Bipolarlife Newsletter March 2019

Issue 110

March 2019

Bipolar Life Victoria

Upcoming Support Groups Meetings

click group location for further information

click group location for further information

Announcement

Bipolarlife Victoria will be running a series of Bipolar Information nights around Melbourne in 2019. We need to educate communities and individuals about bipolar, particularly with the undiagnosed. Everyone will be welcome at these evenings.

We also have Bipolar Workshops planned in 2019 with a primary focus on self help strategies. The workshops will be 4 sessions over a 4 week period.

Bipolar books – We have ordered 91 bipolar books to supplement our support group’s libraries. These books can be borrowed by our members free of charge.

Article

Transcranial Magnetic Stimulation (TMS)

Transcranial magnetic stimulation (TMS) is a noninvasive form of brain stimulation in which a changing magnetic field is used to cause electric current at a specific area of the brain through electromagnetic induction.

An electric pulse generator, or stimulator, is connected to a magnetic coil, which in turn is connected to the scalp. The stimulator generates a changing electric current within the coil which induces a magnetic field; this field then causes a second inductance of inverted electric charge within the brain itself.

TMS has shown diagnostic and therapeutic potential in the central nervous system with a wide variety of disease states in neurology and mental health, with research still evolving.

Adverse effects of TMS are rare, and include fainting and seizure. Other potential issues include discomfort, pain, hypomania, cognitive change, hearing loss, and inadvertent current induction in implanted devices such as pacemakers or defibrillators.

TMS is non-invasive, and does not require surgery or electrode implantation. Its use can be divided into diagnostic and therapeutic applications.TMS can be used clinically to measure activity and function of specific brain circuits in humans, most commonly with single or paired magnetic pulses.

The most widely accepted use is in measuring the connection between the primary motor cortex of the central nervous system and the peripheral nervous system to evaluate damage related to past or progressive neurologic insult.

Repetitive high frequency TMS (rTMS) has shown diagnostic and therapeutic potential with the central nervous system in a wide variety of disease states, particularly in the fields of neurology and mental health, with new studies continually emerging.

During the procedure, a magnetic coil is positioned at the head of the person receiving the treatment using anatomical landmarks on the skull, in particular the inion and nasion. The coil is then connected to a pulse generator, or stimulator, that delivers electric current to the coil.

Although TMS is generally regarded as safe, risks are increased for therapeutic rTMS compared to single or paired diagnostic TMS. Adverse effects generally increase with higher frequency stimulation The greatest immediate risk is fainting, though this is uncommon. Seizures have been reported, but are extremely rare. Other adverse effects include short term discomfort, pain, brief episodes of hypomania, cognitive change, hearing loss, impaired working memory, and the induction of electrical currents in implanted devices such as cardiac pacemakers and defibrillators.

TMS uses electromagnetic induction to generate an electric current across the scalp and skull. A plastic-enclosed coil of wire is held next to the skull and when activated, produces a magnetic field oriented orthogonal to the plane of the coil. The magnetic field can then be directed to induce an inverted electric current in the brain that activates nearby nerve cells in a manner similar to a current applied superficially at the cortical surface.

The magnetic field is about the same strength as an MRI, and the pulse generally reaches no more than 5 centimeters into the brain, unless using a modified coil and technique for deeper stimulation.

This electric field causes a change in the transmembrane current of the neuron, which leads to the depolarization or hyperpolarization of the neuron and the firing of an action potential.

Deep TMS can reach up to 6 cm into the brain to stimulate deeper layers of the motor cortex, such as that which controls leg motion. The path of this current can be difficult to model because the brain is irregularly shaped with variable internal density and water content, leading to a nonuniform magnetic field strength and conduction throughout its tissues.

History

Luigi Galvani undertook research on the effects of electricity on the body in the late 1700s, and laid the foundations for the field of electrophysiology. In the 1800s Michael Faraday discovered that an electrical current had a corresponding magnetic field, and that changing one could induce its counterpart.

Work to directly stimulate the human brain with electricity started in the late 1800s, and by the 1930s electroconvulsive therapy (ECT) had been developed by Italian physicians Cerletti and Bini. ECT became widely used to treat mental illness, and ultimately overused, as it began to be seen as a panacea. This led to an ensuing backlash in the 1970s.

Around that time, Anthony T. Barker began exploring use of magnetic fields to alter electrical signaling within the brain, and the first stable TMS devices were developed in 1985.They were originally intended as diagnostic and research devices, with evaluation of their therapeutic potential being a later development. The first TMS devices were approved by the FDA (USA) in October 2008.

From Wikipedia

Our Stories

The Bipolar Toolbox

Anyone who has bipolar, be it bipolar 1, 2 or 3 knows how unpredictable this condition is. You’re feeling like you’re doing really well and your emotional wellbeing is in check, when out of the blue you get hit. Be it by a spout of hypomania or a depression. You just don’t know what happened, everything went well and no you’re all over the place.

Often there are early signs, but most of the time it’s easy to ignore them as you’re just too busy with life and can’t take care of yourself.

Often the first sign that things are going downhill is when your sleep pattern changes. All of a sudden you can’t fall asleep as you keep having these racing thoughts. Or you keep waking up at 4 am in the morning and just simply can’t go back to sleep. Instead of feeling exhausted you start feeling winded up and experience racing thoughts throughout the day which can also lead to thoughts of grandeur, ‘I can achieve anything’ thoughts and you feelings of being on top of the world. But behold, before you know it your world comes crushing down and you’re engulfed in a low mood where everything is an effort and life is just too much.

A good way to keep these episodes as minimal as possible is to create an early warning signs list and a tool box.

It’s great to discuss these tools with your psychiatrist and get his or her input as well. For example, it might be good to adjust your medication if you feel your mood is slipping away. Be it extra medication to help you sleep or a different dosage to get you of your high.

A toolbox can be a great tool to add things to do and say to yourself when things start getting out of hand. Be it having a relaxing bath and some meditation before you go to bed when you start noticing you get to winded up before bedtime. It could be that you take extra ME time, by reading your favorite book, eating the most delicious cake without feeling guilty, listening to your favorite music, painting, running – what ever centres you and calms you down.

It’s also helpful to have a positive dialogue with yourself reassuring yourself that this phase will pass and you can influence your thoughts by telling yourself that things will change again.

It’s good to know you’re not alone with your bipolar and joining a support group is also a great tool in your toolbox.

I have bipolar 2 and used my toolbox for many years now. It helped me to prevent to slip into another catatonic depression for 11 years and I hope it might help you too.

by Anna

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