Sleep-Circadian Rhythms Tied to Bipolar Spectrum Disorders

Sharing a private practice with his wife, Miriam Galindo, PsyD, in Irvine, California, Dr. Jorge Galindo is a licensed marriage, family, and child therapist. Among Dr. Jorge Galindo’s areas of extensive knowledge is the assessment and treatment of patients who have bipolar spectrum disorders (BSD).

As reported in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, a recent study by a University of Pittsburgh researcher involved the discovery of a neurobehavioral signature that may predict future mania or hypomania occurrences among those with BSD. Usually arising in young adulthood, BSD involve depression and frequent extreme mood changes, which often necessitate intensive treatments.

Previous research by the professor demonstrated that sleep-circadian rhythm disruptions, as well as heightened reward motivations, can lead to the onset of mania/hypomania. Brain imaging studies demonstrate BSD as particularly associated with elevated activation of reward expectancy within the left ventrolateral prefrontal cortex, a key reward-processing hub.

In the most recent study, such markers were clustered together and studied, with the hypothesis being that impulsivity, reward sensitivity, and sleep-circadian characteristics would be associated with greater mania risk. The study, with a 12-month followup, demonstrated this and helped identify high-risk, moderate-risk, and healthy groups. It also brought attention to the potential of combined clinical and neurobiological measures in early BSD identification and intervention.

At the same time, London-based researchers uncovered single nucleotide polymorphisms that they characterize as distinct enough to form the basis of the first-ever psychiatric diagnostic test based on biomarkers.

A Look at the Bipolar Disorder Spectrum

Jorge Galindo, a licensed marriage, family, and child therapist, works in Irvine, California alongside his wife, Miriam Galindo, Psy.D. He is a certified domestic violence provider with the City of Orange, where he undertook a doctoral internship at an award-winning inpatient psychiatric hospital, St. Joseph Hospital. During this internship, Dr. Jorge Galindo received special training in assessing bipolar spectrum disorders.

Bipolar spectrum disorder is a group of conditions characterized by extreme mood swings between mania (a mental condition characterized by intense exhilaration or euphoria, delusions, and hyperactivity) and depression. The most common types are bipolar I and bipolar II disorder.

Bipolar I disorder involves episodes of mania that typically last at least one week. During manic episodes, a person may feel euphoric, energetic, and highly productive. However, mania can lead to poor judgment, impulsivity, and other problematic behaviors. Bipolar I disorder also involves depressive episodes.

Bipolar II disorder involves episodes of hypomania, which are less severe than mania but still disruptive. During hypomanic episodes, people experience an elevated mood and increased energy and activity levels. However, they can continue functioning normally. Bipolar II disorder also involves major depressive episodes.

In addition, the bipolar spectrum includes conditions like cyclothymia (a substantial mood fluctuation from the norm, although not as severe as bipolar I and II) and other specified bipolar and related disorders. These involve subthreshold mood episodes that still cause significant distress and impairment. While the specific symptoms and severity vary, all bipolar spectrum disorders share a common theme of extreme fluctuations in mood and energy levels. Mood swings can be unpredictable, and severely impact one’s life and relationships.

Effective management of bipolar spectrum disorder requires a combination of medication, psychotherapy, and lifestyle changes. Medications like mood stabilizers and antipsychotics can help control mood episodes, while psychotherapy can teach coping skills and strategies for managing triggers. Changes in diet, sleep, and daily routines can also help stabilize moods and promote well-being.