Researcher calls for change in understanding of bipolar disorder

One of the country’s top researchers into causes and treatments of bipolar disorder has called for sweeping changes in the way the illness is understood and diagnosed.

Professor Nick Craddock of the Mood Disorders Research Team at Cardiff University says a better understanding is needed of the genetic, biological and psychological factors that determine a person’s susceptibility to the illness.

Writing in Pendulum, the journal of MDF The Bipolar Organisation, Professor Craddock suggested that within a generation or two many people currently diagnosed with bipolar disorder or schizophrenia could receive a wholly different diagnosis.

Outlining his vision of the future, Professor Craddock said that some of those who retain the diagnosis could avoid the prescription of mood stabilising or anti-depressant medication, relying instead on a combination of lifestyle changes, counselling or treatments designed to combat adverse hormonal changes.

Research conducted by Professor Craddock’s team found that bipolar disorder can manifest itself very differently in different people and that the symptoms an individual experiences can change over time.

Professor Craddock believes that current labels, such as bipolar 1, bipolar 2, and major depression can lead to confusion and misdiagnosis, with patients showing identical symptoms being diagnosed as having bipolar, schizophrenia or depression.

“We would have to look very closely at the person’s own individualised experience of the illness in order to get a full understanding of what is required to treat them effectively,” said Professor Craddock.

“We might move towards talking, for example, about bipolar spectrum disorder which would mean that the person is susceptible to ups and downs – but it might include people who at the moment are variously described as having bipolar 1 disorder, severe depressions and schizophrenia.”

A better understanding of the specific biological, psychological and environmental factors that trigger mood-swing disorders could lead to a wider, more tailored range of treatments, said Professor Craddock.

“We may well identify forms of illness which only occur when there are certain triggers,” he said.

“One example might be something that is triggered only by sleep deprivation.

“If we find their illness is only likely to occur under certain triggers, maybe the only thing we need to do is advise the person to avoid the triggers, in this case by getting enough sleep.

“Some form of medication will still be necessary in most cases, but by understanding more about the illness, the hope is that we’ll be able to develop treatment that will precisely adjust the chemicals that are out of balance without causing chemical changes that might cause side effects.”

The Mood Disorders Research Team at Cardiff, which is recognised as one of Europe’s leading academic centres of study into bipolarity, last month entered into a collaborative partnership with MDF The Bipolar Organisation, with Professor Craddock taking on the role of the charity’s Scientific Adviser.

“Over the coming years there will be an unparalleled opportunity for advances in the understanding of bipolar disorder to be translated into improvements in quality of life,” said Professor Craddock.

“To make this happen we need to work together to ensure that our politicians and the NHS support the necessary research and service developments.”