The Science & Treatment of Bipolar Disorder | Huberman Lab

Intro

In this episode of the “Huberman Lab” podcast, Dr. Andrew Huberman explores the science and treatment of bipolar disorder. Bipolar disorder is a severe condition that causes maladaptive shifts in mood, energy, and perception, and those suffering from it are at a 20-30 times greater risk of suicide. Dr. Huberman discusses the incredible backstory of lithium, a treatment for bipolar disorder, and its impact on the brain. He also delves into the biology of mood regulation and the importance of understanding parallel pathways. Additionally, Dr. Huberman explores the potential treatments and therapies available for bipolar disorder.

Main Takeaways

The Science of Bipolar Disorder

• Bipolar disorder is a severe condition that causes maladaptive shifts in mood, energy, and perception.
• Those suffering from bipolar disorder are at a 20-30 times greater risk of suicide.
• Bipolar disorder affects about 1% of people and has a higher incidence of suicide than the general population.
• Age of onset for bipolar disorder is typically between 20-25 years old, but can be earlier.
• Bipolar disorder has two main types: bipolar one and bipolar two.

The Backstory of Lithium

• Lithium is a treatment for bipolar disorder with an incredible backstory about its discovery.
• Dr. Cade, an Australian psychiatrist, discovered the use of lithium for bipolar disorder through experiments with urine from manic patients.
• Lithium has a profound and positive effect in reducing symptoms of mania in human patients with bipolar disorder.
• Lithium treatment increases BDNF, which permits neurons and their connections to change more easily if proper environmental conditions are met.
• Lithium is neuroprotective and can prevent neurons from dying under certain conditions, particularly excitotoxicity.

The Biology of Mood Regulation

• The brain’s ability to change in response to experience both for good and for worse is discussed.
• Understanding parallel pathways is fundamental to how we are organized biologically and how our brain and body act together.
• A recent paper published in the journal Cell titled “An Inter-Organ Neural Circuit for appetite suppression” illustrates the principle of parallel pathways.
• GLP-1 is a small protein that suppresses appetite and is being explored for treating diabetes and obesity.
• Yerba mate can stimulate GLP-1, causing mild gut distension to make you feel full and increasing satiety in the brain.

Treatment and Therapies for Bipolar Disorder

• Drug therapies, such as lithium, antipsychotics, and ketamine, are necessary for most cases of bipolar disorder.
• Talk therapies, such as cognitive behavioral therapy, family-focused therapy, and interpersonal and social rhythm therapy, can be helpful in supporting or augmenting drug therapies.
• Repetitive transcranial magnetic stimulation (RTMS) is a non-invasive treatment that targets specific neural circuits to reduce activity and has shown effectiveness in reducing depressive episodes and manic episodes in people with bipolar disorder.
• Psilocybin is being explored as a clinical therapy for major depression, OCD, and eating disorders, and is being studied in controlled clinical trials for the mania associated with bipolar disorder.
• Lifestyle interventions, such as proper sleep, exercise, nutrition, social interaction, and sunlight, can support the nervous system and psyche of someone with bipolar disorder.

Summary

The Science of Bipolar Disorder

Bipolar disorder is a severe condition characterized by maladaptive shifts in mood, energy, and perception. Those suffering from bipolar disorder are at a significantly higher risk of suicide compared to the general population. The age of onset for bipolar disorder is typically between 20-25 years old, but it can occur earlier. There are two main types of bipolar disorder: bipolar one, characterized by extended periods of mania, and bipolar two, characterized by both manic and depressive episodes. Understanding the biology and genetic factors behind bipolar disorder is crucial for effective diagnosis and treatment.

The Backstory of Lithium

Lithium, a treatment for bipolar disorder, has an incredible backstory. Dr. Cade discovered its effectiveness through experiments with urine from manic patients. Lithium has a profound and positive effect in reducing symptoms of mania in human patients. It increases BDNF, which allows neurons and their connections to change more easily. Lithium is also neuroprotective and can prevent neurons from dying under certain conditions. Despite its success, lithium was not readily available to patients for 21 years due to its natural occurrence and inability to be patented.

The Biology of Mood Regulation

The brain’s ability to change in response to experience is crucial for mood regulation. Understanding parallel pathways, which are independent pathways that accomplish a common goal, is fundamental to our biological organization. GLP-1, a small protein that suppresses appetite, is being explored for treating diabetes and obesity. Yerba mate can stimulate the release of GLP-1, leading to mild gut distension and increased satiety in the brain. The interplay between the brain and body, and the regulation of mood, energy, and perception, is a complex and fascinating area of study.

Treatment and Therapies for Bipolar Disorder

Bipolar disorder requires a combination of drug therapies and talk therapies for effective treatment. Drug therapies, including lithium, antipsychotics, and ketamine, are essential for managing the symptoms of bipolar disorder. Talk therapies, such as cognitive behavioral therapy, family-focused therapy, and interpersonal and social rhythm therapy, can provide additional support and help individuals navigate through manic and depressive episodes. Non-invasive treatments like repetitive transcranial magnetic stimulation (RTMS) and emerging therapies like psilocybin are also being explored as potential options. Lifestyle interventions, such as proper sleep, exercise, nutrition, social interaction, and sunlight, can complement drug therapies and support overall well-being.

Conclusion

Bipolar disorder is a complex and serious condition that requires comprehensive treatment approaches. Understanding the science behind bipolar disorder, such as its genetic factors and neural circuitry, is crucial for accurate diagnosis and effective treatment. The discovery of lithium and its impact on the brain has revolutionized the treatment of bipolar disorder. Additionally, exploring parallel pathways and the interplay between the brain and body provides valuable insights into mood regulation. With a combination of drug therapies, talk therapies, and lifestyle interventions, individuals with bipolar disorder can manage their symptoms and improve their quality of life.