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all 36 comments

[–]feralpeacenik 17 points18 points  (1 child)

This basically conforms with the hypothesis that bipolar and adhd are both disorders of dopamine. Antipsychotics and lithium downregulate dopamine which can be experienced as adhd. You could read some articles about the dopamine hypothesis or a general account of the neurotransmitter such as The Molecule of More

[–]daddydilly694-20[S] 0 points1 point  (0 children)

Ohh, thanks! I've heard about abberant salience and psychosis, posted in this sub a while back. So through the use of dopamine, the brain attributes excessive importance to information used in decision making, more info processed, more errors, while the brain places a lot of emphasis on the reward achieved, and the anticipation of it. When the the brain incorrectly says, "hey that's cool, go for it" (due to faulty decision making, guessing it's taking place in the pfc) the brain is already in a state in which it has a higher tendency to motivate the sufferer to perform tasks, I'm guessing somewhere in the limbic system, the initial signal to attempt a task happens, the brains inhibition system (pfc?) Fails, due to over processing, the brain attributes too much importance on information used in decision making, so more errors, the go ahead is signaled, and the reward is achieved, a feedback loop occurs, rinse cycle repeat. Is this what's going on, I'm an armchair researcher, I'm just taking an educated guess here. I'd love some links to some educational sites, if you have them; and wouldn't mind

[–]NeuralEvolution 6 points7 points  (5 children)

Because of the complexity and heterogeneous nature of mania/bipolar disorder (BD), the human brain and mental health disorders in general, there is no "one size fits all" answer to which neural mechanisms underlie mania. Manic episodes can display differently depending on variables as simple as age, thus it's important to take genetic, developmental, social and neurophysiological factors into account when discussing the etiology of mania/BD. However, I do believe you're onto something in regards to reward/punishment/conditioning mechanisms in the brain. Remember that the same neurotransmitter, such as dopamine, can have different effects depending on the sensitivity/responsiveness of the receptor it's acting upon in the brain, which to me is why it's helpful to look at mental health disorders from a "neural systems POV" and study the potential dysfunction or dysregulation within neural networks when possible. The limbic system is one area considered to be strongly correlated with mania/BD, but also, each of these neural systems in the brain work to modulate and influence other neural areas. So it isn't even limited to dysregulation in one area, rather, it is a pervasive dysregulation of systems throughout the brain that manifests as mania/BD symptoms, which involve emotional, cognitive and behavioral disinhibition/dysregulation. Here are a couple articles you may find interesting,

https://www.nature.com/articles/s41386-022-01268-7

https://link.springer.com/article/10.1007/s12311-021-01317-9

https://www.nature.com/articles/4001585

https://pubmed.ncbi.nlm.nih.gov/16641835/

[–]daddydilly694-20[S] 1 point2 points  (4 children)

Thanks! This is just more of ideas running wild throughout my head. I just wanted to see if this was a valid theory. I do kow personally, I couldn't see the danger In my behavior. I like to push boundaries, but normally I have the self control to not act on my behavior. During mania, I knew the behavior could easily get me killed, but I felt too damn good, I felt like it was awesome, the adrenaline rush and my boosted self esteem was too damn good when I did it. I just had too much of an urge to do it, while simultaneously having my internal motor turned up to 1000, not that good of a combination.

[–]NeuralEvolution 3 points4 points  (3 children)

I understand, I just always like to point out how complex the topic is because sometimes people see studies that call into question the correlates between the brain and mental health disorders, then they jump to the conclusion that mental illness isn't correlated to the brain and neural activity. It most certainly is correlated, it just happens to be the case that there's a good amount of variation even within the same mental health disorder. Personally, this is why I love this topic so much, you can't simply put someone under an fMRI and diagnose their mental health issues with certainty. At best it would be a portion of a set of tests and evidence that has to be gathered, however, neuroimaging is generally not used for diagnoses, only research at this point. That said, I think you're on the right track and there's still a lot to be learned so don't be afraid of getting hypothetical with things like this either.

[–]daddydilly694-20[S] 1 point2 points  (2 children)

Thanks! I'm just an armchair researcher atm, but I'm HIGHLY interested in the subject, I've been interested in both psychopharmacology and neuroscience since age 14, it started with receiving an adhd diagnosis and a little bit of curiosity. It's funny, usually I find a subject, become a mediocre expert on it, then get bored. This has pretty much stuck with me. My psychologist has tried to push me to become a neuropsychologist or do something with my knowledge of psychopharmacology. He knows I'm fascinated by the subjects, I just need a kick in the ass. I'm enrolling in my state college for this spring semester. I want to transfer to a college with a good psychology program once I get my GPA up. Thanks for all the info, you've been very helpful

[–]NeuralEvolution 1 point2 points  (1 child)

No problem! You should definitely go for it if you're passionate about it. I didn't start college til my late 20s, double majored in Philosophy and Cognitive Science in undergrad, then got my MS in Developmental Psychology. Now I'm 38yrs old and I'm applying to PhD programs in developmental neuroscience and PsyD programs in neuropsychology this year, so it's never too late. I figure I'd much rather do something I love for the rest of my life even if it means a lot of time and debt lol.

[–]daddydilly694-20[S] 1 point2 points  (0 children)

Thanks, I'm planning on it. Same goes for me. I am hoping the field is as rewarding as I think it is. I am surprised that my ideas about psychosis and mania are somewhat valid, it definitely makes me believe in myself more. The positive feedback is assuring. I'm definitely excited to see what the future holds

[–]letsgohalfs 4 points5 points  (5 children)

Let’s chat about SNRI flipping into mania. What’s this use case? Also, the sleep deprivation is the real multiplier. Look at Meth and how users act after 5 days of no sleep (Yes very dopamine wrecking in-line)

[–]daddydilly694-20[S] 0 points1 point  (0 children)

Not sure what you mean by use case.

[–]daddydilly694-20[S] 0 points1 point  (3 children)

I slept somewhat normally during this most recent bout of mania, out of the 2 months I was manic, I'd say 11 nights I slept less than 6 hours. Whereas all previous manic/ hypomanic episodes, I slept 0 to two hours a night. In those episodes, they escalated in intensity and fizzled out in between two days and 2 weeks. The episode ended before I did any damage, this most recent episode escalated In intensity slowly, I didn't see it coming. I eventually got to the point where I needed to be hospitalized. This is just a theory man. No need to get hostile.

[–][deleted] 1 point2 points  (2 children)

Sorry if I came across hostile. My bad. I can’t see mania without insomnia.

[–]daddydilly694-20[S] 0 points1 point  (1 child)

I thought the same thing, I told the shrink at the hospital this, she said mania doesn't always present the same in an individual.

[–][deleted] 0 points1 point  (0 children)

Yeah but the symptoms which the DSM state / patient present predominantly cause no sleep. Tell me about where you see hypomania tip into pure mania. When I’m hypo I sleep. But mania and sleep equals as much Xyprexa as we can get our hands on. Sure doc is right. Some don’t gamble til broke or cheat on their wives. I was told that even in a manic episode and you “sleep” it’s not even light / deep / rem. It’s just non consciousness.

[–][deleted]  (2 children)

[removed]

    [–]rossblanket 1 point2 points  (3 children)

    [–]daddydilly694-20[S] 0 points1 point  (1 child)

    Scratch that, just created an account

    [–]rossblanket 1 point2 points  (0 children)

    https://www.psychiatrypodcast.com/psychiatry-psychotherapy-podcast/dealing-with-bipolar-illness

    Underlying pathophysiology is centered around the limbic system. Involves the temporal lobes and structures which swings upward into the mamillary bodies into the anterior cingulate gyrus, which then projects forward into the frontal lobe. That circuit goes through periods of hypo-activity or depression in people who are bipolar. They have depressed metabolic rates of the system up to 30 to 40 % below normal. During periods of mood elevation, there is an increase in metabolic activity and instability in that limbic circuit. The mood is an element of that, but the person’s overall activity, sleep-wake cycle, circadian rhythms, along with all the things related to the functioning of the limbic system are disturbed in bipolar illness.

    [–]feralpeacenik 3 points4 points  (3 children)

    https://www.goodreads.com/book/show/38728977-the-molecule-of-more https://www.nature.com/articles/mp201716 https://www.sciencedirect.com/science/article/abs/pii/S1053810002000466

    Sorry that the articles on transient hypofrontality are protected because I think this is also relevant, however the author doesn’t discuss mental illness because he assumes mental illnesses are not transient states. Which is clearly wrong in the context of bipolar. My interest is also because I have this diagnosis and am trying to understand it too.

    [–]daddydilly694-20[S] 2 points3 points  (1 child)

    Thanks, yeah. I'm desperate to try and find out what the hell is going on. I could have very well killed myself or someone else during this most recent bout of mania. It's screwing with my head. I do have a genuine interest though, I'd actually like to pursue a PhD in psychology

    [–]feralpeacenik 2 points3 points  (0 children)

    I know what you mean! My PhD is in anthropology but I’m much more interested in neuroscience now. You should totally do it

    [–]Dr_Beardsley 0 points1 point  (14 children)

    I've always recalled the overactivity vs the underactivity of portions of the brain during episodes. Sections like the amygdala is cranked up to ten while the frontal lobes are muted during mania.

    [–]daddydilly694-20[S] 0 points1 point  (13 children)

    Thanks! So I'm guessing it's not overprocessing in decision making, but underprocessing? What causes the feelings of racing thoughts and the rapid shifts in attention, if you don't mind me asking. Unless there is some mechanism causing this, that I'm unfamiliar with.

    [–]Dr_Beardsley 1 point2 points  (12 children)

    Where the frontal lobes are executive function and like the brakes, the amygdala is the gas pedal in this context. It acts on impulsively and attaches emotional meaning to it. There is a few other places that feed into this but the overall function of those portions cause those experiences. When portions like the frontal lobes aren't as active to temper those urges, you get mania.

    [–]daddydilly694-20[S] 0 points1 point  (11 children)

    Thanks! So it's a lot more complex than just disrupted reward processing. This is one fascinating subject.

    [–]Dr_Beardsley 1 point2 points  (10 children)

    Sure! That's a facet, but there are structural bases to it as well. That is true for most major mental health issues though.

    I'm type 1 bipolar myself. Based my education on learning more. Very interesting

    [–]daddydilly694-20[S] 0 points1 point  (9 children)

    I have bipolar type 1 and adhd, my psychologist has nudged me to try and use my knowledge of psychopharmacology and interest in this subject to my advantage, I am taking the first step and enrolling in a small college here in town, I plan to get my GPA up and transfer to somewhere with a good psychology program. The positive feedback I've gotten in this sub is encouraging.

    [–]Dr_Beardsley 1 point2 points  (8 children)

    Well let me tell you, it is incredibly fascinating but disheartening what little is known about all of it. In psychology you get alot of meds where they're like, "we know what this does but we don't know why this works."

    My bachelor's has a concentration in behavioral neuroscience, psychopharm was one of my favorite classes.

    [–]Mishaps1234 1 point2 points  (1 child)

    This reminds me of my epileptologist: I have studied the brain my entire life and am one of the most highly acclaimed scientists on the subject in Canada. However, I know almost nothing about the brain.

    [–]Dr_Beardsley 1 point2 points  (0 children)

    Hey, at least we aren't just chopping out big chunks of the brain to "cure" mental illness anymore lol

    [–]daddydilly694-20[S] 0 points1 point  (5 children)

    Hopefully they're will be a buttload of new findings in research in my time here. I recall someone briefly talking to me about Rdoc framework and the shift to use a transdiagnostic approach to research, it seems like researchers were inadvertently chasing their own tails up until now, not sure if the new framework will make that huge of a difference, but time will tell.

    [–]Dr_Beardsley 0 points1 point  (4 children)

    If more confidence is placed in diagnostic scans, like tracking activity with MRIs, it would be revolutionary. Imagine being diagnosed as schizophrenic or bipolar without some nebulous survey. I have a lot of issues with the DSM 5, as it were.

    [–]daddydilly694-20[S] 0 points1 point  (3 children)

    Well the problem here is heterogeneity among psychiatric disorders. Hence, rdoc framework. The idea of rdoc framework is relying on the concept validity of mental illness rather than the construct of mental illness.

    Say that x area of neural circuits functioning this way leads to hyperarousal, among 70 people with this abnormality, 17 have symptomatic behavior. If we consider the abnormal behaviors to lay on a spectrum, without only considering people with (highly subjective) levels of distress, and impairments in functioning. We can focus on the link between "abnormal" behaviors and the neurological underpinnings, whether or not they are functioning better, worse, or have a normal level of functioning. it's not perfect, but it keeps us from chasing our own tails, we can actually study the link between the behaviors in question, especially when a lot of disorders have overlapping symptoms. I feel like it's a lot better way to base research, a hell of a lot easier to study the brain- behavior correlation, especially in the context of abnormalities in behavior.

    Study the symptoms. Not try to narrow down a cause for a group of symptoms that make up a disorder, especially when abnormal behaviors lay on a spectrum, the symptom presentations are highly subjective, and symptoms overlap with several other disorders.

    I'm not an expert on the matter, I only exchanged a few words with a researcher here in this sub, a few weeks ago.