Monday, July 18, 2011
My Visit to Stanford University 2011
Last weekend I had the opportunity to attend the 7th Annual Mood Disorder Education Day at Stanford University. I went last year for the first time and wasn’t sure if I should go again because it could be the same information, but I was pleasantly surprised to find that this wasn’t the case. If anything, this visit has encouraged me to attend every year!
This year there was a lot of focus on the biology of mood disorders, it was fascinating to hear about the latest research and what lies ahead in the future. Here’s a few highlights from my notes, please keep in mind that this is my interpretation of the information presented. Once Stanford posts the presentation slides online, I’ll let you know.
To my delight, Dr. Alan F. Schatzberg, Professor of Psychiatry and Behavior Sciences and the Director of the Stanford Mood Disorder Center, opened up with the declaration that “Mood disorders do occur in children.” He explained that in the past, they thought it wasn’t possible prior to the age of 18 years, but today they confirmed that it does occur. He also shared how they’re looking into different genes to determine how individuals respond to medication and what their typical symptoms will be when exposed to stress. Can you imagine a day when they’ll be able to examine genes and determine what medication will help the most, eliminating the years that patients struggle going from medication to medication in search of the perfect cocktail, while exposing themselves to awful side effects along the way. This is very encouraging!
Dr. H. Brent Solvason, Associate Professor of Psychiatry and Behavioral Sciences, gave a lecture on Neuromodulation treatments for those who are treatment resistant, which unfortunately is a large population. So far, ETC (Electroconvulsive Therapy) remains the most effective treatment for these hard to treat cases with 75% getting well after treatment. Keeping them well remains the challenge. Among other treatment options discussed, one that I found very interesting was Cyberknife Treatment for bipolar depression. They use a low dose of radiation and target an area in the cortex. It’s a painless procedure that’s only been studied on two human cases. So far, the results are encouraging. What I found fascinating about this treatment was that individuals could get better through a “no contact” surgery and avoid a life long battle with medications. I look forward to hearing about this research in the future.
One of my favorite speakers is Dr. Manpreet Singh, Assistant Professor of Psychiatry and Behavioral Sciences and Co-Director of the Pediatric Mood Disorders Clinic. In her presentation, she discussed how mood disorders cause major development issues in children. She discussed the strong heredity link in families and how the disorder looks different in children than adults. She explained that in children with bipolar disorder, it’s difficult for the child to regulate impulses and emotions. She used an example of a child, who as a young toddler, may not have the brain development to look both ways before chasing after a ball in the street, but as the child grows, the brain develops and allows the processing to take place to evaluate safety and gives the child impulse control, so they think to look both ways before crossing the street. In the same way, children with bipolar disorder lack this developmental function so they can’t control their impulses and emotions like other children their age. She explained that in the prefrontal cortex, interactions in the brain go wrong due to disconnections between areas of the brain. Another interesting topic discussed was that bipolar kids tend to read neutral facial expressions on others as being hostile or angry. I found this to be very interesting because I’ve had numerous occasions where my son will ask me, “what’s wrong? You look angry,” when I was casually doing something.
Later in the day, we got to break into smaller groups and ask questions one-on-one with a few of the presenters. I found this session to be worth the long drive alone! Of course I went to Dr. Singh’s group for Child and Adolescent Mood Disorders. Can you imagine being in a room of about 20 parents and having a doctor available to answer all of your questions for 2 whole hours? I found it pretty amazing!
(Can you tell?)
During this session, there was a discussion about the heredity of mood disorders, in response, Dr. Singh discussed the “Goodwin” study among a few. This particular study showed that when one parent has bipolar disorder, there’s a 30% chance that the children will have a mood disorder. When one parent has bipolar disorder and the other parent has mood issues, there’s a 70% chance that the children will have a mood disorder. She also shared that in children who have symptoms that look bipolar, only 10–15% actually have bipolar disorder as an adult, with the remaining having depression instead. For those kids that do develop bipolar disorder as a child, the disorder tends to be a more severe form as an adult.
Other highlights from Dr. Singh included:
The benefits of taking Lithium and how it restores brain matter in the frontal cortex and through research has proven to help prevent suicides.
30% of bipolar patients had depression first. Depression can be a precursor to bipolar disorder.
It takes an average of 16 years to get a bipolar diagnosis.
When it comes to medications, there has to be a risk-benefit evaluation: Live with the symptoms or live with the side effects. What’s worse?
When it comes to symptoms in children, we can’t guarrantee what’ll happen, we need to wait, watch and wonder. Don’t let your anxiety define your child’s outcome.
You should track moods and always evaluate “What are we doing with these medications—Is this working?”
It’s still unknown if early treatment curbs the progression of the disease.
In addition to the above, there were great speakers about “Sleep and Mood Disorders” and the “Nature Verses Nuture in Mood Disorders” along with presenters from NAMI and DBSA which can be read about in the slides found on http://bipolar.stanford.edu/ once they’re posted to the website.
But I have to admit, one of the most enjoyable parts of this event was to meet some of you in person! Thank you Bug’s Mom, Heather and SW for making this a great day!
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Links recommended by Dr. Singh:
A Guide to Psychiatric Medication for Young People:
Youth and Bipolar Foundation of Northern California
Slides for this event will be posted at:
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Keep your eyes out for an upcoming post with Robert Villanueva, the West Coast Regional Director for Lets Erase the Stigma and National Trainer for NAMI! I had the exciting opportunity to meet him in person and discuss his latest developments geared to end the stigma of mental illness. As a person who lives with Bipolar Disorder himself, his mantra of “I live well with mental illness” gives hope for many of those still struggling.