Course Description:

$375

Known to the ancient Greeks and Romans as a distinct psychiatric ailment characterized by cyclic extremes of mood and behavior, bipolar disorder remains today one of the most challenging mental illnesses for clinicians to address – challenging to identify, challenging to treat. Mainstream interventions adhering solely to psychopharmaceutical approaches are incomplete, and do not account for biologic factors that so often influence the trajectory of this complex disorder.

Through a functional and integrative approach, it becomes possible to address etiologic factors that contribute to BD, and formulate targeted, personalized interventions for patients that make health and balance possible.

This unique course, co-taught by Drs. Greenblatt and Bongiorno, elucidates a novel functional medicine model for the treatment of BD, of which medication is just one of several therapeutic pillars. Approved pharmaceuticals for mania, depression, mixed-episodes, and maintenance will be reviewed in detail, after which the course will explore biochemical abnormalities associated with BD that open the doors to functional interventions. Genetics, nutritional deficiencies that impact neurotransmission and signaling cascades, mitochondrial dysfunction, and other factors will be examined, as will evidence-based interventions that address intrinsic imbalances, support balanced neurochemical signaling, and optimize affective regulation. Clinical pearls and concept-to-application bridges are proffered throughout the course, which together support a paradigm of patient-provider collaboration wherein the greatest successes may be realized.

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Modules:

Module 1 (Dr. Greenblatt)

1. Exploring Bipolar
– Definitions
– BD Mania vs. Depression
– Clinical course
2. Untangling Etiology
– Genetics
– Loci / Single-Nucleotide Polymorphisms of interest
– An environment-systems biology model of BD
– Rethinking the Genetics vs. Environment equation
3. Logistical hurdles
– Non-adherence – implications and consequences
– Comorbid conditions
4. A History of Bipolar
– Models and definitions, from Galen to Kraepelin
– The advent of psychopharmacology
– Early- to mid-20th century treatment approaches
5. Medications
– Exploring FDA-approved medications and classes
– Medications indicated for mania, depression, mixed episodes, maintenance
– Rethinking how we prescribe
6. Lithium: A Gold Standard
– John Cade and the lithium breakthrough
– The lithium dose-response curve; elucidating pharmaceutical vs. nutritional
– Lithium, an essential micronutrient; the lithium-deficiency hypothesis
– Mechanisms of neuroprotection
– Lithium as part of a multimodal treatment approach
– Clinical indicators of functional lithium deficiency
– Testing; elucidating blood levels
7. A New Way Forward
– Recommendations for testing, assessment – can we identify BD early?
– Common BD triggers
– Forging a partnership with patients

Module 2: Bipolar Class Plan I (Dr. Bongiorno)

1. Bipolar Disorder: Stats and Epidemiology
– Bipolar incidence, prevalence
– Suicide in BD populations
2. The Bipolar Class Plan
3. The Diagnosis: Classifications and Criteria
4. Underlying Factors:
– Mitochondrial dysfunction (membrane damage, NAD depletion, oxidative damage)
– Toxins
– Genetics (MTHFR, COMT, ANK3, and others)

Module 3: Bipolar Class Plan II (Dr. Bongiorno)

1. Laboratory Testing
– Blood Sugar
– RBCs / anemia
– Iron levels
– Thyroid panel
– Pregnenolone
– Inflammatory Markers
2. Focused Biomedical Analysis: Cortisol other Hormones
3. Organic Acids Testing – indicators of neurotransmitter availability, activity
4. Other Tests
5. An Integrative Approach to Bipolar
– Sleep
– Hydration
– Food
– Exercise
– Spirit / Natura
– Environment
– Detoxification
– Supplements (B vitamins, Omegas, Probiotics, Vitamin D, CBD, Lithium orotate, N-acetyl cysteine)

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