Bipolar I and II Disorder: A Diagnosis, Not A Prison Sentence

On Bipolar Disorder: “You are not your illness. You have an individual story to tell. You have a name, a history, a personality. Staying yourself is part of the battle.” Julian Seifter,

Just a few days ago, eighty-seven year old comedian Jonathan Winters died. Some of you may be too young to know him, but I’m sure you know the many gifted entertainers who were influenced by Winter’s brilliant improvisations, like that of Robin Williams, Jim Carrey, Jimmy Kimmel and Steve Martin. You may also be unaware that Mr. Winters struggled with bipolar illness his whole life. One of the most damaging manic episodes came in 1959, when Winters was reported to have climbed the mast of a moored historic ship in San Francisco while drunk and naked; he was subsequently transported to a sanatorium.” (Washington Post, Jonathan Winters, Improvisational Genius).

But, no doubt, bipolar disorder contributed to Mr. Winter’s comic genius of being able to dig ruthlessly into American archetypes as the subject matter of his routines and also to his nervous breakdowns. Friends, family and employers viewed him as wildly unpredictable and thus a professional liability, which is often the perception people have of bipolar persons. Nonetheless, like Jonathan Winters, there is a long history of entertainers (Catherine Zeta-Jones, Marilyn Monroe, Patty Duke, Robin Williams, and Carrie Fisher), entrepreneurs (Larry Flynt and Ted Turner), writers and poets (William Styron, Sylvia Plath, F. Scott Fitzgerald, Ernest Hemingway, William Blake, Walt Whitman and Ralph Waldo Emerson), composers (Rachmaninoff, Tchaikovsky and Mozart) and world leaders (Abraham Lincoln, Winston Churchill, and Napoleon Bonaparte) who have still been able to leave their creative mark on the world despite having bipolar disorder (Famous Bipolar People).

The link between creative genius and bipolar illness does exist. But, let’s not get too carried away by the exceedingly good company that you, or a family member, are keeping if you have this disease. Because, as you know too well, the periods of high creative productivity is no match for times that you have had to spend either in manic confusion or in the despair of depression; the kind of depression that makes 20% of bipolar people take their lives through suicide.  American Clinical Psychologist, Kay Redfield Jamison describes well her own emotional struggle with the disease. “There is a particular kind of pain, elation, loneliness, and terror involved in this kind of madness. When you’re high it’s tremendous, you’ve never functioned better. But, somewhere, this changes. The ideas come too fast and are far too many. Confusion replaces clarity, memory goes, and humor and absorption are replaced by fear and concern. Everything previously moving with the grain is now against— you are irritable, angry, frightened, uncontrollable, and enmeshed totally in the blackest caves of the mind that you never knew were there. It will never end, for madness carves its own reality.” Kay Redfield Jamison, An Unquiet Mind: A Memoir of Moods and Madness

Indeed, Bipolar Disorder does carve out its own reality, if left untreated. With proper diagnosis, treatment and management, people can achieve their goals and forge a fulfilling life. Unfortunately, some bipolar people do not seek treatment, until a manic episode gets them in trouble sexually, financially, or with the law. Or, they are misdiagnosed, as the symptoms can present as a range of disorders that include clinical depression, schizoaffective disorder, and even the attention deficit and anxiety disorders. And, still some people refuse treatment altogether, to maintain their creative edge.

For sure, BPD is a challenging mental health condition. Its onset, progression, diagnosis, treatment and management of the illness is challenging to patients as well as to the professionals treating them.

The Cause

Bipolar disorder is a combination of genetic, neurochemical, and environmental factors that come together in ways to trigger the onset of the disorder. Bipolar disease runs in families. Twin studies have taught us that bipolar disorder is more genetic (nature) than a result of childrearing (nurture). Identical twins who share the same gene profile will have a 65% chance of sharing BPD. This drops to around 5% to 20% for fraternal twins. Also, if one of your parents has bipolar disorder, then you will have a 15% to 25% chance of also having the illness. Overall, studies have placed the genetic heritability of bipolar disorder at 60% to 85%.

But, how does the gene for BPD actually lead to the symptoms that makeup the illness? The gene for BPD causes a malfunction in the brain’s neurotransmitter system (nerve chemicals and messengers) that is responsible for thinking, modulation of mood, and control of behavior. The illness is generally dormant in childhood. But, tends to be activated by stress in the late teenage, young-adult years. Fluctuations in hormones, pressures to establish an adult identity, and to settle on an educational and professional path can overwhelm the brain chemistry of the person who has the gene for this disease.

But, even more instrumental to the progression of the disease process is what happens to the brain upon its onset. Essentially, the first bipolar episode sensitizes the brain’s chemicals and nerve messengers to subtle stresses coming from within and outside the person. Think of the first onset, like a wood log that is hard to light on its own. But, once you position twigs around it, the log lights easily. This is what happens to the brain after the first onset of a bipolar episode. Stress repositions chemical messengers (twigs) around the gene for bipolar illness (the log) that makes it highly likely that the next time the person is stressed the gene will get expressed in brain activity. Over time, the brain becomes increasingly sensitive to stress so that even the mildest change can activate a manic-depressive episode. It’s like with each stressful episode, more and more twigs get added to the fire. This is called the kindling effect, and it is the reason why BPD is so hard to manage.

There are two types of bipolar disorder that are distinguished by type, frequency, and intensity of the manic and depressive episodes.

Bipolar I Disorder

One of the defining features of Bipolar I disorder is a manic episode that does not have to be preceded by depression. The manic episode consists of extreme changes in energy level, activity, sleep, and behavior that accompany a dramatic shift in mood. Symptoms include an inflated sense of one’s capabilities, little need for sleep, pressure to talk, flight of ideas and racing thoughts, rapid shifts in attention, hyperactivity, impulsivity, and destructive action. There is also an increase in goal-directed behavior (social and occupational) and involvement in activities that have a high risk for harmful consequences to the person (buying sprees, sexual acting-out, foolish business investments, drug and alcohol use, explosive emotionally and irritable, and scrapes with the law) Symptoms of Bipolar Disorder, National Institute of Mental Health.

Bipolar II Disorder

In contrast, Bipolar II is characterized as the presence or history of one or more major depressive episodes and at least one hypomania episode, without  precedence of a manic episode. Hypomania has similar features to mania only in a much lesser degree and lasting only a few hours at a time. Because their symptoms are milder, it’s easier for the affected person to deny that they may have bipolar disease, especially because their hypomania seems normal to them. It’s a welcome relief from their usual depression (Bipolar II People Masquerade As Just Happy, New York Times).

Like bipolar I persons, they are usually  intelligent, artistic, and emotionally sensitive people. But, it is their history of depression, rather than a manic episode, that usually gets them to seek treatment. Nonetheless, they can suffer just as much as people with the type I version of the disease and can engage in the same types of self-destructive behaviors that worsen their illness.

Clinicians themselves have difficulty differentiating between bipolar I and II disorders. Since the types of patients, lengths of episodes, and age of onset are very similar. However, the real difference between the two is the difference in mania (bipolar I) versus hypomania (bipolar II).

The following questions about BPD come from people who follow me on my Facebook page for Psychology in Everyday Life. I want to share these questions and my responses with you, as you may have the same questions.

1. Can you cure bipolar disorder? Bipolar illness, like diabetes or epilepsy is managed rather than cured. It is a high-maintenance disorder. To manage it well, you have to take prescribed medication, reduce your stress, eat a nutritious diet, and refrain from using too much alcohol and drugs. Unfortunately, these treatment and health habits can be a challenge for people who have this disease. 30% to 60% of persons with BPD also struggle with alcoholism or substance abuse, as a way to self-medicate rapid changes in mood (National Institute of Alcoholism and Alcohol Abuse). This is why following a treatment regimen is critical to avoiding behaviors that activate mood swings.

2. Is it possible for bipolar people to live normal lives?  Yes, most certainly, you can, if diagnosed and treated properly. I have treated many people in the past who are bipolar. Once they got treatment, they completed their educations, were able to have stable, healthy relationships, married, and have successful careers.

I treated a young woman who struggled with long periods of dark depression, in which she wished to sleep and never wake up, just to end her pain and suffering. She was very intelligent and talented, but was unable to get up in the morning, let alone finish her education. Psychiatrists first put her on antidepressant medication, which made her feel a little better. But, the telltale sign that there was something more going on than just depression was the destructive acting-out she did when she felt better. She went from one lover to the next and shopped until she, and her finances, dropped. After being put on Lithium, she was able to finish school, establish a career, and eventually marry her lover of many years. Without the right treatment, her biology would never have had permitted her to live a normal life.

3. Should you avoid stress if you have this disorder? It’s not possible to completely avoid stress. But, you can learn how to manage stress better, through psychotherapy, sound diet, and by engaging in behaviors that strengthen rather than weaken you. Alcohol and drug use are a no-no with this disease. Also, it’s vital that you bring supportive, healthy people into your life, so that you are not traumatized by relationship. When you accept that you don’t have the biology to stand such traumas to your psyche and body, you will begin to choose better.

4. Can you treat bipolar disorder without medication? If a person has a true bipolar I disorder, they have to be treated with some medication. But, eating properly helps to manage the disorder. A diet that high in the omega fatty acids stabilizes neuronal firing, which reduces the brain’s sensitivity to stress (A Dietary Treatment for Bipolar Disorder, Psychology Today). This suggests that extremes in diet, like eating protein alone (depresses the brain) or eating too many carbohydrates or sugar (over excites the brain) can bring about fluctuations of mood. A balanced diet is best, to keep mood swings at bay.

5. Which medications treat bipolar I disorder? Bipolar disorder is treated with mood stabilizers, along with antidepressants, and psychotics if needed. Lithium (a cell salt) is one of the oldest mood stabilizers, but, it’s still one of the most effective medications for manic-depression. More recently, psychiatrists have begun to treat mood destabilization with anticonvulsant medications (Depakote, Lamictal, Topamax, Tegretol and Trileptal) that are typically used in epilepsy. They reduce brain excitation that desensitizes the brain to stress and the mood swings that come with it. But, like most of the powerful psychiatric medications, there are side effects, like cognitive slowing, forgetfulness and brain fog. Sometimes, antipsychotic medications are used to reduce psychosis that can come with extreme states of mania or deep states of depression. These include Zyprexa, Geodon, Risperdal, Abilify, and Clorazil. Also, antidepressant medications, like Prozac, Paxil and Zoloft treat depression in bipolar disorder (National Institute of Health on BPD). Remember, these are all powerful medications, the combination of which can often cause more side effects than benefits. The goal is to feel better not to become a zombie. I have treated people who first came to me so doped up with medications that they could barely remember the door out of my office. I recommend that you do a lot of self-study on your own, so that you can work with your doctors to find the best treatment regimen that works for you. If your doctor resists your participation in this effort, I say, shop for another doctor!

6. Who do I see to make the diagnosis? Psychiatrists and clinical psychologists are most qualified to diagnose bipolar disorders. They have extensive education and training in diagnosis and treatment of mental health disorders. Even if you see a clinical psychologist first, you still have to see a psychiatrist to confirm the diagnosis and to prescribe medication. In addition to medication, you should also get some psychotherapy, to help you to manage the disorder and to learn to cope better with stress. I have worked very harmoniously with psychiatrists through the years managing my patients who needed prescribed medications. Many times patients ask me if I can call their primary care physician and tell them which medication to prescribe. They want to avoid the higher price of a psychiatric visit and also to waste no time in getting treated. Of course, I say no, because prescribing medication falls outside of my education and degree. But, even more than this is the welfare of the patient. Remember, especially with bipolar disorder, it’s critical that you see professionals skilled to make a proper diagnosis so that you get the right treatment. It’s not smart to cut corners, when it comes to your mental health.

7. How can I be sure that my family member really has bipolar disorder?  To be sure, I would get two separate evaluations from psychiatrists or a psychiatrist and a psychologist. They are best trained to make this diagnosis. But, remember, this disorder is difficult to diagnose for the many reasons I mention here, today. Thus, you have to give the professional a chance to help you, which means you may have to try a few medications before you find one that helps. Also, there’s a rule of thumb when it comes to medication. If the medication stops the bipolar symptoms that are troubling you, then most likely you have a bipolar disorder.

It’s not easy to accept that you have to live with a mental health problem for life, especially bipolar disorder. You have to remember that it’s a diagnosis that tells you what is wrong and what you need to do to treat and manage it. But, it is in no way a prison sentence. Indeed, as Julian Seifter says well, just because you have an illness doesn’t mean that it takes away from who you are. “You have an individual story to tell. You have a name, a history, and a personality.

Thus, if you think you may have this disorder, get the help that you need to make the proper diagnosis. Push through your embarrassment or fear of discovering that you may be bipolar. The only thing worth fearing is the lack of knowledge and resource to help you to live the best life possible.

I hope you liked my post today. If so, please let me know by selecting the Like icon that follows. You can also Tweet or Google+1 today’s post to let your friends know about it. Take good care of yourself. Warmly Deborah.

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29 Responses to “Bipolar I and II Disorder: A Diagnosis, Not A Prison Sentence”

  1. superbly intergratred content.

    • avatar Dr. Deborah Khoshaba says:

      Hello Khalid, thank you for your feedback. There is much to say about this disease, so I’m glad that you found the material in the post well integrated. Good to see you here today Khalid. Warm regards, Deborah.

    • avatar Louise Rosemary says:

      I really like this article. It is highly informative and non-judgmental. Thank you.

      Being an individual who lives with bi-polar disorder and all the stigma and fear of stigma that attaches itself to the diagnosis, I would ask for you to use less stigmatizing language yourself.

      Instead of being bi-polar, a person has bi-polar.

      Language is powerful and this slight change in language serves to assert that people are not their diagnoses but as you so aptly wrote,”have an individual story to tell…have a name, a history, and a personality.”

      • avatar Dr. Deborah Khoshaba says:

        Hello Louise. I’m so glad the article was informative and non-judgmental. I couldn’t have gotten nicer feedback. Yes, the stigma is terrible. I hope for the world to become more sensitive and aware of all mental health disorders. This is why I started Psychology in Everyday Life. Thank you and to everyone else who regularly comments here — helping to demystify and destimatize all mental health conditions. We are all human and everyone of us will have some emotional/mental health issue with which we will have to contend with in our lives. I love what you say– an story to tell with a name, history and unique personality. Warm regards to you Louise. Deborah.

      • avatar Kkcook says:

        Thanks for your comment. I was diagnosed three years ago at the age of 21, and I have been hospitilized twice. What really made an impact in “accepting” was exactly what you said. I have Bi Polar, I am not Bi Polar. The stigma is out there still, but by first educating ourselves and then others we can help society move away from these “crazy” stigmas!!!

        • avatar Dr. Deborah Khoshaba says:

          Hello Kk, yes, you are right; the stigma is still out there. But, the more people come out and talk about it and articles like these, the more public awareness. Thank you so much for writing today Kk. If you haven’t take a look at some of my recent articles on bipolar disorder. Warm regards to you Deborah.

  2. This is a wonderful evaluation of bi-polar disorder, and really helps the readers understand and work well with this trouble, whether it is in them or those close to them. Debbie, you have well expressed the essentials that are needed for understanding, and done it in such a helpful way.

    • avatar Dr. Deborah Khoshaba says:

      Hello Sal, thank you for your continued support and friendship. I see you read my posts regularly and take time to comment. Thank you again. Warmly Deborah.

  3. avatar Md. Lutfar Rahman says:

    Bipolar makes two different identification of a man, giving a conflicting situation or mental stress within a man at d same time…they need extra love, affection, support from everybody…

    • avatar Dr. Deborah Khoshaba says:

      Hello Dr. Rahman, I think it does take very supportive, understanding family members and friends to understand the struggle that people with bipolar disease go through. You are so right, just being understood can help them much. Thank you for adding this important point. Warmly Deborah.

  4. avatar rumman says:

    I think im suffering from bipolar disorder:)

    • avatar Dr. Deborah Khoshaba says:

      Hello, if you think you are suffering from this disorder, the best thing to do is to go to a Psychologist or Psychiatrist to talk about the symptoms you have. They will help you to understand what’s going on and if indeed you have some of the bipolar symptoms. Good to say hello to you today. Warmly Deborah.

  5. avatar Deana says:

    Hello! Thank you for clarifying differences between BP I and II. Unless in the biz, people tend not to know these important differences exist. Thanks also for sharing the list of famous persons with BP. In my practice, I often share the list of famous persons with ADHD. It is helpful to the kids, and to their parents, knowing what others living with the disorder have achieved.

    The take away, for me, is your comment that living well with mental illness means accepting that everyday choices must be made with great care, based on kindling. All sufferers I have treated, or known personally, eventually express how difficult acceptance of this is. It does seem unfair having margins one must live within, though this should not be confused with having to live a marginalized existence. As you mention, living with a mental disorder is no different than living with any disease requiring long-term treatment and lifestyle changes.

    Blessings to you! Thanks again, as always!!! XO

  6. avatar Dr. Deborah says:

    Hello Deana, I love what you say: “That it seems unfair having margins one must live within, though this should ot be confused with having to live a marginalized existence.” Beautiful and wise. Thank you for sharing you words with us. Blessings to you too my friend. Warmly Deborah.

  7. avatar Zerevan M Xalid says:

    How are you, Dr.? I hope you are fine and always will be. I keep every single word that I hear from you and will treat them
    very well as I do it with my studies. Anything you recommend me I’ll be ready to do it as a duty for what you write is something within which we can find comfort and be at our ease; let’s say your words of wisdom in a better sense. Thank you very much my dear friend or my most sociable and approachable friend online ever for these favours you, all the time, do us. Best wishes warmly.

    • avatar Dr. Deborah Khoshaba says:

      Hello Zerevan, it’s always a pleasure to hear from you. I’m doing very well. I have been busy writing another article to share with you and everyone else. How are you my friend? I hope you are very well. Thank you always for your friendship. Warmly Deborah.

  8. avatar Audra Gray says:

    Insanely superb article, I have been searching for something or someone to be able to explain BPD I & II to my husband in this way and I’m so thankful to have come across it!!! I actually received more clarification between being misdiagnosed (being told I am bipolar, being told I’m not…so many times)

    Thank you!!

    • avatar Dr. Deborah Khoshaba says:

      Hello Audra. Thank you. I’m so glad that you got more clarification on Bipolar dx through my post here. You are right that sometimes you learn more through being misdiagnosed. It’s wonderful that you kept searching and learning. Thank you for your support. I hope to see you here again soon. Warmly Deborah.

  9. avatar Frank Jordan says:

    After hearing that Robin Williams took his own life today, I went in search of reports of whether he was bipolar or not. I found a reference to him in your article here. My thoughts go out to him and his family on this tragic occasion.

    I found this article both moving and informative. As a sufferer of bipolar type II, I would just like to add one small thing. Because bipolar type II doesn’t have the manic behavior that bipolar type I has, and because it’s main symptom is depression, it is often misdiagnosed as major depression. I read that bipolar type I sufferers go for an average of six years before they’re correctly diagnosed, while bipolar type II sufferers go for an average of almost 12 years before they’re correctly diagnosed. In short, bipolar type II can mimic major depression, with dire consequences.

    • avatar Dr. Deborah Khoshaba says:

      Hello Frank, thank you. I’m so pleased that you found my article helpful. It is indeed often misdiagnosed as major depression. Thank you for highlighting this important fact, as especially because different treatment approaches need to be considered in Bipolar II depression. I hope you also took a look at my articles (Bipolar Depression: Misunderstood and Misdiagnosed and Bipolar II Treatment Considerations).

      Thank you again Frank. I couldn’t agree with you more. And, you take good care. It sounds like you have done much to treat your bipolar depression and have researched it thoroughly. I wish all sufferers of Bipolar II Disorder would become so knowledgeable. Warm regards Deborah.

  10. avatar Pat Penick says:

    Very informative article about bipolar disorder. I am skeptical of your statement that medication is required; you probably do not know this, but many AA groups and members regard all these types of medications with skepticism; there is a very large group in Southern CA, the Pacific Group, which believes that an alcoholic is not sober if he is on these meds. Experience has shown them this… I found this website tonight browsing around the web after hearing about Robin Williams’ suicide today; my guess is that he has the best psychiatric help that money can buy–or rather, had. I see that Jonathan Winters turned down his doctors’ recommendations for electroshock therapy early on; good move, as it later turned out that electroshock therapy did a lot of damage. We shall see about all these new drugs as well, won’t we? It does appear that most of the shooters in these mass killings and school shootings are on various meds–the descriptions of the side-effects of those things are really something! Your list of famous people who were bipolar sounds like reasonable conjecture: “William Styron, Sylvia Plath, F. Scott Fitzgerald, Ernest Hemingway, William Blake, Walt Whitman and Ralph Waldo Emerson), composers (Rachmaninoff, Tchaikovsky and Mozart) and world leaders (Abraham Lincoln, Winston Churchill, and Napoleon Bonaparte) who have still been able to leave their creative mark on the world despite having bipolar disorder” –some alcoholism in that group for sure, perhaps self-medication–or self-delusion, as in the case of Papa Hemingway–who would only “live life on his terms” as he said near the end of his life. Really, I don’t know of anyone who gets to name their own terms for life–even Napoleon! Long rant here; count me as one who is down on the legal medications–and the illegal ones as well I suppose. Everyone makes their choices and gets their consequences… The people I have known on anti-depressants are not doing so well… As a nation we don’t seem to be doing so well; I look at these tough people in various 3rd world countries, and they don’t seem to need the various drugs…

    • avatar Dr. Deborah Khoshaba says:

      Hello Patrick, thank you for taking the time to comment and share with us today. I do know well how AA feels about medications. Patrick, through the years, as you can imagine, I have treated many people who have been regularly going to AA and greatly treated by this wonderful organization.

      My patients who have had serious alcohol and drug use problems have been managed by a number of professionals to help them to stay sober. I have some patients 13 to 20 years sober now who have had also been on antidepressant medications because they would have not been able to stay sober without them. And, the use of antidepressants did not cause widespread alcohol or drug relapse. Taking prescribed medication that helps to keep one alive is completely different than abusing prescribed and non-prescribed drugs to self-medicate. But, I am a strong proponent of prescribed medications when needed but with a change in lifestyle in which nutrition, exercise and stress and self management techniques are implemented to manage symptoms but also to lower the need for excessive use of prescribed meds.

      Electroshock is primitive today. I agree–how sad that these types of treatments were used in the past.

      Thank you very much for your comment today and for sharing with us. Warm regards Deborah.

  11. avatar Dr. G says:

    Dear Dr. Khoshaba,

    Your article is very well written and concisely pulls together a lot of information on this challenging disorder that now afflicts my 13 YO child. Even though I wish, due to the significant side effects, that medication was not needed to manage Manic Depression (which is a far better descriptive name than BPD),they are essential to stabilize those in acute episodes (especially those with mixed state BPD) so that they can function and live, something I can attest to first hand! I believe it is dangerous to blanketly dismiss using medications like Mr. Penick suggests. The challenge for us all is to maximize the quality and fulfillment of life for BPD sufferers by titrating their treatment regimen (that includes medication, diet, psychotherapy, CBT etc.) over time to achieve this with the least side effects.

    • avatar Dr. Deborah Khoshaba says:

      Hello Dr. G., thank you. Yes, it can begin that young as you know. With this disorder it is dangerous to dismiss the importance of medication as a first-line of treatment, as this is truly a disorder of the brain chemistry. Thank you for your expertise and sharing with us today Dr. G.. Best wishes to your family and a healthy life for your child who has manic depression. Deborah.

  12. avatar Marcelo de Almeida says:

    Hello Deborah, I must say that a doctor makes a difference when explaining bipolarity. When my wife told me she was sure I had the disease I almost laughed, and ironically asked; “But isn´t that what you diagnosed my mom with?!!!” However, as my wife had really done her homework, I realized, by the her arguements, that she was probably right. After all it almost certainly runs along blood lines throughout the generations. Now, I am stuck on a question that can´t wait: “If doctors like Marc Millar (the lithium doctor) as he´s called, along with John Gray (the writer of the book- ‘Men are from Mars and…’, on Youtube interviews, strongly defend the treatment of this disese using lithium orotate, which is based on the compatibility of the orotic acid with brain fluid, rather than taking high doses (300-600mgs) of carbo lithium, which seems to have the wrong structure to penetrate the brain cortex in eficient quantities. So, after watching many of these videos I came to the conclusion that lithium is being used to reconstruct the brain, physically. Now, I don´t really know how the brain´s synapsis work but I get the idea that light , soft metals make the most eficient bridges for electrical brain impulses. These doctors argue that as we have worn our soils down through perpetual farming, the tired land has run low on lithium, as its easily absorbed by biology. This is because of its minimal size, weight, and its soft nature, which as a result also enables it to mold into our brain tissue, after years of taking the mineral. They have been using lithium to protect brain cells from neo toxins like aluminum and other heavy metals which only slow brain activity down. Marc Millar really got my attention when he spoke of the statistic of an average of 22 military veterans who commit suicide daily. He spoke of how carbo lithium intoxicates the blood and taxes the kidneys due to the high doses needed to have any effect on the brain. To make a long story really short, I am wondering if chemical compounds produced in laboratories only deal with the side effects caused by bipolarity, instead of patching up severed cells(due to accidents), malformed connections and cells(due to birth defects), and natural corosion by time (due to diseases or old age), the way lithium would do in its attempt to reconstruct, reform, or just protect brain cells by forminga permanent coating in the cortex. I hope my question is not too long, I´d just like to know more. Thank you for your dedication, and your attention.

    • avatar Dr. Deborah Khoshaba says:

      Hello Marcelo, thank you for writing me today. That’s a very interesting question (do manufactured chemical compounds only treat results of impaired connections rather than regenerate connections altogether?). I don’t know if you mean regenerate to the extent where medications are not needed. If so, I have never heard of this. That being said, more and more research is showing that the way a gene for certain physical and mental health illnesses gets expressed in the gene can change with medication, nutrition, and even with exercise. If you read my article on BDNF Makes the Brain Better — you’ll find some of this research here.

      With regard to bipolar disorder, I’ve written a few other articles on bipolar disorder in 2014. Take a look at these articles; I talk about medications today that don’t just facilitate modulation of nerve firing but also get the chemistry in the brain to act quite normal. For example, there’s a new class of drugs called atypical antipsychotics that actually correct the brain so that it functions normally. Latuda, a medication used now to bipolar II depression is one of these medications.

      I am familiar with Millar’s ideas. I know the psychiatric field isn’t convinced of this finding (permanent coating in the cortex). Of course you know they do a lot of research before they get on board with these kinds of findings. But that being said, I cannot say that Millar isn’t right. And, lithium, long term, can negatively impact the kidneys.

      I can appreciate why people are looking for less toxic solutions to bipolar disorder. If you are wondering about this for yourself, there’s some questions I’d ask myself:
      1. Are you bipolar I or II? This can make a big treatment difference, where lithium isn’t even the standard treatment of choice.
      2. Have you been professionally diagnosed? I would get this diagnosis so you can get your questions answered and form a relationship with a professional who is willing to work with your ideas. Many psychiatrists today treat bipolar disorder with omega 3’s and other food and nutritional vitamins. This is especially the case with bipolar II disorder.

      I hope this helps for now Marcello. Thank you for an excellent question. Take good care. Warm regards Deborah.

  13. avatar Dr. Deborah Khoshaba says:

    Thank you so much. I think better and better treatments are coming, especially since we now have more knowledge on the specific genes contributing to this disorder. If you haven’t already you may want to take a look at my other two articles on Bipolar II Depression (one is called Bipolar II Depression: Misunderstood and Misdiagnosed and the other Bipolar II Depression: Treatment Considerations). Warm regards Deborah.


  1. […] I can still remember when he was on campus at UNC filming Patch Adams in the mid-90s. He suffered from Biploar disorder. A hard demon to defeat, even if you own it and want to treat it. I hope in my lifetime that we discover better treatment options. For more about biplolar disorder click here. […]

  2. […] like his hero, the legendary comedian Jonathan Winters, Williams battled bi-polar disorder, depression and substance abuse his entire life. His most recent visit to rehab in June of this […]

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