Suffering from bipolar disorder? Practice yoga

Yoga practice may yield significant mental health benefits for people with bipolar disorder, a survey study suggests.

Also known as manic-depressive illness, bipolar disorder refers to a brain condition that causes unusual shifts in mood, energy, activity levels and the ability to carry out day-to-day tasks.

"Some individuals with bipolar disorder believe that yoga has had a significant positive impact on their life," said co-researcher Lisa Uebelacker from Brown University in the US.

For the study, the researchers recruited 109 individuals who identified themselves as having bipolar disorder and as being yoga practitioners.

Of 86 individuals with useable responses, 70 had positive results on a screening questionnaire for manic symptoms.

Participants reported practicing yoga for an average of six years; they attended a yoga class twice a week and practised yoga at home three times every week, on average.

Most participants believed that yoga had benefits for their mental health. Two-thirds said that yoga positively affected their depressive and manic symptoms.

They also reported positive emotional effects of yoga, such as reduced anxiety and worry; positive cognitive effects, especially in terms of increased mindfulness; and positive physical effects, such as weight loss, increased energy, and improved sleep.

Fifteen respondents said that yoga had been significantly life-changing.

However, yoga is not without risks - including potential worsening of symptoms related to bipolar disorder, the researchers noted.

About one-fourth of respondents reported some type of negative effects related to yoga.

"Our results suggest that hatha yoga may be a powerful positive practice for some people with bipolar disorder but that it is not without risks and, like many treatments for bipolar disorder, should be used with care," the researchers wrote.

The study appeared in the Journal of Psychiatric Practice.   

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Kids With ADHD, Aggression May Benefit From 2nd Med

Children with attention-deficit/hyperactivity disorder (ADHD) who also are extremely aggressive might benefit from taking an antipsychotic drug along with their stimulant medication, a new study suggests.

Prescribing powerful antipsychotic medications to children with behavioral problems is controversial. Little is known about the long-term safety of these medications, which are approved by the U.S. Food and Drug Administration to treat severe mental illnesses such as schizophrenia and bipolar disorder. And previous studies have provided little evidence to support the idea that they help quell youngsters' violent outbursts.

But the new study, which was published online in the January issue of the Journal of the American Academy of Child and Adolescent Psychiatry, suggests there might be some merit to the idea, at least for severely troubled kids.

The study looked at a subset of children with ADHD who also are physically violent, meaning they're either destructive or aggressive toward themselves or others, the researchers said.

"The children who participated in this trial had far more significant behavioral issues than the typical child with ADHD alone," said study author Michael Aman, director of clinical trials at Ohio State University's Nisonger Center.

"These are children who are really in conflict with their communities and their families," Aman said. "They seem to be in a spiral they can't get out of."

The 168 children in the study were between 6 and 12 years old with a diagnosis of ADHD and oppositional-defiant disorder or conduct disorder. All had displayed recent episodes of serious physical aggression in which they destroyed property or, at a minimum, left bruises on themselves or others.

All were started on a stimulant medication -- typically long-acting methylphenidate (sold under the brand name Concerta), which is a common treatment for ADHD. Their parents got special training in how to manage impulsive behaviors.

After three weeks, those who had not been helped enough by the basic measures were allowed to start a second medication, which was assigned at the start of the study. Sixty-one kids who started the second medication took the antipsychotic risperidone (Risperdal) for six more weeks, while 69 children continued basic treatment and got an added placebo pill.

After nine weeks, children who took Risperdal in addition to their stimulant medication saw modest but significant improvements in behavior compared to those who continued on the stimulant by itself.

"I don't think it's a grand slam, but I do think it indicates that there is some justification for what doctors have begun to do, which is to combine treatment," Aman said.

Aman said the average improvement on Risperdal was moderate. "Buried in that moderate are kids who did much better, kids who did somewhat better and some kids who didn't do better at all," he said.

Aman said scientists really need to look more closely to understand why some children had big improvements with the addition of Risperdal while others got no further help.

In some cases, Risperdal seemed to cancel some of the most bothersome side effects of the stimulants, including loss of appetite and trouble falling asleep.

But Aman cautioned that antipsychotics must always be prescribed with great care since they cause weight gain and increase the risk for type 2 diabetes.

The study was sponsored by a grant from the U.S. National Institute of Mental Health.

About half of children with ADHD who are referred for psychiatric help have behavioral disorders as well as ADHD, according to the U.S. Centers for Disease Control and Prevention.

An expert who was not involved in the research praised the study and said it would help doctors sort out what is often a tricky treatment decision.

In kids with ADHD and aggressive behaviour, "recent guidelines say you should try to treat the ADHD first," said Joseph Blader, an associate professor at the University of Texas Health Science Center at San Antonio. "Then the issue is, how long do you spend doing that if the child is having these explosions, these meltdowns, potentially hurting people, on the threshold of getting kicked out of school? Two weeks? Three weeks?"

Blader said that, because so many of the kids in the study's placebo group continued to improve on the stimulant medication alone, doctors might be justified in waiting a few more weeks to see if the aggression improves along with the ADHD.

"I think this study shows that you get a lot of bang for your buck with stimulants and parent training," he said. "Unless it's a very extreme situation, it's optimal to let those play out [before trying a second medication]."

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5 major psychiatric disorders share common genetic link

The findings provide insight into the biological pathways that may predispose an individual to disease and could ultimately lead to the development of new therapeutic avenues to treat the five major psychiatric illnesses.

Scientists have identified the five psychiatric disorders, bipolar disorder, major depressive disorder, schizophrenia, autism and attention deficit-hyperactivity disorder (ADHD), share a common genetic link.
They showed substantial overlap of genetic risk factors shared between bipolar disorder, major depressive disorder and schizophrenia and less overlap between those conditions and autism and attention deficit-hyperactivity disorder (ADHD).

They are now moving toward understanding the molecular underpinnings of psychiatric illness.
The findings provide insight into the biological pathways that may predispose an individual to disease and could ultimately lead to the development of new therapeutic avenues to treat the five major psychiatric illnesses.

Study co-senior author Kenneth S Kendler, MD, professor of psychiatry, and human and molecular genetics in the Virginia Commonwealth University School of Medicine, and an internationally recognised psychiatric geneticist, said that this is a very large scale study using a new, innovative statistical method.
Kendler asserted that prior to this model, we have not been able to address these questions and their results have given them by far the clearest picture available to date of the degree of genetic similarity between these key psychiatric disorders.

He said that the team is hoping that this will help them both in developing a more scientifically based diagnostic system and understanding the degree of sharing of the biological foundation these illnesses.
The study builds on findings published earlier this year in The Lancet, which reported that specific single nucleotide polymorphisms, or SNPs, are associated with a range of psychiatric disorders that can occur during childhood or adulthood.

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5 psychiatric disorders share common genetic link

Scientists have identified the five psychiatric disorders, bipolar disorder, major depressive disorder, schizophrenia, autism and attention deficit-hyperactivity disorder (ADHD), share a common genetic link. 

They showed substantial overlap of genetic risk factors shared between bipolar disorder, major depressive disorder and schizophrenia and less overlap between those conditions and autism and attention deficit-hyperactivity disorder (ADHD). 

They are now moving toward understanding the molecular underpinnings of psychiatric illness. 

The findings provide insight into the biological pathways that may predispose an individual to disease and could ultimately lead to the development of new therapeutic avenues to treat the five major psychiatric illnesses. 

Study co-senior author and an internationally recognized psychiatric geneticist, said that this is a very large scale study using a new, innovative statistical method. 

He asserted that prior to this model, we have not been able to address these questions and their results have given them by far the clearest picture available to date of the degree of genetic similarity between these key psychiatric disorders. 

He said that the team is hoping that this will help them both in developing a more scientifically based diagnostic system and understanding the degree of sharing of the biological foundation these illnesses. 

The study builds on findings published earlier this year , which reported that specific single nucleotide polymorphisms, or SNPs, are associated with a range of psychiatric disorders that can occur during childhood or adulthood. 

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Bipolar Disorder Drugs May 'Tweak' Genes Affecting Brain

Medications taken by people with bipolar disorder may actually be nudging hundreds of genes that direct the brain to behave more normally, according to new research.

The study suggests that anti-psychotic drugs activate a wide range of genes, changing their function. 

"A gene's activity in any given cell will vary depending on what it's exposed to.

It's not often that scientists stumble upon something in research that they totally weren't expecting to see. "It was a major surprise to us that people treated with an antipsychotic [medication] had changes in the gene expression pattern.

The findings could help point the way to new gene-targeted and stem cell therapies, and provide valuable insight into what causes manic-depressive mood swings.

However, a genetics expert not connected to the study was more cautious about drawing implications from its findings.

Bipolar disorder, also known as manic-depressive illness, affects about 5.7 million American adults, or about 2.6 percent of the U.S. population aged 18 and older, according to the U.S. National Institute of Mental Health (NIMH). The brain disorder causes severe and unusual shifts in mood, energy, activity levels, and the ability to carry out routine daily tasks.

The new research, published in a recent issue of the journal Bipolar Disorders, involved examining 26 brains donated to a nonprofit brain bank. Fourteen of the brains were from people who had bipolar disorder. Of those, seven were from people who had been taking one or more antipsychotic medications -- such as clozapine, risperidone and haloperidol -- when they died. Twelve brains were from those with no mental health condition.

In comparing the brains, the scientists observed that the genes of those that had been exposed to anti-psychotics at the time of death or during their lifetime were similar to those from people who did not have bipolar disorder. This suggests that the drugs may normalize or suppress the kinds of brain pathology one would expect in bipolar disorder, according to the researchers.

The study also supports the idea that the ability of brain cells to effectively communicate with each other may be impaired in people with bipolar disorder. The researchers found that the brains of people who were taking anti-psychotics and those who did not have bipolar disorder showed striking similarities in how their brains relayed signals between cell gaps, or synapses, and on high-speed neuronal "freeways" called the nodes of Ranvier.

While anti-psychotic medications can often be effective in moderating the effects of bipolar disorder, the side effects are often difficult for people to deal with. These include metabolic syndrome -- a combination of symptoms that increase the risk of developing cardiovascular disease and diabetes -- as well as weight gain, increased blood sugar levels, and tremors.

"It's still not known if these changes just happen to occur or play a key role in the therapeutic effect," said a Dr. 

The researchers don't have data on what medications the brains were exposed to during their lifetimes. Patients [with bipolar disorder] are exposed to antidepressants, drugs of abuse, and other medications, and we don't have medication exposure data on the brains [of the people without bipolar disorder].

According to the study, the research represents a step toward a radical evolution in the design of drugs for psychiatric conditions by the pharmaceutical industry.

"A lot of these psychiatric illnesses fluctuate, but now we give medications at a constant rate, almost as if we were giving a diabetic the same amount of insulin no matter what the person's blood sugar is," a  researcher said. "Medications as we know them will change based on our understanding of the biological mechanisms behind disease."