Bipolar Disorder Blog

This question was posed to the US presidential candidates during their debate on October 7th. What do you think? About.com's Guide to Patient Empowerment, Trisha Torrey, has put up a poll on this subject. Please weigh in on this poll and also leave us a comment about your feelings.

For more on the candidates' health care proposals and how they would affect people with bipolar disorder, see Mental Health Care - Campaign 2008.

Although there are no formal studies looking at the connection between bipolar disorder and fibromyalgia (FMS), there are many personal reports that these two conditions seem to occur together. In our forum community there are many people who have fibromyalgia. One reason for this may be that both depression and mania can have a negative effect on sleep or sleep quality, and inadequate good sleep has been shown to cause FMS.

I, too, have FMS, and a few years ago I developed costochondritis, a painful inflammation of the cartilage that connects the ribs to the breastbone. I thought I was having heart problems! For me, it took months to go away.

Now Adrienne Dellwo, About.com's Guide to Fibromyalgia and Chronic Fatigue, has written Fibromyalgia & Costochondritis, explaining more about costochondritis and how it may be linked to FMS. I thought it was important to bring this article to the attention of our community because of the apparent connection between FMS and BP.

For more on BP and the sleep problems that could lead to FMS, see Mood Disorders and Sleep.

Do you have fibromyalgia? Have you had costochondritis? Leave a comment.

~Marcia

I take a total of twelve pills every day at five different dosing times. I bought a medicine tray and they don't fit! Plus it only has 4 slots a day. Right now everything is overflowing out of a gallon Ziploc bag. I am sometimes forgetting to take things. I hope someone can help me to figure this out, without the help of a full time home health nurse. LOL ~ from Foundlight, a member of our forums

Well Foundlight, you are hardly alone! It is characteristic of people with bipolar disorder to forget their medications or to miss doses. We’ve actually had this discussion in the forums previously and compiled some of the answers into tips for Managing and Remembering Medications. These are tips written by people who deal with medication issues every day. We’ve also compiled some information into a quick reference for How to Manage Your Medications. Have any additional thoughts for Foundlight? Join her discussion.

It's long been known that compulsive gambling is a problem for many people with bipolar disorder. But a study published in the September 2007 issue of the Journal of Affective Disorders found that for those with bipolar I disorder, the odds of having a gambling problem were more than twice as high as the general population.

The study looked at 37,000 people aged 15 or over. In addition to the finding that bipolar I disorder made a huge increase in the likelihood of problem gambling, the researchers found other contributing factors that raised the incidence: being male, not having a college education, being unmarried, and abuse of illicit drugs and/or alcohol. They even found that a higher level of physical activity decreased the risk of having a gambling problem.

The researchers recommended that those with bipolar I disorder be screened for gambling issues, particularly when substance or alcohol abuse exists.

Source: McIntyre, RS, McElroy SL, Konarski JZ, Soczynska JK, Wilkins K, Kennedy SH. "Problem gambling in bipolar disorder: results from the Canadian Community Health Survey." Journal of Affective Disorders (Sept 2007): 27-34.

Frequently discussions in our community center on alternative or supplemental therapies to prescription medications. The value of supplemental therapies varies greatly from one substance to the next. For example, there have been many warnings about the problems caused by St. John’s Wort for those with bipolar disorder. However, research has shown that the Omega-3 fatty acids found in certain fish and fish oils are good for people who suffer from bipolar disorder and other mental illnesses.

The value of alternative treatments is heavily debated. Case in point - Truehope. Truehope Nutritional Support Ltd is the company that markets the nutritional supplement known as Empowerplus (aka EM Power+, EM Power, and Synergy). This company has been the center of a number of legal battles because of its unsubstantiated claims. However, Rebecca - a long, respected member of our forums – is adamant that there is another side to this story and that this treatment is viable.

Trisha Torrey, About.com Guide to Patient Empowerment, offers a word of caution citing the long history of quacks and snake oil salesman. “The caution to us is obvious. Please be careful! Be sure that the information you find about any form of medical treatment is reliable and credible before you go sending your money off to someone who is only out there to take it away, with no benefit, and possibly deadly consequences, to you.”

Another point in this discussion is that it is unfortunately common for people to confuse various drug terms - drug, medication/medicine, prescription, over the counter, herbal remedy, dietary supplement - thinking that some words inherently mean a substance is safe. These misconceptions are knowingly played up by marketing campaigns. However, substances presented as innocuous in advertising, or in common understanding, have the potential to be dangerous most especially when taken in combination with other agents.

Know the details about the drugs (prescriptions and over the counter) you take and always discuss any changes, additions or deletions to your drug regimens with your doctor. ~ Kimberly

For more than twelve years, mental health parity – the requirement for health insurance to cover mental illnesses at the same levels as physical illnesses – has been a topic of political discussion when the first Mental Health Parity Act was introduced by Senator Paul Wellstone now deceased. There have been provisional bills past as well as many revisions and iterations of related legislation. Many states have enacted their own laws, but to date there has not been a ratified act.

In June, I blogged on this topic noting that the House and Senate had both approved versions of the legislation, and President Bush had indicated that he supports the principle of mental-health parity. However, the bill still has not moved forward.

Add your voice to those demanding action in Congress on mental illness insurance parity. On Wednesday, September 10, advocates will be calling their U.S. Representative and Senators urging passage of the legislation requiring equitable coverage of mental illness treatment by group health plans.

Call the toll-free Parity Hotline: 1-866-PARITY4 (1-866-727-4894) tomorrow, Wednesday, September 10. The Parity Hotline reaches the U.S. Capitol switchboard, which can connect callers to the offices of their members of Congress – both House and Senate. Urge your members of Congress: "Don’t adjourn for the year without passing mental illness insurance parity (HR 1424-S 558)."

You can find more information about this through the National Alliance on Mental Illness. I will be making the call tomorrow. I hope you do to!
~ Kimberly

The word communication, teen, and parent, rarely fall into the same sentence. Teenagers and communication with parents just don’t seem to mix well in most families. However, for teenagers with bipolar disorder, communication with parents is imperative to ensure that proper treatment is received by the teen. When he was 17, Dan, an active member of this site, wrote an article about using blogging to facilitate conversations between parents and teens.

In the September 2008 edition of the Archives of General Psychiatry, a research team presented findings about using family-focused treatment with teens who have bipolar disorder. For the teens and their families randomly assigned to the family-focus treatment group, they participated in 21 sessions over a 9 month period. During the sessions, the families were educated about the disorder and treatment. They participated in communication training and they worked on problem-solving skills. This study found that teens in this group spent fewer weeks in depressive episodes.

I realize I am extrapolating a bit beyond the scope of this study, but I think this emphasizes the importance of the whole family being involved in a treatment plan. Do you think family-focused treatment – therapy sessions in which the whole family participates – would help you and your family? ~ Kimberly

The Americans with Disabilities Act (ADA) is a law that gives civil rights protection to individuals with disabilities. It is designed to protect people with disabilities from discrimination in hiring, job assignments, promotions, pay, firing, benefits, layoffs and all other employment-related activities. It also provides that reasonable accommodations must be made for employees with disabilities.

Canada also has laws that protect those with disabilities. Last week an Ontario Divisional Court reiterated the importance of these laws upholding the finding by the Ontario Human Rights Commission that a company discriminated against an employee by firing him when he disclosed that he had bipolar disorder. The man was awarded nearly $80,000 in damages. Thulasi Srikanthan reports about this case on Canada.com.

I find this story both encouraging and disturbing. Encouraging in that a person’s rights were protected and he was given compensation for the incident. However, it is really disturbing that an employer could be so crass. Have you told your employer about having bipolar disorder? What has your experience been with this?
~ Kimberly

"What Causes Bipolar Disorder?" We’ve all asked this question at some time. Unfortunately there is no straight answer to this question … yet. One theory is the diathesis-stress model, which is actually applied to many diseases and conditions. The basic idea is that a person inherits a genetic vulnerability to a disease and then a trigger -- or more likely multiple triggers -- in your life brings the disease out. We discuss this theory in detail in the article linked above.

Research continues to find evidence that supports this theory. A consortium of research teams led by Nick Craddock of Cardiff University in Wales and Pamela Sklar of the Massachusetts General Hospital has been searching for genetic variants predisposing people to bipolar disorder. From a study pool of 4,000 patients with bipolar disorder, they have been able to identify two genes that put new emphasis on a possible cause of the disease. Nicholas Wade with the New York Times reports that the "Gene Hunt Hints at Cause of Bipolar Disorder".