You have bipolar disorder, and so did your mother and her father, plus other relatives. You're worried about whether your child will inherit bipolar disorder. Will a specialized eye exam someday be able to help predict whether your child will develop BP? A new study reported in the journal Biological Psychiatry suggests that this may be possible.

At the back of the eye is the retina, which contains two types of light sensors called rods and cones. Rods see black and white and are important for sight in low light conditions and for peripheral vision. Cones see color. Although researchers already knew that retinal anomalies were detected in people diagnosed with bipolar disorder and schizophrenia, the effects of the illness and use of medication for it made those findings no good for research purposes.

In this study, researchers examined the retinas of healthy young adults who were at high risk for developing BP or schizophrenia and compared them with a control group whose families did not have a history of those illnesses. They found that in the high risk group, the ability of light to activate the rods was significantly reduced. There was no difference in the cones' responses between the two groups.

The identification of a possible new biomarker for BP is exciting. The study's authors concluded that this particular response of the retina's rods may be an "early and specific biomarker of risk" that may help in future genetic testing and prevention research.

Does a diminished response of the rods lead to perceptual problems in BP and schizophrenia? It's possible. DNA quoted Dr. John Krystal, editor of Biological Psychiatry, as saying, "It is important to appreciate that for schizophrenia and bipolar disorder, as for colour-blindness or selective hearing loss, people who appear to perceive the world normally may actually have subtle but important problems with perception, which may contribute to other adaptive impairments." Do you think this relates to you?
~Marcia

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A study published in the British Journal of Psychiatry this month found that students aged 15-16 who got excellent grades were four times as likely to develop bipolar disorder than those receiving average grades. In the group with excellent grades, boys were more likely than girls to develop the illness. According to a report on the study in the Telegraph, the link was strongest in children whose grades for language and music were high.

The Telegraph quoted the study's authors as giving several possible explanations for these results: "First, people in a state of hypomania, a mild period of mania or elevated mood, can often be witty and inventive, and able to link ideas in innovative ways.

"Second, people with bipolar disorder often experience unusually strong emotional responses, which may help their talent in art, music and literature. Third, people with hypomania often have extraordinary stamina and can keep concentrating for long periods of time."

Yet at the same time, Dr. Russell Federman at the University of Virginia posted a blog saying that bipolar disorder was less common among students at the University than in the general population. He attributed this to "[t]he selective admission and stressful academic environment of the University weeding out those whose instability has derailed their academic performance." The British study certainly conflicts with that statement!

Dr. Federman's conclusion is not based on any scientific evidence, but rather on his own observations as director of the University's Counseling and Psychological Services. Given the stigma people with bipolar disorder encounter, it seems likely to me that a large number of students may not have disclosed their illness to his department. Also, many students may not have realized yet that problems with moods may be caused by bipolar disorder.

In light of the British study, Dr. Federman's assertion does not seem particularly credible. What do you think?
~Marcia

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As reported by the Associated Press, this month the Archives of General Psychiatry has published the results of a study that was designed to find out whether omega-3 fatty acids such as are found in fish oil have any benefit in preventing psychosis from developing, specific in teens and young adults.

The study was small - just 81 participants - but the results were strong enough to make the outcome very encouraging. The patients, aged 13 to 25, were selected on the basis of being at ultra-high risk for developing a psychotic disorder such as schizophrenia, based on early symptoms. After one year, 27.5% of the placebo group had developed full-blown psychosis, but only 4.9% of those taking omega-3 fatty acids had done so.

If these findings stand up in larger studies, will the results turn out to have an application to the psychosis of Bipolar I Disorder? Many doctors routinely recommend fish oil capsules to patients of all ages with bipolar disorder, and I've talked to parents who have said fish oil made a big difference in their bipolar children. There are already some studies that show fish oil is good for depression.

One great thing about all this is that fish oil is good for you in a number of ways. It helps to lower cholesterol and thus reduce the risk of heart disease. As an anti-inflammatory, studies are showing fish oil to be of use in treating arthritis and lupus. Research even suggests that fish oil can help prevent Alzheimer's.

Omega-3s are considered essential fatty acids - meaning your body needs them but can't manufacture them, so obtaining them through your diet or supplements is necessary for good health. So while the jury is still out on the effectiveness of fish oil in improving mental health, it's still a good thing if you make sure you are getting enough omega-3s one way or another. See Omega-3 Fatty Acids - there are links at the bottom that will give you information on how best to get them in your diet and buying supplements.
~Marcia

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Recently a lot of people have been searching the internet for information about Trileptal, which is an anticonvulsant drug (that is, it helps control seizures in conditions such as epilepsy) used as a mood stabilizer in treating bipolar disorder. The search popularity may be because Trileptal is weight-neutral, unlike some other drugs in its class.

Trileptal has not been approved by the Food and Drug Administration for treatment of bipolar disorder, but it has been prescribed off-label for years for this use. Read the Trileptal Drug Profile for information about this drug, including major side effects and risks during pregnancy.
~Marcia

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