Many of us are aware that the chemicals and neurotransmitters, dopamine and serotonin play a big role in the brain, affecting moods and thoughts. Too little serotonin, and you get depression. Too much dopamine (a neurotransmitter) and you get mania, and often, hallucinations. An example of an excess of dopamine is in the high you get during use of cocaine or methamphetamine, two things someone whom is bipolar should never use!
Glutamate has recently been found to be in excess in the brains of bipolar patients. Glutamate is a neurotransmitter, like dopamine, and is necessary in memory and learning.1 Genetic and other abnormalities have been found in people with bipolar disorder. Glutamate, to be put more simply, is an amino acid which acts as a messenger for nerve cells. It bonds to a neuron and tells it when to shoot off neurons2. With people with bipolar disorder, it doesn’t function properly, there is often too much glutamine in a manic or mixed episode.
It’s no myth that mentally ill folks smoke more than the non-mentally ill. A study by The Journal of the American Medical Association
reported that 44.3% of all cigarettes in America are consumed by individuals who live with mental illness and/or substance abuse disorders. This means that people living with mental illness are about twice as likely to smoke as other persons.Withdrawal from nicotine in the mentally ill can sometimes lead to excess depression and anxiety. Findings show that smoking in the mentally ill have an underlying biological etiology3
Nicotine administration normalizes several sensory-processing deficits seen in bipolar disorder and schizophrenia4. Most studies have been done with schizophrenics, but there is are phenotypes5 that suggest bipolar disorder and schizophrenia are linked to a gene defect.
From a brain-based perspective, research is being done to determine if and how nicotine is involved in some of the brain’s memory functions. If nicotine is a factor, then this could explain why so many people living with an illness like schizophrenia or other illness involving cognitive deficits may smoke. Even though smoking is thought to enhance concentration and cognition, the effects are short in duration. It is known that people diagnosed with schizophrenia often smoke before the onset of symptoms and that they smoke more often and inhale more deeply than smokers without schizophrenia.6
Smoking is often a form of self medication. I quit last May, 2012, and I still find myself reaching for a cigarette when I’m stressed out, anxious, or angry. I definitely agree in studies that say its a form of self medication. Quitting cold turkey (I had an e-cig but it pooped out on me) sucked, and I slept, for literally three days, due to the stimulant effect of nicotine. I still have cravings which come and go with my moods.
Nicotine does, however, increase psychotic symptoms because it can cause antipsychotics to be flushed out of the system more quickly, due to the effects smoking has on the kidneys6. Nicotine can act either as a stimulant or a depressant depending on dose and history of use. Today, scientists are researching nicotine receptors in the central nervous system. The reason why many depressed people feel better after smoking a cigarette is that they are correcting a chemical imbalance altered temporarily by nicotine7.
Nicotine and GABA
First, what is GABA? We’ve heard a lot about it. I’ve taken this quote to explain:
“GABA is the communications speed controller, making sure all brain communications are operating at the right speed and with the correct intensity”, writes Joseph M. Carver, Clinical Psychologist. When there is too little GABA, we become overstimulated and engage in excessive and impulsive behavior. When there is too much GABA, we become overly relaxed and sedated. The levels of GABA are low in schizophrenia and bipolar disorder as well as in epilepsy and other seizure disorders.”
The effects of nicotine on GABA are quite profound: GABA rises 10% after smoking a nicotine inhaler, and 45 minutes later, the brain was producting GABA 4x’s faster than an average, non-smoker brain. GABA acts as an inhibitor in the hippocampus part of the brain, slowing the firing of neurons8.
How does this relate to bipolar disorder though?
The increase of GABA acts as a mood stabilizer, temporarily and can reduce anxiety. Smoking has negative effects on mania due to serotonin, though. Depending on the current mood, the nicotine could have a negative, or paradoxical effect on your mood. Nicotine can sedate and calm, but prolong mania, due to serotonin levels. Interesting stuff!
Glutamate and Nicotine
“Nicotine affects glutamate in the brain and may be one reason why so many people with a mental illness smoke.1”
Common familial or genetic risk or underlying neurophysiology.
The observable physical or biochemical characteristics of an organism, as determined by both genetic makeup and environmental influences