About 9 months ago, my partner James who is low-functioning bipolar, had a change in the way he reacted to the medications he had been stabilized on for 5 years. They didn't work anymore.
At first I only saw the killer rage. Then, after he walked in and announced he had kidney disease and blood cancer, and no evidence would convince him otherwise, I realized that hypochondria had transmogrified into somatic delusions. 30 mg of Abilify daily was added to his regimen, and it worked. He was stabilized again.
He decided to start up his ebay button store again. In doing so, everything was foreign to him. The software had changed. His cognitive ability to figure out how to fill out an ebay form and do simple html was gone. What was once only dyslexia had become a more serious disability, which is called cerebellar degeneration in scientific studies. (As an aside, I went into the ebay store as him and fixed everything and spent days teaching him how to do things again. He learned very slowly, but he learned.)
A study in Neuropsychiatry Review found something significant. "Perhaps the most remarkable finding from these detailed evaluations was that 21 of the cerebellar degeneration patients (68%) met criteria for a mood disorder, including 11 (35%) with major depression and 10 (32%) with either dysthymia or a brief depressive episode."
In "Bipolar Disorders, An International Journal of Psychiatry and Neuroscience, images noted "abnormalities in the third ventricle, frontal lobe, cerebellum, and possibly the temporal lobe."
Cognitive development in bipolar disorder is understandably focused on children, so they could be spared this kind of suffering in later life. However, it seems there is a link between the worsening of all symptoms as the bipolar patient gets older. Cerebellar degeneration travels on the same bus with everyone else.
The ultimate question scientists don't know yet, is can the degeneration be drastically reduced in an older patient, if bipolar disorder is diagnosed and treated correctly in childhood?
References:
http://www.neuropsychiatryreviews.com/apr01/npr_apr01_cerebellar.html
http://www.blackwell-synergy.com/doi/abs/10.1034/j.1399-5618.2002.01157.x
Tags: abilify, bipolar-disorder, cerebellar-degeneration
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