Wednesday, October 17, 2018

Bipolar and Wonky Wiring -- The Football Version

The brain is like a football team.  Go Ducks!


There are several parts, each playing its own position and fulfilling a particular function.  Together they run plays that have been rehearsed and repeated over and over, many until nearly automatic.  The behavior of the other team/environment requires adaptation of these plays, often in mid-play.  And communication among the members is essential.


Here is how they line up on the brain field.  Analysis is at the front, near the forehead.  Memory and emotion hang out together.  Coordination is at the back.  Basic life functions are at the base of the skull.  Communication runs through the middle, connecting them all to one another.



But you don't know the players without the program.  Let's start at the base and back.  The first to develop in the evolutionary scheme, this is sometimes called the lizard brain.  It handles the housekeeping functions: survival, systems that take no conscious thought whatsoever, like beating heart and breathing lungs, and response to danger, the so-called fight, flight or freeze function.  The lizard brain is at the top of the spinal column, positioned to send messages to heart, lungs, and limbs on a hair trigger.

In football terms, I am calling the lizard brain the front line, tackles and guards.  Gotta be careful that these guys don't jump offside.  When things get intense, they don't always wait for orders.

Wrapped around the lizard brain is the limbic system, the mammalian brain, what we share with dogs, cats, rats.  It handles mood, memory, and hormonal control.  Positioned in the middle, messages between the lizard brain and the front pass through the mammalian brain.  In terms of speed, it comes online in second place.

Let's call these the running backs.  Even though big passes get the most attention nowadays, without a solid foundation of a running game, your passing game is too predictable.  These are the guys who play with heart.

Next we add the outer layer, the primate brain, known as the prefrontal (in the front of the) cortex.  Our highly developed cortex, bigger than other mammals, is how we have run out ahead of our co-inhabiters of the planet to maintain control of the game, adding analysis, evaluation, prioritizing, complex social interactions, planning, and attention.

These are the wide receivers, tight end, and quarterback.  The quarterback is the executive function, in charge of choosing and initiating the plays.  The quarterback takes time to, well, think, and then to tell everybody else what to do.  Thirty seconds to decide the play, assign roles, and get into position.  Thinking takes time.

When the play begins, the quarterback keeps thinking, scanning the environment, noting what is happening, giving signals for any needed changes.  Sometimes what the quarterback wants, the rest of the team just can't handle.

So all of thinking, responding, reacting, moving, changing, leaping, protecting takes communication.  In the brain, the players are what we call the grey matter.  The lines of communication are literally that, lines, called the white matter, with chemical reactions happening within the lines and then between one brain cell and the next, to send the message from one part of the brain to another.


One of these lines is called the Automatic/Internal emotional regulatory network.  It connects the prefrontal cortex (PFC) (thinking) to the globus pallidus (subconscious movement) and thalamus (sending information from the senses to the PFC).  The line goes through the anterior cingulate cortex (ACC) which decides how important any of this information is.  So throw a painful memory on top of this network, maybe that perfect last-play-of-the-Super-Bowl Hail Mary pass that slipped through your fingers.  If the network functions well, you may get That was last season, this is this season.  If the network was formed poorly in utero and early childhood, and has repeatedly produced wonky results, you may get depression.

Another line is called the Volitional/External regulatory network.  This one similarly connects thinking, evaluating, and sensing brain parts.  Throw an external event on top of this network, say, the next pass interference on you that the ref missed.  It decides how you are going to feel, and what you're going to do about how you feel.

These two lines collaborate with each other and regulate the amygdala (fight/flight/freeze).  So you can see how they need to work well to keep you from getting thrown out of the game.  They work differently for people with bipolar, affecting mood regulation and impulse control.

Other lines, the scientists call these networks, manage self-reflection, processing social information, creative work, future planning, and memory.  People with bipolar have poor connectivity in all of these.


The bottom line: the largest difference between the brains of people with bipolar and other brains is poor connectivity in bipolar brains in any variation of the communication networks between PFC (thinking) and limbic system (emotion), running through the ACC (evaluating).

At least that's the bottom line of the wonky wiring aspect of bipolar.  Previous posts addressed other aspects, including:

Bipolar and mitochondria on poor communication within and between cells, and

Bipolar and cortisol, one example of dysregulation of hormones, neurotransmitters, and the immune system.

I expanded on the particulars that interested me most, because, well, it's my blog.  I'll be happy to address any related topic that interests you.  Feel free to leave a comment.

I hope you have enjoyed my What Causes Bipolar series.  A shout out to Ron Pies, Clinical Professor of Psychiatry at Tufts University, bioethicist, editor of PyschiatricTimes.com, and aspiring mensch, who provided my homework assignment and chief resource, "Integrated Neurobiology of Bipolar."

football positions by Kainaw in public domain
brain graphics in public domain
flair by facebook.com
photo of Mocha by Ayputs and used under creative commons license
Can you HEAR me meme from lenballantine.com

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