Progression of Bipolar Disorder

Mine has definitely worsened. More intense episodes, first full blown manias, first psychosis....all in the last two years. I don't know what tipped off the worsening but it's been terrible.

Google GLYX-13. That's just the beginning.

Oh yes...Ketamine's cousin! I can't wait!

Interesting! Thanks!

I am the same way. If there is a kid in the street and they are about to get hit by a car I can react with no fear and do something. When I played sports I was never nervous and always supremely confident but when it comes to going into work day after day and making dinner walking dogs cleaning the house I need medication so I don't break down. It really sucks.

Mine has just gotten worse.

You're welcome!

My MI became worse over time. Now I am on disability.

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What I do know is that I managed without meds until I was 24 and was pretty functional. When something bad happened, I would become depressed (truly clinically depressed, not just sad) but there was always a reason for the episode. Fast forward 10 years. When I tried to stop or reduce my meds, my life would fall apart whether there was a trigger or not. The depression would be incapacitating. (I'm bp 2, so I just had hypomania not mania, which was uncomfortable and embarrassing, but not dangerous). So, my general impression is that I'm getting worse, but fortunately I can be pretty well managed on meds.

I think one thing to consider is PTSD like symptoms caused by episodes. A bad episode can be traumatizing and can skew our future thinking and thus worsen how we manage through the episodes.

That's very interesting. So if you anticipate that, does it make a difference in the next episode? Or does it just not matter, do you experience a sort of amnesia of that understanding?

Yes, it's funny -- there are times when I feel like there is no real "sad" for me. I just go straight to depressed, even if it's just mild.

It makes me so angry when I get depressed for no reason. I'd almost rather there be a reason half the time.

It has become worse over time. I also rarely feel sad. I just go directly into depression. Now I am on disability wanting very much to have a normal life whine includes a job.

Mine kind of blossomed at age 50... so, yes, it got worse. But at least I understand it now...

If you really can't have a job, can you do something like volunteer?

Yes. I can volunteer. That is a good idea. I just need to find out where I can volunteer. This would be an excellent step for me to take.

I'm glad to hear it. I'd love to know what you wind up doing.

I believe it does get worse, not merely because of observation, but due to the research I've been doing to try to find a way to cope. It's been beneficial so far, learning what I have, so I think I'll share it since it might help others prioritize how they manage their bipolar.

Any person placed under enough stress will develop cognitive deficits. When such stressors are unavoidable the physiological response to those stressors are unavoidable. That this is the case often results in additional psychological stress, which can be embodied in terms such as "catastrophizing".

Chronic acute stress leads to a sustained elevation of stress hormones which leads to neuronal cell death and prevents nuerogenesis in the regions of the brain which "[play] important roles in the consolidation of information from short-term memory to long-term memory and spatial navigation." This leads to difficulty learning new information as well as accessing and applying existing knowledge - this affects how well someone is able to contrive methods to cope with stress. Sleep deprivation can also prevent neurogensis from taking place (it is important to get sleep!).

Another result of chronic stress, at least in bipolar (not the best memory late at night), is the release of a protein, Kiinase C, which can damage the dendrites of neurons. This can lead to deficits in working memory. Such a deficit, again, impacts one's ability to function and thereby respond appropriately to stress.

While such mechanisms might've played important roles throughout humanities evolution we now exist in a society which places much greater stress upon individuals. Our environment has changed faster than our ability to physiologically adapt to it. For people susceptible to stress this presents difficulties (an understatement ofc).

With the variety of cognitive deficits impacting our ability to cope in a high-stress environment our ability to effectively cope is more easily compromised. In addition to the brains physiological responses to stress we have bipolar to deal with. As cognitive deficits increase as a result of chronic stress our stability is further impacted, which leads to more stress, and it gets out of control quite fast, often before we can catch it let alone devise a means to cope with it. A firestorm develops and medication is used to quench the immolation of our mind.

Funny thing about these medications, they have side effects. I've quite recently learned that Benzodiapines are highly addictive: one can develop tolerance to them, dependance, and then withdrawal symptoms. Symptom doesn't quite describe my experience though. I've been coping, barely, with bipolar II for eighteen years and thought I was going totally and completely insane when I was experiencing interdose withdrawal 'symptoms' from Temazepam. That I thought I was going crazy - the reasons and experiences I had - created additional stress and the thing about Benzo withdrawal is that stress is amplified by it. During Benzo withdrawal one can experience a variety of cognitive deficits arising from the Benzos themself, and then also from the withdrawal, on top of which the imbalance between inhibitory and excititory neurotransmitters can lead to excitotoxity which eats away at neurons and can lead to neuronal cell death. Brain damage. Well, more brain damage as the nature of Benzo dependance could be defined as brain damage, although that is, I believe, not a technically accurate description as the neurological changes to GABA receptors that Benzos cause can be recovered from, slowly, painfully, or sometimes without any problem whatsoever (it depends on the individual - side note, never cold turkey Benzodiapines, NEVER!).

So, we people with Bipolar have a lot of stress to cope with. Not just due how bipolar affects our chemical balance but due to the outcomes in life which affect how much stress we have and how we can cope with that stress.

Stuff I do to cope:

Sleep. Exercise. Diet.
One can find a lot of good advise on all of these searching this forum - some of my own post history directly addresses these topics in a condensed form, much like this post.

Therapy.
Personally I haven't found a therapist that works for me yet, but I have spent a lot of time trying to understand my own mind and why it is the way it is. I'd say concurrently engaging in both approaches would be ideal, but it depends a lot on personal interest in philosophy, psychology, and cognitive science.

Alternative Medicine.
I'm not a fan of it, but if it's been studied and shown to have some efficacy I consider it. Sorting through papers on pubmed isn't easy, and figuring out enough to comprehend the basics of what those articles actually mean has taken months of slow learning. So far what I have investigated and found worthy of serious consideration is Withania Semnifera, L-Theanine, and L-Taurine.

It should be noted that there are many substances I have not looked into yet. I have been looking for substances relevant to my own current needs.

Withania Semnifera is from Indian Medicine. It's more like a general wellness drug that anyone can take and improve their health with than a specific treatment. However, it is specifically associated with helping alleviate stress. It's been well studied - at least, well enough for me to consider it and add it to my own treatment - although my pdoc said he hadn't heard of it when I asked if he had, so investigate for yourselves.

L-Theanine is found in Green Tea, but as a supplement it can be effective in helping reduce stress by improving focus, promoting a sense of mindfulness and calm. It can help with Benzo withdrawal, which is why I bothered with it.

L-Taurine is the most abundant protein in the human body. However, in high dosages (a dosage above the normal dietary intake and production of Taurine within the body) it can promote relaxation. Its action, as it seems to be so far understood by what I have read, is similar to Benzos and should not, in my inexperienced opinion, be taken in conjunction with Benzodiapines. It may, or may not, help with Benzo withdrawal; it may or may not make recovery from Benzo dependance more difficult. It's a question to ask your pdoc and a decision one should make for themself after careful consideration. However, if you're not on a Benzodiapine it could serve as an effective means to reduce stress every now and then. One of those nights you know you need to go to sleep and know you're going to have trouble doing so. Do not use Taurine supplements with caffeine.

Keep your mind engaged.
No matter how poor my working memory was I still tried to read something, think something, do something. Even while severely depressed I still tried because I knew that that brains plasticity will adapt to its environment. It's a muscle that will atrophy when not properly exercised and even the tiniest effort will mitigate how difficult it is to recover. Besides which, hey, I now know stuff!

Meditation.
If ones mind is without thought, then one cannot think psychologically distressing thoughts. It takes a lot of practice, but it can help with calming down. Start by taking a deep breath. Take another. Another. Breath deeply and slowly and be at rest - still your mind. Let your thoughts fade from one to the other, to another, again. Slow, deep, breaths.

It's a lot of information, but that's how I'm currently able to cope and after several months of depression, rapid cycling, psychological distress, withdrawal, and constant suicidal ideation I finally experienced something spectacular - life didn't completely suck. Progress!

This was awesome, thank you for such an informative post! Much respect for all the research you've done. How did you come to find all of this?

One thing I found interesting was that our environment has changed faster than our ability to physiologically adapt to it -- but we've changed our environment faster than our ability to physiologically adapt to it. It seems so odd that we would do that to ourselves, no? Other animals are content to keep things as they've been for millenia, but humans as a species seem to have this neurotic need to keep changing things, and while they increase their lifespan, they get sicker in the process.

I think it's progressed more over time. However my coping skills have progressed too. So I am better able to handle it each time. I guess you can say it's all relative.

I am 48 and have been in treatment since i was 25. I would say my manias are less intense but my depressions about the same. My friend who is in his fifties says his bipolar has improved so that gives me hope.

Here are my thoughts:

This is from a man who deals directly with Mania and have only had one episode of clinical depression after my original diagnosis.

My problems relate directly to blood sugar levels.

The riddle I had to solve myself is how to keep myself balanced and keep my mind from going into an upward spiral.

The key is diet. I find that leafy greens (primarily spinach) provides the nutrients and cleans the body of toxins as well as being a source of appetite fulfilling energy.

With the reduction of sugar/carbs in my diet I was able to reduce my dependancy on Zyprexa to shut down mania episodes. At this point I've been completely off meds for 6 weeks while relying completely on spinach as my main meal 2-3 times daily. Around 200 calories of spinach daily.

Starting the spinach diet also provided me the energy needed to workout. So between diet and excercise I have been able to lose 15-20 lbs in 5 weeks or on average 3 lbs a week steadily along with 2 belt notches.

So, do I believe that age matters? Yes.
The reason I believe that age matters? It takes longer to recover from injury and metabolic rates slow down. Therefore if the body/mind gets out of whack it takes longer to properly clean up. Thus, yes bipolar can get worse with age.

However, trends can be reversed applying the right pressures.

I started on Wikipedia at "Neuron" and just keep clicking or Googling anything I didn't understand. All I've really been focused on is learning just enough to know how to fix myself since professionals haven't been all to helpful in that regard.
The changes we've made, the 'progress', oddly does as much harm as good. The lifespan of humans during hunter gatherer times were on average less than ours, but when someone managed to live through childhood, adolescence, and into adulthood they lived longer and healthier lives than the average American does.

I like that you started at the smallest thing. And your determination is very admirable.

I suppose Americans, on an evolutionary scale compared with other cultures/countries, could possibly be considered a dying breed? In the long run, I mean.

Most certainly. A very significant portion of jobs requiring highly trained and capable individuals are increasingly filled by people who are from other nations. This is due to an education system and overall culture that is not up to the task to fill those positions.