issue 90 (our 8th year)
issue 90 (our 8th year)
Circuits in the brain involved in pursuing and relishing rewarding experiences are more strongly activated in people with bipolar disorder, guiding them towards riskier gambles and away from safer ones, researchers report. The study used brain imaging to identify neural pathways that are responsible for the symptoms of the disorder. The findings will help to design, evaluate and monitor therapies for bipolar disorder.
Researchers at the Universities of Manchester and Liverpool have discovered that circuits in the brain involved in pursuing and relishing rewarding experiences are more strongly activated in people with bipolar disorder — guiding them towards riskier gambles and away from safer ones.
The study by the Universities of Manchester and Liverpool, published in the journalBRAIN, used brain imaging to identify neural pathways that are responsible for the symptoms of the disorder. The findings will help to design, evaluate and monitor therapies for bipolar disorder.
Patients with bipolar disorder experience episodes of depression and mania (periods of intense excitement and irritability, often leading to very risky behaviour) which occur unpredictably. It is one of the most serious and difficult to treat forms of mental illness, associated with reduced life expectancy, a high risk of suicide, and sometimes persistent impairment of work and social relationships.
In recent years, a number of people in the public eye, such as Stephen Fry and Catherine Zeta-Jones, have spoken openly about their diagnosis of bipolar disorder, raising awareness of the condition. But problems with social stigma, stereotypes, and prejudice against sufferers are still widespread.
The Medical Research Council funded study will look at the neuroscience underlying the risky decisions made by bipolar patients. Researchers Dr Liam Mason and Professors Wael El-Deredy and Daniela Montaldi at The University of Manchester, in collaboration with Professor Richard Bentall and Dr Noreen O’Sullivan at the University of Liverpool, invited participants to play a game of Roulette in which they made safe or risky gambles. The researchers measured their brain activity throughout using functional magnetic resonance imaging (fMRI).
Their findings revealed a dominance of the brain’s “pleasure centre” which drives us to seek out and pursue rewards, responding to them automatically — before conscious awareness kicks in. This ancient brain area, called the nucleus accumbens, was more strongly activated in people with bipolar disorder compared to a healthy control group.
Another key difference arose in the prefrontal cortex, a recently evolved area of the brain which is associated with conscious thought. Much like the conductor of an orchestra, it gives us the ability to coordinate our various drives and impulses — such as quelling our urges when faced with risky decisions — allowing people to make decisions that are less immediately rewarding but better in the long run. The researchers found that for control participants, their prefrontal cortex guided them towards safe gambles and away from risky ones. For the people with bipolar disorder the balance swung the other way: greater neural activity for risky gambles.
Professor Wael El-Deredy said: “The greater buzz that people with bipolar disorder get from reward is a double-edged sword. On the one hand, it helps people strive towards their goals and ambitions, which may contribute to the success enjoyed by many people with this diagnosis. However, it comes at a cost: these same people may be swayed more by immediate rewards when making decisions and less by the long-term consequences of these actions.”
Professor Richard Bentall said, “This study shows how we can use the new tools of neuroscience to better understand the psychological mechanisms that lead to a psychiatric disorder which, until now, has been very difficult to understand.”
Dr Liam Mason, who now works at the Institute of Psychiatry in London, said: “Understanding how the brain works to regulate the pursuit of goals will help us to design, evaluate and monitor better therapies for bipolar disorder.”
The researchers are keen to explore the potential for psychological therapies that can support people in engaging with their value systems and therefore better regulate their pursuit of goals.
Source: Manchester University
When you have seasonal bipolar disorder, you may find yourself wondering how you can handle it. You might feel frustrated as you try to cope with seasonal relapses or episodes. You may also have questions about treatment, managing your stress, or taking care of your health overall. There are steps you can take to manage your disorder. For example, you can try establishing a treatment plan and coping with bipolar episodes. You can then work on building a support team, taking care of your overall health, and managing your stress.
Stick to your treatment plan. The most important thing you can do to handle seasonal bipolar disorder is to establish and maintain a treatment plan. This will give you the resources and support you need to manage your disorder. If you don’t already have one set up, talk with your primary care provider about establishing one. If you do have one established, then continue your therapy doing the things you do to manage your disorder.
If you have a treatment plan, but feel it isn’t working, contact your health care professional and let them know. You could say, “I don’t think my current plan is working. Can we make some adjustments?”
If therapy isn’t currently part of your treatment plan, consider adding it in. Talking to a counselor, therapist, or other mental health professional can help you handle your seasonal bipolar disorder in several ways. Therapy, in general, has a strong evidence base in terms of managing bipolar disorder, especially when used with medication management. Your therapist can also offer you tips and strategies for handling your disorder as well as provide you with encouragement and other support.
Ask your primary care provider for a reference to an effective therapist.
If you’re already attending therapy, you may want to consider increasing your number of sessions during the seasons that your bipolar disorder is most challenging.
Learn the triggers for your disorder. Although your bipolar disorder may be seasonal, there may still be certain things that lead to you having a manic or depressive episode. Being aware of the situations, people, and places that cause you a lot of stress can help you recognize what may trigger an episode. Once you know the things that stress you, you can work to avoid them.
Triggers are events, places, people, or situations that may make it likely that you will have a bipolar episode. For example, very stressful situations like starting or ending a new school or job may trigger a bipolar episode.
Pay attention to the things that are going on during the season that you usually have the most trouble with your bipolar disorder. For example, is it all of the extra activity but less structure of the summer that causes you problems?
Recognize your signs of a bipolar episode. There are several indicators that you may have that a depressive or manic episode is coming. Some of the signs are common for people with bipolar disorder, while some signs of an episode will be specific to you. Handle seasonal bipolar disorder by paying attention to thoughts, feelings, and actions that suggest an episode may be starting.
Keep in mind that you may experience more manic episodes during the warm months and more depressive episodes during colder months.
For example, many people feel irritable, restless, and unfocused at the onset of a manic episode.
On the other hand, feeling fatigued, hopeless, and withdrawing may be signs of a depressive episode.
Use your journal or another log to keep track of your feelings, emotions, and actions so that you can identify patterns in your behavior and signs of an episode.
Seek help immediately. Although you may already have a treatment plan established, if you are experiencing a bipolar episode you should contact your mental health professional or primary care provider. Your treatment team can provide you with the resources and support you need to work through your episode, as well as handle seasonal bipolar disorder.
As soon as you feel you may be experiencing a bipolar episode, you should tell your treatment team, “I need to come in immediately because I think I’m having an episode.”
If possible, ask someone close to you to intervene if you’re acting irrationally. For example, you might tell your sibling, “If I start taking stupid risks, please let my treatment team know I might be having a bipolar episode.”
Join a support group. Building a network of people to help you handle your seasonal bipolar disorder is a good idea for a number of reasons. For example, joining a support group can provide you encouragement, friendship, and new coping strategies. In addition, spending time with other people who have seasonal bipolar disorder can help you relieve tension by giving you a safe space to share what you’re going through.
Consider joining an online support group or forum if you can’t attend an in-person support group.
Rely on your family and friends. The people that care about you can do a lot to help you manage your seasonal bipolar disorder. They can encourage you and help you manage your treatment plan. They can also help you handle any stress you’re going through as a result of your disorder.
Tell the people close to you that you might need their support. For example, you might say, “This is around the time of year that my bipolar disorder gets really crazy. Could you help support me while I go through this?”
Remember that it’s okay to ask someone to just come be with you if you’re feeling a little down.
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Swipe Left for Love is a play about a young woman living with bipolar that addresses serious issues through comedy and story. Yes, it is my story, or a culmination of things that have happened in my life – the economic style graph that has been my life until diagnosis and acceptance.
Swipe Left for Love is me being fearless. I’ve stripped myself stripped bare. Every part of the journey of getting to the comedy festival this year has been amazing for me personally.
In April of 2014 I was diagnosed with Bipolar after years of being misdiagnosed with depression. Consequently I have a life that looks like the economic cycle – big highs, big risks, big success and then BIG crashes, suicide attempts and a stint in rehab – such fun!
The diagnosis has changed my life and since accepting it and ensuring I do what my psychiatrist says – I live life in between the poles – but my creativity is not limited – in fact it has been enhanced, and Swipe Left for Love has come out of this new found stability.
My life has been chaotic, hilarious, stupid and colourful. My brother once said to me “Amanda, I often wonder if it’s chaos that comes to you or you bring the chaos…”
Chloe James – the lead character is me. The antagonist, Angela, is also me. All the other characters are based on a mish-mash of horrors and wonders in my life and each situation is based on something that happened to me so yes, I am baring my soul. Through comedy and original music I wrote (just two of the songs, written twelve years ago)!
In former lives I made wine, created the Adelaide Food & Wine Festival, had my own wine label and PR business. In former lives I also didn’t leave the house for three months. Sizes 8-18 populated my closet. I had an eating disorder, too.
This all sounds very horrible – but the play addresses all of this, plus adultery, infidelity, friendship, sex, love and masturbation – through comedy.
I have big hopes for it. It and the people who have helped bring it to life mean everything to me.
Please come and support it – you can get tickets via eventbrite – https://www.eventbrite.com.au/e/swipe-left-for-love-a-play-with-music-tickets-30947214953
And find out more about me and the play – the cast of nine – at our website –