New Explanation of Bipolar Disorder



I thought some who visit this newsgroup may be interested in a new
explanation of bipolar disorder in women, connected to menstrual cycle
phase and over stimulation due to testosterone and DHEA.

Bipolar Disorder, DHEA and Testosterone in Women.

(Copyright 2006, James Michael Howard, Fayetteville, Arkansas, U.S.A.)

I suggest this disorder may be caused by an inappropriate combination of
stimulation caused by testosterone and dehydroepiandrosterone (DHEA) and
dehydroepiandrosterone sulfate (DHEAS). DHEAS is the large supply of this
hormone in the blood from which the active molecule, DHEA, is converted.
These hormones are connected with mania, depression, and menstrual
problems.

Manic episodes have been connected with the luteal phase of the cycle
(Biological Psychiatry 1993; 33: 194-203). Free testosterone levels were
significantly higher in premenstrual syndrome than controls in the luteal
phase and DHEA levels were significantly higher in PMS in the luteal phase
(Psychoneuroendocrinology 1992; 17: 195-204). A later study also reported
increased DHEA and free testosterone in the luteal phase (Gynecological
Endocrinology 2004; 18: 79-87). DHEA levels are significantly lower during
the luteal phase in ?premenopausal healthy women? (Psychological Medicine
2004; 34: 93-102). ?Early-onset menstrual dysfunction? has been reported
more often in women with bipolar disorder and women with depression
compared to healthy controls (Journal of Clinical Psychiatry 2006; 67:
297-304). The opposite side of this hypothesis is that low DHEA has been
connected with depression (Archives of General Psychiatry 2005; 62:
154-162). When DHEA is low these individuals feel depression.

Testosterone is high in mania (European Archives of Psychiatry and Clinical
Neuroscience 2003; 253: 193-6). Increased testosterone has been connected
with early puberty and obesity in girls (Journal of Clinical Endocrinology
& Metabolism 2006; February 21). The metabolic syndrome is ?alarmingly
high? in bipolar disorder (Bipolar Disorder 2005; 7: 424-30). DHEA is
being considered as a treatment for metabolic syndrome (Journal of the
American Medical Association 2004; 292: 2243-8).

A common treatment for bipolar disorder, valproate, actually causes similar
problems to testosterone. Valproate increases weight gain, testosterone,
and DHEAS (Epilepsia 2004; 45: 1106-15 and New England Journal of Medicine
1993; 329: 1383-8). Valproate increases testosterone during the luteal
phase (Journal of Affective Disorders 2005; 89: 217-25) and contributes to
menstrual abnormalities (Bipolar Disorders 2005; 7: 246-59). However,
valproate is effective in bipolar disorder. The effects of valproate may
be used to ?tease? apart the connection of DHEA and testosterone in mania
and depression in bipolar disorder.

Valproate increases DHEAS. This means that valproate is reducing
conversion of DHEAS to DHEA. I suggest a combination of high testosterone
and high DHEA over-stimulate the brain and cause ?mania.? One treated with
valproate will possibly experience the effects of excessive testosterone
but not the stimulating effects of testosterone and excessive DHEA
simultaneously. Valproate reduces this mania by reducing available DHEA.
Lithium also reduces DHEA. In rats, lithium reduces DHEA and DHEA levels
(International Journal of Neuropsychoparmacology 2004; 7: 71-5). When this
combination of androgens declines, ?depression? occurs. I suggest this may
fit type 1 bipolar disorder. Type 2 may reprsent a state of low DHEA which
results in depression interrupted periodically by the combination of
simultaneous testosterone with a reduced DHEA level.

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