Una de cada dos personas con trastorno bipolar no es diagnosticada

Aparece entre los 15 y los 25 años. Es padecida por entre el 2 y el 5 por ciento de la población.

Alrededor del 49 por ciento de las personas que sufren un trastorno bipolar no está diagnosticado y el 31 por ciento de los que conocen esta enfermedad han recibido un tratamiento equivocado de depresión mayor.

Al menos así lo aseguraron varios expertos reunidos en el XI Seminario Lundbeck 'Trastorno Bipolar: El desgobierno de la mente', llevado a cabo en Ibiza (España). Además, según los especialistas presentes en el evento, el 34 por ciento de estas personas ha vivido más de 10 años con síntomas de la enfermedad antes de su diagnóstico.

Y aunque las cifras que entregaron correspondían a España, de acuerdo con los psiquiatras y neurólogos, estas pueden extrapolarse a otras latitudes y es posible que reflejen lo que pasa en países en vías de desarrollo, como Colombia.

Según el psiquiatra Antonio Carlos Toro, coordinador del programa de salud mental del Hospital San Vicente y profesor de la Universidad de Antioquia, "esta enfermedad suele aparecer entre los 15 y los 25 años y se calcula que es padecida por entre el 2 y el 5 por ciento de la población mundial; sin embargo, a nivel local la estadística puede ser menor, pero por simple falta de consulta".

Toro afirma que como este trastorno se caracteriza por dos fases -una depresiva y otra maniaca que es de euforia o exaltación- , y la primera es más común que la segunda, "eso hace que muchas veces el paciente sea tratado como un depresivo y no responda al tratamiento o recaiga porque tiene es trastorno bipolar".

De ahí, el diagnóstico equivocado. Durante el seminario en España, los expertos recordaron que cada vez hay avances más grandes e investigaciones más completas sobre el tratamiento de este trastorno, pero sigue siendo muy difícil diagnosticarlo durante las primeras etapas de la enfermedad.

En concreto, el trastorno bipolar es una enfermedad mental que, con los medios actuales, es perfectamente tratable en la mayor parte de los casos.No afecta a la inteligencia, sino a la regulación de las emociones, y sus causas son una combinación de factores genéticos y ambientales.

Asimismo, su tratamiento es farmacológico y psicoterapéutico. Según la Programa de Trastornos Bipolares del Servicio de Psiquiatría en el Hospital Universitario La Paz de Madrid (España), Consuelo de Dios, "tiende a ser crónica y recurrente, y se puede manifestar con un conjunto de diferentes síntomas psicológicos, conductuales y físicos no siempre fáciles de diagnosticar y tratar.

No obstante, muchos pacientes adecuadamente tratados pueden llevar una vida y unas relaciones normales".

Se estima que el trastorno bipolar puede disminuir la esperanza de vida entre 13 y 30 años. Y, de acuerdo con la especialista De Dios, en esta enfermedad la mortalidad está relacionada con causas no naturales como el suicidio o los accidentes, pero, más aún, con causas naturales, entre las que se cuentan problemas cardiovasculares y endocrino-metabólicos.

"Las enfermedades que con más frecuencia se presentan en el paciente con trastorno bipolar son la obesidad mórbida, la diabetes mellitus y las enfermedades cardiovasculares -le dijo a la prensa de su país tras el evento-. Además, los problemas de abuso de sustancias, incluyendo el alcohol, son mucho más frecuentes en el paciente con trastorno bipolar que en la población general, y esto también conlleva un alto riesgo de morbimortalidad". 

* Con información de www.elmundo.es

Scientists Find Truth in "Mad Scientist" Stereotype: There Is a Link between Genius and Insanity

By Christine Hsu. Medical Daylt. June 04, 2012.

Genius and insanity may actually go together, according to scientists who found that mental illnesses like schizophrenia and bipolar disorder are often found in highly creative and intelligent people.

The link is being investigated by a group of scientists who had all suffered some form of mental disorder. 

Bipolar sufferer Kay Redfield Jamison, a clinical psychologist and professor at Johns Hopkins University School of Medicine, said that findings of some 20 or 30 scientific studies confirms the idea of the "tortured genius" or "mad scientist".   

Jamison said that creativity appears to be significantly linked to mood disorders, especially bipolar disorder.  For instance, one 2010 study that tested the intelligence of 700,000 Swedish 16-year-olds found that highly intelligent adolescents were more likely to develop bipolar disorder in a decade-long follow-up.

"They found that people who excelled when they were 16 years old were four times as likely to go on to develop bipolar disorder," Jamison said Thursday night during a panel discussion at New York’s World Science Festival.

Bipolar disorder is a condition in which people have dramatic mood swings between "mania" or extreme happiness and severe depression. 

Panelist and researcher James Fallon, a neurobiologist at the University of California-Irvine said that research found that people who suffer bipolar disorder tend to be more creative when they’re coming out of deep depression. 

Fallon suggested that when a bipolar patients' mood improves, activity decreases in the lower part of a brain region called the frontal lobe and increases in a higher part of that lobe, a shift that is also seen when people have bouts of creativity.

"There [is] this nexus between these circuits that have to do with bipolar and creativity," Fallon said at the panel.

Elyn Saks, a mental health law professor at the University of Southern California who also developed schizophrenia as a young adult, said that people with psychosis do not filter stimuli as well as others without the disorder, meaning that they're able to ponder contradictory ideas simultaneously and gain insight into loose associations that the general unconscious brain wouldn't even consider worthy of sending to consciousness.

Saks said that while the invasion of nonsense into conscious thought can be overwhelming and disruptive, "it can be quite creative, too."

Studies on word associations that ask participants to list all the words that come to mind in relation to a stimulus word like "tulip" found that bipolar patients experiencing mild mania can generate three times as many word associations in the same amount of time as the general population. 

The findings suggest that mania can lead to bouts of genius because the great amount of unsuppressed ideas means a greater probability of producing something original and profound.

Many prodigies like painter Van Gogh, author Jack Kerouac and mathematician John Nash had displayed self-destructive behaviors, and it is unclear as to why humans have evolved this trait. 

"The notion of a 'tortured genius' or 'mad scientist' may be more than a romantic aberration," says the World Science Fair. "Research shows that bipolar disorder and schizophrenia correlate with high creativity and intelligence, raising tantalizing questions: What role does environment play in the path to mental illness?"

Scientists wonder whether the mental disorders are being positively selected for in the gene pool, and if there is actually a line between gift and deficit. 

Past studies have suggested that much of the link between genius and madness is produced by one particular gene called the DARPP-32, and that three out of four people inherit a version of the DARPP-32 gene, which enhances the brain's ability to think by improving information processing in the prefrontal cortex of the brain. 

However panelists noted that while society benefits from the productivity of its "tortured geniuses," people who are affected by mental disorders that often lead to bouts of creative energy don’t always consider their moment of brilliance to be worth their suffering.

"I think the creativity is just one part of something that is mostly bad," Saks said.

Published by Medicaldaily.com

Neurociencia del incienso: virtudes psicoactivas de este ingrediente ritual

Por. Luciano Montlune. Pijamasurf. Mayo 2012.
A pesar de que muchas personas utilizan el incienso como una metafora mística, investigadores confirman que esta sustancia posee bondades psicoactivas que actúan en forma fáctica contra la ansiedad y la depresión.

Desde hace milenios distintas tradiciones místicas han utilizado el incienso como un catalizador de manifestaciones etéreas así como una especie de facilitador sensorial para entablar conexiones entre el mundo de la materia y el del espíritu. Sin embargo, como suele ocurrir, la ciencia había prestado poca atención a los posibles efectos neurológicos de estas sustancias. Tal vez por eso el estudio que realizaron conjuntamente investigadores de la Universidad Johns Hopkins y de la Universidad Hebrea de Jerusalén resultó particularmente innovador. 

Utilizando como muestra resina de Boswellia, árbol bastante popular en ciertas regiones de África y Arabia que ha sido tradicionalmente utilizado para extraer resina que posteriormente se quema para cobijar con su humo recintos religiosos, los investigadores comprobaron que al entrar en contacto con una persona este incienso activa canales iónicos del cerebro. El resultado de esta interacción es un estado de relajación neurológica –debilita sensaciones ligadas a la depresión y a la ansiedad.

Raphael Mechoulam, co-autora del estudio, enfatiza en el efecto neurológico del incienso, una sustancia que muchos utilizan contemplando exclusivamente su papel metafórico:

“A pesar de la información contenida en antiguos textos, la psicoactividad de los componentes de la Bosweilla no han sido investigados. Comprobamos que el acetato de incienso, un componente de resina de Bosweilla, cuando probado en ratones reduce la ansiedad y provoca un comportamiento anti-depresivo. Aparentemente en la actualidad la mayoría de los usuarios asume que el quemar incienso solo tiene un significado simbólico”. 

 Para determinar los efectos de esta resina sobre el sistema nervioso los científicos administraron acetato de incienso a los ratones y comprobaron que ciertas áreas de su cerebro, aquellas ligadas a los circuitos nerviosos y al manejo de emociones, respondían significativamente al estímulo –específicamente activó una proteína llamada TRPV3 que se presenta en el cerebro de todo mamífero y esta relacionada a la percepción de temperatura.

“El estudio también provee una explicación biológica a las prácticas religiosas que se han preservado a lo largo de milenios, atravesando el tiempo, la distancia, la cultura, la religión. El quemar incienso realmente te ofrece una sensación de calor y hormigueo alrededor del cuerpo” afirma emocionado el entonces Editor en Jefe de The FASEB Journal, Gerald Weissmann. 

Algo que me resulta especialmente interesante es el concebir este estudio realizado en 2008 como un episodio más de un fenómeno apasionante: la ciencia llegando a conclusiones que de algún modo las tradiciones místicas manejaban ya desde hace siglos o incluso milenios. Para entender mejor esta relación consideremos la siguiente analogía.

Podemos percibir a la ciencia y a la magia como dos hermanas que caminaban juntas. Una de ellas que manifiesta como virtudes distintivas la serenidad y la claridad se mantiene sobre el sendero cristalino mientras que la otra, inquieta y caprichosa, decide separarse para tomar otro camino, el cual resultará largo y tedioso. Miles de años después ambas se reencuentran en su destino original, y mientras que la magia arribó con milenios de anticipación, aguardando pacientemente a su ‘otra yo’, la ciencia decidió rodear el camino, lo cual le implicó múltiples tropiezos en buena medida detonados por su soberbia y su desconfianza –pero al parecer ese era su ineludible destino. 

No deja de ser curioso como la ciencia celebra cuando comprueba metódicamente un postulado místico, olvidando que durante siglos se dedicó a descalificarlo. Si hace un par de décadas hubiésemos intentado explicar a un científico que el incienso tiene propiedades que van más allá de la estética sensorial, y que de manera inexplicable, pero también innegablemente, inducen condiciones propicias para la oración, el rezo, o la meditación, muy probablemente nuestra afirmación habría sido discriminada. Sin embargo hoy, luego de cinco mil años de uso del incienso en contextos espirituales –recordemos que en China hay indicios de esta práctica que datan del neolítico– celebra el haber confirmado propiedades psicoactivas de este ingrediente ritual.

Pero más allá de observar este divertido retraso científico no deja de ser reconfortante para nuestras mentes, a fin de cuentas educadas en contextos racionales, confirmar que esa seducción metafísica que hemos mantenido durante años frente al incienso en realidad responde a un tangible estímulo neurológico que favorece nuestro diálogo con el espíritu. Dejemos pues, con aún más confianza, que la efímera y ágil silueta de su humo siga abrazando nuestros espacios (como el río acaricia la tierra que atraviesa sin detener su marcha). 

Twitter del autor: @paradoxeparadis / Lucio Montlune  

Abnormal Psychology and Underground Black Metal

InfoBarrel. By Ulalume, 2011. 
The concept of “abnormality” as it relates to psychology is not a particularly easy concept to grasp. While there are some legitimate definitions of abnormality (such as a requirement for psychological dysfunction, personal distress, and atypical behavior), the requirements are ultimately very vague when being considered by multiple people from different cultural backgrounds. The best definition of abnormal behavior would indicate that the behavior has the potential to not be deemed a psychological disorder simply because it is abnormal, yet still maintain that those individuals who adhere to the abnormal are, in the least, significantly different than their societal counterparts. My relatively active involvement in the underground black metal scene in the United States has the potential to be viewed as abnormal due to the themes expressed in the music (Satanism, anti-religion, anti-establishment, war, violence), the extreme sound of the music, and non-traditional feelings towards subjects related to human vitality.    

The abnormality of the black metal music scene is not strictly related to the audible music, rather the ideological ideas and theatrical imagery directrly related to the scene; whether it be at live shows or in some other context, as they tend to push the boundaries of what is socially acceptable, and therefore what is normal and abnormal. One specific example that I witnessed occurred in New Jersey at the Starland Ballroom where the band band Behemoth played. In a room filled with fog machines and darkness, their front man (who goes by the stage name Nergal, a name associated with demons) came out and addressed the crowd with a Christian Bible in his hand. He had no reservations when he yelled into his microphone that the Bible “is a book of lies.” At the end of his speech, he tore pages out of the text, threw them at the crowd, and proceeded to scream the opening line of his next song. While it may be debatable as to whether or not it is abnormal for an individual to be non-religious, there is no doubt that the active expression of these beliefs in such a manner would be perceived as abnormal; particularly to those outside of the in group of fellow black metal fans and musicians. The imagery of ripping up a religious text, the incorporation of pentagrams and inverted crosses to stage sets, and the bodily adornments of leather clothing, chainmail, spikes, armor, and corpse paint (white paint on the body in similar fashion to rock band KISS, however utilized in such a way to make an individual appear to be dead) all add to the abnormal effect.

            In addition to the appearance and thematic elements of black metal, there is no denying that the music that is created is tonally offensive to those who are not adjusted to it. Black metal is created to sound extremely treble heavy (with little bass at all in many songs), forcing the songs to inevitably use more of the higher frequency tones which are very harsh on the ears; in comparison to music which is generally composed to utilize a lot of bass and rhythm mixed with some higher frequency tones. To add to this harshness, the instruments are generally played in a very dissonant manner so as disrupt any melodic phrase in the music. The pace of the music is frequently very fast, with the rhythm often coming in the form of sixteenth and thirty-second note bass drumming. Finally, the vocal style is typically that of a mid-ranged screamer. As an active black metal musician, I adhere very closely to these musical qualities so as to continue this underground music tradition. Many bands take a minimalistic approach to the music, myself included, which inadvertently functions in such a way that most songs sound very much alike. Ultimately, all of these abnormal musical elements combined form the antithesis of modern Western music.

            There is no denying that black metal intends to portray the darker aspects of the human condition. While for some individuals involvement in this music scene may be primarily due to angst, for myself and many others it is in very many ways a spiritual experience to be absorbed in the music and atmosphere present at many black metal concerts. An element of irony exists because anti-religion is frequently a subject often expressed through imagery and lyricism, yet the act of gathering together as fellow members of a relatively organized group has similar qualities to those religious institutions. The abnormality of this gathering is the purpose for coming together. In religious institutions people gather for the sake of socializing and worshipping god, however at a black metal concert many individuals are particularly introverted and removed from one another; but seemingly bound by the need to express feelings regarding negative life experiences. The abnormality lies in the fact that even if these feelings are natural and experienced by all human beings universally, the active expression in aggressive ways is frowned upon by normal society. Themes related to human vitality like depression, suicide, life and death, and deeply philosophical ideas are examined, and oftentimes the ability for musicians to be able to express their feelings regarding these topics allows them to channel their emotions into what could be deemed a “positive” form of expression, even if some may view their form of expression as abnormal or eccentric. For myself, the opportunity to sit down with my guitar and keyboard, compose music, and write meaningful lyrics is ultimately what assists in keeping me alive. There are very few other outlets available for an individual to express their most intimate feelings with others than as is provided by the black metal scene.  

            What constitutes a social “abnormality” is a fairly controversial subject. The psychological definition of abnormality gives a good starting point when we analyze other people, groups, cultures, and the like; however labeling a group as “abnormal” may inadvertently offend because many abnormalities are simply normality when viewed from the in group. As a member of a black metal band, I cannot help but feel at home when around other people with similar interests as myself. With that said, there is no denying that the black metal music scene is very abnormal in comparison to many other music scenes; much less other groups of people in general. Black metal consists of themes related to the darker aspects of life, sounds that are oftentimes tonally harsh, and general openness with regards to issues dealing with human vitality.