Question:
i received an interesting email about how, if BP goes medically untreated, the condition can worsen every time there is an episode of mania or depression. this is called kindling. anyone got any info, please? later, gators shawn
Response:
Disagree with Mark. "Kindling" is a pretty well understood phenomenon, with a manic swing compensated for by a corresponding depressive swing, oscillating more (higher amplitude) the longer it’s uncontrolled. In my case, kindling has been set off bad psymed use… I go WAY hypomanic on SSRIs alone, way depressed on over-prescription of mood stabilizers and anti-psychotic. Lower doses do better..maybe not get "better" as fast but as oscillation cycle dampens more equilibrium is attained. I figure that for me to do well on the pmeds, I should get a dose of each appropriate to a five-year-old (for example 5mg Effexor XR, 125mg Depakote & 2.5mg Seroquel, rather than the 375mg, 1250mg and 100mg respectively I ended up on). Good luck getting a pdoc to agree, though. Seems to me they act as a marketing wing of the drug corps. Selling more pills = better treatment? I don’t think so…. Jim "Must the breathing pay for those who breathe in and don’t breathe out? There’d be no game brother, if no one’d play…" Don Van Vliet (aka Captain Beefheart) "Petrified Forest" from "Lick Off My Decals Baby"
Response:
Hi, "kindling" refers to the idea that, the more "episodes" (manic or depressed) that occur, the more likely it is that they will reoccur. The theory is that the neural connections are strengthened with each episode, so they are more easily triggered later on. Kindling is documented pretty well for epilepsy, so that led to it being researched in bipolar as well. There is evidence for supporting this and not… Personally I think that in my case it is a valid phenomenon and logically it makes sense. The research with unipolar depresion in children finds that if you can quickly begin treatment, it is less likely that the child will continue to have depression later in life. I can’t document that one as I received the info. during a conference on depression and I’m too lazy to go find it, but it was a researcher from Stanford University that was speaking at the conference. http://www.mentalhealth.com/mag1/p5h-bp01.html (not) http://www.mhsource.com/bipolar/bp9802research.html (for)
Response:
> The only STATISTICAL constant is, the cycles become more rapid with >age.
This is certainly not true for children and adolescents with bipolar disorder. Research shows they are MORE likely to rapid cycle, or ultra-rapid cycle, than adults are. Vicki H.
Response:
Misleading statistics, Pal—an example of bad math. The cycles go their own way, individually—and just because they get worse with one patient, don’t mean shit to the rest of ‘em. Some folks’ cycles actually get better with time! And some get worse. It’s a nefarious disease; deal with it. The only STATISTICAL constant is, the cycles become more rapid with age. And even then, it’s just a general trend…. Your mileage may vary. Bummer, ain’t it? — When responding personally, remove the "nospam" from my address. Sorry for the extra typing, but we’ve got to Nuke the SpamBot Slimeballs!
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