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How Bipolar Disorder Works · Stuff You Should Know

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Speaker 1: Welcome to you. Stuff you should know from house stuff
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Speaker 1: works dot com. Hey, and welcome to the podcast. I'm
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Speaker 1: Josh Clark with Charles W. Chuck Bryant that makes this
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Speaker 1: stuff you should know. I'm Jerry's here too. So it's
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Speaker 1: all good. The original gang. That's going pretty good. Man,
0:38
Speaker 1: How are you? I'm great? Good, Okay, then let's get
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Speaker 1: to it. Yeah, do you have a good set up
0:44
Speaker 1: for this one? It's sorry now, No, I think it
0:47
Speaker 1: kind of speaks for itself. I mean it's bipolar disorder.
0:50
Speaker 1: Like we it's been around long enough, and I think
0:52
Speaker 1: it's been um exposed enough. People have been educated enough
0:58
Speaker 1: that you know, anything I do would just seem jackasses. Uh.
1:03
Speaker 1: While we were just talking before we hit record about
1:06
Speaker 1: whether not we know anyone who has bipolar disorder, and
1:09
Speaker 1: I think most people probably know someone. You might not
1:12
Speaker 1: even know it, but um, I definitely like I had
1:16
Speaker 1: a very specific friend in college. You had it, and
1:20
Speaker 1: that was you know, it was like twenty, so it
1:22
Speaker 1: was you didn't know about that stuff when you were
1:24
Speaker 1: twenty at least I didn't. So it was very weird.
1:27
Speaker 1: And that's first time I've ever heard the term. And uh,
1:31
Speaker 1: you know, he fit the profile as far as being
1:34
Speaker 1: super up and uh, full of life and energy one
1:40
Speaker 1: moment and then super down and very troubled to say
1:44
Speaker 1: the least. And this was these are words I'm using
1:47
Speaker 1: from my twenty year old self. You know, I just thought, man,
1:50
Speaker 1: he's like he's super super happy or now he's super down.
1:54
Speaker 1: But that's this sort of a rudimentary way to describe it. Yeah, yeah,
1:58
Speaker 1: I mean, I mean that is bipolar to order in
2:00
Speaker 1: a nutshell, And that's why they used to call it
2:01
Speaker 1: manic depressive disorder too. Yeah. When did they stop that?
2:05
Speaker 1: I think maybe in the nineties. It seems like to
2:08
Speaker 1: me it sounds about right. Um, and you're you're not
2:11
Speaker 1: too far off from everybody knowing somebody with bipolar disorder,
2:15
Speaker 1: because apparently about five point seven million adults in the
2:19
Speaker 1: US are diagnosed with bipolar disorder, and I think three
2:22
Speaker 1: percent of the population worldwide is estimated to suffer from it. Yeah,
2:27
Speaker 1: and you said adults. Um, it can manifest itself in children,
2:33
Speaker 1: but generally, UM, teenage, mid teenage years and up is
2:38
Speaker 1: when you're going to first start seeing signs of it. Yeah,
2:40
Speaker 1: fifteen to twenty five from what I understand in general. Um,
2:44
Speaker 1: And as you said, Chuckers, like the the condition of
2:48
Speaker 1: bipolarity UM is characterized by intense, frequent swings from very
2:57
Speaker 1: very happy to very very sad. And it's much beyond
3:03
Speaker 1: the average person's mood swings. Because I mean, like if
3:07
Speaker 1: if you're fifteen years old and you're listening to this
3:10
Speaker 1: and you're like, well, sometimes I'm unhappy and then other
3:13
Speaker 1: times I'm said, that's normal. Um, this is far beyond normal.
3:17
Speaker 1: Like where you are in either case, like you say,
3:21
Speaker 1: super up or super depressed. Um, it's nowhere near what
3:26
Speaker 1: you are normally. And in some cases of the most
3:30
Speaker 1: severe bipolar disorder, there is no normal. It's either totally
3:33
Speaker 1: one way or totally the other, and the person suffering
3:37
Speaker 1: from it to swings back and forth, maybe over the
3:41
Speaker 1: course of a couple of weeks, UM, and lives like that. Yeah.
3:46
Speaker 1: Uh sadly, UM, Like we have a couple of stats
3:49
Speaker 1: about the effects. We'll get too early here. H you're
3:53
Speaker 1: less likely to have a job if you are bipolar.
3:57
Speaker 1: That seems really high. Yeah. Um, ten times more likely
4:03
Speaker 1: to abuse alcohol or drugs, which is as a cyclical
4:06
Speaker 1: effect because alcohol and drugs are really rough on you
4:09
Speaker 1: if you have bipolar disorder. Well, yeah, they can trigger
4:11
Speaker 1: a swing one way or the other. Yeah. I saw
4:13
Speaker 1: that in my friend actually in college fu. Yeah, and
4:18
Speaker 1: of bipolar patients, uh successfully commit suicide out of who
4:23
Speaker 1: try it, and those numbers are startingly high. Yeah, yeah,
4:27
Speaker 1: that's very high. That's start startlingly startling. Okay, um, so
4:35
Speaker 1: let's talk about this. What's the what is I've already
4:38
Speaker 1: kind of given a rough overview, but let's dig into
4:42
Speaker 1: the symptoms of bipolar disorder. Yeah. They're basically, um, they
4:47
Speaker 1: characterize two swings, mania and depression. If you're having a
4:52
Speaker 1: manic episode, you're gonna be a great mood, You're gonna
4:56
Speaker 1: be high on life, you're gonna have a lot of energy.
5:00
Speaker 1: You're probably gonna be talking really fast. And it's called area.
5:04
Speaker 1: So what log area? What's that excessive talking? Talkativeness? Oh yeah, um,
5:11
Speaker 1: just really fast thoughts like everything. What was that movie
5:14
Speaker 1: with brad Cooper and de Niro, Oh, Silverlings Playbook? No,
5:21
Speaker 1: the other one, and you're gonna say that, although that
5:23
Speaker 1: is what other movie of those two been in together,
5:25
Speaker 1: the one with um where you take a pill and
5:28
Speaker 1: you can like tap into more of your brain, which
5:30
Speaker 1: is de Niro. Isn't that too? Yeah, I don't know
5:32
Speaker 1: the name of that movie. I know what you're talking about.
5:34
Speaker 1: It wasn't a very good movie, but exceptional or amazing
5:38
Speaker 1: or I can't remember. This is at the point when
5:41
Speaker 1: people are yelling into their car stereo, including Bradley Cooper. Yeah,
5:46
Speaker 1: he's like, you idiot. Yeah, And I can't believe I
5:50
Speaker 1: just forgot about Superlians Playbook because that directly covers this. Yeah,
5:55
Speaker 1: but what I was talking about was the manic He
5:56
Speaker 1: was almost mannek in that other movie where just ideas
5:59
Speaker 1: all that I'm at a hyper speed and he just
6:01
Speaker 1: couldn't do them fast enough. So that's characteristic of a
6:05
Speaker 1: manic episode. Sorry, Bradley Cooper. Uh, you're distracted, you don't
6:09
Speaker 1: maybe need as much sleep, you're restless, you're puritable, you
6:12
Speaker 1: might want to have a lot of sex. Like everything's
6:16
Speaker 1: just uh, magnified, I think, yeah, and with a manic episode,
6:22
Speaker 1: they're often like all of this is often accompanied by
6:25
Speaker 1: a sensation of euphoria. So most people who suffer from
6:29
Speaker 1: bipolar disorder don't go seeking treatment when they're in a
6:33
Speaker 1: manic state, right, because they can like that. Yeah, for
6:36
Speaker 1: some people a manic state, you can have all these things,
6:39
Speaker 1: but it's instead of accompanied by euphoria, it's accompanied by irritability, uh,
6:45
Speaker 1: quickness to anger. So it's not all it's not all
6:48
Speaker 1: fun and games for everybody. But for the most part,
6:52
Speaker 1: if you're in a manic episode and you're bipolar, you're
6:55
Speaker 1: you enjoy the manic episodes way more than you enjoy
6:58
Speaker 1: the depressive eppisodes. Yeah, and I think both are super
7:02
Speaker 1: rough on friends and family because in the manic state,
7:04
Speaker 1: you you don't know quite what you're gonna get, you know, right, well,
7:09
Speaker 1: like you may you engage in um very risky behavior.
7:12
Speaker 1: You may make a bunch of risky investments, may buy
7:16
Speaker 1: a lot of stuff. Um, it can go so far
7:18
Speaker 1: as to uh, you can have psychotic symptoms. So in
7:23
Speaker 1: a manic episode where you're displaying psychotic symptoms, you may
7:27
Speaker 1: think you are God or totally UM, infallible, untouchable, can
7:33
Speaker 1: do no wrong, and then that can feed into the
7:36
Speaker 1: symptoms of you know, engaging in very risky behavior. You
7:40
Speaker 1: can even hallucinate like full on see things. Yeah, you
7:43
Speaker 1: can suffer from delusions and hallucinations. So the d s
7:47
Speaker 1: M says that if you have a certain number of
7:49
Speaker 1: manic symptoms UM for at least one week, then that
7:53
Speaker 1: is considered a manic episode. So that has kind of
7:57
Speaker 1: changed apparently with the d s M five. This is
8:00
Speaker 1: ds M four stuff. With the d s M five,
8:04
Speaker 1: they um really kind of they I think that the
8:07
Speaker 1: prevailing idea was what's with this whole um bipolar other
8:13
Speaker 1: otherwise specified, not otherwise specified. It's just a total cop out,
8:18
Speaker 1: which we'll get to in a minute. But the idea
8:20
Speaker 1: that there's like this, you don't fit this one or
8:22
Speaker 1: this one, so you fit this generic third. Actually I'm
8:25
Speaker 1: glad that's changed. I think they've kind of dug into
8:28
Speaker 1: diagnosing even more. We changed some of the thresholds and
8:31
Speaker 1: exclusionary criteria and now um it's a it's supposed to
8:36
Speaker 1: be a little more laser guided UM. But one of
8:40
Speaker 1: the ones, one of the things they did change was
8:42
Speaker 1: that for example, UM, I think as little as five
8:46
Speaker 1: days of an episode is enough to constitute a diagnosis
8:50
Speaker 1: rather than like a week or two weeks or something. Right,
8:53
Speaker 1: that makes sense, yeah, um. And then you have hypomania,
8:56
Speaker 1: which is sort of like mania light UM, just a
9:00
Speaker 1: less intense version of mania. UM. So that's the mannic swing.
9:05
Speaker 1: The depressive side of the coin uh is exactly what
9:09
Speaker 1: you think, but like amplified by a million. Like you're
9:14
Speaker 1: not just sad, you feel despair, and your sluggish and
9:17
Speaker 1: you can't focus, and you're restless and you're irritable. Um.
9:22
Speaker 1: These are where the suicidal thoughts are coming. So it's
9:25
Speaker 1: it's not your garden variety depression that you might feel
9:30
Speaker 1: on a day to day basis, because we all feel
9:32
Speaker 1: that that's right. And you might also experience UM mixed symptoms,
9:36
Speaker 1: which is called a mixed episode. So for example, you
9:40
Speaker 1: might have UM like a lot of intense energy, but
9:45
Speaker 1: you might also be suffering from feelings of utter despair,
9:49
Speaker 1: which sounds like a horrible combination. Um. And basically you
9:54
Speaker 1: can take stay any mania and then add um just
9:59
Speaker 1: some some of the depressive like suicidal thoughts managed suicidal thoughts, right,
10:03
Speaker 1: that would be a mixed episode, right, and then you
10:06
Speaker 1: have something called rapid cycling, which is uh, when these
10:11
Speaker 1: swings are presenting themselves. Do you know what d S
10:13
Speaker 1: M Five says? Like, Uh, I couldn't find that it
10:17
Speaker 1: had a lot of um changes to the rapid cycling.
10:21
Speaker 1: I think that what they found was that UM drugs
10:24
Speaker 1: that doesn't necessarily respond to drugs very well. And they've
10:28
Speaker 1: they've kind of started to understand rapid cycling a little more.
10:30
Speaker 1: But I don't know what they changed with the diagnostic
10:33
Speaker 1: criteria for that. Well, here they characterize it by a
10:36
Speaker 1: year of at least four episodes of mania, hypomania or depression. Right,
10:40
Speaker 1: so like if you have four episodes in a year,
10:43
Speaker 1: you've you've got rapids. Apparently that's rapid. I think it
10:47
Speaker 1: can be a lot more rapid than that. I think
10:48
Speaker 1: like that's the minimum to be considered rapid cycling. Alright,
10:53
Speaker 1: So what are the different types of bipolar disorder today?
10:58
Speaker 1: There's definitely bipolar one, which is essentially your your life
11:03
Speaker 1: is going from one end of the spectrum to the other.
11:07
Speaker 1: There's not periods in between really where you're um, where
11:12
Speaker 1: where you're stable. Right, that's the most severe obviously, Yeah,
11:17
Speaker 1: you have bipolar to which um the sequel that's right. Uh.
11:22
Speaker 1: That means you have at least one episode of depression
11:25
Speaker 1: and one at least one hypomanic episode, but you could feel,
11:30
Speaker 1: you know, somewhat stabilized in between, which is a big
11:34
Speaker 1: differentiation apparently between one and two. Um. And then, like
11:38
Speaker 1: we said, there used to be bipolar disorder no, not
11:41
Speaker 1: otherwise specified the cop out right, and it was there
11:45
Speaker 1: was a lot of people who were just kind of
11:46
Speaker 1: fitting into this and weren't necessarily getting the right diagnosis.
11:51
Speaker 1: And I guess they've expanded the criteria um for bipolar
11:55
Speaker 1: one and two, and then they've also kind of looked into, um,
11:59
Speaker 1: massive depressive disorder uh and then said, well, you you,
12:04
Speaker 1: this has some aspects of mania as well, and that's
12:06
Speaker 1: technically a bipolar disorder too. So they kind of did
12:09
Speaker 1: away with it a little bit, I think as they
12:11
Speaker 1: thought they were looking bad. Yeah, it's so hard to
12:13
Speaker 1: category I mean, I know, they take a lot of heat.
12:15
Speaker 1: It's tough to categorize mental illness because it's so different
12:18
Speaker 1: for everyone, and well, a lot of people criticize the approach.
12:21
Speaker 1: The basis of the d s M is tell me
12:24
Speaker 1: how you're feeling, which is flawed in and of itself
12:27
Speaker 1: to begin with, because subjective reporting is just completely unreliable. Yeah,
12:32
Speaker 1: but you can't take a blood test. And and then
12:35
Speaker 1: secondly to to to further subjectively interpret those subjective self
12:41
Speaker 1: reports uh into supposed you know criteria and then saying well,
12:47
Speaker 1: you have XX and X, but you don't have X,
12:49
Speaker 1: so technically you're not bipolar, which means you don't have
12:52
Speaker 1: your insurance won't cover these meds that you need. The
12:55
Speaker 1: whole system is very screwed up, which is why they're
12:57
Speaker 1: hoping to do things like create blood test that's say, ah,
13:01
Speaker 1: you have bipolar one, and it's because of this UM,
13:05
Speaker 1: these neurotransmitters are messed up, so you will respond very
13:08
Speaker 1: well to this specific dose of this medicine. I don't
13:12
Speaker 1: think we're more than ten years fifteen years away from it,
13:15
Speaker 1: but it's it's gonna be a long, horrible ten or
13:18
Speaker 1: fifteen years for people who are suffering the most from
13:20
Speaker 1: bipolar disorders. That can't come fast enough. Uh. And then
13:24
Speaker 1: the final um unless that's gone away, to psyclothymia, is
13:27
Speaker 1: that's still around, that is the least severe, and that
13:30
Speaker 1: is um at least two years of hypomania and milder
13:35
Speaker 1: depression swings. And I think also that's I believe it's
13:38
Speaker 1: still around, but I think it's um it's changed a
13:41
Speaker 1: little too. And I think that um. Apparently the child
13:44
Speaker 1: psychologists of the field said, you guys, there's a lot
13:48
Speaker 1: of um exuberance and even mania symptoms that are totally
13:52
Speaker 1: normal in adolescents. So let's let's tighten this up a
13:56
Speaker 1: little bit because we don't want kids to be diagnosed
13:58
Speaker 1: with bipolars because their parents think that they're hyper. Right.
14:01
Speaker 1: Put my fifteen year old on lithium exactly. Yeah. So
14:04
Speaker 1: I think that they managed to kind of change the
14:06
Speaker 1: criteria for cyclothymia, saying this is just above the normal
14:10
Speaker 1: threshold of mood swings. Yeah. Um. So, like we said,
14:15
Speaker 1: they don't know or I don't know if we did,
14:17
Speaker 1: they don't still know what causes it directly, um, nor
14:20
Speaker 1: do they know how the drugs that treat it are. Yeah.
14:24
Speaker 1: I mean there's a lot of like try this out.
14:27
Speaker 1: It's like we know spaghetti will start to stick to
14:31
Speaker 1: a refrigerator. We don't know exactly why, but let's strow
14:33
Speaker 1: it at the side anyway, but what they do know
14:37
Speaker 1: is that genetics can play a role. You are gonna
14:40
Speaker 1: have an increased likelihood to develop it if someone in
14:43
Speaker 1: your like if your parents had it, let's say, but
14:45
Speaker 1: they also have these odd outliers, like you could be
14:50
Speaker 1: a twin and your twin has bipolar disorder, but you don't, right,
14:53
Speaker 1: So it's just sort of a mystery still. But yeah,
14:55
Speaker 1: it seems like they that it does have people are
14:58
Speaker 1: genetically predis post and then an environmental factor can trigger
15:03
Speaker 1: their bipolar disorder, like a really rough childhood or a
15:08
Speaker 1: bad life event or something really really good. But a
15:12
Speaker 1: sudden swing in normalcy and a person that is genetically
15:16
Speaker 1: predisposed um to bipolar disorder is what can kick it
15:22
Speaker 1: off in your life. Yeah. Um, other we already talked
15:25
Speaker 1: about drugs and alcohol that can definitely trigger um seasonal changes.
15:30
Speaker 1: I think we've talked about seasonal effective disorder SAD. Yeah, SAD,
15:34
Speaker 1: which I think I think most people experience a little
15:37
Speaker 1: bit of that, right. But again, if you're genetically predisposed
15:40
Speaker 1: for the way I see it, and this is totally unscientific,
15:44
Speaker 1: but just from researching this, it seems like you you
15:47
Speaker 1: have there's a normal baseline for brain chemistry. Uh. And
15:51
Speaker 1: it's not a thin line. It's like a pretty good
15:54
Speaker 1: sized block. And it's easy to also get outside of
15:58
Speaker 1: that one way or the other right, and when you
16:01
Speaker 1: are outside of it, you have the symptoms of bipolar disorder.
16:05
Speaker 1: And if you're bipolar one, you're just constantly going from
16:08
Speaker 1: the top to the bottom of that block. And that
16:10
Speaker 1: sounds very scientific and needs to understand the block. Well,
16:13
Speaker 1: I mean maybe not scientific, but easy to understand, okay.
16:16
Speaker 1: And then if you if you say, have bipolar two,
16:19
Speaker 1: you can exist within that normal range, but you can
16:22
Speaker 1: be knocked out of it, but your brain chemistry is
16:26
Speaker 1: already predisposed to having bipolar disorder by virtue of being
16:30
Speaker 1: able to overproduce or underproduce certain neurotransmitters. That's it, I
16:34
Speaker 1: think will ultimately be the understanding of it. Well, I know,
16:37
Speaker 1: they definitely tie a lot of mental disorders to either
16:41
Speaker 1: too much or not enough uh dopamine and serotonin. Like
16:46
Speaker 1: it's it's definitely brain chemistry going on, yes, you know,
16:50
Speaker 1: and that's yeah, they think that that's the basically the
16:54
Speaker 1: basis of it is just fluctuations in brain chemistry like
16:57
Speaker 1: super low serotonin during manic and depressive episodes is charted. Yeah,
17:02
Speaker 1: and apparently sarotonin's one of the brain one of the
17:05
Speaker 1: narrow transmitters that are like, everybody calmed down, let's just
17:09
Speaker 1: keep things stable here. That's what sarotonin is. And you
17:13
Speaker 1: can have too much dopamine, which can result in both
17:16
Speaker 1: mania and depression. Yeah, and I think too much is
17:21
Speaker 1: also present in psychosis too, so hallucinations delusions, that's why
17:26
Speaker 1: you can have those during such a tough thing to
17:29
Speaker 1: try and study, you know. Yeah, I'm reading that. I
17:32
Speaker 1: started that book. John Ronson, the great John Ronson, who
17:35
Speaker 1: listens to our show, by the way, writer of Men
17:37
Speaker 1: who Stare at Goats, oh neat. Yeah, he's a fan.
17:40
Speaker 1: And hey John Ronson his his book The psychopath Test.
17:45
Speaker 1: Let's started reading that. Yeah, it's super interesting. So far.
17:48
Speaker 1: Is it uh, semi historical fiction? Is it nonfiction? Is
17:52
Speaker 1: it totally fiction? It's sort of a look at how
17:55
Speaker 1: the industry, the mental health industry, tackles mental health. So
17:59
Speaker 1: it's not fiction. Yes, that sounds like it's up my alley. Then, yeah,
18:02
Speaker 1: I should have said nonfiction right off the bat. You're like,
18:05
Speaker 1: I'm gonna make you guess. Yeah, I will let you. Uh,
18:08
Speaker 1: I'll let you borrow it after a fenshion Actually how
18:09
Speaker 1: about that? Okay, and then I will take you up
18:12
Speaker 1: on that right after these messages. All right, So I
18:19
Speaker 1: guess we can talk a little bit about how it
18:21
Speaker 1: has treated medication wise. Um, it is a long term
18:26
Speaker 1: illness that is is basically looked at as a uh
18:30
Speaker 1: even a lifelong illness for most people, something you have
18:33
Speaker 1: to deal with, uh forever. Yeah, Um, medication wise, lithium
18:39
Speaker 1: since the nineteen seventies has been the go to. Uh
18:43
Speaker 1: it still is. It's a mood stabilizer and it's gonna
18:46
Speaker 1: help out with both sides of your mood swings and
18:49
Speaker 1: apparently which it works for you, right, And I like,
18:51
Speaker 1: like you said, that's the go to and it typically
18:54
Speaker 1: like people tend to respond to that. Yeah, it's it's
18:58
Speaker 1: a go to for a reason, not just because it
19:00
Speaker 1: was first or that there's a Nirvana song he he
19:04
Speaker 1: was bipolar, right, sure? Um, and uh, there are alternatives
19:12
Speaker 1: to lithium because not everybody responds to it. Not everybody
19:15
Speaker 1: has a good reaction to it. With even somebody who
19:20
Speaker 1: does respond well to lithium, UM, they have to keep
19:24
Speaker 1: a pretty good eye on your lithium levels in your
19:27
Speaker 1: blood stream, so you have to visit the doctor quite
19:29
Speaker 1: a bit. The whole point of I guess the rigamar
19:33
Speaker 1: role that you will go through when you're diagnosed with
19:35
Speaker 1: bipolar and say I want to combat this with meds
19:39
Speaker 1: UM is basically shooting blind and using a pragmatic approach
19:47
Speaker 1: to medicating you into saying, Okay, you're reacting well to
19:51
Speaker 1: this one, Let's try a slightly lower dose and see
19:54
Speaker 1: what happens. And with lithium in particularly, they keep an
19:58
Speaker 1: eye on it through through blood tests. But with all
20:00
Speaker 1: meds using used to treat bipolar disorder, they're going to
20:04
Speaker 1: really kind of like, um, try everything. Yeah, and it's
20:07
Speaker 1: still like how you feeling, Yeah, tell me how you're feeling,
20:11
Speaker 1: not let's do this uh test to read on the
20:15
Speaker 1: screen how you're feeling still yeah, you know uh. And
20:18
Speaker 1: again part of the reason why is because they don't
20:21
Speaker 1: quite know how some drugs work. They just know that
20:23
Speaker 1: they do work for some people, but not everybody. Yeah.
20:26
Speaker 1: Anti convulsants is another UM another one that they use,
20:29
Speaker 1: and it's also a mood stabilizer and I think that
20:34
Speaker 1: calms down the when your brain is the parts of
20:37
Speaker 1: your brain at least that are ramped up and overacting. Right.
20:41
Speaker 1: One of the ways that it affects that is by um,
20:46
Speaker 1: increasing the amount of GABBA in your brain. You know,
20:49
Speaker 1: gabba kind of What does that stand for? Again, it
20:55
Speaker 1: stands for gamma amino beautyic acid. Obviously, well done, thank you,
21:03
Speaker 1: It's been a while since I tried to pronounce something hard. Uh. Well,
21:07
Speaker 1: you can use the anti convulsants sometimes, even with lithium. Again,
21:11
Speaker 1: it's can be a cocktail of drugs that you're on. Right,
21:15
Speaker 1: depending on what works for you. A typical anti psychotics
21:19
Speaker 1: can help. Um. They usually use those after they've tried
21:23
Speaker 1: the lithium. I think they tried lithium first, unless you're
21:27
Speaker 1: a teenage girl or a pregnant woman, right. Um. And
21:31
Speaker 1: then uh, the antipsychotics work because um, they affect the
21:37
Speaker 1: amount of dopamine in your brain. And again, high levels
21:41
Speaker 1: of dopamine can lead to psychotic symptoms, which is why
21:44
Speaker 1: they call the drugs that treat those anti psychotics, right. Um.
21:49
Speaker 1: And then benzodiazepine a k A. Relaxants. I think those
21:53
Speaker 1: are used less, probably because uh, they're addictive or can
21:57
Speaker 1: be addictive. Yeah, and then least the short term used
22:02
Speaker 1: and they yes, they use them to promote healthy sleep.
22:06
Speaker 1: To um, Like you said, one of the symptoms, especially
22:09
Speaker 1: of mania, is just going without sleep, like you got
22:12
Speaker 1: too much to do and you don't even need it,
22:15
Speaker 1: so you don't sleep. Um. And one of the I
22:20
Speaker 1: guess the presence of gabba or low amounts of gabba,
22:25
Speaker 1: which is a neuro transmitter that's involved in getting sleep.
22:28
Speaker 1: I believe staying asleep too, um kind of underlies this
22:33
Speaker 1: idea that your sleep cycle is off and it's either
22:37
Speaker 1: the result of your bipolar disorder or it's helping to
22:41
Speaker 1: cause your bipolar disorder. Either way, they found that promoting
22:45
Speaker 1: healthy sleep. For example, there is a thing called dark therapy,
22:48
Speaker 1: which is no exposure to artificial light after dark for
22:52
Speaker 1: a certain amount of time can help promote healthy sleep
22:55
Speaker 1: and can help stabilize bipolar disorder symptoms. All that makes sense, Well, yeah,
23:02
Speaker 1: the like it always kills me when I see people
23:04
Speaker 1: on Facebook at like three am saying on Facebook that
23:08
Speaker 1: they have insomnia, Like, well, you've got a little shiny
23:12
Speaker 1: bright screen in your face, start by putting that down
23:15
Speaker 1: and see what happens. Um. So yes, So with there's
23:19
Speaker 1: all these little clues out there, Chuck that, like so
23:23
Speaker 1: many pieces of the jigsaw puzzler on the table, they
23:25
Speaker 1: just haven't been fit together yet, you know. But it
23:29
Speaker 1: seems like there's, um, there's a kind of a hornet's
23:32
Speaker 1: nest out there. I wondered, can you live with bipolar
23:36
Speaker 1: disorder without medication? And apparently there's a big divide in
23:41
Speaker 1: the bipolar community, like there's pro med and anti med
23:45
Speaker 1: And I've seen comparisons between talking about like religion or
23:49
Speaker 1: politics or meds with bipolar people. It's all the same,
23:53
Speaker 1: like you want to avoid those things to keep things friendly. Um.
23:57
Speaker 1: But I've seen that some people are like, yes, you
24:00
Speaker 1: can live without meds, but you probably can't get too
24:05
Speaker 1: stable without meds. And you get the stable, then maybe
24:09
Speaker 1: you can. But um, there's practically no way to get
24:13
Speaker 1: the stable without the help of medications. So people who
24:16
Speaker 1: have bipolar story will be like, I've been med free
24:19
Speaker 1: for a year, which is great because it means that
24:22
Speaker 1: they have managed to fight off episodes and triggers, but
24:26
Speaker 1: they've done that through other therapy to not just avoiding treatment.
24:32
Speaker 1: Because if you avoid treatment, not only does the does
24:35
Speaker 1: does your condition get worse, it gets harder to treat. Yeah, yes,
24:41
Speaker 1: the episodes supposedly definitely get worse. Yes, you go. Uh. Well,
24:46
Speaker 1: there are all kinds of therapies that you use along
24:49
Speaker 1: either in place of your medications or along with and
24:52
Speaker 1: we won't get too much into these because we've gone
24:54
Speaker 1: through most of them before, but cognitive behavioral therapy of course,
24:59
Speaker 1: family therapy, group therapy e c T. We did. We
25:02
Speaker 1: did a whole show on e c T, didn't we. Yeah,
25:03
Speaker 1: we did. That was a good one. Yeah, electro convulsive
25:05
Speaker 1: therapy and UM. One that I hadn't heard of, social
25:09
Speaker 1: rhythm therapy. I hadn't heard about this either, but it
25:12
Speaker 1: makes utter and complete sense. Yeah, and that has to
25:14
Speaker 1: do with UM. I think getting your yourself and your
25:19
Speaker 1: body on a set schedule is much better for you
25:23
Speaker 1: if you have bipolar disorder, not only just sleep, but
25:25
Speaker 1: just regular regulating your your day and your schedule. Yeah.
25:30
Speaker 1: And I don't think anybody's suggesting that bipolar disorder is
25:34
Speaker 1: a mind over matter type situation, like I think there
25:38
Speaker 1: are very few mental illnesses that are that more clearly
25:43
Speaker 1: demonstrate the brain based understanding of mental illness than bipolar disorder.
25:49
Speaker 1: Like your neurotransmitters and the chemicals in your brain are
25:53
Speaker 1: out of whack. It's as simple as that. UM. What
25:56
Speaker 1: these other non medication therapies seek to do, especially the
26:00
Speaker 1: UM the interpersonal and social rhythm therapy and coignitive behavioral therapy,
26:05
Speaker 1: is to get you to confront this thing, to confront
26:08
Speaker 1: your condition and learn to understand it. Like, understand what
26:12
Speaker 1: your triggers are. Understand that you have to have X
26:15
Speaker 1: amount of hours of sleep or night or else you
26:18
Speaker 1: may end up in like a manic episode. Understand that,
26:21
Speaker 1: like you just can't drink whiskey. Maybe you can have
26:24
Speaker 1: a beer like every couple of weeks or something, but
26:27
Speaker 1: you can't touch whiskey because you'll end up in like
26:29
Speaker 1: a manager a depressed Like, there are triggers out there
26:32
Speaker 1: and for you personally, these are your triggers and if
26:35
Speaker 1: you avoid them, you can stay in that stable range
26:39
Speaker 1: and and learn to live with bipolar disorder. Yeah, you know,
26:43
Speaker 1: super interesting. Yeah, alright, so right after this break, we're
26:46
Speaker 1: gonna talk about whether or not there's a link between
26:49
Speaker 1: creativity and bipolar disorder. Hey, Chuck, we've got a pretty
26:54
Speaker 1: good website, but not everybody does, even though they might
26:57
Speaker 1: want one, Well, we have a team of people putting
26:59
Speaker 1: it together. We do, but just the everyday person walking
27:03
Speaker 1: around out there has a team of people just waiting
27:05
Speaker 1: to help them get their website together. And then a
27:07
Speaker 1: Squarespace that's right. It is super easy to use. If
27:10
Speaker 1: you want your own website, you can have one with
27:12
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27:16
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27:18
Speaker 1: even if you get confused, which you probably won't, they
27:21
Speaker 1: have great seven customer support. That's right. They're very design
27:24
Speaker 1: centric and if you want to create a logo, they
27:27
Speaker 1: have an easy logo creator. You can go check it
27:29
Speaker 1: out for yourself at squarespace dot com slash logo. Plus,
27:32
Speaker 1: you have something to sell on your internet site, well,
27:36
Speaker 1: all of their plans have commerce options, from hosting an
27:39
Speaker 1: entire store to accepting donations for your personal blog. Yeah,
27:42
Speaker 1: and it's a very responsive design, so your website is
27:45
Speaker 1: gonna look great on every device, on your laptop, your tablet,
27:47
Speaker 1: your mobile phone. It is pretty great, my friends. Guys.
27:50
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28:09
Speaker 1: get ten percent off of your first purchase that squarespace
28:12
Speaker 1: dot com slash stuff with the offer code s t
28:14
Speaker 1: u f F. Alright, buddy. There has long been um
28:21
Speaker 1: debate on whether or not creative people are either more
28:25
Speaker 1: likely to be bipolar or bipolar can lead to creative genius. Yeah,
28:31
Speaker 1: didn't we talk about do we do an episode on that?
28:33
Speaker 1: It wasn't in a Thinking Cat? I think it was
28:35
Speaker 1: in Can this Thinking Cat Make Me a Genius? Episode? Yeah?
28:40
Speaker 1: Trans magnetic stimulation Yeah yeah, yeah, Um, yeah, there's there's that.
28:45
Speaker 1: It's that latent inhibition kind of thing for schizophrenia and creativity. Yeah.
28:50
Speaker 1: I mean, there's definitely like a laundry list of very
28:53
Speaker 1: creative people throughout the years that suffer from bipolar, from
28:57
Speaker 1: Beethoven to Jimmy Hendrix who wrote Manic Depression, Sylvia Plath,
29:03
Speaker 1: at Garlin, Poe excel Rose is on the list. Yeah,
29:06
Speaker 1: Graham Green Dickens, did I say, Dickens, No, but you
29:10
Speaker 1: just did Francis Ford Coppola, Brian Wilson, The Beach Boys. Yeah,
29:15
Speaker 1: he he really had a terrible episode after um did
29:21
Speaker 1: Smile ever get released and it it just flopped? Well,
29:26
Speaker 1: it got released recently. I never got released at there,
29:31
Speaker 1: So something happened that set him off. I guess the band,
29:35
Speaker 1: the rest of the band members wanted to go in
29:36
Speaker 1: a different direction. Well, he was obsessed with the Beatles too,
29:39
Speaker 1: and trying to be better than the Beatles. And I
29:42
Speaker 1: mean Smile was up there was pretty good. But yeah,
29:45
Speaker 1: I guess it never got released in maybe that's what
29:49
Speaker 1: triggered his episode and started the dark years. Yeah, and
29:53
Speaker 1: this was long before anybody understood anything like this. Is
29:55
Speaker 1: prior to the advent of the use of lithium for
29:58
Speaker 1: bipolar disorder. Oh yeah, they didn't come around to the seventies. Uh. So,
30:04
Speaker 1: I have a thing that I like to read. It's
30:08
Speaker 1: a little long, but there's this great article from Slate
30:11
Speaker 1: called what does it feel Like to Have Bipolar Disorder?
30:13
Speaker 1: And it was written by someone named Mills Baker. Uh
30:17
Speaker 1: And it kind of backs up a lot of what
30:18
Speaker 1: we're feeling here, but gives you just a little insight
30:21
Speaker 1: since uh, we're not. Since we can't talk firsthand, we'll
30:26
Speaker 1: let Mills Baker do it. See mine please. I think
30:30
Speaker 1: only in their extremes, armenia and depression actually unintelligible to
30:35
Speaker 1: ordinary folks. That is, at their utmost intensity, they're unlike
30:38
Speaker 1: anything a normal person experiences. UM, But at most times
30:42
Speaker 1: they're not at all so different from the maximally intense
30:46
Speaker 1: moods that everyone knows, just more so, longer lasting, and
30:50
Speaker 1: disconnected from normative causes. And that seems to be one
30:53
Speaker 1: of the big points. Is basically what he's saying is
30:57
Speaker 1: that it's not so different maybe than feeling manager depressed yourself,
31:01
Speaker 1: but it's way more intense, it lasts for way longer,
31:04
Speaker 1: and there's may not be a cause, right and not
31:08
Speaker 1: to I don't have bipolar sort of, but it would
31:11
Speaker 1: seem like it's too a debilitating degree, like it affects
31:14
Speaker 1: the rest of your life negatively. Yeah. Um, bipolar is
31:18
Speaker 1: less about short term mood instability than about long term
31:21
Speaker 1: mood cycles. Uh. Instability is a part of it, but
31:24
Speaker 1: not the only part. Second, the cumulative effected these cycles
31:27
Speaker 1: on the formation of a personality significant, so after a
31:31
Speaker 1: childhood of radically of radically changing interest and attitudes. On
31:34
Speaker 1: such a timeline, one develops a certain excitability, flightiness, distractability,
31:40
Speaker 1: or perhaps that's just me again. It's different for everyone,
31:44
Speaker 1: but it is a major part of being bipolar, the
31:46
Speaker 1: personality that is shaped by a lifetime of intense, fluctuating moods.
31:51
Speaker 1: So he's taken just a more macro approach. It's gonna
31:55
Speaker 1: make you who you are. You can't just look at
31:57
Speaker 1: the bad mood or the upmood. It's gonna basically form
32:01
Speaker 1: your personality over the years. Yeah, I would imagine. Uh.
32:04
Speaker 1: To know what it feels like is to know the
32:06
Speaker 1: quality of that uh phenomenon logical experiences a bipolar person
32:11
Speaker 1: encounters that an unaffected person does not. I don't think
32:15
Speaker 1: there are many of these going berserk, being creative, having
32:18
Speaker 1: an awful temper, not being able to trust my own
32:20
Speaker 1: emotional reactions. These have a certain weight when I list
32:24
Speaker 1: them out. Uh, they can even sound unique. But everyone
32:26
Speaker 1: loses it. Everyone has moments of charisma and creativity and success,
32:30
Speaker 1: strength and achievement, and everyone struggles with himself. You may
32:33
Speaker 1: not hallucinate, which this guy does, by the way, but
32:36
Speaker 1: I can bet you understand what it's like for your
32:39
Speaker 1: mind to misbehave and react insanely. If you haven't yet
32:42
Speaker 1: lost control of your life, just wait. Uh. And for me,
32:46
Speaker 1: the most enduring way that bipolar feels different is in
32:49
Speaker 1: how I cannot trust my reactions. I thought this part
32:51
Speaker 1: was really interesting. When someone says something to you and
32:54
Speaker 1: you recognize it as an insult, for instance, as abuse
32:58
Speaker 1: or abuse, you your react to anger is appropriate and
33:01
Speaker 1: you can commit to it, or you can make some
33:03
Speaker 1: determination based on your values and your reason and choose
33:06
Speaker 1: a different course of action. I can't even trust the
33:09
Speaker 1: person in that the person even insulted me, So I
33:13
Speaker 1: can't trust my emotional perceptions or reactions. So that's got
33:16
Speaker 1: to make you just feel way out of sorts if
33:18
Speaker 1: you can't even you know, feel like you're trusting your
33:20
Speaker 1: own emotions, right like if you that's one that's the
33:24
Speaker 1: one thing that you have is your how you're feeling
33:28
Speaker 1: about any given situation that makes up your personality and
33:31
Speaker 1: large part and if that seems flawed to you, that untrustworthy. Uh.
33:37
Speaker 1: And then finally, that is the strangest thing about how
33:39
Speaker 1: it feels after the dust of the actual disorder settles
33:43
Speaker 1: more than a decade in Uh, this guy is talking
33:46
Speaker 1: about his twelve year I think since he was diagnosed
33:50
Speaker 1: after more than a decade in the open, insanity has
33:52
Speaker 1: abated and visits only briefly. The idea that I'm a
33:56
Speaker 1: secret artist is absurd. What's left is a more less
34:00
Speaker 1: normal life in which I have to emphasize mental hygiene
34:03
Speaker 1: like prioritizing regular sleep, for example, and which I always
34:07
Speaker 1: feel doubt about what I think and feel, as we
34:09
Speaker 1: all probably should anyway. Yeah, so he seems and he's
34:13
Speaker 1: on medication, and uh, it seems like he has a
34:17
Speaker 1: healthy attitude about it. I think it's interesting to hear
34:19
Speaker 1: people talking first person about mental illness. Well, it's I'm
34:24
Speaker 1: sure it's a lot easier for him to talk about
34:26
Speaker 1: it now too, that he's got it licked. Yeah, or
34:29
Speaker 1: you know, coping with it at least. So you got
34:33
Speaker 1: anything else? I got nothing else. This is a good one.
34:36
Speaker 1: Hopefully it helps some people. Yeah, thanks to Mills Baker
34:38
Speaker 1: for being open to Slate about the disorder. Thanks to
34:43
Speaker 1: Slate and Mills, Mills and Slates. If you want to
34:47
Speaker 1: learn more about bipolar disorder, you can type those words
34:50
Speaker 1: into the search part how stuff works dot com. Uh,
34:52
Speaker 1: it will bring up a very good article and a
34:55
Speaker 1: bunch of other stuff too. Uh. And since I said
34:58
Speaker 1: very good article, that means it's time for listener mail. Josh,
35:03
Speaker 1: I'm gonna call this a shark correction. Really. Yeah, remember
35:07
Speaker 1: how we um talked about sharks basically perfected themselves and
35:10
Speaker 1: haven't changed in millions of years? Yeah? Oh yes, yes,
35:14
Speaker 1: I was like, we haven't talked about sharks forever, Now
35:17
Speaker 1: I remember yet. Yeah. Well, there's some brand new findings,
35:19
Speaker 1: which is pretty excited in Jake Hayes from New York
35:22
Speaker 1: City Sitnizsen. I really enjoyed the Darwin in Natural Selection episodes, guys,
35:26
Speaker 1: and thought you might find this recent study published in
35:28
Speaker 1: the journal Nature. Uh. That is interesting given the example
35:33
Speaker 1: you gave about sharks. Apparently, contrary to the theory that
35:37
Speaker 1: they have barely changed over the past hundreds or millions
35:39
Speaker 1: of years, they may have evolved significantly actually from their
35:43
Speaker 1: ancient ancestors and may not be the living fossils we
35:45
Speaker 1: thought they were scientists that thought that shark gills were
35:48
Speaker 1: an ancient system that predated modern fish. However, a newly
35:52
Speaker 1: discovered fossil of a shark that dates back million years,
35:56
Speaker 1: so it's a remarkably different gilt skeleton than modern shark. Uh.
36:00
Speaker 1: This fossil provides evidence that shark gills have evolved over
36:03
Speaker 1: time and that it is actually modern day fish that
36:06
Speaker 1: may be the ones with the old GIL systems. The
36:09
Speaker 1: new GIL system may have changed over time to help
36:12
Speaker 1: sharks sprint after their prey or pry open their jaws
36:16
Speaker 1: to eat larger things. So uh, he said, he just
36:20
Speaker 1: came across this article and I saw it all over
36:22
Speaker 1: the place. Of course, like you know, two weeks after
36:25
Speaker 1: we recorded. I think it was even like a day
36:27
Speaker 1: or an hour or something. Yeah, I think you're right,
36:30
Speaker 1: But it's pretty cool info. And that is uh. Once again,
36:34
Speaker 1: Jay Hayes from New York City. Nice, thanks a lot, Jake.
36:37
Speaker 1: We appreciate you. And I think a few other people
36:40
Speaker 1: let us know about it too. Yeah, um, but none
36:43
Speaker 1: but Jake was from New York City, so we selected him. Uh.
36:48
Speaker 1: If you want to let us know you're from New
36:50
Speaker 1: York City, we want to hear about it. You can
36:52
Speaker 1: hang out with us outside of the podcast on Twitter
36:55
Speaker 1: at s Y s K Podcast. You can hang out
36:57
Speaker 1: with us on our Facebook page, Facebook, dot com, slash
37:00
Speaker 1: stuff you Should Know. We also have Pinterest, Instagram, the
37:03
Speaker 1: whole Jam. You can send us an email to Stuff
37:05
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37:09
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37:11
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37:19
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