What New York University researchers wanted to understand is if an optimistic attitude can be linked to the same brain regions that show irregularities in people who suffer from depression. Using functional magnetic resonance imaging (fMRI) some participants in the study were asked to imagine a positive future event, such as winning an award, while other participants were asked to image a negative future event, such as the end of a romantic relationship.

Researchers found that participants more vividly imagined future events than negative events. Participants also felt that the positive events were more likely to occur in the near future, while negative events were imagined to happen later in time.

When participants imagined positive future events it activated the rostral anterior cingulate and amygdala areas of the brain. These are the same areas of the brain that seem to malfunction in people suffering depression. The rostral anterior cingulate are of the brain is believed to regulate emotional responses, which suggest that healthy individuals are better able to regulate emotional and autobiographical information to create a positive outlook of future events.

Researchers pooled data from 4 studies involving 153,000 patients. Patients taking just SSRIs were twice as likely to develop upper GI bleeding. Those taking SSRIs along with NSAIDs increased the risk of GI bleeding to 6 times that of patients taking neither medication.

A distinction between which SSRI caused the greatest GI bleeding was not made. However, previous studies show that paroxetine (Paxil®), sertraline (Zoloft®), and fluoxetine (Prozac®) are most often associated with abnormal bleeding. NSAIDs include prescription medications such as Celebrex® and over-the-counter drugs such as aspirin and Aleve®.

The researchers estimate that for every 411 patients over the age of 50 and taking SSRIs, one is likely to develop upper GI bleeding requiring hospital admission. In patients taking both SSRIs and NSAIDs, one out of 82 would be expected to develop the problem.

The most vulnerable patients are older adults because they are more likely to have conditions such as osteoarthritis that require the use of NSAIDs.

Medications, called tricyclic antidepressants, help offset the imbalance of the neurotransmitters serotonin and norepinephrine. They accomplish this by not allowing the neurotransmitters to flood back into the brain cells that emit them, which makes the neurotransmitters available to other cells. By redirecting the neurotransmitters helps relieve depression in patients. How the medications shut down the pumps at the molecular level remained a mystery until recently.

Researchers used bacteria with a pump that operates almost identically to the one in the brain cells, but changes in its molecular structure are easier to analyze.

Experiments shows that tricyclic antidepressants latch onto the bacterial pump, changing its molecular structure in a way that effectively stops the pumping action. Now that scientist know that plugging these kinds of pumps is one way to reduce their activity, researchers may be able to develop medications that target them more directly and efficiently. This could result in more effective antidepressants with fewer side effects. The findings may also extend to the development of medications for other mental illnesses in which pump dysfunction plays a role.

Often the depressive phase of bipolar disorder is thought to be a period when the patient is at risk, but the manic phase has its own dangers. During the manic phase patients may risk harmful behaviors they might not otherwise engage in doing. For example, lavish spending sprees they cannot afford or pleasure-seeking behaviors with potentially serious health consequences.

Bipolar disorder patients are often at greatest risk from the time of the onset of the manic phase to the time when the medication for treatment takes effect. Unfortunately, it takes a considerable time for the medications often used for treatment to take effect because they do not directly enter into the brain, but rather work through a kind of chain reaction.

The objective of the medication is to block an enzyme thought to be over-active during the bipolar disorder’s manic phase. That enzyme is called protein kinase C (PKC), which regulates activities in brain cells.

In a recent 3 week study, researchers tested Tamoxifen as an alternative to treatment for the manic phase of bipolar disorder. Tamoxifen is best known as a treatment for breast cancer with the unusual property of also entering directly into the brain and blocking the enzyme PKC. This means that period between the onset of the manic phase of bipolar disorder and point when the PKC is under control is considerably shorter.

The good news is that in the 3 week study, 63% of the patients had reduced manic symptoms, while only 13% of the control group taking a placebo showed improvement. The bad news is that although tamoxifen was successful in reducing the symptoms of the bipolar disorder manic phase, by controlling the PKC enzyme, it also blocks estrogen (which is the property that makes it useful as a treatment in some cancers.)

Researchers feel that they have established a ‘proof of principle’ that shows targeting PKC directly is a feasible strategy for developing faster-acting medications for manic phase. Tamoxifen may not be the solution for treatment of bipolar disorder manic phase, but it has opened the door for further research.

In a 3 month follow-up those who received only the mood stabilizer faired better than those who were given both the mood stabilizer plus an anti-depressant.

The patients who received intensive psychotherapy in addition to medication reported better life satisfaction and better relationship skills than those who received only brief therapy and medication. When it came to work functioning both groups fared the same.

The difficulties for bipolar parents are that dealing with their children often increases the stressors that are likely to contribute to their distress, destabilization, and a possible relapse of their bipolar disorder. Over time the behavior becomes cyclical.

Children of parents who have polar disorder have been found to be at an increased risk of behavioral and emotional disturbance, which compound emotional issues for both themselves and the parent(s) with bipolar disorder.

The University of Manchester’s School of Psychological Sciences is currently conducting a study of bipolar parents and the effectiveness of a positive parenting program called Triple P. The University has had success with the program previously in a study of depressed mothers. One of the main advantages of the Triple P program is that it is cost effective in delivering a quality parenting service to a geographically dispersed group.

The reason for the researcher’s concern about the tremendous increase of bipolar diagnosis in children is that a 2001 study found that nearly half of bipolar diagnosis in adolescent patients made by community clinicians were later re-classified as other mental disorders. The problem is compounded by the fact that treatment for bipolar disorder in adults has been well researched, but few studies have examined the safety and effectiveness of psychiatric medications for treating bipolar children and adolescents.

A study found that despite the lack of psychiatric medication research for treating children and adolescents diagnosed as bipolar, they are often medicated in a similar way as adult bipolar patients. About 1/3 of both adults and children with bipolar were prescribed an antidepressant. Of those prescribed an antidepressant about 1/3 were not also given a mood stabilizer, which is not advisable according to a recent study. It was also found that adults taking a mood stabilizer did not benefit by also taking a antidepressant.

One main difference found in treatment of bipolar children and adults was that children and teens were more likely to be prescribed a stimulant medication–usually something prescribed for treating ADHD–while adults were more likely to be prescribed a medication to treat anxiety disorders.

The researchers noted that given the lack of studies on appropriate treatments for youth with bipolar disorder there is an urgent need for additional research on the safety and effectiveness of medication treatments that are commonly prescribed to this age group.

She is quite articulate about her experience with Bipolar Disorder, which makes for interesting reading. Like many disorders, diseases, and conditions that cannot be determined by a blood sample or MRI scan, her diagnosis was more a process of eliminating what it was not rather than what it is.

What is impressive about Seaneen is her inquisitiveness to understand the process of her mental disorder. Her article, Is Bipolar Disorder a Form of Epilepsy? is a good example of how she weaves technical research material with her personal experiences so that it puts a human face on information that is otherwise emotionally disconnected medical jargon.

You’ll find her site listed under Disability Happens’ Recommended Blogs.

Researchers were curious to determine if bipolar children were getting medical attention sooner and more often due to at least one parent having the disorder. Researchers decided to determine if a high correlation existed between children diagnosed with bipolar disorder and a parent diagnosed with severe mood dysregulation.

They did not find the same high parent–child bipolar disorder correlation with bipolar child and severe mood dysregulation parent. Because the high correlation did not exist, the authors warned that children with non-episodic irritability should not mistakenly be diagnosed as being bipolar.

Researchers based their research on MRI scans of 20 people with the bipolar disorder and an equal number in a control group. Over time everyone’s brain showed a loss of brain tissue, but individuals with the bipolar disorder showed significant loss of gray matter. Those who lost the greatest amount of gray matter were also the ones with the most episodes of mania and depression accompanied with the biggest decline in brain function.

What is not known is if the loss of gray matter is the cause or effect of the bipolar disorder. It may be that stress or genetic factors cause the brain shrinkage. Also, it could be that cycles between mania and depression result in the loss of gray matter. Either way the loss of brain tissue emphasis the importance of continued treatment for those with bipolar disorder.