Loony Saints - Margaret of Cortona Edition

Every once in a while, Prozac Monologues reaches into my Roman Catholic childhood's fascination with saints, especially the ones who today might be assigned a diagnostic code in the DSM.  Twice, Lent Madness has introduced me to new ones that I share with you.

A few years ago it was Christina the Astonishing.










Today it's Margaret of Cortona.  If you're a Lent Madness regular, you'd expect Margaret to be a shoe in for the first round of voting, where her competition is a stuffy old bishop/theologian, because Margaret became a Franciscan and, more significantly, her story features a dog.  Lent Madness voters are suckers for dogs.

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.

Bipolar and Mitochondria

Misfirings and mis-timings of a number of systems affecting: hormones, neurotransmitters, and immune system cycles that go off-kilter; glitches in communication between brain cells and within brain cells; and wonky wiring among the networks that connect the thinking, feeling, and evaluating parts of the brain -- that's bipolar disorder in a nutshell.  Okay, a very full nutshell.  Last week I explored one example of hormone cycles gone off-kilter, cortisol.

This week, we go inside cells to discuss my favorite little critters, mitochondria.  I first learned about mitochondria from Madeleine L'Engle, from the second of her Wrinkle in Time series, A Wind in the Door.  Charles Wallace is sick, dying, because of a problem inside his cells.  His mitochondria are not doing their job.

Mitochondria are organisms (technically, organelles) that crawled inside the cells of animals back when animals were being formed out of the ooze.  It is a beautiful relationship.  We are their hosts and meal ticket; they are the power plants that convert food into energy.  If they don't work well, neither do we.  Since the brain uses bucket loads of energy, a problem with energy production has serious consequences for anything the brain is supposed to do.

What Do Mitochondria Do?

Bipolar and Cortisol

Y'all know about Bipolar as the mood disorder of Up and Down.  You have seen the movies, watched the soap operas and dramas.  The medications promise to reduce the number of trips around the loop de loop.

That's important, because what goes up must come down, and the fall can be mighty.  But there is more to is that that.

In a person with bipolar, a whole series of mis-timings and misalignments in our internal and external cycles results in a failure to maintain balance.  The list includes: dysregulation of hormones, neurotransmitters, and immune system; irregularities in communication between brain cells and within brain cells; and wonky wiring among the networks that connect the thinking, feeling, and evaluating parts of the brain.

In other words,

Over the next few weeks, I will sample this list, especially the items that are true all the time, even when not on that roller coaster.

Dysregulation of cortisol is one of my favorites, to use the term loosely.  Cortisol is the get-up-and-go hormone.  It gets you out of bed in the morning and manages energy throughout the day in response to stress.

What Causes Bipolar -- III

No, your genes did not make you do it.

And the Prozac Monologues Tutorial on Bipolar Disorder continues, with installment #3.

Bipolar starts in the genes. But there is no smoking gun. There is no genetic defense. If you mortgaged the house, went to Vegas, lost the money, caught a disease, now you're in divorce court and maybe jail, nope.

Your genes did not make you do it.

The way the scientists put it, genes do not code for behavior. Okay, as last week's post says, it starts in your genes. But you are not doomed to end up in divorce court. You have just got some extra challenges to surmount.

Mental illnesses are developmental. They start with a brain that has certain vulnerabilities which come from genetic variations from the norm. These are vulnerabilities, not scripts.

Bipolar — What’s That in Your Genes

Your genes — that’s where bipolar gets started. Of all the mental illnesses, bipolar is the most heritable. That means it has the strongest genetic connection. In studies of identical twins, if one twin has bipolar, so does the other in 75% of the pairs. That compares to 60% with depression and 35% with schizophrenia.

If one parent has bipolar, a child is 13 times more likely to develop bipolar than a child with parents who do not have the disorder. If both parents have it, the child is 36 times more likely to develop it.

So you go to your doc and present symptoms of depression. Your doc will ask, Does anyone in your family have bipolar? But that's not the question you will answer. When you say No, the question you are probably answering is, Has anybody in your family ever been diagnosed with bipolar — that you know about?

What Causes Bipolar?

While Prozac Monologues the book is on its way to publication😲Prozac Monologues the blog is being revived.  I start the revival with a preview/expansion series on the chapter called Balancing Act, aka, The Science Chapter.

A friend who happens to be an academic psychiatrist reviewed The Science Chapter.  He wrote, Pathophysiology of BP is really tough, even for us "bigwigs", and I hope you have some success summarizing it for a non-professional audience.


So I said, Hold my beer.

And here it is:

In a person with bipolar, a whole series of mis-timings and misalignments in our internal and external cycles results in a failure to rebalance.  The list includes: dysregulation of hormones, neurotransmitters, and immune system; irregularities in communication between brain cells and within brain cells; and wonky wiring among the networks that connect the thinking, feeling, and evaluating parts of the brain.

Okay, that will take some unpacking, which I will do over the coming weeks.  Meanwhile,

it's like this:

Stay tuned...