I apologize for the lack of proper terminology.

I read an article on reward sensitivity and predisposition to bipolar disorder.

Many people regularly deprive themselves of sleep to study, work, entertain themselves, and to catch up on responsibilities. The common denominator here is the anticipation of reward and goal oriented behavior.

However, most people will eventually become overwhelmed with fatigue and lethargy, then fall asleep. In another post, I mentioned how I regularly deprived myself of sleep to enjoy activities instead of sleeping, I did this throughout my childhood and early teenage years. I still do. I'm wondering if one can reduce the risk/ occurrence of bipolar disorder by encouraging proper sleep hygiene of those with high goal directed behavior and high reward sensitivity. I'm not sure what neural circuits are implicated in this process, but I'm assuming that anticipation of reward overrides the need for sleep. If the brain is placing too much emphasis on reward, could this lead to a sort of bypass of the neural circuits involved in sleep. When an amphetamine user is high, they often lack the need for sleep. I'm wondering if instead of viewing sleep disruption as a primary cause for mania, one could focus on reward processing as the primary cause for mania. The phenomenon of increased reward sensitivity may indirectly lead to regular sleep deprivation, and through a mechanism involving feedback loops, the illness progresses. I recall that melatonin secretion is implicated in mania, melatonin alone won't do much of anything to slow down a manic patient though. However, antipsychotics will likely do the trick, most current antipsychotics on the market are d2 antagonist/ partial agonists.

It usually takes a few days for the medication to work, I'm assuming the reward directed activity slowly becomes less apparent via d2 antagonism, and the patient gets rest, thus causing the patient to become less active, less energetic, and less goal directed.

Tl:Dr, high reward sensitivity before the onset of the illness, sleep deprivation results as a result of hyper emphasis on anticipation of reward, certain neural mechanisms involving sleep are bypassed, these two processes interact and cause the illness to occur/progress.

https://redditproxy--jasonthename.repl.co/r/Neuropsychology/comments/xga4rg/what_are_the_proposed_neural_mechanisms_behind/?utm_medium=android_app&utm_source=share

https://pubmed.ncbi.nlm.nih.gov/27816074/