Common mental health comorbidities include anxiety, ADHD, PTSD, eating disorders, and substance use disorders.1,5,7,8,10 Common physical conditions include CVD, metabolic syndrome, type 2 diabetes, obesity, irritable bowel syndrome, neurological diseases, and respiratory diseases.2,5,6,8,10-12 Suicide and chronic physical comorbidities, particularly CVD, contribute to the significantlyabout 20% to 30%lower life expectancy of individuals with BD, compared with the general population.2,5,8,10-12 Etiology and Treatments The etiology of BD is not clear, but recent research has uncovered potential genetic, epigenetic, and environmental contributors.1,2,4,8 Researchers have suggested that an interplay between oxidative stress, mitochondrial dysfunction, inflammation, and immune dysfunction may underlie the disorder.13,14 Elevated oxidative stress levels can damage cells, DNA, and mitochondria, and may contribute to immune and neurocognitive dysfunction in BD, including altered levels of neurotransmitters that affect mood.2,7,13 Mitochondrial disturbances, in turn, can increase oxidative stress and alter intracellular calcium levels, which are typically elevated in BD.2,13-15 Individuals with BD tend to have increased inflammatory markers, which can indicate high levels of inflammation systemically and neurologically.4,7,10,16,17 Additionally, some studies have found imbalances in the microbiota of people with BD, which can contribute to inflammation, oxidative stress, and immune dysfunction.2,7,14 Chronic inflammation and oxidative stress likely factor into the higher rates of chronic physical conditions in individuals with BD, including metabolic disorder, diabetes, and CVD.11,12,16 Typical treatments for BD include medications, psychotherapy, and complementary treatments.1 Commonly prescribed medications are antidepressants, antipsychotics, anticonvulsants, and lithium.7 Rates of medication nonadherence are high among people with BD and adverse side effects are common
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doi: 10.1001/archpedi.1969.02100030073008
Cancer cells have an alkaline intracellular pH
Reactive Oxygen Species and Cellular Defense System
