesity, the authors said that this is the first study to identify distinctive neural or brain activity in people with addictive eating behavior.

In addition, Gearhardt said, ”If food cues take on enhanced motivational properties in a manner analogous to drug cues, efforts to change the current food environment may be critical to successful weight loss and prevention efforts. Ubiquitous food advertising and the availability of inexpensive palatable foods may make it extremely difficult to adhere to healthier food choices because the omnipresent food cues trigger the reward system.”

Source PsychCentral

Teens Who Choose Music Over Books Are More Likely to Be Depressed, Study Finds

By ScienceDaily


Adolescents who spend more time listening to music are far more likely to have major depressive disorder, while young people who spend more time reading books are far less likely to have such a diagnosis, according to a University of Pittsburgh School of Medicine study published in the April edition of the journal Archives of Pediatric and Adolescent Medicine.

The findings add to the growing body of research linking emotional health to media exposure. The study was unique in that it was one of the first to measure media exposure using an intensive “real-life” methodology called ecological momentary assessment, in which the behaviors of study participants are repeatedly sampled in real time. The method is more reliable than standard surveys and helped researchers recognize this large association between exposure to music and depression, said Brian Primack, M.D., Ed.M., M.S., assistant professor of medicine and pediatrics at Pitt’s School of Medicine, who led the study.

The study involved 106 adolescent participants, 46 of whom were diagnosed with major depressive disorder. Researchers called the participants as many as 60 times during five extended weekends over two months and asked them to report if they were using any of six types of media: television or movies, music, video games, Internet, magazines or newspapers, and books.

The researchers found that young people who were exposed to the most music, compared to those who listened to music the least, were 8.3 times more likely to be depressed. However, compared to those with the least time exposed to books, those who read books the most were one-tenth as likely to be depressed. The other media exposures were not significantly associated with depression.

“At this point, it is not clear whether depressed people begin to listen to more music to escape, or whether listening to large amounts of music can lead to depression, or both. Either way, these findings may help clinicians and parents recognize links between media and depression,” Dr. Primack said. “It also is important that reading was associated with less likelihood of depression. This is worth emphasizing because overall in the U.S., reading books is decreasing, while nearly all other forms of media use are increasing.”

Major depressive disorder, also referred to as clinical or major depression, is the leading cause of disability in the world. Its onset is common in adolescents and is thought to affect one in 12 teenagers, according to the National Institute of Mental Health.

Source ScienceDaily

Yoga May Benefit People With Abnormal Heart Rhythms

By HUFFPOST LIVING


Rigorous practice of yoga can help reduce episodes of irregular heartbeat and improve the symptoms of anxiety and depression often associated with atrial fibrillation, a new study has found.

On average, yoga cut patients’ episodes of atrial fibrillation in half and significantly improved quality of life, according to research presented today at the American College of Cardiology’s 60th Annual Scientific Session.

Previous research has demonstrated the positive impact of yoga on overall heart health, but this is the first study to examine the benefits of yoga specifically on patients with atrial fibrillation.

“The practice of yoga is known to improve many risk factors for heart disease including high blood pressure, high cholesterol, hardening of the arteries, and stress and inflammation in the body,” said Dhanunjaya Lakkireddy, M.D., associate professor of medicine and director of the Center for Excellence in Atrial Fibrillation, Cardiovascular Research Institute, Mid America Cardiology, University of Kansas Hospital, Kansas City, Kansas and lead investigator of the study. “There are currently no proven complementary therapies that are known to help decrease the symptoms of atrial fibrillation in a noninvasive fashion with minimal side effects and reasonable safety and efficacy.”

In this study, researchers followed 49 patients with atrial fibrillation who had no physical limitations and who were new to the practice of yoga. For three months, participants were permitted to engage in any type of physical activity they were previously accustomed to doing. This was followed by a three-month period during which they participated in a supervised yoga program consisting of breathing exercises, yoga postures, meditation and relaxation. Forty-five-minute yoga sessions were administered by a certified professional three times a week. Participants were also given an educational DVD and encouraged to practice the exercises at home on a daily basis, depending on their comfort levels.

Lakkireddy found that the three-month yoga intervention significantly reduced the number of episodes of irregular heartbeat among atrial fibrillation patients compared with the initial three-month period during which subjects were participating in the physical activity of their choice. Yoga also reduced self-reported depression and anxiety scores and improved quality of life scores in the areas of physical functioning, general health, vitality, social functioning and mental health.

“These findings are important because many of the current conventional treatment strategies for atrial fibrillation include invasive procedures or medications with undesirable side effects. Success with these therapies varies widely, and they are often only modestly effective in controlling heart rhythm,” Lakkireddy said. “It appears yoga has a significant impact on helping to regulate patients’ heartbeat and improves their overall quality of life. Any intervention that helps in reducing or controlling the arrhythmia burden in atrial fibrillation can have a huge impact on public health.”

Given the low cost, safety and effectiveness of yoga, the authors recommend that it be considered in the overall treatment strategy for atrial fibrillation and other complex heart rhythm disorders.

Source Huffington Post

Zombieland

By Emily Deans, M.D


Back in the day we ate a lot of brains. Stands to reason. All animals come with one, after all. And we certainly wouldn’t leave behind such a great source of important fat. You don’t think we just took the skinless boneless chicken breast and left the rest behind, did you?  In fact, anthropologic data suggests that the opposite is true – we preferentially grabbed the fatty bits (marrow, organ meats, fatty meat), and that we would also seek to hunt for particular animals in season when they were fattiest.  In fact if you were fastidious and ate only the lean meat, you might succumb to so-called “rabbit starvation,” where you have plenty of protein but suffer from malnutrition and hunger. Humans cannot live on protein alone.

Have you seen the movie Zombieland? I highly recommend it if you are into a bit of gore and fun, and while the dietary advice isn’t necessarily paleo, the exercise discussions take a functional fitness turn… (that last link is not entirely “safe for work,” as they say, due to some foul language).

Zombies might be lacking in variety with their chosen food, but they certainly wouldn’t be lacking in micronutrients and omega 3s! Brains are also an especially rich source of phospholipids, one of which, phosphatidylserine, was mentioned by a commenter on my other blog. She seems to have had luck with it helping her joint pain and fatigue. Terrific! But why?

Well, phospholipids are found in many foods, but the highest concentrations are in brains, seafood, and some organ meats. When one looks back at different hunter-gatherers roaming the world, they would tend to eat a lot of seafood, or they ate a lot of large land-roving mammals, or both. It would make sense that today we might have a lot less phospholipid intake compared to our evolutionary past. In fact, today’s foods contain about 1/3 the amount of phospholipids they did even at the beginning of the 20th century (1).

Research in phospholipids was heating up in the 80s and 90s, but then a little illness came along called mad cow disease, and since the major source of phospholipids for supplements was cow brain, things slowed down for a while until an alternative soy source was found. Not surprisingly, the soy sourced supplement is somewhat different than the animal sourced one, but looks like from perusing pubmed that almost all the latest research was done with the soy version. If you are not fond of soy, krill oil combines omega 3 and phospholipids, and since krill (or the algae they eat) are the food for marine animals from which many ancient humans got their phospholipids, it would certainly be a more evolutionarily pedigreed source than soy. Not keen on krill or pills in general? Eggs and chicken and beef heart have tons of choline, the precursor of the phospholipid phosphatidylcholine.

Phospholipids are necessary to form cell membranes and to form the particles that carry cholesterol around in the blood stream.  Who cares?  Well, if we don’t have enough of the precursors to make the phospholipids, the fat will get stuck in our livers, leading to the aptly named fatty liver.  Lack of choline, for example, has been associated with both fatty liver and the development of diabetes.  You might be interested to know that women eating the standard American diet have insufficient choline intake, and that the small percentage eating enough choline get it from eating an unusually high number of eggs.

But what does the research show about our brains and muscles? Do we suffer as human beings because we’ve greatly reduced our phospholipid intake, especially in the last century? Well, in sports performance studies, phospholipids can help reduce pain and speed up recovery. And supplementation can result in a statistically significant improvement in your golf shot (2). A study of memory and cognition in the elderly didn’t show any improvement using the soy-derived versions (3), though other earlier studies showed positive effects. But the most intriguing part of the research is when you find out that ingestion of phospholipids has been found to reduce increases in ACTH and cortisol in response to stress(4).  That is remarkable – it would imply that having plenty of phospholipids on board would diminish our total hormonal stress response, and decrease the damaging effects of chronic stress along the way.  Effects that would include an increased vulnerability to depression, anxiety, diabetes, and heart disease.

I’ve always wondered why we modern humans are considered so “stressed.” I mean, sure, we are probably way more stressed than the majority of our ancestors who worked obtaining food 17 hours a week and otherwise hung out and told stories and played games. But the most accepted pathophysiologic model for major depressive disorder and other mental illness is the stress diathesis model. Meaning stress combined with genetic vulnerability changes your brain and causes your symptoms. There’s a lot of research support for this model and it makes a great deal of sense. BUT. Mental illness has been increasing over the 20th and 21st centuries, especially depression. Maurizio Fava MD said in a lecture it is increasing on the order of 10% in each generation since the 1950s. That is HUGE. We know this (in America at least) from epidemiological catchment studies (5) done since the beginning of the 20th century.

But are we really more and more stressed? In the first 50 years of the 20th century, there were two world wars. Millions of people died from flu epidemics, and when my mother was a child, there was still constant fear of polio. By the 60s we were worried about global nuclear annihilation. Sure, now I have to remember 40 different passwords and traffic is pretty rotten, and we worry about terrorism and natural disasters and relatives with chronic illness, and men and women are still fighting wars, but is that more stressful than what families faced in the last century? Ot the centuries before, also ridden with war, plague, and famine?

I don’t think stress has changed so much, at least in recent history. Agricultural humans have always been unhealthy and stressed, and I don’t see how increases in cardiovascular disease and mental illness over the past 100 years could be explained *strictly* by a stress (cortisol) model.

I contend (as many do) that the MAJOR change in the last 100 years has been our industrialized diets. Agriculture is one thing, and not good for human health (though it did beef up human fertility). But industrialization of the food supply, I believe, is the primary causative factor in our modern physical diseases and our modern decline in mental health.

And here we have a bit of evidence that may bring diet and stress together at last. Phospholipid supplementation, in a few studies, decreases our stress response, especially to emotional stress. Imagine day after day of munching on mammal brains or atlantic herring, rich in phospholipids, and thus (if one believes the research) having a blunted hormonal response to emotional and physical stressors, compared to our relatively phospholipid deficient diets of today. Modern disease pathology is all about the cortisol, as much as it is all about the insulin.

We are built for eating brains and/or seafood (or eggs).  Ancestral migration patterns would seem to suggest that is the case. The farther we stray from achieving the micronutrient richness of our ancestral diets, the more we seem to suffer.

Source Psychology Today