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A Urine Test Could Distinguish Between Bipolar Disorder And Depression


Distinguishing major depressive disorder and bipolar disorder might be about to get far easier.

A Urine Test Could Distinguish Between Bipolar Disorder And Depression
An easy and reliable method of distinguishing bipolar disorder from major depressive disorder could save tens of thousands of lives, and transform millions more. Now researchers at Chongqing Medical University, China, claim to have found just that in a study based on biomarkers in urine.
The popular image of someone with bipolar disorder is epitomized by prominent figures such as Robin Williams – bouts of severe depression punctuated by off-the-wall mania. In reality, it is often not so easy to recognize; even Williams said he was never officially diagnosed. Moreover, as a new paper in The Journal Proteome research notes, “Multiple depressive episodes usually occur prior to the first manic episode in many bipolar patients.”
In these cases, the symptoms of bipolar can be very difficult to distinguish from those of major depressive disorder (MDD). Since MDD is the more common condition, clinicians often jump to an MDD diagnosis; indeed, many don’t even think to investigate the possibility of bipolar. Studies have found that as many as 39% of patients diagnosed with MDD have unrecognized bipolar.
The paper adds: “A large percentage of BD subjects are incorrectly treated with antidepressants in clinical practice.” The consequences can be lethal. Selective seratonin reuptake inhibitors (SSRIs) such as Prozac and Celexa probably don’t help people with bipolar. SSRIs are alleged to increase suicide risk among bipolar patients, a major concern since bipolar sufferers have suicide rates around 20 times the population as a whole.
While efforts have been made to alert doctors to the dangers of this sort of misdiagnosis, as long as we continue to rely only on multiple subtle signs, the problem will remain.
The Chongquing team think they have found a way out of this problem, having identified biomarkers whose concentrations are different for people with bipolar or MDD.
The authors note that some of these biomarkers have been investigated before, but individually did not provide a sufficiently reliable method for diagnosis. However, senior author Dr. Peng Xie proposed that multiple markers in combination might succeed where each had failed.
For the study, experienced psychiatrists recruited 71 people with bipolar disorder, 126 whose diagnosis of MDD was considered reliable, and 126 “healthy controls.” Each group was divided into a training set and a test set. For the training set, the researchers knew the subject’s condition ahead of time and used this to identify relevant markers, while in the other set it was a blinded test to confirm the predictive capacity of these markers. The researchers examined the urine of those in the training set to identify 20 metabolites associated with either MDD or bipolar.
An initial trial on the test set identified 76% of those with MDD and 79% of those with bipolar, falling short of what would be required clinically. However, when the results were reanalyzed, six metabolites stood out.
After normalizing these six metabolites to creatinine concentration in urine, the authors found they could achieve 90% reliability in distinguishing between the two conditions.
The authors note that the study’s subjects had a common ethnicity and had been treated at the same hospital, necessitating further research to see whether the results can be generalized. However, the research adds to work published last year suggesting biomarkers could play a major role in depression diagnosis.

22 Things To Remember If Your Loved One Suffers From Type 1 Diabetes


22 Things To Remember If Your Loved One Suffers From Type 1 Diabetes

Many people mistakenly think Type 1 Diabetes develops because of a sugar-laden diet and lack of exercise. If your loved one has this disease, you know how far this is from the truth.
But imagine how difficult it is for them to constantly hear phrases like, “but you’re not fat,” or, “should you eat that?”
Day in and day out, they live with a disease that is largely misunderstood by the public. Unless you have Type 1 Diabetes, you can never completely understand what living with a life-threatening disease that needs constant treatment is like. However, you can support, empathize, and find heartfelt compassion for your loved one.
If you can remember the following twenty-two things that your loved one faces, you’ll come a lot closer to walking in their shoes:

1. They constantly face misguided judgments

Many people don’t know that Type 1 Diabetes is inherited. Your loved one constantly feels faulted by ignorant people for eating too much sugar or not exercising.

2. They have an incurable autoimmune disease, not a lifestyle disease

They cannot cure their disease by changing their diet or by exercising. Please help them by correcting people who suggest they quit eating sugar or start riding a bike.

3. They live each day with a serious disease that often seems to arise out of the blue for no apparent reason

With their diagnosis of diabetes, their lives changed forever and they had nothing to do with it.

4. Their definition of normal is much different than yours and mine

They will take injections or use an insulin pump for their entire life. Theirnormal is giving themselves several shots a day or monitoring a pump attached to their abdomen.  Normal is keeping their blood sugar in a safe range, or else they could get hypoglycemia and slip into a coma.

5. They look like everyone else from the outside

…but the inside is way different. Their pancreas has stopped producing insulin, and if they don’t take insulin, they will slip into a coma and could die. They live with this reality.

6. Insulin pumps can make management easier, but not worry-free

Insulin pumps come closer to mimicking how a healthy pancreas would work, delivering insulin on a set schedule. This is not a cure, and diabetics need to monitor their carb intake and watch their blood sugar levels. Successful pumps require frequent user input.

7. They want to smack people who ask them if they got the disease from eating too much sugar

Their disease has nothing to do with indulging in too many sweets and they are sick of being asked if they have an insatiable sweet tooth.

8. They live with a disease that never leaves

Even using state-of-the-art monitoring systems, there is no program-and-forget option for Type 1 Diabetics. Too much or too little insulin can result in death.

9. A canine could be their best friend and save their life

Specially trained dogs can sense rapid changes in blood chemistry before the symptoms of hypoglycemia are evident. A diabetic alert dog might be a wonderful gift for your loved one.

10. They grew up with parents who need to protect and hover

Most people are diagnosed with Type 1 Diabetes as small children or adolescents. They grew up with parents who needed to protect and care for their child. It can be a matter of life or death, after all.

11. They represent just 5-10% of the diabetics in the world

…but the impact it has on their lives is often huge and overwhelming.

12. They need you because they have lost other close friends to the disease

Type 1 Diabetes is life-threatening and is the seventh leading cause of death in the United States.

13. If you see them acting strangely, they are not drunk, and it could be life threatening

The symptoms of hypoglycemia include shakiness, blurred vision, confusion, and lack of coordination.  Get help if you notice them acting strangely.

14. The insulin they inject or pump each day is not a cure

They will take it every day in order to stay alive.

15. They can’t ever have a holiday from this disease

It is with them every minute of every day.

16. Life is a never-ending balancing act

They have to be their own mathematician, nurse, and dietitian just to stay alive.

17. They hate it when you offer everyone but them a slice of birthday cake

They know how to handle their blood sugar much better than you do, so let them indulge and adjust their insulin levels.

18. They live with a disease that is often stigmatized

Some 71% of people with type 1 diabetes feel like they are stigmatized as being a burden on the healthcare system or a failure of personal responsibility.

19. Help them by becoming a Type 1 Diabetes myth-buster

They live in a world that misunderstands Type 1 Diabetes. Help people understand the difference between Type 1 and Type 2 diabetes.

20. They don’t want you to treat them like they are handicapped

Yes, they live with a disease, but diabetes does not affect their intelligence or make them immune to people’s stares at their pumps and insulin pins.

21. They are wise well beyond their years

From a young age, they have had to take control of their health care. Diabetes pushed them to be their own best health advocate and nurse.  They have seen friends die from this disease.

22. They want your love and support, but not your pity

They want you to treat them like a human, one who feels joy and pain. True compassion and empathy show that you want to understand what life is like for them.
True empathy is walking in your loved one’s shoes and seeing their world without judgment. Empathy is not being bossy or giving unsolicited advice.
Remember that your loved one understands their disease a lot better than you do. So rather than telling them to change their lifestyle, why not treat them to a fun evening or pamper them with a day at a spa? Perhaps join them for a diabetes fundraising walk.
What would be the biggest improvement in their life?
A cure for diabetes. Help the research by donating to research for a cure
People with Type 1 Diabetes often feel alone and misunderstood, but with your support and solidarity, they can feel accepted and appreciate.