The Science & Treatment of Bipolar Disorder | Huberman Lab Podcast #82

In this episode, I explain the biology, symptoms, causes and types of bipolar disorder (sometimes called bipolar depression). I discuss neuroplasticity and how the brain normally regulates mood, energy, and perceptions; then, I contrast that with the biology of bipolar disorder, which is characterized by extremes of energy and mood, e.g., mania and depression. I outline the mechanisms through which bipolar disorder manifests in the brain, including deficits of interoception and reduced connections between the parietal and limbic systems. I also outline how treatment options (such as lithium) work in part through homeostatic plasticity.’ I discuss not only lithium but also the treatment of bipolar with ketamine, different talk therapies, electroconvulsive therapy, transcranial magnetic stimulation, and nutraceuticals, including Omega-3 and Inositol supplementation. This episode should interest anyone who has or knows someone with bipolar disorder and, more broadly, those interested in how the brain works to create a balance between thoughts, energy levels, focus, and mood.

#HubermanLab #Bipolar #BipolarDisorder

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Timestamps
00:00:00 Bipolar Disorder
00:02:23 Momentous Supplements
00:03:42 Tool: Appetite Suppression & GLP-1, Parallel Pathways, Yerba Mate
00:10:23 InsideTracker, ROKA, Blinkist
00:14:24 Prevalence & Severity of Bipolar Disorder
00:16:30 Bipolar Disorder I, Diagnostic Criteria of Mania
00:28:58 Bipolar Disorder II, Individual Variability
00:33:07 Bipolar I vs. Bipolar II: Manic, Depressive & Symptom-Free States
00:38:20 Consequences of Bipolar Disorder, Heritability
00:46:53 Bipolar Disorder vs. Borderline Personality Disorder
00:51:51 Mania & Depression, Negative Impacts
00:53:06 History of Lithium Treatment
01:02:44 Lithium Treatment & Side-Effects
01:05:05 Effects of Lithium: BDNF, Anti-inflammatory & Neuroprotection
01:10:10 Neural Circuits of Bipolar Disorder, Interoception, Hyper- vs. Hypoactivity
01:17:11 Neural States & Mania, Parietal Lobe & Limbic System
01:22:58 Homeostatic Plasticity, Synaptic Scaling, Lithium & Ketamine
01:36:00 Talk Therapies: Cognitive Behavioral Therapy, Family-Focused Therapy, Interpersonal & Social Rhythm Therapy
01:43:18 Electroconvulsive Therapy (ECT), Transcranial Magnetic Stimulation (rTMS)
01:48:01 Psylocibin, Cannabis
01:51:50 Lifestyle Support, Supplements: Inositol & Omega-3 Fatty Acids
02:03:31 Omega-3s, Membrane Fluidity & Neuroplasticity
02:06:44 Mania, Creativity & Occupations
02:15:33 Bipolar Disorder: Diagnosis, Neural Circuits & Treatment
02:17:45 Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous Supplements, Instagram, Twitter, Neural Network Newsletter

The Huberman Lab Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user’s own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.

[beaupritchard]

I was diagnosed with bipolar 4 years ago I've learnt the hard way that it's best to stay away from all drugs including alcohol. The drug I used mainly was Marijuana which ended up sending me into psychosis and extreme manias which would end me up in hospital. Also found alcohol had a pretty negative effect on me and didn't mix well with my medication. Been sober over a year now and am living a much better life along side regular exercise, good sleep and healthy lifestyle. If you've got bipolar and are struggling keep pushing! I never thought my life would be this good again 👍

[cassie]

I'm disappointed that the only medication closely mentioned in this episode is lithium. I've lived with bipolar 1 disorder since I was 15 (13 years now) - and the medication class that has completely saved me and allowed me to live a normal life is anti-epileptic meds.

I was hoping to learn more about how my medication and how it was discovered as therapeutic. I have SO MANY questions!

1. How is it that antiseizure meds are so effective?
2. I was on Trileptal for 5 ish years and then eventually experienced breakthrough episodes and changed medications over a handful or rocky years. Is it common to need to change meds every 5 years or so? Of course there are so many factors in play here.

I also want to point to the most insidious human emotion I've had to fight off - shame. You mention all the negative things that follow a manic episode - financial, professional, relationships, etc. but you don't mention the intense feeling of shame that comes when you "come to" after a manic episode and have to untangle layers of delusion you've lived under. Along with my neurochemical differences, shame has been the main fuel for depression and major depressive episodes in my life. Please thumbs up if you've read this far and can relate. I do love this podcast and did learn some new things in the later half of the episode. Cheers!

[Loveinthemist]

Shoutout to all of my fellow bipolar peers. We aren’t alone. Sometimes doing “the least” can be the most. I understand you.

[abufalistini]

I stopped my meds for a year because I convinced myself that I didn’t actually have bipolar disorder and the doctors only wanted to use me for money because of how expensive the meds were. One year later, absolutely catatonic, it hit me that I actually need treatment. Experiencing all the emotions a single person feels in an entire lifetime in one day gets pretty exhausting. It’s so much more than the moody stereotype.

[hoteyesng]

Hey guys, BP1 here. Since my diagnosis, which was during psychosis then hypomania with manic symptoms. Then the depression came. I quit alcohol. I didn't use other substances. Kept my exercising routine, make sure I get enough sleep everyday started eating well. I feel now I'm healthier than people without disorders. To my fellow BPs, keep away from any substances including alcohol, start exercising, you'll get addicted to the exercise because we have that addicting gene lol, get good sleep everyday, eat well, and you'll be healthier than most people.

[fleshhammer]

I got diagnosed with bipolar 1 5 years ago. Been experiencing constant symptoms all my life. I've been medicated for 4 years now, but I had been an alcoholic for most of that. Now I am a recovering alcoholic and recovering from decades of episodes. To anyone suffering out there, as low as you feel, or as insane you are thinking, there is hope to get better. Don't give up and be safe.

[jessepacella]

I’ve been bipolar since I was youngun. It has brought me close to greatness and then shattered everything good I’ve ever had. 40yrs old now and I am fighting this with every thing I have. Married 5yrs and this has been trying for my wife. Oh yeah, I also have ADHD ta boot…. I’m trying to keep my world on my shoulders without falling…without failing AGAIN. I have always downplayed my issues due to the fact I was raised by old school dudes who said “go run that shit off or put on the gloves and get in the ring” Nothing a good beating won’t fix. I am envious in a way of the younger generation who were taught to deal and acknowledge their sicknesses.

[Jennifer-bwku]

Psychedelics are just an exceptional mental health breakthrough. It's quite fascinating how effective they are against depression and anxiety. Saved my life.

[revanthreddy]

This podcast actually changed my life and how I look at things. Literally one of the best podcasts ever out there.

[stephenhopkins]

As someone who's struggled daily through one symptom or another every single day for more than half of my life, I want to sincerely thank you for the compassion and respect that you gave us while discussing our condition. I had to fight back tears many times throughout the episode... more often than not we're called "crazy" or "psycho" and given no credit for how hard we try to manage our symptoms but we're so quickly demonized when we make a mistake. Thank you so much for your work Andrew.

[jessicanear]

As a bipolar individual, I really struggle with the fact that I really want to become a mom someday but I also don’t want to possibly pass on this disorder to my children. I feel very isolated sometimes and when I think of my condition I start to hate myself a little for being so off putting. I wish I could completely isolate itself from society. That way I can just live freely and not worry about how everyone perceives me. Wouldn’t feel so insecure bc I wouldn’t have to be reminded how different I am from anyone else. Just run away, become a new person everywhere I go. Just live day by day doing as I please. Seems freeing. Sounds like peace.

[SantanuBanerjie]

I was diagnosed with Bipolar-2 at the age 62. Now, at 64 and with 4 medications taken daily, the only thing that changed for better is that I react less to triggers.
What changed for a lot worse is that, I have all symptoms of severe bipolar depression (10/10). My family thinks I am doing better because I am ‘calmer’ and ‘less impulsive’. But I am pretty much in a vegetative state. I have lost interest in just about anything. Starting my day is dreadful: I am so debilitated in the morning that getting ready for work, like shaving and ironing my clothes have completely fallen off my priorities.
This is a fantastic presentation. So informative. Knowing about your own condition can be quite empowering!

[KarlMagnusBlindheim]

Thank you for this. I have been following your work since the first episode and I just wanted to say that you have inspired me to go back to school and pursue a degree in cognitive neuroscience at the age of 42. I have worked with communication and design as an art director in the advertising industry my whole life. But after recently being diagnosed with ADHD on top of an older bipolar II diagnosis I dove into the neuroscience in order to understand my divergent brain. I have decided to leave the industry and spend the second half of my life working in science communication and advocacy, helping neurodiverse children and youth with an emphasis on issues with attention, addiction and technology. So - thank you Dr. Huberman. Your enthusiasm for science and the human brain is more inspiring than you'll ever know.

[shabnamrahimi]

I am a psychiatric nurse practitioner and absolutely love your lectures. I refer my patients to your podcast for a comprehensive yet easy to understand explanation of their condition. Thank you for all you do❤

[BrownGeorge-pwxo]

I was diagnosed with BPD since my teenage, spent my whole life fighting BPD. Also suffered severe depression and mental disorder. Not until my mom recommended me to psilocybin mushrooms treatment. Psilocybin treatment saved my life honestly. 8 years totally clean. This is something that really need to be use globally to help people with related health challenges.

[karenswan]

I'm 70, in 1998 I was diagnosed with manic depression (I don't like the term bipolar disorder because too many people think they know what that is, and they don't have to a clue.) More to the point, after five years or so of medications that didn't really help along with continued symptoms, a wonderful doctor suggested I try lithium, which I was afraid of. It totally changed my life. It's been hard to find reliable information about effects of using lithium with aging. So far I have just had to reduce the dose somewhat to keep blood levels appropriate. Thank you for r all the work you did on this video.
I watched it twice.

[laurenkeranakis]

I've had terrible experiences with psylocibin. Drove me into mania and psychosis. Cannabis almost ruined my life mentally, physically and financially. Alcohol is my biggest demon though. I have Type 1 Bipolar Disorder and being completely sober has helped tremendously. I hope to cut out caffeine one day as well. I still struggle with SI. I find that some type of cardio everyday helps. Even if it's just walking for 30 min, I feel better. I'm happiest in the summer when I can SUP or kayak almost daily. Fall and winter with the time change are crushing. I also enjoy writing poetry extensively.

Sending love to everyone who has it. It's hard to exist with this complex disorder.

[livelearngrow]

I hate bipolar 1. It is so hard to treat. Esp when I have CPTSD too. It impacts me so much. Everyday is a fight. Everyone I love suffers. There are some very dark days.
Loved ones - hold on. Don’t give up. The illness hurts you, there is a trapped human inside that body who cares and wants to treat you well. ❤🎉

[lizvlx]

as a person who is the partner of somebody who experiences mania: it can be very different to how it is described here. Especially if it is not the first, but rather the 4th, 5th, 10th time. The person experiencing the mania does recognize it often. they will maybe be the opposite of distracted by hyperfocused. they will not be impulsive but the opposite - they will try to control themselves a lot, as they are scared to be impulsive. They will feel the drive and power of the mania, but not act upon it but suffering greatly because this shit is exhausting. Also, they can be quite aggressive, as in anything that comes in their way or in the way of the simplistic manic thinking will be pushed away - in words but also in a physical way - not with the intent to hurt but forgetting this could cause pain.

[giazn]

Wow!!! This video was excellent!!! Thank you.
I'm a psychiatric clinician w/bipolar II disorder myself & you captured nuances of my experience that I've never heard or read from anyone else. One thing I would add, at least in my case, is that my depression w/bipolar II feels even lower than that of major depression.