It's World Heart Day, a global awareness day to shine a light on the fact that heart disease and stroke are the world's leading causes of death, and that 80% of premature deaths from these causes are preventable. It may not be immediately obvious why this is relevant to bipolar disorder. What if we told you that mortality from these vascular causes is at least doubled among people with bipolar disorder, based on both their increased rates and premature onset? Or that the strength of the vascular-bipolar link exceeds what can be explained by lifestyle, standard vascular risk factors, or medications? Did you know that the vascular-bipolar connection is a two-way streeet? By that we mean bipolar disorder tends to be more severe among people with vascular risk factors and, conversely, more severe symptoms of bipolar disorder increase the risk of heart disease.
Does all of this sounds like a downer? Clearly, the vascular-bipolar link is a concerning one. But it's also a link that we can turn to as a source of hope for people with bipolar disorder. From the perspective of treatment, there is the hope that improving heart health -- through a combination of lifestyle interventions and medications --could improve mental health for people with bipolar disorder. From the perspective of research, there is hope that biological factors linking bipolar disorder with heart disease and stroke could yield clues about causes of, and novel treatment approaches for, bipolar disorder. From the perspective of stigma, awareness of the vascular-bipolar link could serve to improve the integration of bipolar disorder alongside other complex medical conditions. To the extent that we can reduce the sense of bipolar disorder (and other mental health conditions) as "different" from medical conditions, this could reduce shame and fear regarding bipolar disorder, which would in turn lead to more people seeking treatment earlier.
This year, the World Heart Federation, organizers of World Heart Day, are asking people to make a promise "for my heart, for your heart, for all our hearts". On behalf of the ISBD Vascular Task Force ---including representatives from Australia, Canada, Chile, Italy, Sweden, Taiwan, and the U.S.--our promise for the 2018 World Heart Day is: we will strive to get the word out about the vascular-bipolar link, we will distill and synthesize the knowledge to date on this topic, and we will advance a research agenda to ensure continued progress in a purposeful and intentional way. Suceeding in our overall goal of focusing on the vascular-bipolar link in order to improve the lives of people with bipolar disorder will require a team effort, including people with lived experience of bipolar disorder, mental health professionals, researchers, and policy makers. Do you have questions, comments, or ideas related to the vascular-bipolar link? Please reach out and share them with us!
Benjamin I. Goldstein, MD, PhD, FRCPC; Chair, ISBD Vascular Task Force
Jess Fiedorowicz, MD, PhD; Co-chair ISBD Vascular Task Force