Bipolar Thoughts

Twinning

I know a few sets of identical twins, and oddly enough a few of my friends from high school and college have recently had twins. And I have always had this question:

Why aren’t they identical?

Usually when they are young it is very difficult to tell them apart, but as they age they generally become very distinct. I suppose the answer is simple: environmental factors. Smoking,weight, diet, exercise all have massive bearing on how you age. Also your stress, your line of work, where you live (if you don’t live near your twin) could all weigh on you as well.

But then you notice strange details that are distinct. The shapes of their nose or eyes are different. Their voices aren’t the same. And of course none of that is to speak of different tastes and interests, lifestyles, work ethic, competitive natures, etc.

So what exactly is controlled by our DNA? Is it just how you look when you come out? Does your DNA have much bearing on how you process life, both physically and mentally?

In the realm of mental illness, a lot of words are thrown at the concept that everything we think, and therefore how we perceive and process information, can be broken down to the molecular level and how certain concentrations of chemicals react with certain cells and specific times. In fact, we rationalize mental illness as a physical disease through this line of reasoning.

Of course all of that is pretty much speculative. There is a ton of research that points in that direction, and it seems the most reasonable, but then you have the case study of twins.

Identical twins are used all the time in research because you almost literally have a “control group” with the exact same DNA. And here is all of what the twin research finds about Bipolar… nada. Twins are no more likely to concurrently develop bipolar than first cousins.

That’s an odd thing, right? Twins have extremely similar cells, and extremely similar chemical make up, so the only thing missing is the stimulus. And maybe the stimulus is the key factor here, but it seems like most twins that grow up in the same house probably have gone through similar things, right? I can’t imagine those slight variations in those three categories having that much effect. But they do.

I’ve never read anything about what I am about to say, so this is straight bullshit from me.

Bipolar doesn’t tend to show up until later in life. The average age of onset symptoms is 25. And I have to wonder, just like how some twins age drastically different, if the aging of the brain is part of the process that leads to Bipolar. It would explain why symptoms don’t present for a long time. It would explain why symptoms in pre-adolescents sometimes go away. It would explain why symptomology can be vastly different at different ages even for the same person. And it would explain why twins don’t present mental illness at similar rates.

That isn’t to say that what research is finding isn’t true, or that mental illness is not in fact a physical illness. Ever wonder how many people are born with the capability of becoming diabetic but simply never eat the food that develops it? Or how many people poised to get lung cancer never smoke? Is this possible with mental illness too?

We are pivoting away from the idea that outside factors matter as much as internal ones when it comes to Bipolar, but should we? Every bipolar I ever met had a pretty traumatic backstory. And while certainly that alone doesn’t cause mental illness, it is a major factor. We are trying to legitimize the disease but are we also putting blinders on to the realities of it?

Now, a slight tangent might confirm my suspicion (as well as doing more, i.e. any, research). It is well documented that Bipolar Disorder is a degenerative disease. Deterioration of the brain occurs more rapidly in people with Bipolar then healthy people. This is not unique to bipolar; it is also seen in schizophrenia and major depressive disorder. It is believed that manic episodes accelerate deterioration more than depression, but both more so than non-symptomatic periods. It is also believed that medication, by reducing the instances of these cycles, can reduce decline. Or in the case of Lithium, medication can even repair damaged grey matter areas.

And anecdotally, this is something I have experienced myself. I feel less sharp then I did before my major breakdown. I am not sure if it was the breakdown, the subsequent medication, or the even more subsequent ECT. But either way it is there. It is real. I have damaged my brain. And I have to wonder if this damage is at least partially responsible for my inability to recover fully and go back into remission. Have I become more bipolar?

It seems silly to ask but it is the logical next step in my line of reasoning here: bipolar onsets with age because it is related to the brain aging. Bipolar deteriorates your brain, or prematurely ages it, whenever you experience a cycle. Therefore each cycle makes you more bipolar. This is borne out in some data anyway, the more frequent you experience cycles the more likely you are to experience them again.

And I guess a bigger question goes back to where I started: if brain aging is at the root of Bipolar Disorder, then what is aging us to this end, and how much does our DNA play into it?