Lithium Might Increase Brain Mass

Ok, no so scared of lithium. If you remember one of my previous posts, I described how MRI scans show that the hippocampus in bipolar patients might be reduced in size, similar to schizophrenia. Well, I just came across another resource about lithium that makes me feel a little better about it. Lithium might increase brain mass.

Without treatment, there seems to be an overall decrease in brain volume in the areas of the hippocampus. But, in a meta analysis on lithium, it appears that patients have increased the volume of the hippocampus compared to healthy patients. What this indicates is something crucial. Not only does lithium appear to work, but it appears to correct some of the damage that bipolar disorder does and is. This at least makes me much warmer to the idea of taking lithium. If it corrects the disorder rather than covering it up, then I’m far more inclined to take it.

http://blogs.psychcentral.com/bipolar/2011/02/lithium-increased-brain-volume-bipolar-disorder/

Schizophrenia and Bipolar Disorder – The Same in the Brain?

It’s old news in terms of the 24 hour news cycle, but I came across an article about brain scans between people with schizophrenia and bipolar disorder. Interestingly enough, in terms of how they appear in the brain, they work in a similar fashion around the hippocampus area. Specifically in the CA 2 and the CA 3 areas.

What does the hippocampus do then? And what are the CAs (cornu ammonis regions)? Primarily, the hippocampus is involved in memory with the CAs as the specific subregions of it. But it does not deal with motor skills or cognitive skills like playing a musical instrument. Rather, one of the roles is in detecting novel events, places, and stimuli (VanElzakker 2008). Its role also includes encoding stimuli in environmental contexts. So what this means is that in terms of interacting with environments, individuals with bipolar disorder and schizophrenia both see novel events in a similar fashion. Personally, I find this a fascinating result since it appears that to some degree, individuals with bipolar disorder and schizophrenia not only see the world in a similar way, but also view it differently from normal people. Perhaps this explains the environmental sensitivity found in both disorders, perhaps it doesn’t. But the findings are there and are interesting none the less. Additionally, since the hippocampus is also involved in long term memory, the reduced size of the hippocampus might explain the memory problems associated with both bipolar disorder and schizophrenia.

However, the similarities do not extend that far. In a study conducted in scanning the grey and white matter of the brains of individuals with schizophrenia and psychotic bipolar disorder, there were few similarities found. In a BJPsych publication, in schizophrenic individuals, there were reductions in grey matter of the temporal lobes, the neocortex, thalmus, and white matter in the cerebellum. These areas are involved in attention, language, emotional regulation, and conscious thought. The only similarities found were in the white matter, the cerebellum, which is involved in emotional regulation.

Furthermore, in a recent UCLA study, researchers found an overlap in genetic markers for bipolar disorder and schizophrenia. Of the 7 genetic markers found in schizophrenia, researchers found an overlap of 3 genetic loci between bipolar disorder and schizophrenia.

What these results demonstrate is that there is a fair amount of overlap between these two diseases. This might be enough to explain why medications for both are so similar. Yet, there are marked differences between the diseases, even between psychotic bipolar individuals and schizophrenia. With these differences, it means that the different classification of the two diseases is well founded, even though there is strong overlap between the DSM IV classification of both conditions with psychotic symptoms. While this is all fairly technical, I do find it an interesting result. I often associated psychotic symptoms of bipolar disorder and schizophrenia as being identical or very similar in some way. Rather, there is a general result that the two disorders are caused in the same way, but present different models in the brain. So there you have it, a crash course in the differences between bipolar disorder and schizophrenia. They seem similar, and they are to some degree, but primarily in the response to new environmental cues and emotional regulation. After that, even the psychotic symptoms differ in their presentation in the brain.

Managing Performance Anxiety with Technology

I’ve plugged Brain Workshop here before as a method to help counter act some of the cognitive side effects of the antipsychotics that I’ve been on. It’s a wonderful program for that and it does have its rewards in increasing fluid intelligence. But I’ve also noticed another change. It helps me with my performance anxiety.

I’m still unsure of whether it is due to abilify or if it is the program itself, but somewhere in my brain, I get a greatly diminished anxiety reaction to stressful cognitive acts. The reason that I can find for this decrease is due to desensitization to the act of cognitive stress by perpetually stressing my performance with the brain workshop. Before, whenever I began to become stressed, my palms would sweat, I would tremble slightly, my motor skills were fairly diminished. But now, working at maximum capacity, I find that these responses are slowly retreating. I still have some physical reactions, but my brain is able to concentrate and be more efficient in remembering tasks.

Another fascinating development is a greatly diminished fear of failure. Now, when I get a bad score or a task wrong. I simply carry on without being phased as much. I just keep going ahead and trying my hardest to keep up.

This brings up yet another reason for why I find this program so important. Not only does it allow me to have an objective measure of my mental performance on any given day with respect to the past days, and it helping to increase my performance in certain tasks, but it also provides a method of desensitization environment.

While I’m suspect on just how much it is just the brain workshop, I’m inclined to believe that it is a combination of abilify and desensitization. In that case, there is increased hope that abilify is truly stabilizing my behavior and mind. Right now, I’m almost giddy with happiness over the prospect that my anxiety might be controlled in addition to my depression and manias. The response is rather dramatic. I hope to relay some of this to my psychologist to see what exactly he thinks of the progress. Still, this is yet another wonderful example of just how much technology can be used to improve quality of life in manic depression and anxiety.

Keeping the Mind Sharp on Drugs

I am always cautious of cognitive side effects of drugs. It is imperative that I retain my cognitive performance for two main reasons. First and foremost is that I am a student that is looking at grad school. It would be disastrous to have my cognition impaired in any significant manner since I rely on my mind remaining as sharp as possible in order to excel. This is not to say that in other lines of work one does not need to use one’s brain. But being at peak performance is critical at this stage of my life, so I’d rather not be fighting off the feeling of being drugged or have memory problems.

The second reason is that cognition is important in controlling my moods. I need to be sharp to identify mood changes and subtle changes in my body’s feelings so I can get on my mood swings quicker. This is almost more important than my school work since being unable to identify my mood swings in time will lead me to destabilize and in essence negate any value of the drug’s benefits.

I don’t think that this just applies to me, I think that cognitive side effects are of primary value to everyone with bipolar. As I said above, having the mind dulled will in essence negate the value of being on the drug to begin with. Every day one monitor one’s mind to see if it is working properly. Without the mind properly functioning, one might as well throw away the drug unless it stabilizes one’s moods significantly. At that point, it’s personal preference. I’ll usually opt for less stable and better cognition since I can handle minor mood swings with cognitive-behavioral methods.

So one needs to keep their mind sharp. Measuring this is incredibly difficult, if not impossible, from a purely introspective stance. To determine my focus, I need to actually try to focus on something. So to determine my mental acuity I need something that’ll actually stress my mind. I can’t do this through paper writing or anything that does not challenge me significantly, but if I try to do something difficult in logic or philosophy, then the reason I’m coming up short may in no way be my mind’s lack of sharpness. To properly measure my mind’s ability, I need something that is objective, sterile, consistent, and behavioral.

This is where Brain Workshop is incredibly useful in two respects. First, it provides a graphing feature so that you can see progress as well as how you compare to previous days in terms of your mental abilities. I’m a huge fan of graphs since my mind has a hard time putting together trends from raw numbers, I need visuals to really make sense of it all, along with trend lines and other things (thank you Descartes for that contribution).

So it gives you some good visual data and numbers, but it also does more. It’s also shown in a study and two repetitions to improve general fluid intelligence. As I’ve stressed earlier, empirical verification is of the utmost importance to me. I don’t like trying things based on claims, I want evidence. If you’re wondering, as I did, fluid intelligence is the kind of intelligence that one uses in figuring out problems without an experiential basis to help out. If you’ve ever done an intelligence test with weird geometric shapes that you have to find out what will fit the pattern (the Raven’s Progressive Matrices test), it is this type of intelligence that it improves. It’s useful in everyday problem solving, so it’s also good for coming up with unique solutions to bipolar problems. It also helps counteract some of the negative side effects of drugs on cognitive performance. So not only can one improve one’s side effects, one can also improve their brain’s performance.

Brain Workshop also compliments my general philosophy on bipolar. It’s not an illness in the usual sense, it only means that one’s mind has emotional hurdles that it needs to overcome. With rigorous discipline, one can find ways to not only counter act some of these hurdles (which can include accommodations), but I think that one can even surpass what is usually seen as “normal” by taking advantage of the different moods and custom tailoring the life you’ve been given in a way that most people will never get around to. I eat healthier than most people, I take advantage of my moods to do reading and things that I enjoy (when possible), I know how to take breaks and when to work myself to the bone without red lining my mind and body, and I’ve searched out new means to keep myself sharp and on top of things. I still have my obstacles, but I’ve also found things that enrich my life through the process of dealing with bipolar that I would never have done if I did not have it or take it seriously. And that’s my outlook, which is that with creative solutions, bipolar can become a strength instead of a weakness. It only means that one needs to do things differently than most people.