Bipolar disorder research gets a boost from new program

Two months before Charita Cole Brown was supposed to graduate from college — and about two years after she experienced her first manic episode and was diagnosed with bipolar disorder — her doctors told her parents they should prepare for the likelihood that she may one day not be able to care for herself.

It was March 1982, and Cole Brown had just experienced a psychotic break eerily similar to what her grandmother had experienced years earlier. Despite her doctors’ prediction that she would never lead a “normal” life, however, within a few years, a counselor had helped Cole Brown find a combination of medication and other wellness strategies that worked for her.

She graduated from college, went to graduate school at Towson University in Maryland, fell in love and raised two daughters to be “some of the kindest women you will ever meet.” Later, during her parents’ final years, she cared for them both.

“Bipolar is not an easy illness. I don’t have any enemies, I don’t think, but if I had an enemy, I would not wish this on them as a punishment,” said Cole Brown, who lives in Baltimore and published a memoir in 2018 called “Defying the Verdict: My Bipolar Life.”

But, she added, “you can live well.”

More than 40 years after Cole Brown’s diagnosis, bipolar disorder — a serious mental illness characterized by dramatic shifts in mood, energy, activity and cognition — remains under-researched, even compared to other mood disorders. While an estimated 2.6% of Americans who are 18 or older have bipolar disorder, people with the condition, especially those who are Black or African American, are often misdiagnosed.

5-year study

Researchers and clinicians at the Johns Hopkins School of Medicine, however, hope that will soon change. They’re recruiting people with the diagnosis for a longitudinal study, in which researchers will follow participants for at least five years with the aim of better understanding the disease and how to treat it.

Hopkins is one of six research institutions around the country that were recruited for the project by BD², a Washington, D.C.-based organization launched last year to bring more resources to studying bipolar disorder. Three family philanthropies joined the Milken Institute to fund the organization, together contributing $150 million to accelerate breakthroughs in treating and understanding the disease.

The institutions leading the five-year study — including the Mayo Clinic, University of Michigan and University of California, Los Angeles — plan to recruit 4,000 people with bipolar 1, a type of the disorder characterized by more severe elevated mood episodes than bipolar 2.

Researchers later hope to expand their focus to bipolar 2 as they attract more funding, said Cara Altimus, managing director of BD². While the organization has enough funding to support the project for five years, researchers hope to follow patients for even longer to get a better sense of how their symptoms and the trajectory of their disorder changes as they age.

Projects of this breadth and scope are rare, even for more frequently studied health problems. Longitudinal studies are expensive and require extensive buy-in from scientists, patients and funders — a trifecta that’s hard to nail down. But, Altimus said, they’re incredibly valuable.

“So much of our science is happening in snapshots — in three-month intervals, in one-year intervals,” she said. “But we all know that our past, medications we’ve taken, life experience very much impact the way that health progresses over time. And you can’t capture that unless you’re looking over a much longer time period.”

25 years and counting 

It’s been more than 25 years since Cole Brown, the memoir author, was last hospitalized because of her bipolar disorder. Her recovery has survived the death of her husband and parents, as well as her older sister, whom she described as the “glue” of her family.

She gets enough sleep. She takes her medications. She meditates on Scripture. She prays. She doesn’t drink alcohol. And above all else, she holds onto hope.

“My life is proof that you can live differently than what people thought,” she said.