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People with Depression and Bipolar Disorder Feel Sadness Differently

Depression and bipolar disorder can both cause people to go through periods of extreme sadness and despair, and even mental health experts may find it difficult to distinguish between the two disorders. But new research suggests these conditions may have very different patterns of brain activity.

Researchers scanned the brains of people with clinical depression and other people with bipolar disorder, and measured these individuals' reactions to emotional photographs. The researchers found differences in the amount of activity in brain areas involved in regulating emotion in bipolar patients, compared with patients who had "unipolar" depression (a term used to distinguish the condition from bipolar disorder).

"As psychiatrists, we have a big problem: We cannot distinguish unipolar depression from bipolar depression," said Dr. Eric Ruhe, a psychiatrist at the University of Amsterdam in the Netherlands. This inability to tell which disorder a patient has is a problem because antidepressant medication usually isn't effective for treating people with bipolar disorder, he said. Such medicines can even increase such a patient's risk of having a manic episode, he said. During manic episodes, a person with bipolar disorder may become agitated, euphoric and sometimes psychotic.

The new findings could lead to a better way of diagnosing and treating patients with these disorders, according to the study, published in the journal JAMA Psychiatry.

People with either depression or bipolar disorder may have bouts of severe depression and difficulty regulating their emotions, whether they are happy or sad. But unlike people with depression, those with bipolar disorder also experience manic episodes, during which they can be very destructive. During these episodes, the individuals may have affairs, sell everything they own or buy things they can't afford. In the new study, Ruhe and his colleagues searched for a better way to distinguish between people with each disorder. They looked at 42 patients with depression, 35 with bipolar disorder and 36 individuals with neither disorder.

The researchers scanned the participants' brains using functional magnetic resonance imaging while testing the participants' ability to regulate their emotions. Researchers did this by showing photos of people depicting different emotions (sad, happy, fearful and neutral). For example, a sad photo might show a person overdosing on pills, whereas a happy photo might depict a person skiing. The researchers instructed the participants to either passively experience the images or actively regulate their emotions by distancing themselves from what they were seeing, for example, by reminding themselves, "this is only a picture." The participants rated how strongly they felt after looking at each image. Researchers measured the individuals' ability to regulate their emotions by subtracting the rating of the passively viewed photos from the rating reported after the participants had actively distanced themselves from the images. 

Unlike previous experiments, this one was conducted both while patients were in a normal state of mind and while they were in a depressed state, and none of the participants were taking psychiatric medication.

Behavioral data revealed that when the participants were feeling normal (not depressed), those with bipolar disorder were much worse at regulating both happy and sad emotions than those with depression. But when they were feeling depressed, the bipolar patients were actually better at regulating happy emotions. Both groups performed about the same when trying to regulate sad emotions while depressed.

The differences in brain activity between the two types of patients were striking, the researchers said in their study. In a nondepressed state, the bipolar patients showed increased brain activity (compared with the depressed patients) in a region called the dorsolateral prefrontal cortex, which is involved in actively regulating emotions. This suggests bipolar patients' brains had to work harder than those of the depressed patients to achieve the same level of emotional control, Ruhe said.

By contrast, in a depressed state, the bipolar patients showed decreased brain activity (compared with the depressed patients) in the rostral anterior cingulate cortex, which acts as a hub connecting the cognitive and emotional parts of the brain.

So even though both the bipolar and depressed patients showed no behavioral difference in controlling their sadness during bouts of depression, their brain activity revealed a big difference, Ruhe said.

Next, it will be important to study whether the differences in brain activity that the researchers observed in the study can be used to differentiate between patients with these two disorders, the researchers said.

Fuzzy Thinking Episodes Are Real Signs Of Bipolar Disorder And Depression

Perhaps you remember a time when focusing wasn’t so hard, and when your thoughts seemed sharper, clearer, as though you were constantly on the edge of your seat. Now, you may find yourself battling fatigue and fuzzy thinking, feeling as though your thoughts aren’t as sharp as they used to be. No, this isn’t early onset Alzheimer’s; it turns out this may simply be a symptom of depression, anxiety, or bipolar disorder.

According to a study out of the University of Michigan, this fuzzy effect is indeed real for depression and bipolar patients, and it can be seen affecting certain parts of the brain on brain scans. The researchers also conclude that based on these results, depression and bipolar disorder are likely to be on a spectrum of mood disorders, rather than being completely separate, unrelated things

In the study, researchers from the University of Michigan Medical School and Depression Center analyzed 612 female participants, two-thirds of whom had experienced major depression or bipolar disorder in the past. Whether they had depression or bipolar disorder, the women with some sort of mood disorder/mental illness performed equally poorly on cognitive tests, which involved reacting to letters flashing on a screen. The women with mental illnesses all lagged behind the women who had no mental health problem on the tests.

Why did this happen? The researchers took brain scans and focused on one particular part of the brain — right posterior parietal cortex, which is associated with executive function (working memory, problem solving, reasoning, etc). They found that the women with depression or bipolar disorder had different activity in the right posterior parietal cortex; depressed participants had higher activity while bipolar disorder participants had lower activity.

“In all, we show a shared cognitive dysfunction in women with mood disorders, which were pronounced in the cognitive control tests and more nuanced in scans,” Kelly Ryan, an author of the study and a neuropsychologist at UM, said in the press release, “These findings support the idea of seeing mood disorders dimensionally, as a continuum of function to dysfunction across illnesses that are more alike than distinct.”

Fighting The Fog

Whatever the mental illness, feeling foggy and unfocused may contribute to feelings of uselessness or lack of self-esteem.

“As someone who suffers from depression I absolutely know what they are talking about with ‘fuzzy thinking,’ quite often your brain just feels like it's swimming in molasses and you have no mental agility,” one Reddit user writes in response to the study. “Everything thought has to be laboriously teased out.”

Fortunately, there are ways to overcome the cognitive effects of depression. That includes, first and foremost, taking a look at your schedule and figuring out whether you’re overwhelmed with too many things on your plate. Chronic stress can tire out your mind and body, and force your mind to shut down, leading to lowered cognitive and memory ability. Time management, exercise, proper sleep, and nutrition will all help you boost your mind’s sharpness and fight the negative effects of depression.

“Reducing overt stress, both emotional and environmental, and learning positive coping mechanisms are terrific therapy for the brain, and your lifestyle and daily schedule may be the first place to start when thinking about what may be causing your mental fog,” nurse practitioner Marcelle Pick writes on Women to Women. In other words, instead of despairing over fuzzy thinking and lost attention, take the steps to figure out what might be behind it.

Source: Medical Daily

Brain develops differently in bipolar disorder.

In adolescents with bipolar disorder, key areas of the brain that help regulate emotions develop differently, a new Yale study has found.

Researchers found that the brain in adolescents with bipolar disorder loses larger-than-anticipated volumes of gray matter, or neurons, and shows no increase in white matter connections, which is a hallmark of normal adolescent brain development.

Researchers noted the differences in the prefrontal cortex and insula in the magnetic resonance imaging scans - repeated over a two-year period - of 37 adolescents with bipolar disorder when compared to the scans of 35 adolescents without the disorder, '' reported.

"In adolescence, the brain is very plastic so the hope is that one day we can develop interventions to prevent the development of bipolar disorder," said senior author Dr. Hilary Blumberg, professor of psychiatry and diagnostic radiology in the Yale Child Study Center.

Bipolar disorder often first appears in adolescence and is marked by severe shifts in mood, energy, and activity levels. Individuals with bipolar disorder can have trouble controlling impulses and have a high risk of suicide and substance abuse.

While adolescents tend to lose gray matter in normal development, the study showed that adolescents with bipolar disorder lose more.

The study demonstrated that they add fewer white matter connections that typically characterize development well into adulthood.

These changes suggest that brain circuits that regulate emotions develop differently in adolescents with bipolar disorder, researchers said.

The study was published in the journal Biological Psychiatry.


Source: ZeeNews.

My Significant Other Has Bipolar Disorder, What Should I Do?

First, it’s important to identify your partner’s major symptoms, and to write these signs down in a journal. The goal is to figure out the main categories of your partner’s symptoms and to list the signs under each one. If your partner has experienced debilitating periods of sadness, followed by periods of high excitement and activity, he or she may have bipolar disorder. Below, you’ll find a list of typical behaviors exhibited by those with bipolar disorder. If your spouse or significant other has been exceptionally excited or active for a week at a time and displays three of the symptoms below, talk with your healthcare provider about bipolar disorder.

  • Exaggerated optimism and self-confidence
  • An inflated perspective about abilities and qualities
  • Racing thoughts
  • Brisk, speech
  • Impulsive behavior
  • Bad decision-making
  • Reckless behavior:
 Compulsive shopping, irresponsible driving choices o rash business decisions
, sexual promiscuity
  • Experiencing delusions (holding untrue beliefs) and hallucinations (seeing and/or hearing things that aren’t there)

Another way to determine if your spouse or significant other has bipolar disorder is to consider his or her childhood. The lives of teens struggling with mood disorders can be marred by poor decisions and/or ineffective, misguided attempts to cope. Mood disordered teens may experience or perpetrate:

  • Academic failure
  • Destruction of property
  • School suspension or expulsion
  • Social isolation
  • Drug and alcohol use
  • Frequent misunderstandings
  • Inability to finish projects
  • Reckless behavior (speeding, unprotected sex, over-spending)
  • Extreme defiance
  • Poor social relations
  • Suicide attempts

 What does It mean for our marriage if my spouse has bipolar disorder?

There are two answers to this question. If you spouse fully accepts the diagnosis and resolves to get treatment, you could begin working together and make the marriage stronger than ever.

If, on the other hand, your spouse refuses treatment, you must learn to protect yourself from abuse. Abuse can take the form of

  • Verbal abuse (rampant blaming)
  • Financial abuse (spending money; taking on massive debt)
  • Emotional abuse (controlling, cruel behavior)
  • Physical abuse (when irritability spins out of control) 
What does my bipolar partner need from me?

First and foremost your support and understanding is needed. In order for you to be supportive you must understand this disorder as well as you possibly can.  There are many ways of learning about the illness.  Listening to your significant other is probably the best resource.

1. Ask your partner about their wants and needs for each main symptom when they’re stable. For instance, you might ask them how you can help when they’re depressed and don’t want to get up; how to contact their doctor when they’re manic; and how you can help them calm down when they’re angry. However, some of your partner’s ideas may not be reasonable. 

2. Learn to respond to bipolar disorder instead of reacting to what your partner does or says. Bipolar disorder is a frustrating illness, and it’s normal to get frustrated yourself and make comments like “What’s your problem?” or “Why can’t you just calm down?” or “If you cared, you’d try harder,” according to Fast and Preston.

But this only makes matters worse and heightens your own frustration. Instead, start statements with “I can see that you are…”; “It seems to me that you are sick…”; “I know you don’t feel well right now. What can we do to treat bipolar disorder so that you can feel better?”

3. Help your partner make good choices around relationships. Stressful relationships are one of the biggest triggers for symptoms. It’s helpful if you can become a buffer between your partner and these relationships by being a good listener and talking about how your partner’s symptoms are affected. It’s also important to work on your own problematic relationships.

4. Help your partner lead a healthy lifestyle. Bipolar disorder is very hard on the body, fortunately, you and your partner can use diet and exercise to manage symptoms and boost your well-being. That’s because both diet and exercise can affect mania, depression, anxiety and anger.

Help your partner figure out which foods negatively affect their symptoms and what physical activities they enjoy doing. You also can help by cooking healthy meals that support the body, mind and spirit.

5. Learn about complementary treatments. In addition to medication and psychotherapy, complementary treatments, such as aromatherapy, massage, acupuncture, yoga and meditation, may be very helpful in managing symptoms. Help your partner by researching these methods.

But remember that just because something is “all-natural” doesn’t make it safe or effective for your partner. For instance, they note that herbal supplement St. John’s Wort can have dangerous drug interactions. Also, some treatments may not be appropriate for certain symptoms, such as an intense massage when your partner is manic.

6. Help them with their medication. When they’re stable, work with your partner to figure out what helps and what doesn’t help for taking their medications. If the medications don’t seem to be working properly, help your partner make an appointment with his or her doctor. Encourage them to voice concerns. It can take time to find the right combination.

Signs and Symptoms of Bipolar Disorder in Children and Adolescents

What are the signs and symptoms of bipolar disorder in children and adolescents?

Youth with bipolar disorder experience unusually intense emotional states that occur in distinct periods called "mood episodes." The extreme highs and lows of mood are accompanied by extreme changes in energy, activity, sleep, and behavior. Each mood episode represents a drastic change from a person's usual mood and behavior.

An overly joyful or overexcited state is called a manic episode. An extremely sad or hopeless state is called a depressive episode. Sometimes, a mood episode includes symptoms of both mania and depression. This is called a mixed state. People with bipolar disorder also may be explosive and irritable during a mood episode.

Symptoms of bipolar disorder are described below.

Symptoms of Mania:

Mood Changes

  • Being in an overly silly or joyful mood that is unusual for your child. It is different from times when he or she is just being silly and having fun. 
  • Having an extremely short temper and unusual irritability.
Behavioral Changes
  • Sleeping little but not feeling tired.
  • Talking a lot and having racing thoughts.
  • Having trouble concentrating or paying attention, jumping from one thing to the next in an unusual way.
  • Talking and thinking about sex more often than usual.
  • Behaving in risky ways more often, seeking pleasure a lot, and doing more activities than usual.
Symptoms of Depression include:

Mood Changes

  • Being in a sad mood that lasts a long time.
  • Losing interest in activities once enjoyed.
  • Feeling worthless or guilty.
Behavioral Changes
  • Complaining about pain more often, such as headaches, stomach aches, and muscle pains.
  • Eating a lot more or less than usual and gaining or losing a lot of weight.
  • Sleeping or oversleeping when these were not problems before.
  • Losing energy.
  • Recurring thoughts of death or suicide.
It's normal for almost every child or teen to show some of these behaviors sometimes. These passing changes should not be confused with bipolar disorder.

Read full article: National Institute of Mental Health. 

Dealing with Bipolar Disorder at Work

People with bipolar disorders or other mental illnesses have challenges when it comes to work. Holding down a job with bipolar disorder is entirely possible. You can achieve success at work. Bipolar  disorder doesn't have to stop you but it may be more difficult for you than for others and it may take more of a toll on you. Here are a few tips on handling work and bipolar disorder.

Don't tell. 

This first piece of advice is contentious. Natasha Tracy, author of the Bipolar Burble blog, says "I recommend not telling anyone at work that you have a bipolar disorder- not even you boss- without a very good reason. That piece of information is "juicy" and telling one person means the information will eventually crawl its way around the office until everyone knows. And whether one person knows or everyone knows, you will likely find out what stigma, discrimination and prejudice are all about. People will start to look at you differently and interpret your actions differently. People will stop recommending you for projects and you might even get passed over for a promotion. And that's all assuming that more overt, illegal acts of discrimination and hate don't happen. If you need to tell you boss, look into filing for a protection as a person with a disability. This can protect you from overt acts of discrimination."

Work hard. 

Perhaps it goes without saying but you should work hard at work.You should strive to work harder than others. Be on time. Turn in projects by the deadline. Create stellar work. Why? Because you are going to need more time off than others for appointments and for sick leave and you need your boss to remember you for your hard work and not your absenteeism .

Don't Stress. 

Try not to let work stress you out. When you're stressed you raise levels of hormones in your body. And when you do this for prolonged spans of times you feel sicker and your immune system becomes comprised. Then you have two problems - you have the flu and you have bipolar disorder. Learn to meditate, practice yoga, do relaxation exercises or just go for a run. 

Take the time you need. 

You want your boss to think of you as a good employee but that doesn't mean that you shouldn't take the sick time that you need and that you've earned. When you're sick just admit it and stay home. It'll be much better for you in the long run than trying to "power through" and making yourself worse for weeks or even months to come. 

Be discrete. 

When you need to take time off, understand that you don't need to say why you're sick, only that you are. It's perfectly fine to take time for a psychiatrist's appointment in many workplaces but you don't need to tell people thats what you're doing. When you need to take time off because you are too depressed, you don't need to tell anyone why you're staying home - you just need to say that you are sick. The details are your business.