Genetics of bipolar disorder

I have a few (distant) relatives with bipolar disorder.  From what I’ve learned in medical school, this is not uncommon.  Many diseases have a genetic component, and psychiatric disorders are not exempt.

The branch of the NIH that studies mental illnesses (NIMH) has funded research looking at genetic and molecular mechanisms for years now but I feel like little headway has been made.  Unlike with many endocrine or cardiovascular diseases, we still don’t have a good laboratory test to diagnose depression or bipolar disorder.  We don’t know how many of our psychiatric drugs work.  Lamotrigine is used for both seizures and bipolar disorder.  Seroquel is used for schizophrenia as well as bipolar disorder.  But why?  Clearly they are very different illnesses.  Sure, sometimes we know which receptor (or set of receptors) the drugs target, but how does that translate to relieving the manic or depressive symptoms?

It’s frustrating because I think psychiatric illnesses get labeled as separate from other “physical” diseases partly because we don’t know the mechanisms behind the disorder.  They are seen as less legitimate by a lot of the public.  We can’t just “snap out” of depression any more than other people can magically stop their heart attacks.  If I end up choosing to go into psychiatry, I hope that research will catch up so that I could more effectively help my patients.

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Happy Thanksgiving!

I have a lot to be thankful for this year.  There’s no way to list all of them, but here are a few things that have been on my mind.

1. I was mostly healthy this year.  No severe manic or depressive episodes for once.  A few small injuries but nothing permanent.

2. My friends/family are awesome and supportive.  Well, some of members of my biological family at least.  But I consider my friends my real family nowadays anyway.  I’m lucky to have them in my life.

3. I passed and met milestones in med school this year.  I was afraid I was going to fail some clinical rotations after some of my academic troubles in the past.  I didn’t honor anything, but life’s still good.  And I will be an MD soon-ish.

4. The United States hasn’t imploded.  After Trump was elected president, I thought he would completely destroy our country.  Even though there’s been some ridiculous things said and done, we are still standing and other friendly countries haven’t severed ties with us. Still surprised there hasn’t been a stronger push to impeach him.

5.  I’ve had some wonderful experiences this year.  Playing in an orchestra, going to concerts, enjoying new restaurants, traveling to fun cities.  I know I’m very lucky to have the free time and funds to do these things.   Hopefully I’ll get to do this next year too.

#MeToo

I am fortunate to have never experienced sexual harassment or assault.

On the other hand, several of my friends (both male and female) have posted on social media that they too had encountered this at some point in their lives.  Some revealed details about the entire incident, others left it at “me too”.

Obviously these are horrible events and I wish they never had to go through it.  Their stories did leave me wondering if I could truly understand what they were feeling, having never had it happen to me.  I am glad that these past weeks have brought awareness to the problem but I think we need to provide more resources and education to the public on how to prevent sexual harassment/assault from occurring and how to support the victims afterwards.  It’s not enough to just say it happens.  (A lot.)  It’s time we did something about it.