Читать книгу Bipolar Disorder For Dummies - Joe Kraynak - Страница 14

Genetic studies indicate that about 60 to 70 percent of bipolar disorder is related to inherited factors, but a variety of nongenetic factors affect how these genes are expressed. Many of these stressors are present in the very early phase of brain development – before birth and in the first months and years of life. However, scientists also believe that ongoing nongenetic factors contribute to the development of bipolar disorder and its course over time. Some of these factors include the following:

✔ Stressful life events: Studies of people with bipolar disorder have found a number of abnormalities in the biological systems that regulate the body’s response to various types of stress. Interactions between these vulnerable systems and environmental stress more than likely play an important role in both the development and progression of bipolar disorder. Acute life events have been found to occur more frequently before mood episodes in people with bipolar disorder.

✔ Early life stress: That same interaction between impaired stress response systems and stress may occur many years before the development of bipolar disorder. Studies suggest that early childhood trauma is associated with a higher risk of bipolar disorder in adulthood.

✔ Substances: Alcohol and/or drug abuse often accompanies bipolar disorder. Some of this may be self-medication – using substances to dull pain and discomfort in the short run. However, substance abuse and bipolar disorder may have overlapping genetic risk factors, so that rather than being a behavioral response to the illness, these conditions may develop alongside one another. Some evidence even suggests that the use of alcohol and drugs may increase the risk of developing bipolar disorder, which raises the question of whether early intervention with drug and alcohol use can help reduce the likelihood of ever having that first mood episode. Tobacco use is also being looked at as possibly interacting negatively with genetic vulnerabilities to bipolar disorder.

✔ Nutrition: Although no research points to specific nutritional triggers for bipolar disorder, people with bipolar disorder have higher rates of illnesses such as cardiovascular disease and type 2 diabetes. These conditions create their own stress and physical damage. Healthful nutrition is an important part of limiting the development and progression of these conditions, which can reduce their negative effects.

✔ Infection: Studies have suggested that maternal infections, particularly with the flu virus, during pregnancy are associated with higher rates of bipolar disorder I in adulthood. The overlap of the infection with genetic risk factors may be a contributing factor to some people’s bipolar disorder. Some research shows a higher rate of infection with toxoplasmosis (a parasite found in cat feces) in people with bipolar disorder, and the current thinking is that the infection interacts in some way with the genetic risk factors to cause psychiatric symptoms.

✔ Sleep/circadian rhythms: Researchers have identified a strong relationship between bipolar disorder and sleep problems. A number of different genetic variations may contribute to these difficulties. Some data suggests that sleep deprivation can be a trigger for mania, and because people with bipolar disorder are already poor sleepers, they’re at much higher risk of sleep deprivation. Sleeplessness creates a vicious negative spiral with bipolar, causing sleeplessness and sleeplessness contributing to bipolar. Sleep management is important in trying to hinder the progression of bipolar disorder.

✔ Hormones: Hormones are mood modulators and may contribute to mood symptoms and patterns. Research suggests that they interact with the genetically vulnerable brain and body systems in people with bipolar disorder to influence the onset and progression of their illness. Women are particularly vulnerable to this effect because of their frequent hormone shifts throughout their lives. Hormonal transition times such as the onset of puberty, pregnancy, and menopause are vulnerable periods for mood episodes (refer to Chapter 10 for more discussion).

Some of the genetic differences in people with bipolar disorder interfere with their body’s ability to regulate or turn off their stress responses – even between mood episodes. These factors stress the body, adding to the already hyped-up response from genetic factors. Finding ways to limit or reduce distress, avoid or treat substance use, and manage sleep and nutrition are some strategies that may help you reduce the severity of the illness. Throughout this book, we describe various techniques for reducing the risks of experiencing mood episodes and managing them when they do occur.

All of the above

Was it the drugs, the genetic predisposition, or the trauma? Likely, all of the above.

My parents, Marcia and Martino, were impoverished, had two kids, and were using illicit drugs. I was born premature and addicted. Each had manic depression, now called bipolar disorder.

They coped with their mental battles by using drugs and alcohol. They would leave my brother Jordache and me unattended, lying in our own filth, screaming, barely clothed, to score. They left us just one too many times. On that day, at a seedy motel, the clerk heard our cries and called the police, and we were then taken into child protective services. It was a gift, our first.

Clearly Jordache and I were predisposed to bipolar disorder. The question remains, did we have a chance? How much did neglect, malnutrition, and abandonment have to do with my condition? How much did the drugs in my system, in utero, contribute to the eventual onset of bipolar disorder?

After Jordache and I were placed into foster care, he developed bronchitis and died. Feeling even more abandoned, I developed a detachment disorder, which would follow me into adulthood. Even today, I battle with anxiety, detachment disorder, and abandonment issues on top of bipolar disorder.

I bounced around from foster home to foster home. Day after day was spent vomiting and having ongoing diarrhea. I was every foster parent's nightmare. Finally, at nine months of age, I was placed into the loving arms of Patrick and Debi Hines. They were my second gift, my greatest blessing next to getting taken in by child protective services.

Soon after I was placed in their care, Patrick and Debi decided to try and adopt me. They fought a two-year court battle to keep me.

Patrick hired the best lawyers he could find to retain custody and won. He and Debi proceeded to adopt me. They cared for me throughout this time and were there throughout the progression of my bipolar disorder I with psychotic features. Even though our lives were rough when I struggled most, we got through it and have come out on the other side.

I will never know to what extent my traumatic infancy, the drugs that entered my system before birth, my predisposition to a mental health condition, or any other factors may have contributed to my getting bipolar disorder. There is no way to measure those things that changed my brain forever. There is no way to tell which played a bigger role or when they overlapped.

For now, I remain confident that no matter my suffering, I will prevail. The chronic suicidal thoughts will not kill me. I won't let them. I have far too much to live for. After my suicide attempt and survival, I know I deserve to be here. I have made a promise to myself and to my family. I will never attempt to take my life again. I will live until the ripe old age of 110, fighting for my mental wellbeing, and I will die in my sleep, holding my wife’s hand, just as in the film The Notebook (which I’ll never admit to having seen, or cried during, twice).

– Kevin Hines (www.kevinhinesstory.com), mental health advocate, speaker, and author of Cracked, Not Broken: Surviving and Thriving after a Suicide Attempt