Thoughts on Bipolar Disorder

Some very famous people are thought to have had bipolar disorder including Vincent van Gogh, Edgar Allen Poe, and others. Poe also had substance abuse problems with alcohol (as did WC Fields). Unfortunately van Gogh committed suicide in 1890. I believe that Poe of Baltimore in the US drank himself to death. Van Gogh's paintings look very normal except for one which showed a skull smoking a cigarette. Poe's stories and his poems were much like things that Stephen King would write.

The Premature Burial by Poe was the scariest story that I ever read. It was based loosely on true events.

I am also very interested in depression. A lot of people have been thought to have had depression including Abraham Lincoln and his wife, Mary Todd Lincoln. She went into an asylum when he was assassinated.

The bibliography has background information on depression and on schizophrenia. Salvador Dali was thought to have had schizophrenia according to Dr. Silano Arieti, a famous psychiatrist and writer.

The Metabolic Syndrome

According to Antoni Sicras, Javier Rejas, Ruth Navarro, Josep Serrat and Milagrosa Blanca, the metabolic syndrome was much higher in prevalence in bipolar disorder than in the general population. Although the group is from Spain, the abstract that I found was in English.

"Compared with the general population managed by the BSA, the prevalence of MS was significantly higher in patients with BD, mainly due to a higher prevalence of obesity, high triglyceride levels, and low HDL cholesterol levels. These findings strongly support the development of health policies addressing this problem in BD patients." Sicras et al (2008)

In the abstract the authors did not say whether they thought that this was due to the medication or to the disease itself or both. My view is that it may be due to both. Bipolar disorder itself is metabolic. My view is that there is a diabetes of the brain in bipolar disorder, and this may contribute to the positive metabolic findings. I accessed the abstract from a database called Health Reference Center Academic. Gale. Needham Free Public Library. 31 July 2008.

Schizophrenia

The Russians do not appear to use the diagnosis "bipolar disorder". They appear to divide everyone into different types of schizophrenia. They use different classifications of schizophrenia than we do in the US. The Russians also do not appear to use the diagnosis "depression".

The Italians also seem to call every mental disease "schizophrenia". Every Italian psychiatry study that I have seen has been on "schizophrenia". An example is the study by Mazzarello et al on lymphocytes in schizophrenia. They found "P type compatible atypical lymphocytes (13.7% in LM) with irregularly shaped nucleus, often showing a lobulation or deep indentation and cytoplasmic basophilia."

"TEM analysis showed, for the first time in schizophrenic patients, fine morphological features of 6 different types of lymphocytes, and the prevalent type presented a cytoplasm rich in free ribosomes and polisomes. Surface morphology observed by SEM presented different characteristics if compared with lymphocytes from control group."

Mazzarello et al

In this quote the term SEM is short for scanning electron microscope. Since the patients were under treatment, it is not clear how much of this pathology was due to the disease and how much was due to the treatment.

My interpretation of these findings is that the "free ribosomes and polisomes" were caused by damage to the rough endoplasmic reticulum. In a normal cell these are embedded in the membranes of the rough ER, which makes protein from amino acids. If the cell were to be flooded with amino acids, this could damage the delicate membranes and explain the pathology. A flooding of the cell with amino acids might cause the brain to burn amino acids for fuel instead of glucose, which would be disastrous to the brain. The brain is designed to run on glucose except in emergencies. Thus schizophrenia could be a perpetual emergency. The brain cannot make sufficient ATP by burning amino acids. This ATP is vital for the brain's energy.

Depression

Unfortunately certain antidepressive drugs interact with certain over-the-counter drugs including Sudafed (pseudoephedrine). This class of antidepressive drugs is called monoamine oxidase inhibitors (MAOIs). This same class (MAOIs) also interact with certain substances in the diet (tyramines). Foods such as cheese and wine must be avoided. The problem is that your blood pressure may go too high, which is a dangerous situation.

OCD and Hypochondria

Hypochondria is a type of OCD (obsessive-compulsive disorder). Other types of OCD include chronic hair-pulling, excessive washing of the hands, etc. The famous doctor Samuel Johnson was thought to have hypochondria when he got older. Also his biographer, Boswell, was also thought to have had hypochondria. Johnson, who was from England, was famous for writing a dictionary.

If there is interest, I may write more about these matters in a future article. It is interesting the doctors are often patients themselves. Another example of this was Dr. Parkinson, who had the disease that he wrote a famous paper about. Also there have been psychiatrists who have attempted suicide.

Conclusions

Different countries often have different diagnostic systems. The US diagnostic system came largely from Germany and Switzerland. The term "schizophrenia" was invented by Bleuler of Switzerland. The term "manic-depressive" was invented by Kraepelin of Germany. My view is that both diseases are similar. In both cases suicide is often seen. Both diseases are metabolic.

People with schizophrenia may hear voices. Hallucinations are seen. Delusions are seen.

More research needs to be done. I will write more articles on these matters if there is interest.

Bibliography

1. www.associatedcontent.com/article/830913/depression_a_scientific_approach_.html

2. www.associatedcontent.com/article/830971/the_blood_and_schizophrenia.html

3. Antoni Sicras, Javier Rejas, Ruth Navarro, Josep Serrat and Milagrosa Blanca. Metabolic syndrome in bipolar disorder: a cross-sectional assessment of a Health Management Organization database. Bipolar Disorders 10.5 (August 2008): p607(10).

4. Mazzarello V, Cecchini A, Fenu G, Rassu M, Dessy LA, Lorettu L, Montella A. Lymphocytes in schizophrenic patients under therapy: serological, morphological and cell subset findings. Ital J Anat Embryol. 2004 Jul-Sep;109(3):177-88.