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Bipolar disorder, or bipolar disorder, is a mental health illness for which everyone carries predisposing genes. The disease is challenging and often difficult to treat, but it can also be alleviated with lifestyle and possibly with the help of CBD oil. This article will introduce you to bipolar disorder, the endocannabinoid system behind it, and how CBD could be helpful in treating it.
What is bipolar disorder?
Bipolar disorder, (manic-depressive), also called bipolar disorder, is a mental health disorder characterized by alternating periods of depression and mania. The mood varies between manic and depressed, and in between there may be long periods called the recovery phase, when the symptoms hardly appear. (1,2,3,4)
About 1-2% of Finnish adults suffer from bipolar disorder and it is equally common in both women and men. The first disease episode usually occurs in young adulthood, between the ages of 15 and 35. The frequency and number of episodes during life varies between sufferers. Sometimes the onset of periods of illness goes in synchrony with the seasons, other times they are the result of more challenging phases of life. For others, the disease is also easier to predict in advance, as the seasons may follow each other cyclically; after depression, mania, then again depression and mania. In between these, there may be a recovery phase, when the mood is typical for the person. (1,2,3,4)
Bipolar disorder is divided into two types. People with type 1 have mania, while people with type 2 only have hypomania. Type 1 in particular includes an increased risk of e.g. divorces, suicide and disability. (1,2,3,4)
Causes of illness
Bipolar disorder is strongly hereditary, but environmental factors probably also predispose to it. Heritability is approx. 10-15 %. (3)
All people carry some predisposing genes, and depending on the circumstances, the disease will break out or not.
According to a recently completed study, the disease is caused by a disruption of the internal clock, which is caused by low-level inflammation in the body, activation of the immune system, and chronic stress. In addition to MJ Rantala, associate professor of evolutionary psychology at the University of Turku, the group that carried out the research includes S. Luoto, J. Borraz-Leon and I. Krams. According to the study, the reduced need for sleep was thought to be a symptom, but now it is thought to be the cause of the onset of mania. Disruption of the internal clock and thus the deterioration of sleep quality and decrease in quantity most obviously triggers mania, because sleep affects chronic stress and the level of inflammation in the nervous system. (5)
The symptoms of the disease vary between seasons as well as between sufferers, and the symptoms can be anything in intensity. A strong change in mood from one extreme to the other is typical, seasonally. The symptoms of bipolar disorder therefore include episodes of depression and mania that are clearly separated from each other.
It would be good to know how to recognize your own initial symptoms, so that the management of the disease is as successful as possible. Usually, the onset of mania is accompanied by increased energy and a decreased need for sleep, an increase in sexual desire and a generally more active approach to life.
The symptoms of the depressive phase are not much different from ordinary depression, when a person is very tired, uninterested and unwilling. During the depression period, even the most important and dearest things are not necessarily of interest, but up to 18 hours of the day are spent sensitively on the bottom of the bed. It is typical that a period of depression follows mania, and in this case depression may also be accompanied by shame and regret for the things that happened during the mania. The depressive phase of bipolar disorder may be associated with a little more depression than usual, e.g. psychotic symptoms, weight gain and slowing down of thoughts and movement. (1,2,3,4)
The depressive phase usually lasts at least a week, but can last even months.
There are two different types of mania. Mania is a faster gear in the life of a bipolar disorder sufferer and then there is enough energy to share with others. The symptoms include a loss of control over one’s own actions, when everything seems to be successful and exciting, one cannot sleep for more than a few hours, and especially one cannot rest on one’s laurels. It’s great to do all kinds of things when you finally have enough power. Talkativeness increases, self-esteem rises and the person may become a “freak for grandeur” who spends money recklessly. During mania, a person is sexually hyperexcited. (1,2,3,4)
Hypomania is clearly milder than mania, but they still have the same elements. During hypomania, a person does not become psychotic, but the mania phase is mainly seen as increased energy, increased self-esteem and a decrease in the need for sleep.
Manic phases usually last from a week to months.
If the symptoms change rapidly, even within one day, from depression to mania and back again, it is called a mixed episode. A mixed episode can be particularly stressful for those closest to you, as unpredictable behavior can bring challenges to everyday life and social situations.
Psychological illnesses are often associated with strong shame, which is why a person is not always willing to admit all the symptoms he has. Depending also on the phase that the person is going through, he may be completely unable to judge that it is e.g. manic episode.
In order to diagnose bipolar disorder, the review often requires a little longer, as the diagnosis requires at least two manic/depressive episodes. In Finland, the time from the first episode of illness to diagnosis is approx. 8 years (5).
Treatment and medication
There is no medicine that can cure or stop mania or depression, but bipolar disorder is treated in such a way that the disease remains as symptom-free as possible and the mood is stable. The most important task of drug treatment is to prevent episodes from recurring, as they also worsen and intensify the symptoms of the next episode.
Commonly used drugs include e.g. antipsychotic medication, drugs that affect sleep, mood stabilizers, and lithium and valproate, which are used to try to stabilize mood during a mixed episode or mania. During the depressive period, the medication differs from the treatment of ordinary depression, as mood stabilizers and antipsychotics are used instead of antidepressants. (3,4)
Medication can be difficult, as only a few commit to regular use of the medication. Often, the drug is stopped independently just at the onset of mania or depression and sometimes also in the middle of the recovery phase, thinking that the medication is no longer needed.
The best way to treat and manage the disease is to acknowledge its existence and the fluctuating episodes it causes. Recognizing the symptoms and reacting to them is of paramount importance even in those moments when symptoms do not occur. Lifestyle greatly affects the onset and maintenance of the disease. Regular routines, a nutrient-rich diet without additives, not intoxicating and minimizing coffee consumption are very important aspects in managing symptoms, as well as taking care of the best possible sleep quality. (3,4)
Various therapies also play a significant role in managing the disease. Such are e.g. individual psychotherapy, and couple and family therapy.
There are several factors behind the onset of bipolar disorder and disruption of vital functions. Good life management is important for treating bipolar disorder. The drugs used in treatment often cause strong side effects, so during the recovery phase it is especially important to take care of the basics so that both mind and body are ready to receive another episode of depression/mania. (3,4,5)
The background of the onset of the disease is therefore a disruption of the internal clock, stress, inflammation of the body and probably also accumulations of heavy metals in the brain. A diet that cleanses the body and relieves inflammation and following it with a competent nutritionist could be significant in terms of treating the disease.
Also, stopping the use of substances, observing regularity in life through routines and adding exercise to everyday life could be effective ways to relieve stress, inflammation and help the internal clock stay on schedule. (3,4,5)
Experiences and tests
There is a lot of material and different tests on the Internet if you want to examine your own or a loved one’s symptoms. You should always talk to a professional about symptoms and suspicions about getting sick, but you can map out the situation first at home, e.g. with this test Mood Disorder Questionnaire MDQ .
The bipolar disorder guide has a lot of information for both the sufferer and their loved ones and can be found here 2. Do I have bipolar disorder? – Bipolar guide.
Experiences, support and peer support are offered by e.g. association Bipolar and you can find them here Bipolar .
Bipolar disorder can be heavy and challenging for loved ones as well. Especially for the family, children and spouse of the person suffering from strong symptoms, both long periods of depression and also long periods of mania can be difficult times, and the situation may not get any easier even during the recovery phase. Often loved ones notice the onset of mania/depression faster than the symptoms, and during the recovery phase, the loved one may unnecessarily get annoyed with their spouse by misinterpreting their behavior. Overreaction and fear of the situation turning in the direction of depression/mania easily causes arguments and the relationship is put to the test because of this. (4)
Mania may take the patient to a closed ward, and during depression the spouse may not be able to do anything about it together. Accepting and putting up with this demands an extreme amount from the spouse, and families are often offered e.g. relationship therapy, in which the experience of both is heard. (4)
The matter is challenging to the extent that the sufferer needs enormous support, understanding and love, especially from the spouse and loved ones. The variability of situations can become burdensome for the family over the years, especially if the disease is still untreated and without a diagnosis and mood-balancing medication. A spouse’s illness may also cause shame, so getting help for both yourself and the sick person can be unnecessarily delayed. (4)
The endocannabinoid system in bipolar disorder
Purpose of the endocannabinoid system is to balance all processes in the body. The system found in almost all living species is responsible for the needs that are necessary for life, such as e.g. appetite, sleep and relaxation and is therefore of course also part of the onset, maintenance and possibly recovery of bipolar disorder.
The endocannabinoid system includes endogenous cannabinoids, their corresponding two receptors and the enzymes that break them down.
Both pro-inflammatory cytokines and the endocannabinoid anandamide a clear increase in levels has been observed in those who are going through at least another episode of the disease. Also, an increase in other, lesser known, endocannabinoids in those who have both schizophrenia and substance abuse problems in addition to bipolar disorder. (6)
Another of the most well-known cannabinoids, 2-AG is at a clearly lower than normal level in those suffering from mental health challenges. (6)
The CB2 receptor has a strong influence on the immune response, and its activation could be significant in the treatment of bipolar disorder, which is partially caused by inflammation in the body. (7)
CBD adjusts the internal clock
Disturbances of the internal clock, low-grade inflammation of the body and stress are common features of bipolar disorder. A compound found in hemp, According to studies, cannabidiol or CBD has an effect on the internal clock , relieves inflammation , and also relieves stress . cannabinoid. CBD is not intoxicating, does not cause addiction and has been found to be effective even after long-term use.
According to research, harnessing cannabinoids for mental health treatment is challenging to the extent that they affect everyone in slightly different ways. However, CBD may also have therapeutic effects on mental health challenges and may also be useful in supporting the treatment of bipolar disorder.
CBD acts mainly through non-cannabinoid receptors, but it also has an effect that activates the cannabinoid system. (8)
The intoxicating cannabinoid, THC(tetrahydrocannabinol), the use of hemp is not recommended for people with bipolar disorder, as THC may e.g. trigger mania. (7)
Bipolar disorder is a difficult-to-diagnose mental illness that causes challenging symptoms that range from deep depression to high-energy mania. Lifestyle has a great impact in terms of disease prevention and treatment, but often alongside them different mood-balancing drugs are needed. CBD oil may relieve symptoms during both depressive and manic periods, but also affect future periods of illness, as CBD in general has been found to have effects that may alleviate the causes associated with bipolar disorder.
- Mieli.fi. Bipolar disorder. https://mieli.fi/mielenterveys-koetuksella/kaksisuuntainen-mielialahairio/. Referenced 2/22/2023
- Central Association of Mental Health. Bipolar disorder. https://www.mtkl.fi/mika-askarruttaa/yleisia-mielenterveyden-hairioita/kaksisuuntainen-mielialahairio/. Referenced 2/22/2023.
- A working group set up by the Duodecim of the Finnish Medical Society, the Finnish Psychiatric Association and the Finnish Youth Psychiatric Association. Duodecim On-site treatment. Bipolar disorder. https://www.kaypahoito.fi/hoi50076. Referenced 2/22/2023.
- Bipo guide. https://bipolaariopas.fi. Referenced 2/22/2023.
- University of Turku. Media release. The researchers found out the mechanism of origin of bipolar disorder. https://www.utu.fi/fi/ajankohtaista/mediatiedote/tutkijat-selvittivat-kaksisuuntaisen-mielialahairion-syntymekanismia. Referenced 2/22/2023.
- Garani R., Watts J. and Mizrahi R.. 2020. Endocannabinoid System in Psychotic and Mood Disorders, a review of human studies. https://pubmed.ncbi.nlm.nih.gov/32898588/. Referenced 2/22/2023.
- Arjmand S., Behzadi M., Kohlmeier KA, Mazheri S., Sabahi A. and Shabani M.. 2019. Cambridge university press. Bipolar disorder and the endocannabinoid system. https://www.cambridge.org/core/search?filters %5BauthorTerms% 5D=Shokouh%20Arjmand&eventCode=SE-AU. Referenced 2/22/2023
- Campos AC, Moreira FA, Gomes FV, Del Bel EA and Guimarez FS. 2020. Multiple mechanisms involved in the large-spectrum Therapeutic potential of cannabidiol in Psychiatric disorders. https://pubmed.ncbi.nlm.nih.gov/23108553/. Referenced 2/22/2023.