WEBVTT - How Bipolar Disorder Works 0:00:00.160 --> 0:00:02.560 This episode is brought to you by Squarespace, the all 0:00:02.600 --> 0:00:04.760 in one platform that makes it fast and easy to 0:00:04.800 --> 0:00:08.480 create your own professional website or online portfolio. For a 0:00:08.520 --> 0:00:11.119 free trial and temperason off your first purchase, go to 0:00:11.160 --> 0:00:15.120 squarespace dot com slash stuff and use the offer code stuff. 0:00:16.239 --> 0:00:19.400 Welcome to you. Stuff you should know from house stuff 0:00:19.440 --> 0:00:27.920 works dot com. Hey, and welcome to the podcast. I'm 0:00:28.000 --> 0:00:30.600 Josh Clark with Charles W. Chuck Bryant that makes this 0:00:30.680 --> 0:00:33.239 stuff you should know. I'm Jerry's here too. So it's 0:00:33.240 --> 0:00:38.040 all good. The original gang. That's going pretty good. Man, 0:00:38.040 --> 0:00:42.400 How are you? I'm great? Good, Okay, then let's get 0:00:42.479 --> 0:00:44.559 to it. Yeah, do you have a good set up 0:00:44.560 --> 0:00:47.000 for this one? It's sorry now, No, I think it 0:00:47.080 --> 0:00:50.000 kind of speaks for itself. I mean it's bipolar disorder. 0:00:50.080 --> 0:00:52.840 Like we it's been around long enough, and I think 0:00:52.840 --> 0:00:58.440 it's been um exposed enough. People have been educated enough 0:00:58.480 --> 0:01:03.400 that you know, anything I do would just seem jackasses. Uh. 0:01:03.440 --> 0:01:06.200 While we were just talking before we hit record about 0:01:06.480 --> 0:01:09.480 whether not we know anyone who has bipolar disorder, and 0:01:09.520 --> 0:01:12.880 I think most people probably know someone. You might not 0:01:12.959 --> 0:01:16.520 even know it, but um, I definitely like I had 0:01:16.520 --> 0:01:19.840 a very specific friend in college. You had it, and 0:01:20.280 --> 0:01:22.399 that was you know, it was like twenty, so it 0:01:22.480 --> 0:01:24.880 was you didn't know about that stuff when you were 0:01:24.880 --> 0:01:27.399 twenty at least I didn't. So it was very weird. 0:01:27.440 --> 0:01:30.960 And that's first time I've ever heard the term. And uh, 0:01:31.200 --> 0:01:33.759 you know, he fit the profile as far as being 0:01:34.600 --> 0:01:40.119 super up and uh, full of life and energy one 0:01:40.160 --> 0:01:44.560 moment and then super down and very troubled to say 0:01:44.560 --> 0:01:47.240 the least. And this was these are words I'm using 0:01:47.280 --> 0:01:50.240 from my twenty year old self. You know, I just thought, man, 0:01:50.520 --> 0:01:53.880 he's like he's super super happy or now he's super down. 0:01:54.560 --> 0:01:57.760 But that's this sort of a rudimentary way to describe it. Yeah, yeah, 0:01:58.000 --> 0:02:00.360 I mean, I mean that is bipolar to order in 0:02:00.360 --> 0:02:01.880 a nutshell, And that's why they used to call it 0:02:01.920 --> 0:02:04.880 manic depressive disorder too. Yeah. When did they stop that? 0:02:05.400 --> 0:02:08.520 I think maybe in the nineties. It seems like to 0:02:08.560 --> 0:02:11.600 me it sounds about right. Um, and you're you're not 0:02:11.680 --> 0:02:15.560 too far off from everybody knowing somebody with bipolar disorder, 0:02:15.600 --> 0:02:19.160 because apparently about five point seven million adults in the 0:02:19.240 --> 0:02:22.800 US are diagnosed with bipolar disorder, and I think three 0:02:22.840 --> 0:02:27.840 percent of the population worldwide is estimated to suffer from it. Yeah, 0:02:27.880 --> 0:02:33.320 and you said adults. Um, it can manifest itself in children, 0:02:33.400 --> 0:02:38.239 but generally, UM, teenage, mid teenage years and up is 0:02:38.560 --> 0:02:40.480 when you're going to first start seeing signs of it. Yeah, 0:02:40.520 --> 0:02:44.760 fifteen to twenty five from what I understand in general. Um, 0:02:44.800 --> 0:02:48.640 And as you said, Chuckers, like the the condition of 0:02:48.680 --> 0:02:57.560 bipolarity UM is characterized by intense, frequent swings from very 0:02:57.639 --> 0:03:03.280 very happy to very very sad. And it's much beyond 0:03:03.440 --> 0:03:07.680 the average person's mood swings. Because I mean, like if 0:03:07.880 --> 0:03:10.480 if you're fifteen years old and you're listening to this 0:03:10.560 --> 0:03:13.400 and you're like, well, sometimes I'm unhappy and then other 0:03:13.440 --> 0:03:17.799 times I'm said, that's normal. Um, this is far beyond normal. 0:03:17.880 --> 0:03:21.320 Like where you are in either case, like you say, 0:03:21.360 --> 0:03:26.840 super up or super depressed. Um, it's nowhere near what 0:03:26.919 --> 0:03:30.160 you are normally. And in some cases of the most 0:03:30.200 --> 0:03:33.919 severe bipolar disorder, there is no normal. It's either totally 0:03:33.919 --> 0:03:37.400 one way or totally the other, and the person suffering 0:03:37.400 --> 0:03:41.400 from it to swings back and forth, maybe over the 0:03:41.480 --> 0:03:46.080 course of a couple of weeks, UM, and lives like that. Yeah. 0:03:46.960 --> 0:03:49.600 Uh sadly, UM, Like we have a couple of stats 0:03:49.640 --> 0:03:52.920 about the effects. We'll get too early here. H you're 0:03:53.600 --> 0:03:56.880 less likely to have a job if you are bipolar. 0:03:57.360 --> 0:04:01.960 That seems really high. Yeah. Um, ten times more likely 0:04:03.040 --> 0:04:06.440 to abuse alcohol or drugs, which is as a cyclical 0:04:06.480 --> 0:04:09.280 effect because alcohol and drugs are really rough on you 0:04:09.360 --> 0:04:11.880 if you have bipolar disorder. Well, yeah, they can trigger 0:04:11.920 --> 0:04:13.960 a swing one way or the other. Yeah. I saw 0:04:13.960 --> 0:04:17.000 that in my friend actually in college fu. Yeah, and 0:04:18.360 --> 0:04:23.760 of bipolar patients, uh successfully commit suicide out of who 0:04:23.800 --> 0:04:27.640 try it, and those numbers are startingly high. Yeah, yeah, 0:04:27.720 --> 0:04:35.320 that's very high. That's start startlingly startling. Okay, um, so 0:04:35.440 --> 0:04:38.880 let's talk about this. What's the what is I've already 0:04:38.960 --> 0:04:42.239 kind of given a rough overview, but let's dig into 0:04:42.279 --> 0:04:47.160 the symptoms of bipolar disorder. Yeah. They're basically, um, they 0:04:47.240 --> 0:04:52.800 characterize two swings, mania and depression. If you're having a 0:04:52.839 --> 0:04:56.080 manic episode, you're gonna be a great mood, You're gonna 0:04:56.120 --> 0:04:59.160 be high on life, you're gonna have a lot of energy. 0:05:00.240 --> 0:05:03.880 You're probably gonna be talking really fast. And it's called area. 0:05:04.720 --> 0:05:11.440 So what log area? What's that excessive talking? Talkativeness? Oh yeah, um, 0:05:11.480 --> 0:05:14.359 just really fast thoughts like everything. What was that movie 0:05:14.400 --> 0:05:21.120 with brad Cooper and de Niro, Oh, Silverlings Playbook? No, 0:05:21.360 --> 0:05:23.640 the other one, and you're gonna say that, although that 0:05:23.760 --> 0:05:25.720 is what other movie of those two been in together, 0:05:25.839 --> 0:05:28.120 the one with um where you take a pill and 0:05:28.120 --> 0:05:30.280 you can like tap into more of your brain, which 0:05:30.320 --> 0:05:32.839 is de Niro. Isn't that too? Yeah, I don't know 0:05:32.880 --> 0:05:34.400 the name of that movie. I know what you're talking about. 0:05:34.440 --> 0:05:37.800 It wasn't a very good movie, but exceptional or amazing 0:05:38.000 --> 0:05:41.760 or I can't remember. This is at the point when 0:05:41.800 --> 0:05:46.360 people are yelling into their car stereo, including Bradley Cooper. Yeah, 0:05:46.440 --> 0:05:50.440 he's like, you idiot. Yeah, And I can't believe I 0:05:50.560 --> 0:05:54.960 just forgot about Superlians Playbook because that directly covers this. Yeah, 0:05:55.000 --> 0:05:56.919 but what I was talking about was the manic He 0:05:56.960 --> 0:05:59.600 was almost mannek in that other movie where just ideas 0:05:59.640 --> 0:06:01.919 all that I'm at a hyper speed and he just 0:06:01.960 --> 0:06:05.120 couldn't do them fast enough. So that's characteristic of a 0:06:05.160 --> 0:06:09.480 manic episode. Sorry, Bradley Cooper. Uh, you're distracted, you don't 0:06:09.560 --> 0:06:12.640 maybe need as much sleep, you're restless, you're puritable, you 0:06:12.680 --> 0:06:16.039 might want to have a lot of sex. Like everything's 0:06:16.080 --> 0:06:21.719 just uh, magnified, I think, yeah, and with a manic episode, 0:06:22.480 --> 0:06:25.839 they're often like all of this is often accompanied by 0:06:25.880 --> 0:06:29.240 a sensation of euphoria. So most people who suffer from 0:06:29.320 --> 0:06:33.520 bipolar disorder don't go seeking treatment when they're in a 0:06:33.560 --> 0:06:36.640 manic state, right, because they can like that. Yeah, for 0:06:36.720 --> 0:06:39.400 some people a manic state, you can have all these things, 0:06:39.440 --> 0:06:45.200 but it's instead of accompanied by euphoria, it's accompanied by irritability, uh, 0:06:45.400 --> 0:06:48.440 quickness to anger. So it's not all it's not all 0:06:48.480 --> 0:06:52.080 fun and games for everybody. But for the most part, 0:06:52.160 --> 0:06:55.680 if you're in a manic episode and you're bipolar, you're 0:06:55.880 --> 0:06:58.520 you enjoy the manic episodes way more than you enjoy 0:06:58.600 --> 0:07:02.320 the depressive eppisodes. Yeah, and I think both are super 0:07:02.400 --> 0:07:04.760 rough on friends and family because in the manic state, 0:07:04.839 --> 0:07:09.279 you you don't know quite what you're gonna get, you know, right, well, 0:07:09.800 --> 0:07:12.680 like you may you engage in um very risky behavior. 0:07:12.720 --> 0:07:16.120 You may make a bunch of risky investments, may buy 0:07:16.160 --> 0:07:18.680 a lot of stuff. Um, it can go so far 0:07:18.720 --> 0:07:23.200 as to uh, you can have psychotic symptoms. So in 0:07:23.240 --> 0:07:27.320 a manic episode where you're displaying psychotic symptoms, you may 0:07:27.360 --> 0:07:33.560 think you are God or totally UM, infallible, untouchable, can 0:07:33.600 --> 0:07:36.240 do no wrong, and then that can feed into the 0:07:36.720 --> 0:07:40.200 symptoms of you know, engaging in very risky behavior. You 0:07:40.200 --> 0:07:43.280 can even hallucinate like full on see things. Yeah, you 0:07:43.320 --> 0:07:47.040 can suffer from delusions and hallucinations. So the d s 0:07:47.200 --> 0:07:49.800 M says that if you have a certain number of 0:07:49.800 --> 0:07:53.600 manic symptoms UM for at least one week, then that 0:07:53.720 --> 0:07:57.560 is considered a manic episode. So that has kind of 0:07:57.680 --> 0:08:00.640 changed apparently with the d s M five. This is 0:08:00.720 --> 0:08:03.600 ds M four stuff. With the d s M five, 0:08:04.120 --> 0:08:07.680 they um really kind of they I think that the 0:08:07.800 --> 0:08:13.600 prevailing idea was what's with this whole um bipolar other 0:08:13.840 --> 0:08:18.080 otherwise specified, not otherwise specified. It's just a total cop out, 0:08:18.120 --> 0:08:20.160 which we'll get to in a minute. But the idea 0:08:20.200 --> 0:08:22.320 that there's like this, you don't fit this one or 0:08:22.360 --> 0:08:25.520 this one, so you fit this generic third. Actually I'm 0:08:25.520 --> 0:08:28.160 glad that's changed. I think they've kind of dug into 0:08:28.200 --> 0:08:31.840 diagnosing even more. We changed some of the thresholds and 0:08:31.920 --> 0:08:36.079 exclusionary criteria and now um it's a it's supposed to 0:08:36.160 --> 0:08:40.720 be a little more laser guided UM. But one of 0:08:40.760 --> 0:08:42.920 the ones, one of the things they did change was 0:08:42.960 --> 0:08:45.960 that for example, UM, I think as little as five 0:08:46.040 --> 0:08:50.280 days of an episode is enough to constitute a diagnosis 0:08:50.880 --> 0:08:53.440 rather than like a week or two weeks or something. Right, 0:08:53.840 --> 0:08:56.880 that makes sense, yeah, um. And then you have hypomania, 0:08:56.920 --> 0:09:00.319 which is sort of like mania light UM, just a 0:09:00.400 --> 0:09:05.520 less intense version of mania. UM. So that's the mannic swing. 0:09:05.559 --> 0:09:09.360 The depressive side of the coin uh is exactly what 0:09:09.440 --> 0:09:14.120 you think, but like amplified by a million. Like you're 0:09:14.120 --> 0:09:17.640 not just sad, you feel despair, and your sluggish and 0:09:17.640 --> 0:09:21.719 you can't focus, and you're restless and you're irritable. Um. 0:09:22.240 --> 0:09:25.400 These are where the suicidal thoughts are coming. So it's 0:09:25.440 --> 0:09:30.560 it's not your garden variety depression that you might feel 0:09:30.559 --> 0:09:32.120 on a day to day basis, because we all feel 0:09:32.160 --> 0:09:36.800 that that's right. And you might also experience UM mixed symptoms, 0:09:36.920 --> 0:09:40.480 which is called a mixed episode. So for example, you 0:09:40.600 --> 0:09:45.400 might have UM like a lot of intense energy, but 0:09:45.679 --> 0:09:48.920 you might also be suffering from feelings of utter despair, 0:09:49.040 --> 0:09:54.080 which sounds like a horrible combination. Um. And basically you 0:09:54.120 --> 0:09:59.000 can take stay any mania and then add um just 0:09:59.120 --> 0:10:03.679 some some of the depressive like suicidal thoughts managed suicidal thoughts, right, 0:10:03.760 --> 0:10:06.080 that would be a mixed episode, right, and then you 0:10:06.120 --> 0:10:11.120 have something called rapid cycling, which is uh, when these 0:10:11.200 --> 0:10:13.760 swings are presenting themselves. Do you know what d S 0:10:13.840 --> 0:10:17.320 M Five says? Like, Uh, I couldn't find that it 0:10:17.360 --> 0:10:20.880 had a lot of um changes to the rapid cycling. 0:10:21.120 --> 0:10:24.480 I think that what they found was that UM drugs 0:10:24.600 --> 0:10:28.160 that doesn't necessarily respond to drugs very well. And they've 0:10:28.320 --> 0:10:30.880 they've kind of started to understand rapid cycling a little more. 0:10:30.880 --> 0:10:33.480 But I don't know what they changed with the diagnostic 0:10:33.520 --> 0:10:36.280 criteria for that. Well, here they characterize it by a 0:10:36.360 --> 0:10:40.640 year of at least four episodes of mania, hypomania or depression. Right, 0:10:40.720 --> 0:10:43.079 so like if you have four episodes in a year, 0:10:43.160 --> 0:10:47.040 you've you've got rapids. Apparently that's rapid. I think it 0:10:47.080 --> 0:10:48.880 can be a lot more rapid than that. I think 0:10:48.880 --> 0:10:53.160 like that's the minimum to be considered rapid cycling. Alright, 0:10:53.160 --> 0:10:58.040 So what are the different types of bipolar disorder today? 0:10:58.440 --> 0:11:03.600 There's definitely bipolar one, which is essentially your your life 0:11:03.760 --> 0:11:06.880 is going from one end of the spectrum to the other. 0:11:07.480 --> 0:11:12.280 There's not periods in between really where you're um, where 0:11:12.360 --> 0:11:17.600 where you're stable. Right, that's the most severe obviously, Yeah, 0:11:17.640 --> 0:11:22.520 you have bipolar to which um the sequel that's right. Uh. 0:11:22.600 --> 0:11:25.280 That means you have at least one episode of depression 0:11:25.480 --> 0:11:30.480 and one at least one hypomanic episode, but you could feel, 0:11:30.679 --> 0:11:34.800 you know, somewhat stabilized in between, which is a big 0:11:34.840 --> 0:11:38.520 differentiation apparently between one and two. Um. And then, like 0:11:38.559 --> 0:11:41.120 we said, there used to be bipolar disorder no, not 0:11:41.200 --> 0:11:45.000 otherwise specified the cop out right, and it was there 0:11:45.080 --> 0:11:46.880 was a lot of people who were just kind of 0:11:46.880 --> 0:11:50.720 fitting into this and weren't necessarily getting the right diagnosis. 0:11:51.200 --> 0:11:55.439 And I guess they've expanded the criteria um for bipolar 0:11:55.480 --> 0:11:59.199 one and two, and then they've also kind of looked into, um, 0:11:59.600 --> 0:12:03.839 massive depressive disorder uh and then said, well, you you, 0:12:04.160 --> 0:12:06.720 this has some aspects of mania as well, and that's 0:12:06.720 --> 0:12:09.920 technically a bipolar disorder too. So they kind of did 0:12:09.960 --> 0:12:11.520 away with it a little bit, I think as they 0:12:11.559 --> 0:12:13.840 thought they were looking bad. Yeah, it's so hard to 0:12:13.840 --> 0:12:15.560 category I mean, I know, they take a lot of heat. 0:12:15.640 --> 0:12:18.280 It's tough to categorize mental illness because it's so different 0:12:18.280 --> 0:12:21.440 for everyone, and well, a lot of people criticize the approach. 0:12:21.840 --> 0:12:24.880 The basis of the d s M is tell me 0:12:24.960 --> 0:12:27.920 how you're feeling, which is flawed in and of itself 0:12:27.920 --> 0:12:32.640 to begin with, because subjective reporting is just completely unreliable. Yeah, 0:12:32.640 --> 0:12:35.880 but you can't take a blood test. And and then 0:12:35.920 --> 0:12:41.760 secondly to to to further subjectively interpret those subjective self 0:12:41.800 --> 0:12:47.319 reports uh into supposed you know criteria and then saying well, 0:12:47.360 --> 0:12:49.240 you have XX and X, but you don't have X, 0:12:49.280 --> 0:12:52.439 so technically you're not bipolar, which means you don't have 0:12:52.640 --> 0:12:55.720 your insurance won't cover these meds that you need. The 0:12:55.760 --> 0:12:57.960 whole system is very screwed up, which is why they're 0:12:57.960 --> 0:13:01.400 hoping to do things like create blood test that's say, ah, 0:13:01.440 --> 0:13:05.600 you have bipolar one, and it's because of this UM, 0:13:05.640 --> 0:13:08.840 these neurotransmitters are messed up, so you will respond very 0:13:08.880 --> 0:13:12.520 well to this specific dose of this medicine. I don't 0:13:12.520 --> 0:13:14.880 think we're more than ten years fifteen years away from it, 0:13:15.800 --> 0:13:18.360 but it's it's gonna be a long, horrible ten or 0:13:18.400 --> 0:13:20.679 fifteen years for people who are suffering the most from 0:13:20.679 --> 0:13:24.520 bipolar disorders. That can't come fast enough. Uh. And then 0:13:24.559 --> 0:13:27.920 the final um unless that's gone away, to psyclothymia, is 0:13:27.960 --> 0:13:30.840 that's still around, that is the least severe, and that 0:13:30.960 --> 0:13:35.200 is um at least two years of hypomania and milder 0:13:35.240 --> 0:13:38.880 depression swings. And I think also that's I believe it's 0:13:38.880 --> 0:13:41.160 still around, but I think it's um it's changed a 0:13:41.160 --> 0:13:44.000 little too. And I think that um. Apparently the child 0:13:44.080 --> 0:13:48.400 psychologists of the field said, you guys, there's a lot 0:13:48.480 --> 0:13:52.920 of um exuberance and even mania symptoms that are totally 0:13:52.960 --> 0:13:56.520 normal in adolescents. So let's let's tighten this up a 0:13:56.559 --> 0:13:58.640 little bit because we don't want kids to be diagnosed 0:13:58.640 --> 0:14:01.640 with bipolars because their parents think that they're hyper. Right. 0:14:01.679 --> 0:14:04.360 Put my fifteen year old on lithium exactly. Yeah. So 0:14:04.400 --> 0:14:06.360 I think that they managed to kind of change the 0:14:06.400 --> 0:14:10.800 criteria for cyclothymia, saying this is just above the normal 0:14:10.840 --> 0:14:15.400 threshold of mood swings. Yeah. Um. So, like we said, 0:14:15.440 --> 0:14:16.880 they don't know or I don't know if we did, 0:14:17.080 --> 0:14:20.440 they don't still know what causes it directly, um, nor 0:14:20.520 --> 0:14:24.680 do they know how the drugs that treat it are. Yeah. 0:14:24.920 --> 0:14:27.480 I mean there's a lot of like try this out. 0:14:27.920 --> 0:14:30.960 It's like we know spaghetti will start to stick to 0:14:31.040 --> 0:14:33.720 a refrigerator. We don't know exactly why, but let's strow 0:14:33.760 --> 0:14:36.880 it at the side anyway, but what they do know 0:14:37.080 --> 0:14:39.560 is that genetics can play a role. You are gonna 0:14:40.360 --> 0:14:43.200 have an increased likelihood to develop it if someone in 0:14:43.200 --> 0:14:45.560 your like if your parents had it, let's say, but 0:14:45.720 --> 0:14:50.000 they also have these odd outliers, like you could be 0:14:50.040 --> 0:14:53.320 a twin and your twin has bipolar disorder, but you don't, right, 0:14:53.520 --> 0:14:55.600 So it's just sort of a mystery still. But yeah, 0:14:55.640 --> 0:14:58.800 it seems like they that it does have people are 0:14:58.920 --> 0:15:03.440 genetically predis post and then an environmental factor can trigger 0:15:03.840 --> 0:15:08.320 their bipolar disorder, like a really rough childhood or a 0:15:08.400 --> 0:15:11.920 bad life event or something really really good. But a 0:15:12.720 --> 0:15:16.840 sudden swing in normalcy and a person that is genetically 0:15:16.880 --> 0:15:22.040 predisposed um to bipolar disorder is what can kick it 0:15:22.080 --> 0:15:25.800 off in your life. Yeah. Um, other we already talked 0:15:25.840 --> 0:15:30.440 about drugs and alcohol that can definitely trigger um seasonal changes. 0:15:30.520 --> 0:15:33.880 I think we've talked about seasonal effective disorder SAD. Yeah, SAD, 0:15:34.560 --> 0:15:37.000 which I think I think most people experience a little 0:15:37.040 --> 0:15:40.720 bit of that, right. But again, if you're genetically predisposed 0:15:40.720 --> 0:15:44.360 for the way I see it, and this is totally unscientific, 0:15:44.440 --> 0:15:47.360 but just from researching this, it seems like you you 0:15:47.480 --> 0:15:51.400 have there's a normal baseline for brain chemistry. Uh. And 0:15:51.440 --> 0:15:54.480 it's not a thin line. It's like a pretty good 0:15:54.520 --> 0:15:58.960 sized block. And it's easy to also get outside of 0:15:58.960 --> 0:16:00.960 that one way or the other right, and when you 0:16:01.000 --> 0:16:04.840 are outside of it, you have the symptoms of bipolar disorder. 0:16:05.400 --> 0:16:08.160 And if you're bipolar one, you're just constantly going from 0:16:08.200 --> 0:16:09.840 the top to the bottom of that block. And that 0:16:10.200 --> 0:16:13.480 sounds very scientific and needs to understand the block. Well, 0:16:13.520 --> 0:16:16.240 I mean maybe not scientific, but easy to understand, okay. 0:16:16.400 --> 0:16:19.600 And then if you if you say, have bipolar two, 0:16:19.640 --> 0:16:22.600 you can exist within that normal range, but you can 0:16:22.640 --> 0:16:26.360 be knocked out of it, but your brain chemistry is 0:16:26.360 --> 0:16:30.640 already predisposed to having bipolar disorder by virtue of being 0:16:30.680 --> 0:16:34.480 able to overproduce or underproduce certain neurotransmitters. That's it, I 0:16:34.520 --> 0:16:37.520 think will ultimately be the understanding of it. Well, I know, 0:16:37.560 --> 0:16:40.760 they definitely tie a lot of mental disorders to either 0:16:41.160 --> 0:16:46.560 too much or not enough uh dopamine and serotonin. Like 0:16:46.640 --> 0:16:50.240 it's it's definitely brain chemistry going on, yes, you know, 0:16:50.880 --> 0:16:54.640 and that's yeah, they think that that's the basically the 0:16:54.680 --> 0:16:57.840 basis of it is just fluctuations in brain chemistry like 0:16:57.960 --> 0:17:02.160 super low serotonin during manic and depressive episodes is charted. Yeah, 0:17:02.160 --> 0:17:05.720 and apparently sarotonin's one of the brain one of the 0:17:05.800 --> 0:17:09.800 narrow transmitters that are like, everybody calmed down, let's just 0:17:09.880 --> 0:17:13.119 keep things stable here. That's what sarotonin is. And you 0:17:13.119 --> 0:17:15.520 can have too much dopamine, which can result in both 0:17:16.359 --> 0:17:21.920 mania and depression. Yeah, and I think too much is 0:17:21.960 --> 0:17:26.640 also present in psychosis too, so hallucinations delusions, that's why 0:17:26.680 --> 0:17:29.280 you can have those during such a tough thing to 0:17:29.320 --> 0:17:32.800 try and study, you know. Yeah, I'm reading that. I 0:17:32.840 --> 0:17:35.680 started that book. John Ronson, the great John Ronson, who 0:17:35.760 --> 0:17:37.840 listens to our show, by the way, writer of Men 0:17:37.880 --> 0:17:40.240 who Stare at Goats, oh neat. Yeah, he's a fan. 0:17:40.720 --> 0:17:45.280 And hey John Ronson his his book The psychopath Test. 0:17:45.400 --> 0:17:48.080 Let's started reading that. Yeah, it's super interesting. So far. 0:17:48.560 --> 0:17:52.639 Is it uh, semi historical fiction? Is it nonfiction? Is 0:17:52.640 --> 0:17:54.880 it totally fiction? It's sort of a look at how 0:17:55.480 --> 0:17:59.560 the industry, the mental health industry, tackles mental health. So 0:17:59.640 --> 0:18:02.520 it's not fiction. Yes, that sounds like it's up my alley. Then, yeah, 0:18:02.520 --> 0:18:05.480 I should have said nonfiction right off the bat. You're like, 0:18:05.520 --> 0:18:08.080 I'm gonna make you guess. Yeah, I will let you. Uh, 0:18:08.119 --> 0:18:09.760 I'll let you borrow it after a fenshion Actually how 0:18:09.760 --> 0:18:12.720 about that? Okay, and then I will take you up 0:18:12.760 --> 0:18:19.399 on that right after these messages. All right, So I 0:18:19.440 --> 0:18:21.720 guess we can talk a little bit about how it 0:18:21.760 --> 0:18:26.840 has treated medication wise. Um, it is a long term 0:18:26.840 --> 0:18:30.160 illness that is is basically looked at as a uh 0:18:30.160 --> 0:18:33.560 even a lifelong illness for most people, something you have 0:18:33.680 --> 0:18:39.720 to deal with, uh forever. Yeah, Um, medication wise, lithium 0:18:39.800 --> 0:18:43.320 since the nineteen seventies has been the go to. Uh 0:18:43.359 --> 0:18:46.240 it still is. It's a mood stabilizer and it's gonna 0:18:46.320 --> 0:18:49.000 help out with both sides of your mood swings and 0:18:49.040 --> 0:18:51.760 apparently which it works for you, right, And I like, 0:18:51.760 --> 0:18:53.840 like you said, that's the go to and it typically 0:18:54.520 --> 0:18:57.960 like people tend to respond to that. Yeah, it's it's 0:18:58.000 --> 0:19:00.399 a go to for a reason, not just because it 0:19:00.480 --> 0:19:04.680 was first or that there's a Nirvana song he he 0:19:04.760 --> 0:19:12.120 was bipolar, right, sure? Um, and uh, there are alternatives 0:19:12.119 --> 0:19:15.880 to lithium because not everybody responds to it. Not everybody 0:19:15.920 --> 0:19:20.400 has a good reaction to it. With even somebody who 0:19:20.440 --> 0:19:24.440 does respond well to lithium, UM, they have to keep 0:19:24.440 --> 0:19:27.080 a pretty good eye on your lithium levels in your 0:19:27.119 --> 0:19:29.200 blood stream, so you have to visit the doctor quite 0:19:29.240 --> 0:19:33.159 a bit. The whole point of I guess the rigamar 0:19:33.240 --> 0:19:35.480 role that you will go through when you're diagnosed with 0:19:35.520 --> 0:19:39.400 bipolar and say I want to combat this with meds 0:19:39.800 --> 0:19:47.920 UM is basically shooting blind and using a pragmatic approach 0:19:47.960 --> 0:19:51.399 to medicating you into saying, Okay, you're reacting well to 0:19:51.480 --> 0:19:54.520 this one, Let's try a slightly lower dose and see 0:19:54.560 --> 0:19:58.199 what happens. And with lithium in particularly, they keep an 0:19:58.240 --> 0:20:00.399 eye on it through through blood tests. But with all 0:20:00.520 --> 0:20:04.159 meds using used to treat bipolar disorder, they're going to 0:20:04.280 --> 0:20:07.360 really kind of like, um, try everything. Yeah, and it's 0:20:07.400 --> 0:20:10.600 still like how you feeling, Yeah, tell me how you're feeling, 0:20:11.160 --> 0:20:14.960 not let's do this uh test to read on the 0:20:15.080 --> 0:20:18.600 screen how you're feeling still yeah, you know uh. And 0:20:18.680 --> 0:20:20.960 again part of the reason why is because they don't 0:20:21.080 --> 0:20:23.439 quite know how some drugs work. They just know that 0:20:23.520 --> 0:20:26.640 they do work for some people, but not everybody. Yeah. 0:20:26.720 --> 0:20:29.879 Anti convulsants is another UM another one that they use, 0:20:29.960 --> 0:20:34.160 and it's also a mood stabilizer and I think that 0:20:34.359 --> 0:20:37.760 calms down the when your brain is the parts of 0:20:37.800 --> 0:20:41.080 your brain at least that are ramped up and overacting. Right. 0:20:41.600 --> 0:20:46.680 One of the ways that it affects that is by um, 0:20:46.720 --> 0:20:49.680 increasing the amount of GABBA in your brain. You know, 0:20:49.760 --> 0:20:55.399 gabba kind of What does that stand for? Again, it 0:20:55.480 --> 0:21:02.960 stands for gamma amino beautyic acid. Obviously, well done, thank you, 0:21:03.400 --> 0:21:07.520 It's been a while since I tried to pronounce something hard. Uh. Well, 0:21:07.560 --> 0:21:11.119 you can use the anti convulsants sometimes, even with lithium. Again, 0:21:11.160 --> 0:21:14.880 it's can be a cocktail of drugs that you're on. Right, 0:21:15.040 --> 0:21:18.760 depending on what works for you. A typical anti psychotics 0:21:19.080 --> 0:21:23.320 can help. Um. They usually use those after they've tried 0:21:23.320 --> 0:21:26.960 the lithium. I think they tried lithium first, unless you're 0:21:27.040 --> 0:21:31.239 a teenage girl or a pregnant woman, right. Um. And 0:21:31.280 --> 0:21:37.280 then uh, the antipsychotics work because um, they affect the 0:21:37.280 --> 0:21:41.160 amount of dopamine in your brain. And again, high levels 0:21:41.160 --> 0:21:44.760 of dopamine can lead to psychotic symptoms, which is why 0:21:44.760 --> 0:21:49.520 they call the drugs that treat those anti psychotics, right. Um. 0:21:49.600 --> 0:21:53.920 And then benzodiazepine a k A. Relaxants. I think those 0:21:53.920 --> 0:21:57.840 are used less, probably because uh, they're addictive or can 0:21:57.880 --> 0:22:02.119 be addictive. Yeah, and then least the short term used 0:22:02.680 --> 0:22:06.560 and they yes, they use them to promote healthy sleep. 0:22:06.640 --> 0:22:09.320 To um, Like you said, one of the symptoms, especially 0:22:09.359 --> 0:22:12.800 of mania, is just going without sleep, like you got 0:22:12.840 --> 0:22:15.679 too much to do and you don't even need it, 0:22:15.760 --> 0:22:20.560 so you don't sleep. Um. And one of the I 0:22:20.880 --> 0:22:25.040 guess the presence of gabba or low amounts of gabba, 0:22:25.200 --> 0:22:28.200 which is a neuro transmitter that's involved in getting sleep. 0:22:28.840 --> 0:22:33.000 I believe staying asleep too, um kind of underlies this 0:22:33.080 --> 0:22:36.639 idea that your sleep cycle is off and it's either 0:22:37.320 --> 0:22:41.119 the result of your bipolar disorder or it's helping to 0:22:41.240 --> 0:22:45.080 cause your bipolar disorder. Either way, they found that promoting 0:22:45.119 --> 0:22:48.440 healthy sleep. For example, there is a thing called dark therapy, 0:22:48.720 --> 0:22:51.919 which is no exposure to artificial light after dark for 0:22:52.000 --> 0:22:55.119 a certain amount of time can help promote healthy sleep 0:22:55.200 --> 0:23:02.320 and can help stabilize bipolar disorder symptoms. All that makes sense, Well, yeah, 0:23:02.359 --> 0:23:04.840 the like it always kills me when I see people 0:23:04.840 --> 0:23:08.840 on Facebook at like three am saying on Facebook that 0:23:08.920 --> 0:23:12.560 they have insomnia, Like, well, you've got a little shiny 0:23:12.640 --> 0:23:15.440 bright screen in your face, start by putting that down 0:23:15.760 --> 0:23:19.880 and see what happens. Um. So yes, So with there's 0:23:19.920 --> 0:23:23.199 all these little clues out there, Chuck that, like so 0:23:23.280 --> 0:23:25.879 many pieces of the jigsaw puzzler on the table, they 0:23:25.960 --> 0:23:28.879 just haven't been fit together yet, you know. But it 0:23:29.240 --> 0:23:32.240 seems like there's, um, there's a kind of a hornet's 0:23:32.240 --> 0:23:36.040 nest out there. I wondered, can you live with bipolar 0:23:36.119 --> 0:23:41.320 disorder without medication? And apparently there's a big divide in 0:23:41.359 --> 0:23:45.040 the bipolar community, like there's pro med and anti med 0:23:45.560 --> 0:23:49.359 And I've seen comparisons between talking about like religion or 0:23:49.400 --> 0:23:53.440 politics or meds with bipolar people. It's all the same, 0:23:53.880 --> 0:23:57.280 like you want to avoid those things to keep things friendly. Um. 0:23:57.320 --> 0:24:00.159 But I've seen that some people are like, yes, you 0:24:00.200 --> 0:24:04.960 can live without meds, but you probably can't get too 0:24:05.119 --> 0:24:09.159 stable without meds. And you get the stable, then maybe 0:24:09.160 --> 0:24:13.160 you can. But um, there's practically no way to get 0:24:13.160 --> 0:24:16.720 the stable without the help of medications. So people who 0:24:16.760 --> 0:24:19.000 have bipolar story will be like, I've been med free 0:24:19.080 --> 0:24:21.960 for a year, which is great because it means that 0:24:22.000 --> 0:24:26.560 they have managed to fight off episodes and triggers, but 0:24:26.640 --> 0:24:31.280 they've done that through other therapy to not just avoiding treatment. 0:24:32.040 --> 0:24:35.240 Because if you avoid treatment, not only does the does 0:24:35.480 --> 0:24:41.480 does your condition get worse, it gets harder to treat. Yeah, yes, 0:24:41.720 --> 0:24:46.880 the episodes supposedly definitely get worse. Yes, you go. Uh. Well, 0:24:46.920 --> 0:24:49.399