Diagnosis Articles

Stem Cell Research Sheds Light on Genetic Factor in Bipolar Disorder

Tuesday, April 8th, 2014

A study published last month in a journal called Translational Psychiatry entitled “Transcripts involved in calcium signaling and telencephalic neuronal fate are altered in induced pluripotent stem cells from bipolar disorder patients” reported interesting findings about the development of brain cells in people with bipolar disorder compared to controls — people without bipolar disorder. The study was unique in two important ways:

  • The study was based on the increasingly accepted concept that even subtle changes in early embryonic brain development can cause symptoms of mental illness that appear later in life.
  • The researchers took advantage of evolving technology that creates stem cells — the origin cells in embryos that evolve into all the different cells types in the body — from adults rather than taking them from embryos. This allows researchers to have access to many more stem cells and also offers the opportunity to compare the stem cells from adults with certain diseases to those without and to see differences in the way they develop.


Difference Between Bipolar Disorder and Borderline Personality Disorder

Tuesday, February 18th, 2014

palmRecently on our Facebook Page, Vicky posted the following:

I was diagnosed bipolar II at the age of 20 but because bipolar type II is so similar to borderline personality disorder its difficult. I have had two diagnoses of bipolar type II and one of BPD.

What exactly is the difference between bipolar II disorder and borderline personality disorder?


Changes from DSM-IV to DSM-5

Wednesday, September 25th, 2013

Many of you probably already know that the Diagnostic and Statistical Manual of Mental Disorders (DSM) was recently updated from version IV to version 5. (That’s not a mistake, the American Psychiatric Association, which publishes the DSM, changed from using Roman numerals to using Arabic numerals.)

I just discovered a 19-page document online that provides an overview of the changes from DSM-IV to DSM-5:

Highlights of Changes from DSM-IV-TR to DSM-5


How Were You Diagnosed?

Tuesday, November 15th, 2011

doctorIn Bipolar Disorder For Dummies, we point out that as part of the initial work up for bipolar disorder you really should have a complete physical first to rule out any potential medical issues. Other possible diagnoses that may be considered by your doctor include the following:

  • Thyroid malfunction
  • Hormone imbalances
  • Diabetes
  • Mononucleosis
  • Chronic Fatigue Syndrome (CFS)
  • Lupus
  • Cancer
  • Cushing’s Syndrome
  • Hepatitis
  • HIV/AIDS
  • Rheumatoid arthritis
  • Medication or other substances that could have triggered symptoms

Sometimes we wonder whether doctors, including psychiatrists, follow the proper protocol in diagnosing bipolar disorder. Before diagnosing you and prescribing any medication, did your doctor perform a physical exam or refer you to an internist/specialist and/or order various tests to rule out medical issues that may have been causing symptoms of mania or depression?

What was the diagnostic process like for you?

Doctor image available from Shutterstock.


Bipolar Disorder Q&A: Can Long-Term Acute Pain Lead to Bipolar Disorder?

Monday, July 11th, 2011

bipolar and long term pain

Chris asks…

Can long term (decade+) acute pain from an artery joining a vein directly in the spine that causes legs to not work very well lead to bipolar? Person has master degree in Mech Engineering and a MBA. Started to make poorer decisions which led to job loss, went on disability, divorce, severe ruminating, depression, possible suicidal thoughts, inability to think things through, sense of being lost and blaming one’s self for all that has gone wrong, fear or what is going to happen and impulsive behavior that cost his life savings.

He knew what to do but didn’t do it to prevent such a large loss of savings. He is seeing a therapist for mental health reasons and a regular doctor for his physical impairments. A lot of his symptoms I’ve seen in several bipolar individuals who I am familiar with. He asked me if he could be bipolar. Therapist thinks pain.

Dr. Fink Answers…


Posture Control in Bipolar Disorder

Wednesday, June 1st, 2011

bipolar and postureIn a recent study entitled “Postural Control in Bipolar Disorder: Increased Sway Area and Decreased Dynamical Complexity,” Indiana University researchers measured and compared the magnitude of postural sway between study participants with and without bipolar disorder. The study involved 32 participants, 16 of whom carried the bipolar diagnosis. The control group was made up of 16 age-matched non-psychiatric healthy participants. Participants were asked to stand as still as possible on a force platform for 2 minutes under 4 conditions: (1) eyes open-open base (feet apart); (2) eyes closed-open base; (3) eyes open-closed base (feet together); and (4) eyes closed-closed base.

The researchers postulated that because many of the structural, neurochemical, and functional abnormalities identified in the brains of those with bipolar disorder are also implicated in postural control, people with bipolar disorder would have less postural control and hence a greater magnitude of sway than those without a brain disorder. In other words, there’s a connection between motor and mood disorders. The results supported their hypothesis:


What Should I Do When Bipolar Medication Is Not Working?

Friday, March 25th, 2011

Kelly Asks…

About a month ago, I was taken off my Lamictal, lithium, Seroquel, and Zoloft. I have a new Dr. who has prescribed me 150mg of Wellbutrin SR and 600mg of Neurontin. I became very depressed, had sleeping problems, and then as the third week hit, I became suicidal.

She increased my Wellbutrin SR to 150 mg twice a day and Neurontin up to 900mg (300mg morning and 600mg in the evening). I feel she is not treating me for my rapid-cycling Bipolar. I am either up or real real down, more down moments than my manic high, which often occurs.

Is she helping me or going to hurt me? I do not want to visit any more hospitals as a result of a doctor not giving me the right doses or too little or, as it is now, I have no antipsychotic meds, which is worrying me. Is this why I feel so depressed and suicidal thinking?

Please help. I am 43. I am not a child with Bipolar. Is this weak for my case? I have been hospitalized twice with Bipolar and I really wish to stay out of them. HELP PLEASE!!!!

Dr. Fink Answers…

Hi, Kelly. I am so sorry to hear that you are struggling like this right now. Most importantly, you should continue to express to your new doctor how badly you are feeling and insist that she explain to you what she is doing and why.


New Genetic Link to Bipolar Disorder

Monday, March 7th, 2011

genetics and bipolarPsych Central’s Senior News Editor Rick Nauert recently posted a piece entitled “Genetic Variant Heightens Risk for Bipolar Disorder.” In it, he calls attention to a recent study published in the American Journal of Human Genetics that’s “based on a relatively new technique for the study of the genetics of bipolar disorder” termed genome-wide association studies (GWAS).

We invite you to check out the post, especially if you’re interested in keeping up on the latest breakthroughs in identifying the genetic component of bipolar disorder. Although it may be years before these genetic studies translate into any sort of gene therapy, if that’s even possible, they deliver an immediate benefit in three important ways:


Sorting Out Childhood Bipolar and ADHD with Brain Imaging

Tuesday, February 8th, 2011

childhood bipolar and ADHDA big challenge in diagnosing bipolar disorder or attention deficit hyperactivity disorder (ADHD), especially in children, is that the two disorders share behavioral symptoms, including impulsivity, irritability, and attention problems.

Unfortunately, they don’t share treatment protocols; if the diagnosis is wrong, treatment may be counterproductive. Stimulants, like Ritalin, which are effective in treating ADHD can make a child with bipolar disorder more manic. Giving a mood stabilizer, like Tegretol, to a child with ADHD may result in little or no improvement or severe side effects. Getting the diagnosis right is the key to effective treatment.


Understanding Psychosis, Hallucinations, and Delusions

Friday, February 4th, 2011

understanding psychology termsIn Wednesday’s post, “Childhood Trauma Linked to Psychosis: Maybe Not,” I introduced a few terms and concepts that many people seem to wrestle with. In this post, I try to clarify the terminology and explain some of the concepts related to psychosis, hallucinations, and delusions.

Psychosis

Psychosis is defined as an abnormality of thoughts (content) or thinking (process). Psychosis is not a diagnosis in itself but a type of psychiatric symptom that occurs in a variety of diagnoses, including schizophrenia and bipolar disorder.

Schizophrenia is primarily a disorder of thinking – psychotic symptoms are the main presenting symptoms. Depressive or manic episodes sometimes include psychotic symptoms, but not always. Certain drugs such as LSD, mushrooms, and other psychedelics can also cause psychotic symptoms.


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Candida Fink, M.D. and Joe Kraynak are authors of
Bipolar Disorder for Dummies.


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