Medical Conditions Causing Mania or Mania-Like Episodes: Pathogenesis • Bipolar Disorder -> Combination of individual, genetic, and environmental factors -> Abnormalities of amine neurotransmitter systems and impairment of neuroplasticity and cellular resilience, particularly frontal and limbic circuitry -> Decreased Inhibitory control of frontal and limbic emotional circuitry • Multiple Sclerosis -> Immune-mediated demyelination alters normal neurotransmitter pathways • B12 deficiency -> Lack of B12 as a cofactor for methionine synthesis -> Downregulation of S-Adenosyl methionine (SAM) pathway -> Decreased myelin synthesis and neurotransmitter regulation • Altered Thyroid Activity -> Decreased thyroid activity -> Decrased central serotonin activity - > Decreased postsynaptic beta-adrenergic receptor activity -> Decrease in catecholamine (including dopamine) transmission • Corticosteroid Use -> Adrenocortical hormones Incresed Dopamine D2 receptor numbers (hypothesis) #Mania #Manic #Secondary #Causes #Differential #Diagnosis #Pathophysiology #Psychiatry
