Bipolar Disorder

[DLD]

Bipolar I Disorder is one of the most severe forms of mental illness and is characterized by recurrent episodes of mania and (more often) depression. The condition has a high rate of recurrence and if untreated, it has an approximately 15% risk of death by suicide. It is the third leading cause of death among people aged 15-24 years, and is the 6th leading cause of disability (lost years of healthy life) for people aged 15-44 years in the developed world.

Causation
Bipolar I Disorder is a life-long disease and runs in families but has a complex mode of inheritance. Family, twin and adoption studies suggest genetic factors. The concordance rate for monozygotic (identical) twins is 43%; whereas it is only 6% for dizygotic (nonidentical) twins. About half of all patients with Bipolar I Disorder have one parent who also has a mood disorder, usually Major Depressive Disorder. If one parent has Bipolar I Disorder, the child will have a 25% chance of developing a mood disorder (about half of these will have Bipolar I or II Disorder, while the other half will have Major Depressive Disorder). If both parents have Bipolar I Disorder, the child has a 50%-75% chance of developing a mood disorder. First-degree biological relatives of individuals with Bipolar I Disorder have elevated rates of Bipolar I Disorder (4%-24%), Bipolar II Disorder (1%-5%), and Major Depressive Disorder (4%-24%).

The finding that the concordance rate for monozygotic twins isn't 100% suggests that environmental or psychological factors likely play a role in causation. Certain environmental factors (e.g., antidepressant medication, antipsychotic medication, electroconvulsive therapy, stimulants) or certain illnesses (e.g., multiple sclerosis, brain tumor, hyperthyroidism) can trigger mania. Mania can be triggered by giving birth, sleep deprivation, and major stressful life events.

Symptoms
In adults, mania is usually episodic with an elevation of mood and increased energy and activity. In children, mania is commonly chronic rather than episodic, and usually presents in mixed states with irritability, anxiety and depression. In adults and children, during depression there is lowering of mood and decreased energy and activity. During a mixed episode both mania and depression can occur on the same day.

Comorbidity
Comorbidity is the rule, not the exception, in bipolar disorder. The most common mental disorders that co-occur with bipolar disorder are anxiety, substance use, and conduct disorders. Disorders of eating, sexual behavior, attention-deficit/hyperactivity, and impulse control, as well as autism spectrum disorders and Tourette's disorder, co-occur with bipolar disorder. The most common general medical comorbidities are migraine, thyroid illness, obesity, type II diabetes, and cardiovascular disease.

Associated Mental Disorders
Bipolar I Disorder is often associated with: alcoholism, drug addiction, Anorexia Nervosa, Bulimia Nervosa, Attention-Deficit Hyperactivity Disorder, Panic Disorder, and Social Phobia.

Diagnostic Tests
There are no diagnostic laboratory tests for Bipolar I Disorder. Thus diagnosis is arrived at by using standardized diagnostic criteria to rate the patient's behavior.

Differential Diagnosis
Bipolar I Disorder must be distinguished from:

Mood Disorder Due to a General Medical Condition (e.g., due to multiple sclerosis, stroke, hypothyroidism, or brain tumor)

Substance-Induced Mood Disorder (e.g., due to drug abuse, antidepressant medication, or electroconvulsive therapy)

Other Mood Disorders (e.g., Major Depressive Disorder; Dysthymia; Bipolar II Disorder; Cyclothymic Disorder)

Psychotic Disorders (e.g., Schizoaffective Disorder, Schizophrenia, or Delusional Disorder)

Since this disorder may be associated with hyperactivity, recklessness, impulsivity, and antisocial behavior; the diagnosis of Bipolar I Disorder must be carefully differentiated from Attention Deficit Hyperactivity Disorder, Conduct Disorder, Antisocial Personality Disorder, and Borderline Personality Disorder

Pathophysiology

The pathophysiology of Bipolar I Disorder is poorly understood. However, a variety of imaging studies suggests the involvement of structural abnormalities in the amygdala, basal ganglia and prefrontal cortex. Research is now showing that this disorder is associated with abnormal brain levels of serotonin, norepinephrine, and dopamine.

Prevalence
Bipolar I Disorder affects both sexes equally in all age groups and its worldwide prevalence is approximately 3-5%. It can even present in preschoolers. There are no significant differences among racial groups in the prevalence of this disorder.

Course
The first episode may occur at any age from childhood to old age. The average age at onset is 21. More than 90% of individuals who have a single Manic Episode go on to have future episodes. Untreated patients with Bipolar I Disorder typically have 8 to 10 episodes of mania and depression in their lifetime. Often 5 years or more may elapse between the first and second episode, but thereafter the episodes become more frequent and more severe.

There is significant symptom reduction between episodes, but 25% of patients continue to display mood instability or mild depression. As many as 60% of patients experience chronic interpersonal or occupational difficulties between acute episodes. Bipolar I Disorder may develop psychotic symptoms. The psychotic symptoms in Bipolar I Disorder only occur during severe manic, mixed or depressive episodes. In contrast, the psychotic symptoms in Schizophrenia can occur when there is no mania or depression. Poor recovery is more common after psychosis.

Manic episodes usually begin abruptly and last for between 2 weeks and 4-5 months (median duration about 4 months). Depressive episodes tend to last longer (median length about 6 months), though rarely for more than a year, except in the elderly.

Treatment And Outcome
The usual treatment for Bipolar I Disorder is lifelong therapy with a mood-stabilizer (either lithium, carbamazepine, or divalproex / valproic acid) often in combination with an antipsychotic medication. Usually treatment results in a dramatic decrease in suffering, and causes an 8-fold reduction in suicide risk. In mania, an antipsychotic medication and/or a benzodiazepine medication is often added to the mood-stabilizer. In depression, an antidepressant medication and/or lamotrigine is often added to the mood-stabilizer. Since antidepressant medication can trigger mania, this medication should always be combined with a mood-stablizer or antipsychotic medication to prevent mania.

Research has shown that the most effective treatment is a combination of supportive psychotherapy, psychoeducation, and the use of a mood-stabilizer (often combined with an antipsychotic medication). There is no research showing that any form of psychotherapy is an effective substitute for medication. Likewise there is no research showing that any "health food store nutritional supplement" (e.g., vitamin, amino acid) is effective for Bipolar I Disorder.

Since a Manic Episode can quickly escalate and destroy a patient's career or reputation, a therapist must be prepared to hospitalize out-of-control manic patients before they "lose everything". Likewise, severely depressed, suicidal bipolar patients often require hospitalization to save their lives.

Although the medication therapy for Bipolar I Disorder usually must be lifelong, the majority of bipolar patients are noncompliant and stop their medication after one year. At 4-year follow-up of bipolar patients, 41% have a good overall outcome and 4% have died. Women with bipolar disorder lose, on average, 9 years in life expectancy, 14 years of lost productivity and 12 years of normal health

Best Recoveries
The best recoveries are achieved when individuals with Bipolar I Disorder:

Get the correct diagnosis (since many are misdiagnosed as having schizophrenia or "just borderline personality")

Get effective treatment and faithfully stay on it for a lifetime (50% need only a mood-stabilizer, but the other 50% require the combination of a mood-stabilizer and an antipsychotic medication)

Adopt a healthy lifestyle (regular sleep and exercise; no alcohol or drug abuse; low stress)

Regularly see a supportive physician who is knowledgeable about the psychiatric management of this disorder

Learn which symptoms predict the return of this illness, and what additional "rescue" medication should be taken

Learn to trust the warnings given by family and friends when they see early signs of relapse

Learn as much as possible about this illness from therapists, the Internet, books, or self-help groups

 

[b21wayne]

Doublelongdaddy, thanks for this great thread about Bipolar Disorder. I can identify with alot in it, having first been diagnosed with Bipolar I, with mixed episodes, in 1981 at the Psychiatric Institute in Wash. D.C. My father was Bipolar, as well as probably his father and grandfather. The years for me have included alot of different medications, i.e. Thorazine, Immipramine, Doxepin, Geodon, Lithium, Tegretol, Lamictal, Nuerontin, Moban, Prolixin, Wellbutrin, Trileptal, Topamax, Carbatrol and serax. The first 8 or ten years were very difficult for me, being institutionalized 9 times in 8 years, and having break through manic episodes even with therapuetic blood levels of Lithium. I was placed on Soc. Sec. Disability for about 9 years, and to be honest thought my life would never include alot of the things that others would consider normal. Things like a job, significant other, home of my own, and the ability to get out of the house much at all. My weight ballooned up over 400 pounds from using food to change my moods, and for a couple of years I would not leave the house. But with the help of some medication changes, supportive family, good psychiatric care, and learning different coping skills and strategies, my life is not the same. I am married now, have a steady job, lost over 200 pounds (though I have put back about 80 of that in the last 15 years), have not been put in a psych. unit for a long time,got a B.A. and Masters, and do function around people on a daily basis. I have been fortunate though in that I have had the same Psyhciatrist since 1989, and I think he helped a great deal, and my wife is a gem. She can put up with my cycling in moods, because even medicated I usually have runs of about 5 up days in a row and then 3 or 4 bad, most of the time, and have a bad habit of not sleeping at all one night alot of weekends. When I get really wired she just smiles at me alot. Functioning with people is still quite difficult for me, because I seem to have alot of social anxiety, and semi panic attacks. Talk about the world turning though, when I went back to school I became a social worker, because I thought I could empathize easily with others who had mental illnesses, and I ended up going back every now and then in a professional role to an institution I was once a patient in Talk about by the grace of God. Enough of my story, the bottom line is there is hope for folks that are Bipolar, I'm living testimony of that

 

[DLD]

Doublelongdaddy, thanks for this great thread about Bipolar Disorder. I can identify with alot in it, having first been diagnosed with Bipolar I, with mixed episodes, in 1981 at the Psychiatric Institute in Wash. D.C. My father was Bipolar, as well as probably his father and grandfather. The years for me have included alot of different medications, i.e. Thorazine, Immipramine, Doxepin, Geodon, Lithium, Tegretol, Lamictal, Nuerontin, Moban, Prolixin, Wellbutrin, Trileptal, Topamax, Carbatrol and serax. The first 8 or ten years were very difficult for me, being institutionalized 9 times in 8 years, and having break through manic episodes even with therapuetic blood levels of Lithium. I was placed on Soc. Sec. Disability for about 9 years, and to be honest thought my life would never include alot of the things that others would consider normal. Things like a job, significant other, home of my own, and the ability to get out of the house much at all. My weight ballooned up over 400 pounds from using food to change my moods, and for a couple of years I would not leave the house. But with the help of some medication changes, supportive family, good psychiatric care, and learning different coping skills and strategies, my life is not the same. I am married now, have a steady job, lost over 200 pounds (though I have put back about 80 of that in the last 15 years), have not been put in a psych. unit for a long time,got a B.A. and Masters, and do function around people on a daily basis. I have been fortunate though in that I have had the same Psyhciatrist since 1989, and I think he helped a great deal, and my wife is a gem. She can put up with my cycling in moods, because even medicated I usually have runs of about 5 up days in a row and then 3 or 4 bad, most of the time, and have a bad habit of not sleeping at all one night alot of weekends. When I get really wired she just smiles at me alot. Functioning with people is still quite difficult for me, because I seem to have alot of social anxiety, and semi panic attacks. Talk about the world turning though, when I went back to school I became a social worker, because I thought I could empathize easily with others who had mental illnesses, and I ended up going back every now and then in a professional role to an institution I was once a patient in Talk about by the grace of God. Enough of my story, the bottom line is there is hope for folks that are Bipolar, I'm living testimony of that

Great to hear that you have finally found some relief. My cycles are very unique to BiPolar disorder due to the extreme length of time I spend in mania or depression. My cycles, this past episode, is very consistent with the way they have always been, 12 months of Mania followed by 12-48 months of depression. Amazingly my depression may be clearing up, and only 6 months and the only change was the addition of Wellbutrin. My current medications are 200mg of Seroquel, 200 Limictal and now 300 mg of Wellbutrin. I am not better but I do see a light at the end of the tunnel, one I thought I would never see. I hate the depression with a passion and inevitably my Agoraphobia sets in which can really prolong a self-induced depression, long after the clinical depression wears off. Very tricky disorder and this does not include my OCD which is MIND BLOWING. How the hell do you think I came up with all this Penis Enlargement shit? I can obsess on something until it is perfect, this and the mania are the only two things that keep me mentally alive.

When Mania sets in, watch out because I will do some ill shit and come back with some new cure for cancer It's like that but I guess that is our gift for suffering the depression.

 

[stagestop]

Bipolar I Disorder is one of the most severe forms of mental illness and is characterized by recurrent episodes of mania and (more often) depression. The condition has a high rate of recurrence and if untreated, it has an approximately 15% risk of death by suicide. It is the third leading cause of death among people aged 15-24 years, and is the 6th leading cause of disability (lost years of healthy life) for people aged 15-44 years in the developed world.

Causation
Bipolar I Disorder is a life-long disease and runs in families but has a complex mode of inheritance. Family, twin and adoption studies suggest genetic factors. The concordance rate for monozygotic (identical) twins is 43%; whereas it is only 6% for dizygotic (nonidentical) twins. About half of all patients with Bipolar I Disorder have one parent who also has a mood disorder, usually Major Depressive Disorder. If one parent has Bipolar I Disorder, the child will have a 25% chance of developing a mood disorder (about half of these will have Bipolar I or II Disorder, while the other half will have Major Depressive Disorder). If both parents have Bipolar I Disorder, the child has a 50%-75% chance of developing a mood disorder. First-degree biological relatives of individuals with Bipolar I Disorder have elevated rates of Bipolar I Disorder (4%-24%), Bipolar II Disorder (1%-5%), and Major Depressive Disorder (4%-24%).

The finding that the concordance rate for monozygotic twins isn't 100% suggests that environmental or psychological factors likely play a role in causation. Certain environmental factors (e.g., antidepressant medication, antipsychotic medication, electroconvulsive therapy, stimulants) or certain illnesses (e.g., multiple sclerosis, brain tumor, hyperthyroidism) can trigger mania. Mania can be triggered by giving birth, sleep deprivation, and major stressful life events.

Symptoms
In adults, mania is usually episodic with an elevation of mood and increased energy and activity. In children, mania is commonly chronic rather than episodic, and usually presents in mixed states with irritability, anxiety and depression. In adults and children, during depression there is lowering of mood and decreased energy and activity. During a mixed episode both mania and depression can occur on the same day.

Comorbidity
Comorbidity is the rule, not the exception, in bipolar disorder. The most common mental disorders that co-occur with bipolar disorder are anxiety, substance use, and conduct disorders. Disorders of eating, sexual behavior, attention-deficit/hyperactivity, and impulse control, as well as autism spectrum disorders and Tourette's disorder, co-occur with bipolar disorder. The most common general medical comorbidities are migraine, thyroid illness, obesity, type II diabetes, and cardiovascular disease.

Associated Mental Disorders
Bipolar I Disorder is often associated with: alcoholism, drug addiction, Anorexia Nervosa, Bulimia Nervosa, Attention-Deficit Hyperactivity Disorder, Panic Disorder, and Social Phobia.

Diagnostic Tests
There are no diagnostic laboratory tests for Bipolar I Disorder. Thus diagnosis is arrived at by using standardized diagnostic criteria to rate the patient's behavior.

Differential Diagnosis
Bipolar I Disorder must be distinguished from:

Mood Disorder Due to a General Medical Condition (e.g., due to multiple sclerosis, stroke, hypothyroidism, or brain tumor)

Substance-Induced Mood Disorder (e.g., due to drug abuse, antidepressant medication, or electroconvulsive therapy)

Other Mood Disorders (e.g., Major Depressive Disorder; Dysthymia; Bipolar II Disorder; Cyclothymic Disorder)

Psychotic Disorders (e.g., Schizoaffective Disorder, Schizophrenia, or Delusional Disorder)

Since this disorder may be associated with hyperactivity, recklessness, impulsivity, and antisocial behavior; the diagnosis of Bipolar I Disorder must be carefully differentiated from Attention Deficit Hyperactivity Disorder, Conduct Disorder, Antisocial Personality Disorder, and Borderline Personality Disorder

Pathophysiology

The pathophysiology of Bipolar I Disorder is poorly understood. However, a variety of imaging studies suggests the involvement of structural abnormalities in the amygdala, basal ganglia and prefrontal cortex. Research is now showing that this disorder is associated with abnormal brain levels of serotonin, norepinephrine, and dopamine.

Prevalence
Bipolar I Disorder affects both sexes equally in all age groups and its worldwide prevalence is approximately 3-5%. It can even present in preschoolers. There are no significant differences among racial groups in the prevalence of this disorder.

Course
The first episode may occur at any age from childhood to old age. The average age at onset is 21. More than 90% of individuals who have a single Manic Episode go on to have future episodes. Untreated patients with Bipolar I Disorder typically have 8 to 10 episodes of mania and depression in their lifetime. Often 5 years or more may elapse between the first and second episode, but thereafter the episodes become more frequent and more severe.

There is significant symptom reduction between episodes, but 25% of patients continue to display mood instability or mild depression. As many as 60% of patients experience chronic interpersonal or occupational difficulties between acute episodes. Bipolar I Disorder may develop psychotic symptoms. The psychotic symptoms in Bipolar I Disorder only occur during severe manic, mixed or depressive episodes. In contrast, the psychotic symptoms in Schizophrenia can occur when there is no mania or depression. Poor recovery is more common after psychosis.

Manic episodes usually begin abruptly and last for between 2 weeks and 4-5 months (median duration about 4 months). Depressive episodes tend to last longer (median length about 6 months), though rarely for more than a year, except in the elderly.

Treatment And Outcome
The usual treatment for Bipolar I Disorder is lifelong therapy with a mood-stabilizer (either lithium, carbamazepine, or divalproex / valproic acid) often in combination with an antipsychotic medication. Usually treatment results in a dramatic decrease in suffering, and causes an 8-fold reduction in suicide risk. In mania, an antipsychotic medication and/or a benzodiazepine medication is often added to the mood-stabilizer. In depression, an antidepressant medication and/or lamotrigine is often added to the mood-stabilizer. Since antidepressant medication can trigger mania, this medication should always be combined with a mood-stablizer or antipsychotic medication to prevent mania.

Research has shown that the most effective treatment is a combination of supportive psychotherapy, psychoeducation, and the use of a mood-stabilizer (often combined with an antipsychotic medication). There is no research showing that any form of psychotherapy is an effective substitute for medication. Likewise there is no research showing that any "health food store nutritional supplement" (e.g., vitamin, amino acid) is effective for Bipolar I Disorder.

Since a Manic Episode can quickly escalate and destroy a patient's career or reputation, a therapist must be prepared to hospitalize out-of-control manic patients before they "lose everything". Likewise, severely depressed, suicidal bipolar patients often require hospitalization to save their lives.

Although the medication therapy for Bipolar I Disorder usually must be lifelong, the majority of bipolar patients are noncompliant and stop their medication after one year. At 4-year follow-up of bipolar patients, 41% have a good overall outcome and 4% have died. Women with bipolar disorder lose, on average, 9 years in life expectancy, 14 years of lost productivity and 12 years of normal health

Best Recoveries
The best recoveries are achieved when individuals with Bipolar I Disorder:

Get the correct diagnosis (since many are misdiagnosed as having schizophrenia or "just borderline personality")

Get effective treatment and faithfully stay on it for a lifetime (50% need only a mood-stabilizer, but the other 50% require the combination of a mood-stabilizer and an antipsychotic medication)

Adopt a healthy lifestyle (regular sleep and exercise; no alcohol or drug abuse; low stress)

Regularly see a supportive physician who is knowledgeable about the psychiatric management of this disorder

Learn which symptoms predict the return of this illness, and what additional "rescue" medication should be taken

Learn to trust the warnings given by family and friends when they see early signs of relapse

Learn as much as possible about this illness from therapists, the Internet, books, or self-help groups

Dear DLD,

For the sufferors of this condition, the overall treatment of the condition is tremendously skewed by the fact that medical professionals will use drugs that come from pharmaceutical companies rather than use common sense in thinking of how to cure the condition.

As you noted above the causation is caused mostly by problems with serotonin, (5HT in medical abbreviations) Dopamine (DP) and Norepinephrine (NE). There is more to it than that, but this is fertile ground to get started with.

Serotonin, Dopamine and Norepinephrine are NEUROTRANSMITTERS. They are part of the 12 main neurotransmitters that the body uses. There are many more neurotransmitters, but those 12 are the main ones. All three work in the brain, and many other places, to relay messages that make it to the brain.

Our nervous system is not "hard wired" as an electrical system in your house would be. In the house electrical system, you turn on a switch, and the light comes on. In the body, the electricity works in the nerve kind of like a string of dominos, with each domino that falls hitting another and another until finally, the signal makes it to the brain where it can be acted on. Only, there is a break in the system that can be called "the receptor"

At this receptor, there is a collection of neurotransmitters, that take the signal (the domino) and move it to the other side of the receptor, (neurotransmission). An analogy would be a wheelbarrow. If you have a lot of wheelbarrows, you can move a lot of domino's across the synapse (the area where the neurotrasnmitter works). If you are short on wheelbarrows (the actual nerurtransmitter) then the signal is weak, or sometimes non existant. If the signal does not make it to the brain, then that circuit is non functional, and what the information that the brain needed to get is lost.

The amount of signal that the neurotransmitter moves can be a lot, or not so much, depending upon a number of variables which we will go into. The brain does not like to have different signal strengths and to show this I used an analogy of a 10,000 track CD player. Imagine your CD player could play 10,000 tracks of separate instruments and you could hear each of the 10,000 tracks separately. Well, if one track was too loud, it would drown out a bunch of the other tracks and you would not enjoy your music. This happens in the brain as well, and since the "volume" of the "music" is controlled by the AMOUNT OF NERUOTRANSITTERS IN THE SYNAPSE (the wheelbarrows hauling the signal across the synapse) there is a volume control for each one of the tracks.

The volume control is called "UPREGULATION-DOWNREGULATION" And the good thing is, is that it is automatic. You may be familiar with this concept because the same concept is used in hormonal circuitry that the weight lifters are concerned about. Injecting a high about of anabolic steroids will tell the brain that there is too much of them in the system, and the upregulation/downregulation function in the brain will turn off, or lower the natural production of those hormones. This is the same function, just in different circuitry. The point that is important here is that like the hormonal side, the neurotransmitter side is AUTOMATIC.

OK, now this is where you are going to have to pay attention. Drug companies are in business to make a profit as their first priority. This is quite reasonable, since if they don't make a profit, they will go out of business, and we will loose the benefit of their products.

NATURAL SUBSTANCES CANNOT BE PATENTED. Ok, so Drug companies (more or less, and this is another subject) need to have PATENTS on the medications so that they can make a profit on them.

NATURAL SUBSTANCES THAT YOU SEE IN THE HEALTH FOOD STORES CANNOT MAKE A MEDICAL CLAIM UNLESS THEY HAVE PROVEN IT TO THE FDA IN EXTENSIVE AND EXPenis EnlargementNSIVE TESTING. That sounds good at first glance as none of us want to be subjected to snake oil salesmen. But now, if you want to know the benefit of any of the products that you will see marketed at the health food store, you have to KNOW WHAT THEY DO INDEPenis EnlargementNDENTLY. That is because they can't make a medical claim without the testing.

Add to this situation, DRUG COMPANIES DO NOT WANT YOU TO KNOW ANYTHING ABOUT ALTERNATIVES BECAUSE THEY WANT TO SELL YOU THEIR PRODUCTS. Well, if I ran a drug company, I might want to do the same thing, especially if my job,-bonus- career- depended on it.

The drugs that raise (at the synapse) Serotonin and Norepinephrine are in the class of drugs called ANTI DEPRESSANTS. Those neurotransmitters affect mood, and much, much more. BUT HOW THEY DO THIS IS THE CRUX OF THE MATTER.

To understand where the "conspiracy" that the drug companies engage in, we have to learn more about how the body works.

The critical item in neurotransmission is the AMOUNT OF THE NEUROTRANSMITTER AT THE SYNAPSE. To use the analogy, the amount of signal (domino's being moved across the gap in the nerve) transmitted depends on how many wheelbarrows (the neurotransmitter) that there are to move, AT THE SYNAPSE.

Since the amount of neurotransmitter is critical, and since the body makes the neruotransmitter all of the time the body must also GET RID of the neurotransmitter all the time as well. In the brain, there are four methods that the body uses to get rid of neurotransmitters. They are:

1. DIFFUSION. Basically, this means that the neurotransmitter, which floats in the brain fluid, simply floats away from the synapse (the switch area) and is no longer useful in transmitting signal.
2. GLIAL CELLS. Glial cells (neuroglia) basically EAT the neurotransmitter, rendering it inoperable as a neurotransmitter. These are located outside the receptor and work with the neurotransmitters that have diffused out of the snyapse.
3. MONOAMINE OXIDASE. (MAO) Monoamine (a single amine, with amine being a chemical description of that class of molecule) is oxidized (converted into a different substance) by MAO and this is done IN and AROUND the synapse (the synapse is the area where the neurotransmission takes place)
4. REUPTAKE. To understand reuptake, we have to go back to where the neurotransmitter is made. The final step in the creation of the neurotransmitter is made at the top of the vesicle (usually-some variation depending upon which one we are talking about). The vesicle is the store house for the neurotransmitter and to make an analogy, it is like the air bellows that one uses to fan the fire in the fireplace. It works the same way. When the body needs more neurotransmitter, the vesicel contracts, and the neurtransmitter is pushed into the synapse. When there are no, or few messages to relay, the vesicle opens and sucks a lot of that neurotransmitter BACK INTO THE VESICLE FOR REUSE LATER. So the point that is important here is the that the vesicle (bellows) expels the neurtoransmitter when needed and sucks it back (reuptake) when it is not needed.

The point above is very important for understanding how and why the modalities as pushed by the drug comanies are second rate at best.

In combatting depression there are six accepted methods for the physician. They are:
1. SSRI's Selective Serotonin Reuptake Inhibitors
2. SSNRI's Selective Serotonin and Norepiniephrine Reuptake Inhibitors
3. MAOI's Monamine Oxidase Inhibitors
4. TCA's Tri Cyclic Antidepressants
5. NRI's Norepnephrine Reuptake Inhibitors
6. Thyroid medications.

Left out is testosterone supplementation, but that is a small, and mild contributor to depression and not relevant for this discussion. Thyroid hormone supplementation is also not relevatant to this discussion.

Out of the remaining 5 items, TCA's and MAOI's are not used much because of the many side effects associated with them. The remaining 3 all involved INHIBITING REUPTAKE at the synapse.

So what is missing from this equation? That should be obvious. Reuptake is a method for removal of the neurotransmitter. So, when you inhibit reuptake, you are restricting the amount of the neurotransmitter that is being sucked back in to the storage receptacle (the vesicle), YOU ARE NOT CREATING ANY NEUROTRANSMITTER. Hmmmm, we are zeroing in on the conspiracy here.

1. All commerical anti depressants work by reducing the methods the body uses to GET RID of the neurotransmitter. NONE WORK ON ADDING MORE NEUROTRANSMITTER TO THE SYSTEM.

2. Hopefully, you are now asking yourself why this is. The answer is simple. THE PRECURSORS FOR THE CREATION OF THE NEUROTRANSMITTERS ARE ALL NATURAL SUBSTANCES AND THERFORE CANNOT BE PATENTED. Remember, to get a patent, you must invent something new. Well, our creator invented this long, long ago. The drug companies know full well that the precursor to Serotonin is 5 HTP, and that the precursor to Dompanine is L-Dopa, and that the chain of creation for Norepinephrine is L-Dopa, Dopamine to Norepinephrine. And they know that the volume of protein consumed is related to the production of all hormones and neurotransmitters. But if they tell you this, they are jeopardizing a multi billion dollar business. And actually it is really a lot worse than this, as I will explain later in this section.

Ok, now let's explore how the body MAKE'S serotonin. Serotonin starts out as the protein TRYPTOPHAN. This is one of the 20 amino acids (proteins) that the body uses to build just about everything that we are. When you eat a whole protein (meat, fish, etc) the stomach digests it, and sends to component parts to the liver. When the liver gets the Tryptophan it can do one of 4 things. It can pass it along unchanged for other uses in the body, or it can convert it through the process of HYDROXYLATION into 5 HTP, or it can convert it into two other items that are not related to this discussion.

The conversion of Tryptophan into 5HTP (which is also known as hydroxylated tryptophan-- and that makes prefect sense as the conversion is done through the process of hydroxylation) is governed by a number of things. They include:
1. The amount of tryptopan (an amino acid aka a protein) that is in your diet.
2. The amount of all the protein in your diet, as it relates to the ability of the body to make the hydroxly donor and the enzymes for conversion. Ok, that is heavy, so a hyroxyl is two hyrdorgen atoms in a particular shape. To make it a particular molecule (the hydroxyl donor) must be plentiful, and it is used in a number of different reactions, the hyroxylation of Tryptophan in only one small use for this donor molecule. Andthere are two enzyme reactions. (an enzyme is "chemical scissors") Taken in whole, this process is a par of "liver
function: and is pretty much a genetic condition.

With all of those variables, certainly a big one is liver function. As it is genetic, there is not much that can be done here. A good diet to supply the building blocs (enzymes, donor molecules, co factors, etc) are always needed. But if your liver funcition is such that you simply do not convert enough 5 HTP, then you will be short of Serotonin.

The next step in making Serotonin is called DECARBOXYLATION. Decarboxylation is simply an enzyme action (chemical scissors) that removes a carboxyl (COOH) from the molecule. The best thing to know here is that THIS IS A NON SATURATED ENZYME ACTION. What this means is that there is a lot more of this enzyme around that is ready to go to work in the creation of serotonin that is necessary for the body. So the good news here is THAT IF YOU DO SUPPLEMENT WITH 5 HTP, YOUR SEROTONIN LEVELS WILL GO UP.

The next question is "how much will it go up" and "will that hurt me if I take too much" The answer to the first question is that the more 5HTP that you take, the more that your Serotonin levels will go up, UNTIL YOU USE ALL OF THE ENZYME THAT DECARBOXYLATES 5 HTP. Then, no more can be created. This excess is recognized and the process of upregulation/downregulation will then turn the volume control down a bit, and you are balanced again.

HAVING SAID THAT, YOU SHOULD ONLY SUPPLEMENT WITH 5 HTP THE MINIMUM AMOUNT NEEDED TO SOLVE YOUR PROBLEM. Taking more will do nothing more for you than to raise the threshold of the upregulation/downregulation process and nothing more.

This is also another way of answering the question "is this safe?' and the answer is Yes.

So you may ask, WHY DO THE DRUG COMPANIES NOT OFFER 5 HTP? And the answer is that there is no profit in it. They cannot patent the molecule and it is already sold over the counter.

The next question is probably "why does my physician not know about this?" This answer is a bit more complex. But for the ones that do not know about it, it is because they only pay attention to what the drug companies tell them. The more charitable answer is that physicians have to practice "defensive medicine" and be able to justify their treatment protocols should they be sued for malpractice. With the case of over the counter supplements, there is no protocol, (or few protocols) that will cover their assess, so they don't go there.

The bottom line here is simple. Any anti depressant that you use can usually be replaced with a much better product that is sold over the counter.

HAVING SAID THAT, SWITCHING YOUR MEDS IS SOMETHING THAT YOU SHOULD COORDINATE WITH YOUR PHYSICAN. The reason is that some of the anti depressants last a long time in the system. 5HTP will work in under one hour. If you are taking a big dose of a long lasting anti depressant, and add 5 HTP, your Serotonin levels (at the synapse) will go way up and this is not good.

DOPAMINE is similar to Serotonin, but with an interesting twist. When dopamine levels are low, instead of working on reuptake, the medical profession normally uses L-DOPA. This cannot be patented as it is a natural substance. The reason that it is used is that the drug companies have no product that will work in inhibiting reuptake. So they sell a product that DOES RAISE DOPAMINE LEVELS. I suppose that it is frustrating to lose that revenue stream for them. The good news here is that L-Dopa is also sold over the counter only as MUCUNA PURIENES. It is interesting to note that in the one head to head test of MUCUNA vs commercial L-DOPA, that the Mucuna was deemed to be more effective. I guess mother nature beat the drug companies on that one.

NOREPINEPHRINE cannot be supplmented directly as it is made from Dopamine. But as was demonatrated above, Dopamine can be created by supplementing with L-Dopa or over the counter with Mucuna.

By creating sufficent levels of Dopamine, the production of NE is pretty much assured. However, it is not guaranteed.

REMEMEBER THAT NOREPINEPHRINE INCREASE BY SUPPLEMENTING WITH L DOPA IS NOT A GURANATY, AS IT IS WITH 5 HTP. DO WORK WITH YOUR PHYSICIAN.

Probably the next question a person would have, would be "what changes can I expect using this as a protocol. The common feedback has been "with ____________(various SSRI's, SSNRI's) life is like watching a black and white TV. With 5 HTP it is like a color TV.

In addition to using 5 HTP, and Mucuna if needed, DO TAKE FISH OIL, at the rate of 6 to 7 grams a day. Do take a good vitamin and mineral program, and do take 50 grams a day of whey isolate protein powder.

Hope that this helps.

 

[Pandora]

Dear DLD,

For the sufferors of this condition, the overall treatment of the condition is tremendously skewed by the fact that medical professionals will use drugs that come from pharmaceutical companies rather than use common sense in thinking of how to cure the condition.

As you noted above the causation is caused mostly by problems with serotonin, (5HT in medical abbreviations) Dopamine (DP) and Norepinephrine (NE). There is more to it than that, but this is fertile ground to get started with.

Serotonin, Dopamine and Norepinephrine are NEUROTRANSMITTERS. They are part of the 12 main neurotransmitters that the body uses. There are many more neurotransmitters, but those 12 are the main ones. All three work in the brain, and many other places, to relay messages that make it to the brain.

Our nervous system is not "hard wired" as an electrical system in your house would be. In the house electrical system, you turn on a switch, and the light comes on. In the body, the electricity works in the nerve kind of like a string of dominos, with each domino that falls hitting another and another until finally, the signal makes it to the brain where it can be acted on. Only, there is a break in the system that can be called "the receptor"

At this receptor, there is a collection of neurotransmitters, that take the signal (the domino) and move it to the other side of the receptor, (neurotransmission). An analogy would be a wheelbarrow. If you have a lot of wheelbarrows, you can move a lot of domino's across the synapse (the area where the neurotrasnmitter works). If you are short on wheelbarrows (the actual nerurtransmitter) then the signal is weak, or sometimes non existant. If the signal does not make it to the brain, then that circuit is non functional, and what the information that the brain needed to get is lost.

The amount of signal that the neurotransmitter moves can be a lot, or not so much, depending upon a number of variables which we will go into. The brain does not like to have different signal strengths and to show this I used an analogy of a 10,000 track CD player. Imagine your CD player could play 10,000 tracks of separate instruments and you could hear each of the 10,000 tracks separately. Well, if one track was too loud, it would drown out a bunch of the other tracks and you would not enjoy your music. This happens in the brain as well, and since the "volume" of the "music" is controlled by the AMOUNT OF NERUOTRANSITTERS IN THE SYNAPSE (the wheelbarrows hauling the signal across the synapse) there is a volume control for each one of the tracks.

The volume control is called "UPREGULATION-DOWNREGULATION" And the good thing is, is that it is automatic. You may be familiar with this concept because the same concept is used in hormonal circuitry that the weight lifters are concerned about. Injecting a high about of anabolic steroids will tell the brain that there is too much of them in the system, and the upregulation/downregulation function in the brain will turn off, or lower the natural production of those hormones. This is the same function, just in different circuitry. The point that is important here is that like the hormonal side, the neurotransmitter side is AUTOMATIC.

OK, now this is where you are going to have to pay attention. Drug companies are in business to make a profit as their first priority. This is quite reasonable, since if they don't make a profit, they will go out of business, and we will loose the benefit of their products.

NATURAL SUBSTANCES CANNOT BE PATENTED. Ok, so Drug companies (more or less, and this is another subject) need to have PATENTS on the medications so that they can make a profit on them.

NATURAL SUBSTANCES THAT YOU SEE IN THE HEALTH FOOD STORES CANNOT MAKE A MEDICAL CLAIM UNLESS THEY HAVE PROVEN IT TO THE FDA IN EXTENSIVE AND EXPenis EnlargementNSIVE TESTING. That sounds good at first glance as none of us want to be subjected to snake oil salesmen. But now, if you want to know the benefit of any of the products that you will see marketed at the health food store, you have to KNOW WHAT THEY DO INDEPenis EnlargementNDENTLY. That is because they can't make a medical claim without the testing.

Add to this situation, DRUG COMPANIES DO NOT WANT YOU TO KNOW ANYTHING ABOUT ALTERNATIVES BECAUSE THEY WANT TO SELL YOU THEIR PRODUCTS. Well, if I ran a drug company, I might want to do the same thing, especially if my job,-bonus- career- depended on it.

The drugs that raise (at the synapse) Serotonin and Norepinephrine are in the class of drugs called ANTI DEPRESSANTS. Those neurotransmitters affect mood, and much, much more. BUT HOW THEY DO THIS IS THE CRUX OF THE MATTER.

To understand where the "conspiracy" that the drug companies engage in, we have to learn more about how the body works.

The critical item in neurotransmission is the AMOUNT OF THE NEUROTRANSMITTER AT THE SYNAPSE. To use the analogy, the amount of signal (domino's being moved across the gap in the nerve) transmitted depends on how many wheelbarrows (the neurotransmitter) that there are to move, AT THE SYNAPSE.

Since the amount of neurotransmitter is critical, and since the body makes the neruotransmitter all of the time the body must also GET RID of the neurotransmitter all the time as well. In the brain, there are four methods that the body uses to get rid of neurotransmitters. They are:

1. DIFFUSION. Basically, this means that the neurotransmitter, which floats in the brain fluid, simply floats away from the synapse (the switch area) and is no longer useful in transmitting signal.
2. GLIAL CELLS. Glial cells (neuroglia) basically EAT the neurotransmitter, rendering it inoperable as a neurotransmitter. These are located outside the receptor and work with the neurotransmitters that have diffused out of the snyapse.
3. MONOAMINE OXIDASE. (MAO) Monoamine (a single amine, with amine being a chemical description of that class of molecule) is oxidized (converted into a different substance) by MAO and this is done IN and AROUND the synapse (the synapse is the area where the neurotransmission takes place)
4. REUPTAKE. To understand reuptake, we have to go back to where the neurotransmitter is made. The final step in the creation of the neurotransmitter is made at the top of the vesicle (usually-some variation depending upon which one we are talking about). The vesicle is the store house for the neurotransmitter and to make an analogy, it is like the air bellows that one uses to fan the fire in the fireplace. It works the same way. When the body needs more neurotransmitter, the vesicel contracts, and the neurtransmitter is pushed into the synapse. When there are no, or few messages to relay, the vesicle opens and sucks a lot of that neurotransmitter BACK INTO THE VESICLE FOR REUSE LATER. So the point that is important here is the that the vesicle (bellows) expels the neurtoransmitter when needed and sucks it back (reuptake) when it is not needed.

The point above is very important for understanding how and why the modalities as pushed by the drug comanies are second rate at best.

In combatting depression there are six accepted methods for the physician. They are:
1. SSRI's Selective Serotonin Reuptake Inhibitors
2. SSNRI's Selective Serotonin and Norepiniephrine Reuptake Inhibitors
3. MAOI's Monamine Oxidase Inhibitors
4. TCA's Tri Cyclic Antidepressants
5. NRI's Norepnephrine Reuptake Inhibitors
6. Thyroid medications.

Left out is testosterone supplementation, but that is a small, and mild contributor to depression and not relevant for this discussion. Thyroid hormone supplementation is also not relevatant to this discussion.

Out of the remaining 5 items, TCA's and MAOI's are not used much because of the many side effects associated with them. The remaining 3 all involved INHIBITING REUPTAKE at the synapse.

So what is missing from this equation? That should be obvious. Reuptake is a method for removal of the neurotransmitter. So, when you inhibit reuptake, you are restricting the amount of the neurotransmitter that is being sucked back in to the storage receptacle (the vesicle), YOU ARE NOT CREATING ANY NEUROTRANSMITTER. Hmmmm, we are zeroing in on the conspiracy here.

1. All commerical anti depressants work by reducing the methods the body uses to GET RID of the neurotransmitter. NONE WORK ON ADDING MORE NEUROTRANSMITTER TO THE SYSTEM.

2. Hopefully, you are now asking yourself why this is. The answer is simple. THE PRECURSORS FOR THE CREATION OF THE NEUROTRANSMITTERS ARE ALL NATURAL SUBSTANCES AND THERFORE CANNOT BE PATENTED. Remember, to get a patent, you must invent something new. Well, our creator invented this long, long ago. The drug companies know full well that the precursor to Serotonin is 5 HTP, and that the precursor to Dompanine is L-Dopa, and that the chain of creation for Norepinephrine is L-Dopa, Dopamine to Norepinephrine. And they know that the volume of protein consumed is related to the production of all hormones and neurotransmitters. But if they tell you this, they are jeopardizing a multi billion dollar business. And actually it is really a lot worse than this, as I will explain later in this section.

Ok, now let's explore how the body MAKE'S serotonin. Serotonin starts out as the protein TRYPTOPHAN. This is one of the 20 amino acids (proteins) that the body uses to build just about everything that we are. When you eat a whole protein (meat, fish, etc) the stomach digests it, and sends to component parts to the liver. When the liver gets the Tryptophan it can do one of 4 things. It can pass it along unchanged for other uses in the body, or it can convert it through the process of HYDROXYLATION into 5 HTP, or it can convert it into two other items that are not related to this discussion.

The conversion of Tryptophan into 5HTP (which is also known as hydroxylated tryptophan-- and that makes prefect sense as the conversion is done through the process of hydroxylation) is governed by a number of things. They include:
1. The amount of tryptopan (an amino acid aka a protein) that is in your diet.
2. The amount of all the protein in your diet, as it relates to the ability of the body to make the hydroxly donor and the enzymes for conversion. Ok, that is heavy, so a hyroxyl is two hyrdorgen atoms in a particular shape. To make it a particular molecule (the hydroxyl donor) must be plentiful, and it is used in a number of different reactions, the hyroxylation of Tryptophan in only one small use for this donor molecule. Andthere are two enzyme reactions. (an enzyme is "chemical scissors") Taken in whole, this process is a par of "liver
function: and is pretty much a genetic condition.

With all of those variables, certainly a big one is liver function. As it is genetic, there is not much that can be done here. A good diet to supply the building blocs (enzymes, donor molecules, co factors, etc) are always needed. But if your liver funcition is such that you simply do not convert enough 5 HTP, then you will be short of Serotonin.

The next step in making Serotonin is called DECARBOXYLATION. Decarboxylation is simply an enzyme action (chemical scissors) that removes a carboxyl (COOH) from the molecule. The best thing to know here is that THIS IS A NON SATURATED ENZYME ACTION. What this means is that there is a lot more of this enzyme around that is ready to go to work in the creation of serotonin that is necessary for the body. So the good news here is THAT IF YOU DO SUPPLEMENT WITH 5 HTP, YOUR SEROTONIN LEVELS WILL GO UP.

The next question is "how much will it go up" and "will that hurt me if I take too much" The answer to the first question is that the more 5HTP that you take, the more that your Serotonin levels will go up, UNTIL YOU USE ALL OF THE ENZYME THAT DECARBOXYLATES 5 HTP. Then, no more can be created. This excess is recognized and the process of upregulation/downregulation will then turn the volume control down a bit, and you are balanced again.

HAVING SAID THAT, YOU SHOULD ONLY SUPPLEMENT WITH 5 HTP THE MINIMUM AMOUNT NEEDED TO SOLVE YOUR PROBLEM. Taking more will do nothing more for you than to raise the threshold of the upregulation/downregulation process and nothing more.

This is also another way of answering the question "is this safe?' and the answer is Yes.

So you may ask, WHY DO THE DRUG COMPANIES NOT OFFER 5 HTP? And the answer is that there is no profit in it. They cannot patent the molecule and it is already sold over the counter.

The next question is probably "why does my physician not know about this?" This answer is a bit more complex. But for the ones that do not know about it, it is because they only pay attention to what the drug companies tell them. The more charitable answer is that physicians have to practice "defensive medicine" and be able to justify their treatment protocols should they be sued for malpractice. With the case of over the counter supplements, there is no protocol, (or few protocols) that will cover their assess, so they don't go there.

The bottom line here is simple. Any anti depressant that you use can usually be replaced with a much better product that is sold over the counter.

HAVING SAID THAT, SWITCHING YOUR MEDS IS SOMETHING THAT YOU SHOULD COORDINATE WITH YOUR PHYSICAN. The reason is that some of the anti depressants last a long time in the system. 5HTP will work in under one hour. If you are taking a big dose of a long lasting anti depressant, and add 5 HTP, your Serotonin levels (at the synapse) will go way up and this is not good.

DOPAMINE is similar to Serotonin, but with an interesting twist. When dopamine levels are low, instead of working on reuptake, the medical profession normally uses L-DOPA. This cannot be patented as it is a natural substance. The reason that it is used is that the drug companies have no product that will work in inhibiting reuptake. So they sell a product that DOES RAISE DOPAMINE LEVELS. I suppose that it is frustrating to lose that revenue stream for them. The good news here is that L-Dopa is also sold over the counter only as MUCUNA PURIENES. It is interesting to note that in the one head to head test of MUCUNA vs commercial L-DOPA, that the Mucuna was deemed to be more effective. I guess mother nature beat the drug companies on that one.

NOREPINEPHRINE cannot be supplmented directly as it is made from Dopamine. But as was demonatrated above, Dopamine can be created by supplementing with L-Dopa or over the counter with Mucuna.

By creating sufficent levels of Dopamine, the production of NE is pretty much assured. However, it is not guaranteed.

REMEMEBER THAT NOREPINEPHRINE INCREASE BY SUPPLEMENTING WITH L DOPA IS NOT A GURANATY, AS IT IS WITH 5 HTP. DO WORK WITH YOUR PHYSICIAN.

Probably the next question a person would have, would be "what changes can I expect using this as a protocol. The common feedback has been "with ____________(various SSRI's, SSNRI's) life is like watching a black and white TV. With 5 HTP it is like a color TV.

In addition to using 5 HTP, and Mucuna if needed, DO TAKE FISH OIL, at the rate of 6 to 7 grams a day. Do take a good vitamin and mineral program, and do take 50 grams a day of whey isolate protein powder.

Hope that this helps.

Stagestop,

I have a member of the family with these disorders Post traumatic stress disorder and Benzodiazepine dependence.

This is the medication the person is on

Diazepam
Sertraline
Sulpiride
PROPRANOLOL
Tegretol Retard
Zolpidem

Does your advise still count for this person or not.

thanks,

Pandora.

 

[stagestop]

Hi Pandora,

I am sorry to hear that your family member has Post Traumatic Stress Disorder. I am sure that he/she is still not doing well at the moment.

I am guessing that you live in Europe as Suppiride is not sold in the US, and my pharmacology reference material does not carry a listing for it. The rest of the drugs that your family member is taking shows a person that is indeed having some problems. As to giving you a course of treatment, that would be unethical. You are working with a physician and he is your contact person.

Having said that, I can certainly offer some education. From that education, you can do your own Internet research and if you like, you could change some things. Some of the things that you could do, would have a rather quick response, and, in my opinion, quite beneficial as well.

First of all, let's start with a basic overview of Post Traumatic Stress Disorder. That person has been involved in a very stressful situation, that he/she relives in their mind regularly. When the body is under stress, it releases a number of hormones in preparation of the "fight or flight" response. All of the body is put on notice that it must be prepared to run as fast as possible, fight as hard as possible, to defend a potential life threatening situation.

The stress hormone Cortisol is immediately pumped into the blood. Norepinephrine (a hormone) is released to close arterioles to the stomach and digestions systems so that blood can be freed to feed muscles, so that you can have maximum strength to run or fight. Blood pressure goes up, carbohydrates are released into the blood and your body is wired to do its best or go down fighting.

But, if there is nothing to do, no place to run, or the stress only exists in the mind, as in this case, a memory of a past event, the body still responds the same way.

Cortisol depresses the production of Serotonin. And every time that your family member thinks about that situation, his stress goes up, Cortisol is released, and Serotonin output suffers. Further, this will continue to happen each and every time that the stressful event is thought about, and this can and does happen in his/her sleep as well.

Panic attacks, which happen without warning, and cause the fight or flight response, are caused by a lack of serotonin. But that is not all that low serotonin levels can cause. Other things that low serotonin levels cause include
1. Irritable bowel syndrome (modern science will tell you that this is an incurable condition, and in the US alone over 11,000,000 people suffer from this, but it is easily curable when serotonin levels go up.
2. Poor sleep. This is very easy to figure out as Melatonin, the "sleep hormone" is made from Serotonin. When you do not have enough Serotonin, you can't make enough Melatonin.
3. Some type of ulcerative colitis. Ulcerative colitis can be fatal, and it is when the colon has an ulcer in it, causing intestinal bleeding, and allowing infection to enter the body. This happens because intestinal mucus has Serotonin as its neurotransmitter. When there is insufficient Serotonin, there can be interruption in the production of intestinal mucus. The intestines are just like the stomach, they are protected from damage by secreted mucous. When it is not there, the lining is attacked by the contents of the bowel.
4. Panic attacks (previously discussed_
5. OCD (previously discussed)
Hydromaxmm, it is late as I write this and I am tired. There are more, but they do not come to mind at the moment.
6. Random pain. This is an interesting effect and it is greatly exacerbated by Sertraline. The person with low levels of Serotonin has low levels everywhere. About 5% of Serotonin rides around the body attached to blood platelets. When there is insufficient Serotonin in general, the amount on the platelets decreases as well. One of the things that the Serotonin that rides around on the platelets does, is work in conjunction with another neurotransmitter, Norepinephrine and is used to control the opening and closing of arterioles. Arterioles are the smallest part of the blood supply delivery system. When they are closed this is called "ataxia" or lack of blood to the cells that it would have supplied. Well, ataxia, (lack of oxygen from blood) causes pain. It goes away when more blood comes to the affected place, but if you are short, really short, the main moves around a lot. Well, Setraline makes this worse, by stripping off Serotonin from the platelets. I would imagine that your family member feels low level pain regularly.

To verify all that I have said, use your browser and look up 5 HTP. This will give you the chemical chain that shows the protein Tryptophan being the source, the conversion to 5 HTP in the liver, and the conversion of 5 HTP into Serotonin. It will also show the conversion of Serotonin into Melatonin.

Next, look up look up Neurotransmitters. This will show that the process of reuptake is as described above.

Next look up Sertraline, and it will give you a complete description of the drug and that it is a SSRI (Selective Serotonin Reuptake Inhibitor), and that the effect of this is to raise Serotonin levels at the synapse.

This should confirm to you that if you decided to get rid of taking the Sertraline that you could do so. You could also get rid of the Zolpidem as it is a sleeping pill. You will not need that when you have sufficient levels of melatonin in his/her system.

The time that is necessary for 5 HTP to become active is about 90 minutes if taken on an empty stomach. With food, it may take 3 hours. After the conversion process begins, it may take 5 to 8 hours to produce sufficient Melatonin for sleep. Therefore, a good suggestion would be to stop taking Sertraline and Zolpidem. The next day, take 100 mg of 5 HTP. The next day take 200 mg of 5HTP and remain at that dosage for a week. Then you can try taking 150 mg of 5 HTP and see if that is sufficient for relief of those symptoms.

I would expect that the difference would be noticeable the first full day after taking the 5 HTP.

As to negatives that accompany taking the 5 HTP, DO NOT RUN OUT. Your family member will feel very poorly if you run out. Naturally, if he/she is no longer bothered by the incident that was causative, you can certainly reduce the dosage, or eliminate it all together.

If and when you begin this, it is a very good idea to take the 6 to 7 grams of fish oil. The "shake" (mixed in a blender with water, or milk, or other liquid) of the Whey Isolate Protein. The amount is 50 grams. Fruit or juices can be added for flavoring. Ice cream can also be added if calories are not a consideration.

Take a good vitamin and mineral program concurrently.

If you decide that this is something that you want to do, you can start anytime. This will not affect the other drugs that you are taking.

And now, I am tired and have to go to bed. The rest gets a bit more complicated. I will try to finish this before I leave town Thursday night, but I may not have a chance to get to it. I will finish this for you though.

Good luck.
Stage

 

[Pandora]

Ok thanks very much stagestop.

 

[stagestop]

Hi again Pandora,

As I mentioned, things get more complex at this point. But lets go back over the first two items that we discussed. Those can be replaced with 5 HTP easily, and it will benefit your family member. There is no risk there to doing that. And as a result, your family member will feel better.

The reason things get complex when essentially you are asking for a second opinion is that defining the condition is pretty much impossible over the internet. Saying that someone has post traumatic stress disorder as a definition is like saying that they are overweight. When you say that someone is overweight, meaning a person that is concerned that they are 10 pounds over their desired weight, or is it someone that is 400 pounds over their desired weight.

Your family member is getting a lot of drugs. So let's go over what post traumatic stress condition is again. It is an event, or series of events that are relived in the mind, either consiciously or unconsciously that cause the body to react with fear, anxiety on an on going basis. The question is how to quanitify "fear" and "anxiety" and it has to be answered by the physician.

Your physician seems to have his hands full. When the fear hits, the body prepares the fight or flight response. Cortisol and its metabolites are dumped in the body. Norepinephrine (noradrenalin in Europe) and Epinephrine (adrenalin in Europe) are released in large amounts. Dopamine goes up for a while, and all cause a number of reactions. Anxiety can be intense, even though the person is not at risk or in danger of anything. They keep reliving their traumatic moments and cause a reaction from the long term preparation of the body to fight or flight.

So, the person needs to be "brought down" so to speak. Your doctor is trying to add to the Serotoin that was not manufactured by giving an SSRI. He is also trying to fix the shortage of melatonin caused by the lack of Serotonin. The 5 HTP will do a much better job of that, as we discussed.

Giving your family member Diazepam for a long period time is not good medical practice and this is why your family member is addicted to benzodiazepines. The doctor gave him Diazepam for so long that it caused his addiction. I am sure that the doctor felt the issues caused by the addiction were better issues than would be the case if he did not take the Diazepam. From here, I am in no postion to argue one way or the other.

If you want to see about getting your family member feeling better though, there is a degree of risk and your physician must work with you. Alternatively, you can get another physician. Please know that the drug load that your family member is taking is heavy, and there are tons of side effects.

To begin weaning your family member off of heavy drugs and (hopefully) onto ones that are not as filled with side effects, a slow withdrawl from Diazepam and the substitution of GABA is the best (in my opinion) solution. Weaning someone off of Diazepam is a slow process. It may take two months. So, you have to give progressively smaller dosages of Diazepam, and progressively larger dosages of GABA. This DOES need to be done under a doctors care. There is no guaranty that it will work. And if so, you may be right back where you started from. In my opinion it is worth the risk because there are so many side effects to what your family member is taking that you would not know one way or the other if Post Traumatic Stress Disorder is still as big a factor for them or not. Again, let me say that I have not seen your family member, and if it is blatanly obvious, then what I have written must be discarded. But it is a start.

If and when you get the Diazepam out of his/her system AND health is improved then we can go onto the the other drugs. They are heavy drugs as well.

I hope that I have been helpful, and wish you all the best.

Stage

 

[Pandora]

Hi again Pandora,

As I mentioned, things get more complex at this point. But lets go back over the first two items that we discussed. Those can be replaced with 5 HTP easily, and it will benefit your family member. There is no risk there to doing that. And as a result, your family member will feel better.

The reason things get complex when essentially you are asking for a second opinion is that defining the condition is pretty much impossible over the internet. Saying that someone has post traumatic stress disorder as a definition is like saying that they are overweight. When you say that someone is overweight, meaning a person that is concerned that they are 10 pounds over their desired weight, or is it someone that is 400 pounds over their desired weight.

Your family member is getting a lot of drugs. So let's go over what post traumatic stress condition is again. It is an event, or series of events that are relived in the mind, either consiciously or unconsciously that cause the body to react with fear, anxiety on an on going basis. The question is how to quanitify "fear" and "anxiety" and it has to be answered by the physician.

Your physician seems to have his hands full. When the fear hits, the body prepares the fight or flight response. Cortisol and its metabolites are dumped in the body. Norepinephrine (noradrenalin in Europe) and Epinephrine (adrenalin in Europe) are released in large amounts. Dopamine goes up for a while, and all cause a number of reactions. Anxiety can be intense, even though the person is not at risk or in danger of anything. They keep reliving their traumatic moments and cause a reaction from the long term preparation of the body to fight or flight.

So, the person needs to be "brought down" so to speak. Your doctor is trying to add to the Serotoin that was not manufactured by giving an SSRI. He is also trying to fix the shortage of melatonin caused by the lack of Serotonin. The 5 HTP will do a much better job of that, as we discussed.

Giving your family member Diazepam for a long period time is not good medical practice and this is why your family member is addicted to benzodiazepines. The doctor gave him Diazepam for so long that it caused his addiction. I am sure that the doctor felt the issues caused by the addiction were better issues than would be the case if he did not take the Diazepam. From here, I am in no postion to argue one way or the other.

If you want to see about getting your family member feeling better though, there is a degree of risk and your physician must work with you. Alternatively, you can get another physician. Please know that the drug load that your family member is taking is heavy, and there are tons of side effects.

To begin weaning your family member off of heavy drugs and (hopefully) onto ones that are not as filled with side effects, a slow withdrawl from Diazepam and the substitution of GABA is the best (in my opinion) solution. Weaning someone off of Diazepam is a slow process. It may take two months. So, you have to give progressively smaller dosages of Diazepam, and progressively larger dosages of GABA. This DOES need to be done under a doctors care. There is no guaranty that it will work. And if so, you may be right back where you started from. In my opinion it is worth the risk because there are so many side effects to what your family member is taking that you would not know one way or the other if Post Traumatic Stress Disorder is still as big a factor for them or not. Again, let me say that I have not seen your family member, and if it is blatanly obvious, then what I have written must be discarded. But it is a start.

If and when you get the Diazepam out of his/her system AND health is improved then we can go onto the the other drugs. They are heavy drugs as well.

I hope that I have been helpful, and wish you all the best.

Stage

Ok thanks again stagestop.

 

[Mr05]

The previous posts have some good advice, especially regarding trying more natural remedies, and I have one more to add: niacin (vitamin b3).

I know this is a serious topic and don't want to impose that their may be a "quick fix" for bipolar, and I don't think I'm a quack, but I suggest that you at least *check out* supplementing with niacin.

Of course you can (or should) also try niacin along with a more complete program that increases EFA (essenial fatty acid) metabolism including but not limited to the vitamins B5 (panothenic acid), B6, Folic Acid, A, C and minerals Zinc, Mg, Calcium, Iron, and Selenium. You can also increase the EFA intake via flax seed oil or fish oil (as mentioned in an earlier reply).

However, for simplicity, *personally* I would start out by simply giving niacin a try along with a multivitamin and if that doesn't help then replace niacin with (or add) the other vitamins, minerals and supplements as you decide what works and what doesn't. I.e. I wouldn't try everything at once because then you don't know what works and what doesn't and it is a pain, cost $ to do everything, and who knows they may interfere with each other. Or if you are desparate and don't have the time then you could try the opposite "subtract" approrach and start with everything (or several) and if it is helping then slowly remove things one at a time, to see if the benefits decrease. Experiment and document your progress or lack thereof.

Niacin has been informally and formally "known" to treat a variety of problems including alcoholism, drug additions, allergies, migraines and phycosis including schizophrenia and even has been shown to help prevent alzheimers, but as mentioned in the previous replies, doctors and pharms do not recommend natural fixes and will simply reject them as useless so you'll have to do your own research, and make a decision as to whether it is worth a try. And of course niacin (or the oher vitamins and minerals mentiond above) may not help at all for you; everyone is different. In fact, you could have an allergic reaction to niacin and your balls may fall off, or your kids may be born with a tail.

Pesonally, I use use 500mg niacin before going into my far-infrared sauna to help flush out toxins. You may have heard about saunas + niacin as part of the scientology detox program but I have nothing to do with scientology.

I have not used niacin for bipolar (I don't think I have it) but honestly I have noticed a better sense of well-being and mood stabilization when taking it, and improved sleep which I understand may be part of the bipolar puzzle. This did not happen when I just used my sauna before "discovering" niacin. My wife recently started using niacin to control her severe migraines and I think she has been through almost every other prescribed migraine medication, but since she just started taking it we'll have to wait a while to see how well it works (so far so good).

Note that you will likely get an uncomfortable, itchy "flush" from niacin, depending on the dosage and your body.

Finaly I think because it dilates your blood vessels it should also be good for Penis Enlargement ;-)

Good luck and a piece of advice: ONLY YOU can effectively manage and control your health, not your doctor nor anyone else.

 

[Nelly Gay]

Bipolar I Disorder is one of the most severe forms of mental illness and is characterized by recurrent episodes of mania and (more often) depression. The condition has a high rate of recurrence and if untreated, it has an approximately 15% risk of death by suicide. It is the third leading cause of death among people aged 15-24 years, and is the 6th leading cause of disability (lost years of healthy life) for people aged 15-44 years in the developed world.

Causation
Bipolar I Disorder is a life-long disease and runs in families but has a complex mode of inheritance. Family, twin and adoption studies suggest genetic factors. The concordance rate for monozygotic (identical) twins is 43%; whereas it is only 6% for dizygotic (nonidentical) twins. About half of all patients with Bipolar I Disorder have one parent who also has a mood disorder, usually Major Depressive Disorder. If one parent has Bipolar I Disorder, the child will have a 25% chance of developing a mood disorder (about half of these will have Bipolar I or II Disorder, while the other half will have Major Depressive Disorder). If both parents have Bipolar I Disorder, the child has a 50%-75% chance of developing a mood disorder. First-degree biological relatives of individuals with Bipolar I Disorder have elevated rates of Bipolar I Disorder (4%-24%), Bipolar II Disorder (1%-5%), and Major Depressive Disorder (4%-24%).

The finding that the concordance rate for monozygotic twins isn't 100% suggests that environmental or psychological factors likely play a role in causation. Certain environmental factors (e.g., antidepressant medication, antipsychotic medication, electroconvulsive therapy, stimulants) or certain illnesses (e.g., multiple sclerosis, brain tumor, hyperthyroidism) can trigger mania. Mania can be triggered by giving birth, sleep deprivation, and major stressful life events.

Symptoms
In adults, mania is usually episodic with an elevation of mood and increased energy and activity. In children, mania is commonly chronic rather than episodic, and usually presents in mixed states with irritability, anxiety and depression. In adults and children, during depression there is lowering of mood and decreased energy and activity. During a mixed episode both mania and depression can occur on the same day.

Comorbidity
Comorbidity is the rule, not the exception, in bipolar disorder. The most common mental disorders that co-occur with bipolar disorder are anxiety, substance use, and conduct disorders. Disorders of eating, sexual behavior, attention-deficit/hyperactivity, and impulse control, as well as autism spectrum disorders and Tourette's disorder, co-occur with bipolar disorder. The most common general medical comorbidities are migraine, thyroid illness, obesity, type II diabetes, and cardiovascular disease.

Associated Mental Disorders
Bipolar I Disorder is often associated with: alcoholism, drug addiction, Anorexia Nervosa, Bulimia Nervosa, Attention-Deficit Hyperactivity Disorder, Panic Disorder, and Social Phobia.

Diagnostic Tests
There are no diagnostic laboratory tests for Bipolar I Disorder. Thus diagnosis is arrived at by using standardized diagnostic criteria to rate the patient's behavior.

Differential Diagnosis
Bipolar I Disorder must be distinguished from:

Mood Disorder Due to a General Medical Condition (e.g., due to multiple sclerosis, stroke, hypothyroidism, or brain tumor)

Substance-Induced Mood Disorder (e.g., due to drug abuse, antidepressant medication, or electroconvulsive therapy)

Other Mood Disorders (e.g., Major Depressive Disorder; Dysthymia; Bipolar II Disorder; Cyclothymic Disorder)

Psychotic Disorders (e.g., Schizoaffective Disorder, Schizophrenia, or Delusional Disorder)

Since this disorder may be associated with hyperactivity, recklessness, impulsivity, and antisocial behavior; the diagnosis of Bipolar I Disorder must be carefully differentiated from Attention Deficit Hyperactivity Disorder, Conduct Disorder, Antisocial Personality Disorder, and Borderline Personality Disorder

Pathophysiology

The pathophysiology of Bipolar I Disorder is poorly understood. However, a variety of imaging studies suggests the involvement of structural abnormalities in the amygdala, basal ganglia and prefrontal cortex. Research is now showing that this disorder is associated with abnormal brain levels of serotonin, norepinephrine, and dopamine.

Prevalence
Bipolar I Disorder affects both sexes equally in all age groups and its worldwide prevalence is approximately 3-5%. It can even present in preschoolers. There are no significant differences among racial groups in the prevalence of this disorder.

Course
The first episode may occur at any age from childhood to old age. The average age at onset is 21. More than 90% of individuals who have a single Manic Episode go on to have future episodes. Untreated patients with Bipolar I Disorder typically have 8 to 10 episodes of mania and depression in their lifetime. Often 5 years or more may elapse between the first and second episode, but thereafter the episodes become more frequent and more severe.

There is significant symptom reduction between episodes, but 25% of patients continue to display mood instability or mild depression. As many as 60% of patients experience chronic interpersonal or occupational difficulties between acute episodes. Bipolar I Disorder may develop psychotic symptoms. The psychotic symptoms in Bipolar I Disorder only occur during severe manic, mixed or depressive episodes. In contrast, the psychotic symptoms in Schizophrenia can occur when there is no mania or depression. Poor recovery is more common after psychosis.

Manic episodes usually begin abruptly and last for between 2 weeks and 4-5 months (median duration about 4 months). Depressive episodes tend to last longer (median length about 6 months), though rarely for more than a year, except in the elderly.

Treatment And Outcome
The usual treatment for Bipolar I Disorder is lifelong therapy with a mood-stabilizer (either lithium, carbamazepine, or divalproex / valproic acid) often in combination with an antipsychotic medication. Usually treatment results in a dramatic decrease in suffering, and causes an 8-fold reduction in suicide risk. In mania, an antipsychotic medication and/or a benzodiazepine medication is often added to the mood-stabilizer. In depression, an antidepressant medication and/or lamotrigine is often added to the mood-stabilizer. Since antidepressant medication can trigger mania, this medication should always be combined with a mood-stablizer or antipsychotic medication to prevent mania.

Research has shown that the most effective treatment is a combination of supportive psychotherapy, psychoeducation, and the use of a mood-stabilizer (often combined with an antipsychotic medication). There is no research showing that any form of psychotherapy is an effective substitute for medication. Likewise there is no research showing that any "health food store nutritional supplement" (e.g., vitamin, amino acid) is effective for Bipolar I Disorder.

Since a Manic Episode can quickly escalate and destroy a patient's career or reputation, a therapist must be prepared to hospitalize out-of-control manic patients before they "lose everything". Likewise, severely depressed, suicidal bipolar patients often require hospitalization to save their lives.

Although the medication therapy for Bipolar I Disorder usually must be lifelong, the majority of bipolar patients are noncompliant and stop their medication after one year. At 4-year follow-up of bipolar patients, 41% have a good overall outcome and 4% have died. Women with bipolar disorder lose, on average, 9 years in life expectancy, 14 years of lost productivity and 12 years of normal health

Best Recoveries
The best recoveries are achieved when individuals with Bipolar I Disorder:

Get the correct diagnosis (since many are misdiagnosed as having schizophrenia or "just borderline personality")

Get effective treatment and faithfully stay on it for a lifetime (50% need only a mood-stabilizer, but the other 50% require the combination of a mood-stabilizer and an antipsychotic medication)

Adopt a healthy lifestyle (regular sleep and exercise; no alcohol or drug abuse; low stress)

Regularly see a supportive physician who is knowledgeable about the psychiatric management of this disorder

Learn which symptoms predict the return of this illness, and what additional "rescue" medication should be taken

Learn to trust the warnings given by family and friends when they see early signs of relapse

Learn as much as possible about this illness from therapists, the Internet, books, or self-help groups

There is a BNBC TV series on BBC1 tonight at 9.00pm about bi-polar illness with Stephen Fry.
It is a British programme but might get shown in the USA at some point ?f

 

[Nelly Gay]

Bipolar I Disorder is one of the most severe forms of mental illness and is characterized by recurrent episodes of mania and (more often) depression. The condition has a high rate of recurrence and if untreated, it has an approximately 15% risk of death by suicide. It is the third leading cause of death among people aged 15-24 years, and is the 6th leading cause of disability (lost years of healthy life) for people aged 15-44 years in the developed world.

Causation
Bipolar I Disorder is a life-long disease and runs in families but has a complex mode of inheritance. Family, twin and adoption studies suggest genetic factors. The concordance rate for monozygotic (identical) twins is 43%; whereas it is only 6% for dizygotic (nonidentical) twins. About half of all patients with Bipolar I Disorder have one parent who also has a mood disorder, usually Major Depressive Disorder. If one parent has Bipolar I Disorder, the child will have a 25% chance of developing a mood disorder (about half of these will have Bipolar I or II Disorder, while the other half will have Major Depressive Disorder). If both parents have Bipolar I Disorder, the child has a 50%-75% chance of developing a mood disorder. First-degree biological relatives of individuals with Bipolar I Disorder have elevated rates of Bipolar I Disorder (4%-24%), Bipolar II Disorder (1%-5%), and Major Depressive Disorder (4%-24%).

The finding that the concordance rate for monozygotic twins isn't 100% suggests that environmental or psychological factors likely play a role in causation. Certain environmental factors (e.g., antidepressant medication, antipsychotic medication, electroconvulsive therapy, stimulants) or certain illnesses (e.g., multiple sclerosis, brain tumor, hyperthyroidism) can trigger mania. Mania can be triggered by giving birth, sleep deprivation, and major stressful life events.

Symptoms
In adults, mania is usually episodic with an elevation of mood and increased energy and activity. In children, mania is commonly chronic rather than episodic, and usually presents in mixed states with irritability, anxiety and depression. In adults and children, during depression there is lowering of mood and decreased energy and activity. During a mixed episode both mania and depression can occur on the same day.

Comorbidity
Comorbidity is the rule, not the exception, in bipolar disorder. The most common mental disorders that co-occur with bipolar disorder are anxiety, substance use, and conduct disorders. Disorders of eating, sexual behavior, attention-deficit/hyperactivity, and impulse control, as well as autism spectrum disorders and Tourette's disorder, co-occur with bipolar disorder. The most common general medical comorbidities are migraine, thyroid illness, obesity, type II diabetes, and cardiovascular disease.

Associated Mental Disorders
Bipolar I Disorder is often associated with: alcoholism, drug addiction, Anorexia Nervosa, Bulimia Nervosa, Attention-Deficit Hyperactivity Disorder, Panic Disorder, and Social Phobia.

Diagnostic Tests
There are no diagnostic laboratory tests for Bipolar I Disorder. Thus diagnosis is arrived at by using standardized diagnostic criteria to rate the patient's behavior.

Differential Diagnosis
Bipolar I Disorder must be distinguished from:

Mood Disorder Due to a General Medical Condition (e.g., due to multiple sclerosis, stroke, hypothyroidism, or brain tumor)

Substance-Induced Mood Disorder (e.g., due to drug abuse, antidepressant medication, or electroconvulsive therapy)

Other Mood Disorders (e.g., Major Depressive Disorder; Dysthymia; Bipolar II Disorder; Cyclothymic Disorder)

Psychotic Disorders (e.g., Schizoaffective Disorder, Schizophrenia, or Delusional Disorder)

Since this disorder may be associated with hyperactivity, recklessness, impulsivity, and antisocial behavior; the diagnosis of Bipolar I Disorder must be carefully differentiated from Attention Deficit Hyperactivity Disorder, Conduct Disorder, Antisocial Personality Disorder, and Borderline Personality Disorder

Pathophysiology

The pathophysiology of Bipolar I Disorder is poorly understood. However, a variety of imaging studies suggests the involvement of structural abnormalities in the amygdala, basal ganglia and prefrontal cortex. Research is now showing that this disorder is associated with abnormal brain levels of serotonin, norepinephrine, and dopamine.

Prevalence
Bipolar I Disorder affects both sexes equally in all age groups and its worldwide prevalence is approximately 3-5%. It can even present in preschoolers. There are no significant differences among racial groups in the prevalence of this disorder.

Course
The first episode may occur at any age from childhood to old age. The average age at onset is 21. More than 90% of individuals who have a single Manic Episode go on to have future episodes. Untreated patients with Bipolar I Disorder typically have 8 to 10 episodes of mania and depression in their lifetime. Often 5 years or more may elapse between the first and second episode, but thereafter the episodes become more frequent and more severe.

There is significant symptom reduction between episodes, but 25% of patients continue to display mood instability or mild depression. As many as 60% of patients experience chronic interpersonal or occupational difficulties between acute episodes. Bipolar I Disorder may develop psychotic symptoms. The psychotic symptoms in Bipolar I Disorder only occur during severe manic, mixed or depressive episodes. In contrast, the psychotic symptoms in Schizophrenia can occur when there is no mania or depression. Poor recovery is more common after psychosis.

Manic episodes usually begin abruptly and last for between 2 weeks and 4-5 months (median duration about 4 months). Depressive episodes tend to last longer (median length about 6 months), though rarely for more than a year, except in the elderly.

Treatment And Outcome
The usual treatment for Bipolar I Disorder is lifelong therapy with a mood-stabilizer (either lithium, carbamazepine, or divalproex / valproic acid) often in combination with an antipsychotic medication. Usually treatment results in a dramatic decrease in suffering, and causes an 8-fold reduction in suicide risk. In mania, an antipsychotic medication and/or a benzodiazepine medication is often added to the mood-stabilizer. In depression, an antidepressant medication and/or lamotrigine is often added to the mood-stabilizer. Since antidepressant medication can trigger mania, this medication should always be combined with a mood-stablizer or antipsychotic medication to prevent mania.

Research has shown that the most effective treatment is a combination of supportive psychotherapy, psychoeducation, and the use of a mood-stabilizer (often combined with an antipsychotic medication). There is no research showing that any form of psychotherapy is an effective substitute for medication. Likewise there is no research showing that any "health food store nutritional supplement" (e.g., vitamin, amino acid) is effective for Bipolar I Disorder.

Since a Manic Episode can quickly escalate and destroy a patient's career or reputation, a therapist must be prepared to hospitalize out-of-control manic patients before they "lose everything". Likewise, severely depressed, suicidal bipolar patients often require hospitalization to save their lives.

Although the medication therapy for Bipolar I Disorder usually must be lifelong, the majority of bipolar patients are noncompliant and stop their medication after one year. At 4-year follow-up of bipolar patients, 41% have a good overall outcome and 4% have died. Women with bipolar disorder lose, on average, 9 years in life expectancy, 14 years of lost productivity and 12 years of normal health

Best Recoveries
The best recoveries are achieved when individuals with Bipolar I Disorder:

Get the correct diagnosis (since many are misdiagnosed as having schizophrenia or "just borderline personality")

Get effective treatment and faithfully stay on it for a lifetime (50% need only a mood-stabilizer, but the other 50% require the combination of a mood-stabilizer and an antipsychotic medication)

Adopt a healthy lifestyle (regular sleep and exercise; no alcohol or drug abuse; low stress)

Regularly see a supportive physician who is knowledgeable about the psychiatric management of this disorder

Learn which symptoms predict the return of this illness, and what additional "rescue" medication should be taken

Learn to trust the warnings given by family and friends when they see early signs of relapse

Learn as much as possible about this illness from therapists, the Internet, books, or self-help groups

There is a BBC TV series on BBC1 tonight at 9.00pm about bi-polar illness with Stephen Fry.
It is a British programme but might get shown in the USA at some point ?f

 

[julymasiando]

Hello. I'm Lussy. 4 months I read your forum. I have a question. Very much it would be desirable to find recreational viagra use. Here: why women shouldnt take viagra I have found that search Very much your opinion interests: Somebody already bought from them? Thanks!
Sorry for bad English. I'm from Madrid

 

[wntwidth]

Just one question, is it possible to be diagnosed with PTSD only or is there usually an underlying illness i.e. BPD, Bi-Polar disorder. I have heard that PTSD is the main diagnoses but there is usually something to go along with it. Sorry for not being educated on this but really wondering. Had an ex that some ppl thought was Bi-Polar and she is taking Pshyc as a major in college. She informed me she didn't want to be diagnosed with it because she never wants to take the Meds (her brother is on). Her brother has PTSD, BPD, and boarder line schizophrenia. I was just wondering, she said she was seeing someone (counselor) and they diagnosed her with JUST PTSD. any input is greatly accepted.

 

[wntwidth]

DLD, SOMEONE ANYONE, please comment on my post I have no experience with Bi-polar and just wondering if the ex might have it?

 

[REDZULU2003]

I think that I may have a mild form of Bi-Polar or something similar with my up and down moods, mostly down. The doctor seems to think no way do I have it, but they dont know everything and its tricky to diagnose with other conditions being overlapped and when you are coming off booze they leave you for abit.

 

[dinobrand]

Bipolar disorder affects men and women both equally. It usually starts between ages 15 - 25. The exact cause is unknown, but it occurs more often in relatives of people with bipolar disorder.

 

[DLD]

Bipolar disorder affects men and women both equally. It usually starts between ages 15 - 25. The exact cause is unknown, but it occurs more often in relatives of people with bipolar disorder.

Bipolar= 2 Abilities to Control both Poles, N and S...with this gift you can create the world and destroy it in a day. Do not let them innendate you wil letters and DSM4,5,6 or whatever screwed up number they have come to. BiPolar is a gift from GOD for the chosen ones!

 

[Deonz]

Funny, this is my first post on this site. But, any beginning is as good as another I suppose. My mother has bipolar.. recently-last semester I was 'institutionalized'. I'm of sound body, just not of mind it seems. It never occurred to me that anything was wrong, I just thought I was really happy sometimes and willing to do a lot of work.. which is good for what I'm doing, or really sad often and not willing to get up and do regular things. I think the stress of school escalated the situations, especially when other things bombarded me outside of school.. Which are far to many stories to tell and that should have happened within a couple of months.
Oh, I forgot to mention I'm 19. I haven't been diagnosed completely. I only take.. Wellbutrin right now. When I went to the hospital, I wasn't taken in because I had a manic episode, quite the opposite. I haven't had a full blown one yet I believe. Nor do I think I will anytime soon haha. Mostly because I've explored ways to tame both sides of my mind, through meditation, medication, and.. lots of sex. I have too much sex, and I'm afraid that might be because of the manic-ish side. I don't know.. I know it's not normal for a 19 year old to have had around.. 30 partners. So. No one knows this.. my therapists, parents, friends. Only you guys now haha. I'm always safe, so I haven't felt it necessary. The point is, I'm not entirely sure whether I have Bipolar, or whether my mind is telling me I have it because all my life I knew my mom had it. My grandmother has it. My aunt on my dad's side has it. Seems these were all women. But, nevertheless, I still acknowledge that there's a possibility. The doctors have also taken this into account, but haven't found any evidence to support it quite yet. So I'm labeled as a Uni-polar depressive.. I need help deciding if my promiscuity.. oh let's face it, I'm a slut. I need to know if this has any possible correlation with mania. And whether I should seek to tell my health care providers about it. Thanks, and I'll.. be posting in other forums soon as well. I'm a bit bashful when it comes to these things. Introducing myself to strangers I mean haha.

 

[DJ916]

they just moved me from hat i was taking to Depakote.....anyone had anything bad with depakote or good?

 

[DLD]

they just moved me from hat i was taking to Depakote.....anyone had anything bad with depakote or good?

It is all a blind dart throw....

 

[DJ916]

coo, dld can you checkout my post in the baind aids and injury forum and give me your thoughts

 

[DLD]

coo, dld can you checkout my post in the baind aids and injury forum and give me your thoughts

Could you link that for me sir?

 

[DJ916]

http://www.mattersofsize.com/forum/showthread.php?66548-BB-size-lump-Help-anyone&goto=newpost

 

[DJ916]

read from top, and as far as the meds they have had me on....two of them made me paranoid as hell, and i just started this depakote and I dont like this shit either....i started hearin ringing in my ears and constant headaches

 

[DLD]

read from top, and as far as the meds they have had me on....two of them made me paranoid as hell, and i just started this depakote and I dont like this shit either....i started hearin ringing in my ears and constant headaches

Currently I have gone off all meds with the exception of Serequel at night but if I can get my hands on some benzos I am stopping that too. I really am sick and tired of the side effects from these meds that seem to only make me fat, slow, lazy and unproductive. If mania is the best it gets then I am good with that. I really need to conquer this cognitively, medications have only held me back from dealing with this in the right way. Of course this scares everyone, when they hear I want to do this, but this is not for them it is for me. I have taken meds for 15 years and I really miss me. Who that is is difficult to pinpoint when taking these meds. After taking them for as long as I have it is almost like I have to start from scratch again and learn who I am. This is scary but it is what I want. I crave being medication free and living in a constant state of bliss and I will have this ONE way or ANOTHER!

Mania rules, I crave it and it is when I feel the best. The rest of the time it is depression but I have become very good at sitting with this. Mainly because I know the mania will be back to play soon No one can really understand this but those who ACTUALLY experience it.

 

[DJ916]

did you get to read the post in the injury forum? i posted a link would really appreciate a reply

 

[DJ916]

http://www.mattersofsize.com/forum/showthread.php?66548-BB-size-lump-Help-anyone

 

[DLD]

Considering writing a book on this disorder. I have been discussing it with my psychologist and I think it would be hugely beneficial to a lot of people. I am trying a completely cognitive approach and I plan on journaling it (which should become the text).

 

[Exiled15]

You right a book about the disorder DLD I will write you 50 pages front and back worth of how this disorder has ruined my life and how ive rizen above the disability. Ive taken meds for it as far back as 12 years old and decided to quit all of them at 21 because I was tired of havin something control me and missed being me as well. Crazy as fuck as I am , I am a super intelligent intellectual blast!! All the medication did was zombify me and make me lathargic... I had an involuntary hospitalization about 4 months back where they labeled me with homicidal tendancys as well and tried prescribing me with Lithium??? I refused all medication!!! Even funnier during all my conversations with the psychologist trying to convince me to take the meds he was baffled I was able to rebuttle every reason why I should with a reason he couldnt argue of why not.. During our hour long sometime 2 hour long conversations he finally made a comparison of me to a Matt Damon in Good Will Hunting (GOING TO THE HOOD) and Butch Cassidy And The Sundance Kid and claimed I had Cassandra Complex as well!!!! Either way ive remained completely sober off all the drugs and hard liquor for around 5 months now and I am able to control my mood swings very well and my mind is more powerful than I ever believed!!! I am currently an entraprenaur, at what I wont say at the moment ,but guarantee I am going to be famous pretty damn soon here.. When the times right I will let only DLD know and I am down for whatever to help a fellow Bipolarist (I'll call it) out by any means!!! This is a very serious illness that can ruin lives and my struggle with it and eventual overcoming of it non medicated and substance free leading to a success story of fame would be a great addition to this book I feel!! If you are trully serious about writing a book and would be interested in my point of view as an addition to make references to private message me and I'll see what I can do to help from my end!!! DLD and EXILED a tail of manic bipolarism and overcoming by strictly will power.. Ha Ha Ha Allright give me a double of 151 bacardi rum with a henessey chaser!!!

 

[Exiled15]

Did I forget to add huge dick bastards through p e also!!!! what a promotion to acceptance of P E world wide this may be as well????

 

[DLD]

A book written from my own perspective would greatly help myself but I am not sure how sound it would be as therapy to other people. I have discussed my beliefs and views with my therapist and the way I see things is unconventional according to the books and views of the powers that be. The way I see things in my own illness is as such:

OCD: Obsessive Compulsive Disorder
Although many would view this a s a disability, I see it as a ability many do not have. I can sit with a problem for as long as it takes to be solved. Problem solving takes the ability to sit with the problem until it can be solved. Without OCD I would not have been able to solbve many of the issues I have been afflicted by.

Bi-Polar Disorder:
Again, this is seen as an awful condition to many but to me, not at all. I have a schedule that is extremely predictable. I know that for 4 months out of the year I will have the energy to get anything done I want. How big the goal is makes no difference, if I want to accomplish it, I will. I also know that with these abilities there is times I will need to rest that may feel depressive, this is OK. I know this is part of the gift of this condition, Work then Rest. Without these massive surges in energy and motivation much of what I have accomplished today would not have happened.

Split Personality Disorder/Borderline Personality Disorder:
Being a very rare condition, SPD effects a very small percentage of the population. A condition called schizophrenia sometimes is confused with SPD or BPD. In my condition there are times when I am able to see and hear things that other can't. I am able to become and live as a completely different persona then that I am in my usual days. I have counted up to 12 different internal voices and 5 different external physicalities, all of who are unique and different than the others. To many this is a crippling disorder but not to me.

Once I made friends with each persona and found the positive qualities and attributes, much different than myself, I was able to start using these episodes to benefit me. Through unique perspective views, to new, original ideas to problem solve, I have used each episode to benefit myself, my family and my followers.

Psychosis is the one illness I struggle with most. For this I still take medication but I soon hope to deal with this is a purely cognitive way. Loosing my temper or becoming frustrated usually ends badly and does not benefit me. Today I still take Serequel to combat this but I know the day will come when this to is used to my benefit.

Tenacity and self belief will always drive my determination to seek out answers to problems never solved before. When I think of how I influenced Penis Enlargement through these gifts I know that it will benefit every other walk of life.

 

[MOSman123]

i have this it is not nice im not taking any drugs for it i have just started reading a very good self help book its called feeling good the new mood therapy check it out

 

[DLD]

i have this it is not nice im not taking any drugs for it i have just started reading a very good self help book its called feeling good the new mood therapy check it out

I will check it out, thanks for the tip.

 

[MOSman123]

i bought on the net for £15 or that i think it is the best selling self help book out there i have just started it but i can see already where i go wrong sometimes

 

[yonni3998]

Hey Dld i thought i would tell you of my personal experiences with Bipolar or personal depression that i experienced . I was raised in a family where my father was a alcoholic passive deadbeat and my mother was a violent rager with her emotions.
My mother threw out and divorced my father when i was young but the abuse from her did not stop. I think she did that as a response as to how she was raised and never thought it would change me as i grew up .
I battled with severe bipolar and manic depressive thoughts all the way through high school thinking it was normal for a teenager to be put through beatings.
As i got older and moved away i was still bipolar/depressive into my mid twenties.I traveled the world and lived across Canada trying to escape my small town thinking that my life would get better if i got farther away from where all my stuff happened.

But this did not change how i was inside with my same bipolar thoughts. When i was 25 i hit rock bottom and moved home to clear my mind and try to get help with myself. I first went to a doctor and he prescribed anti depressants and i took them but they only made me slow and dull in my mind. So i talked to my uncle who is a psychologist and he recommended work with a trained therapist in whats called NLP.

NLP stands for Neuro-linguistic programming and i started to see this therapist for help.
It has changed my mind and without a doubt my life. I think medications only calm the mind but they will never solve as to why we engage in this bi polar rollercoaster.
For me it was from definite early childhood trauma and abuse from both my parents that cracked me and made these negative emotions become a learned response to stress .

So if we never get to re-program our mind into realizing what makes us go into that bi-polar roller coaster we will never get any positive life change. No drug will re-program these thoughts.
My suggestion is to find a Nlp therapist that can help and it will radically change your thoughts and help a person regain their mind instead of being controlled by it.

I have learnt alot from Nlp and my whole life outlook has become better . It has changed me from a weak minded person into a wiser , stronger man .

Feel free to ask any question about Nlp if you like. Hope this helps

 

[MikeShlort]

uigj

 

[tizalee]

How Bipolar Disorder is different from Unipolar Depression? Can anybody help

 

[pdguy]

I was diagnosed with Bipolar 1 in 1997 and unlike others on this thread, I have
not overcome and gone on to see any success in either my art or my
engineering abilities. Now days I am in a 4 year long cycle of depression and
before that I was mostly up and manic with creative projects and once even
owned a state of the art digital recording studio in 1995 made one album of
my own music but had no outlet of distribution and other factors made it all
fail.
Another thing is that I am Bipolar 1 with psychotic ideations and for many years
thought of myself as the antichrist. But that only happens when I am way
manic and these days I am on meds for that. Bipolar 1 has been both a blessing
and a curse. As an artist it's great to have it, but only in varied degrees but
like in my case when the demons start talking it's hard to shut them completely
out without being way over medicated to the point of drooling on one's self.

Then there's the depression and we haven't even talked about that yet.......
Now I am on meds that keep me closer to base line so I can do things like PE
now and ride my Harley ect. I had to go on SSI in 1997 and have not gone on
from there. Thank you DLD for your great post/thread on BP 1.

 

[pdguy]

It makes me a little nervous here that nobody has responded to my post above.
I seem to be the only bipolar 1 on this thread that has not made it yet with any
success in life. <

I think it is because my BP1 is really bad even on meds. If anyone wants to talk
about just how bad it really is, then I can do that. But it just might be best to
not know how bad BP1 can really be. Sometimes I feel like screaming at people
for being so damn stupid until I realize my own stupidity.

BP1 effects the MIND more than people think. It's not just an emotional roller
coaster it's also a mental one. It borders on genius and insanity. Sometimes
I wonder if I am in the genius mode or the insane one.

If you do not have to worry about your BP1 then you don't have it that bad.
To be perfectly honest with you all here at [words=http://www.mattersofsize.com/join-now.html]MoS[/words], I am not a well man in the
mind as a direct result of my personal type of BP1 w/psychotic ideations.

If you don't know what that means, then you don't have to worry about
it. Just be glad you don't have it that bad and enjoy your life the best
that you can and I will try to do the same.

 

[Lightning]

I think everyone has some degree of bi-polarism.

 

[pdguy]

Just so you all don't think I am a lier about having BP1 and bordering on genius and
insanity, I am giving you this LINK to my piano compositions and all of my art to enjoy for free.

Angel
aka
pdguy

 

[Lightning]

Just so you all don't think I am a lier about having BP1 and bordering on genius and
insanity, I am giving you this LINK to my piano compositions and all of my art to enjoy for free.

Angel
aka
pdguy

Amazing talent my brother! DLD is a bit of a pianist as well, check his link out DLD.

 

[pdguy]

I think everyone has some degree of bi-polarism.

I disagree, that is what that pharmacy corporations want us to believe so they can sell their
drugs to people who don't even need em! And most doctors are in bed with them.

 

[pdguy]

Amazing talent my brother! DLD is a bit of a pianist as well, check his link out DLD.

How do I find his link?

 

[Lightning]

How do I find his link?

I meant for DLD to check out your link.

 

[pdguy]

I meant for DLD to check out your link.

Silly Me!!!!!!!!!:blush:

 

[DLD]

Just so you all don't think I am a lier about having BP1 and bordering on genius and
insanity, I am giving you this LINK to my piano compositions and all of my art to enjoy for free.

Angel
aka
pdguy

Link please sir?

 

[DLD]

I disagree, that is what that pharmacy corporations want us to believe so they can sell their
drugs to people who don't even need em! And most doctors are in bed with them.

Bi-polar is only a pharmaceutical way to say "inspired to depression"

These doctors will never understand the mind of one who has such vast understandings and wisdom, it scares them and they medicate out of fear.

 

[pdguy]

Link please sir?

thanks for asking for the link DLD HERE.