November 17, 2004
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U.S. sees dearth of
A look at bipolar disorder on campus
By Kingson Man
" Daily &taff Qeporter
F or a disorder that is often first diagnosed from 18 to 24 years
of age, it strikes many as surprising that college students
aren't more aware of bipolar disorder. Lost in the shuffle of
breakups and hookups, good grades and bad, a pattern of mood
swings is easily written off as part of the college experience.
G oing crazy at 17 wa8
e mcxt traumatic
experience I ever had,"
writes Lizzie Simon in her book "Detour: My
Bipolar Roadtrip in 4-D." The Columbia Uni-
versity student was first diagnosed with bipolar
disorder at the age of 17. And her life was about
to get a lot crazier when she'd have to deal with
her problem at college.
At Columbia, Simon managed her disorder
privately, for the most part. "In 1998, nobody
talked about mental health, depression, bipolar
disorder. I felt very much alone," Simon said.
So she coped in a personal, individual way. "I
was an overachiever. I had straight A's, produc-
tions going on, was a workaholic."
In her spare time, Simon went to the library to
research her condition. She also went to support
groups secretly and didn't tell any of her friends.
She emphasized the role of personal responsi-
bility in the management of her health and as part
of this responsibility, understood the importance
of a proactive relationship with her psychiatrist.
"You shouldn't just go into the office and lis-
ten and do whatever they tell you. Come with
questions." For her, visits with psychiatrists
weren't lectures, but discussion sections.
i s defined as "a
brain disorder that
causes shifts in mood,
energy and ability to function" by the National
Institutes of Health. The process of diagnosing
people, however, is more difficult.
For 2 to 4 percent of the population, bouts of
mania and depression are indicative of a seri-
ous psychological disorder, according to the
Henry Ford Health Center in Detroit.
There is no blood test or clear physiological
indicator for bipolar disorder like there is for
chicken pox or the flu. Rather, diagnosis is based
on a list of symptoms as defined by the Diagnostic
and Statistical Manual, also known as DSM-IV,
said Vicki Hays, associate director of the Univer-
sity's Counseling and Psychological Services.
"People don't 'look' bipolar," said Melvin
McInnis, Professor of bipolar disorder and psy-
chiatry in the University of Michigan Health
System. "Most students who end up seeing a
psychiatrist have gone through many levels
of health providers. It takes a good hour to get
to know the person and develop rapport and a
trusting relationship, but for a good clinician it's
not as difficult as it sounds."
Differentiating between bipolar disorder and
schizophrenia or depression, however, is more dif-
ficult. During treatment, students may be in either
their depressive or manic states and be falsely
diagnosed. An antidepressant may push someone
with bipolar disorder into a manic episode.
Emerging directions in the science of bipo-
lar disorder aim to improve the methods of
diagnosis. Studies of twins and adopted chil-
dren show a genetic link for the disorder
between first-degree relatives. Neuroimaging
studies that use MRI and PET scans are also
attempting to identify specific patterns of elec-
trical charges or abnormalities in the brain.
Current research has not identified the manner
in which bipolar disorder changes the brain's
chemical composition or neural wiring.
"Is there a specific pathophysiological change
in the brain? The answer, for now, is no," said
Cathy Frank, director of outpatient services at
the Henry Ford system.
"Jf youVe ever seen
one you'll remember it
for the rest of your life."
That's how McInnis described witnessing a
severe manic episode.
Clear-cut cases range from individuals who
feel elated and enlightened to extreme degrees,
such as one student who went to the Caribbean
islands and spent $10,000 throwing parties for
strangers or an architect who went through
two-day periods in which he could "see how
things were supposed to be done, thought more
clearly, could easily draw 3-D renditions, all
with little or no sleep," McInnis said.
But bipolars aren't always feeling like they're
"dancing on the table, driving at 100 miles per
hour," he said.
"Most commonly, an individual has a low-
grade chronic depressed mood for 60 to 70
percent (of the time). "The real problem,"
McInnis said, is the patients who are "not
totally sick, who - even untreated - are get-
ting to jobs and classes."
The enduring phenomenon of chronic low-
grade depression causes symptoms most college
students are familiar with: feeling tired all the
time, having a hard time concentrating and not
being able to achieve at one's potential.
Distinguishing between individual dif-
ferences of personality and the more harm-
ful effects of a disorder is subtle, and "isn't
going to be found in one gene," McInnis
The measure of temperament - whether
a person is intro- or extroverted, how one
reacts to positive or negative news, how one
deals with stress - are all helped by current
psychological surveys, "and these tools are
continuing to be useful," McInnis said.
However, survey evaluations aren't enough
to shed light on the underlying causes of tem-
perament and more severe mood disorders.
Upcoming research will focus on biochemi-
cal pathways and how genetic dysfunctions or
environmental stresses may have a cascade of
psychological consequences. "It's a wonderful
time to be in the field," McInnis said.
"V nowledge that its a
is particularly important,"
Frank said, emphasizing the importance of a
healthy relationship between patient and psy-
Current treatment entails a combination of
medication and psychotherapy. Also used to
treat schizophrenia, "Lithium remains one of
the best medications around to treat bipolar
disorder," McInnis said.
Also under investigation are drugs used to treat
epileptics, but McInnis said, at this early stage,
"We don't understand how the dickens it works."
Another treatment method being researched
is the use of trans-cranial magnetic stimula-
tion, or using specifically tuned magnetic fields
to relieve some symptoms of depression. Work
is underway to miniaturize the technology to
create a handheld device for treatment.
This past summer, the University held a con-
ference on depression and college students - the
only one dedicated to the topic in the United
States, McInnis said. But he added that "colleges
have been by and large under resourced."
In an effort to raise awareness nationwide,
Simon has been traveling around the country
with the Detour to Wellness series of events,
which aims to create communities of support
and to raise the profiles of younger people suf-
fering from bipolar disorder. There will be a
Detour to Wellness event in Dearborn tomor-
row and details can be found at www.detour-
On campus, the University's Counseling
and Psychological Services in the Michigan
Union and Pierpont Commons offers free
counseling to enrolled students for bipolar
disorder, depression and other concerns.
Also available is the Institute for Human
Adjustment in East Hall and the University
Hospital's outpatient psychiatric services,
In addition to traditional forms of treat-
ment, however, Simon encouraged students
to come to a personal understanding and
approach to their wellness. "I wasn't a full-
time patient during those productive college
years ... you are so much more than your
Though the United States has
always prided itself as a world lead-
er in innovation and technology, the
number of American students to major
in science or engineering has declined
steadily in recent decades. Economics
Prof. Dimitriy Stolyarov attributes these
trends to student perceptions that science
and engineering are not well-paying career
choices and to poor pre-college preparation
in math and the sciences.
"There is a fundamental reason why the
economic incentive of becoming a law-
yer is more than the economic incentive
from becoming a physicist," Stolyarov said.
"That's because the product that the physi-
cist produces may become valuable 30 years
from now or 100 years from now, when the
physicist is already dead."
According to the National Science Board,
the number of degrees in science and engineer-
ing awarded by U.S. schools to American stu-
dents is declining - and has been for well over
Reports released in 1999 and 2003 show
there has been little to no change in the num-
ber of undergraduates receiving degrees in
engineering between 1981 and 1995. Yet the
percentage of U.S. degrees awarded to foreign-
born students has increased, indicating that the
number of American students graduating with
degrees in either the sciences or engineering is
on the decline.
From 1990 to 2000, the percentage of for-
eign-born students receiving a bachelor's
degree increased from 11 to 17 percent of all
students receiving degrees, a master's degree
from 19 to 29 percent and a doctorate from 24
to 38 percent. Stolyarov believes this decline
directly correlates with student performance in
math and science before they decide on a col-
The National Center for Education Statistics
reported in 1998 that students in American
elementary schools score lower on standard-
ized tests in science and math than students
in elementary schools in other industrialized
nations. Those gaps in test scores continue
through American secondary education, leav-
ing American students with rankings below
such countries as Singapore, Japan, Sweden
and the Netherlands, according to the NCES.
The report is based on the results of the
1995 Third International Mathematics and
Science Study, or TIMSS, which involved
more than a halfimillion students in 41 coun-
tries around the world. In the tests, American
eighth graders scored 28th in math and 17th in
science, and 12th graders scored 19th in math
and 16th in science.
Top nations for eighth-grade math were Sin-
gapore and Japan, and the top nations for 12th
grade math were the Netherlands and Sweden.
Stolyarov said he sees a distinct difference
between American students' educational expe-
riences and the teaching of math and science in
the world's highest-scoring nations, including
his native Russia.
As fewer Americans leave college with science
or engineering degrees, the number of foreign
graduates in the two fields increases.
"Here, the American society is highly indi-
vidualistic,"Stolyarov said. "Every educational
subject is a matter of debate. People are trained
to be decision-makers, and people are trained
to be critical thinkers that question authority
rather than conform."
Stolyarov said the top nations at each grade
level tested in TIMSS all have much more
conformist societies than the United States.
Stolyarov added that it is not only American
educational attitudes that account for the lack
of interest in engineering and science. but the
economic structure as well.
U.S. society has "a very unequal distribution
of incomes," Stolyarov said. The highest-scor-
ing nations in the TIMSS tests also pay teach-
ers relatively better than in the United States,
making it "easier for smarter people to become
"Here, (in America), the smartest people go
into law or financial services rather than teach-
ing," he said.
Stolyarov added that universities in general
are not providing their students with enough
information on salaries and other economic
incentives to foster continued interest in engi-
neering and especially the sciences.
Engineering senior Samuel Serrano said
when he made the decision to pursue an
engineering degree, he was confident it
would yield a secure, well-paid job, but that
the recent economic slowdown has made
him less certain. "Three years ago I would
have made the argument that as a computer
science engineer I would have a job," Ser-
- He added that he has remained in the Col-
lege of Engineering despite a strong interest
in film "because it's already too muchof an
Engineering senior Julia Angstrom, however,
had somewhat different motives for choosing
engineering. "I think (money) did play a large
role," Angstrom said. "Not necessarily because
I wanted to have more cash, but that it made it
seem like the work I would be doing would be
more valuable. I felt that'it would make a larger
contribution to the world"
Angstrom said despite the recent economic
trends, she still believes she will make a valuable
contribution through a career in engineering.
Despite their different motives, both Ser-
rano and Angstrom have stuck with their
initial degree choices, but according to the
College of Engineering about 28 percent of
students either quit the school or transfer to
One such student is Mark Eadie, an LSA
senior studying history, who originally declared
aerospace engineering at the end of his fresh-
"I have nothing against engineering," he
said. "I really liked the stuff that I did. It just
didn't fulfill me."
SHARE OF FOREIGN-BORN SCIENTISTS AND ENGINEERS BY
DEGREE LEVEL, 1990 AND 2000
Bachelor's 1990 Census
Deg .r .. 2000 Census
5 10 15 20 25 30 35 40
BACHELOR'S DEGREES IN SCIENCE AND MATH FIELDS BY
U.S. CITIZENS AND PERMANENT RESIDENTS, 1977-2000
5Q,)QQ - Bologleal $nleno
40,000 Computer Science
1977 1982 1987 1992 1997 2000
SOURCES: U.S. BUREAU OF THE CENSUS, NATIONAL SCIENCE FOUNDATION
GRAPHIC BY LINDSEY UNGAR
Researcher counts cancer cells
in blood, studies breast cancer
By Genevieve Lampinen
Daily Staff Reporter
Jeffrey Smerage, a clinical fellow at the Uni-
versity's Comprehensive Research Center, has
developed a study using state-of-the-art tech-
nology to measure the effectiveness of specific
treatments on breast cancer patients.
The project is based on a separate study con-
ducted in August by the Comprehensive Can-
cer Center and other national cancer centers.
The study showed that the number of tumor
cells circulating in the blood of a cancer patient
shortly after they have started treatment may be
a good indication of whether the treatment will
This study used novel technology to isolate
and extract cells to examine - a groundbreak-
ing, fast and efficient technique to observe
cancer. Currently, patients must wait months
before bone scans or X-rays can be done to see
how effective the treatment has been.
Armed with knowledge of this technol-
ogy and an interest in the study, Smerage was
accepted to participate in the Young Investiga-
tors Training Course, a specific research train-
ing program targeting researchers who are
jumpstarting their careers in clinical research.
Smerage was one of four national research-
ers selected for the two-week course. The
researcher submits a proposal for a clinical
research study that fits the agenda of the South-
west Oncology Group, a national research
institute that sponsors the course, said Dayna
Sparks, the group's operations representative.
"The goal is for (the researcher) to come out
of the course with a fully developed protocol that
will be activated within the group," Sparks said.
Smerage's proposal was to create a trial
studying whether changing chemotherapy
treatments in a patient with elevated tumor cell
numbers would be
effective. This pro- Now that this
posal is related to
the August study, is available, re
and it will be con- it to fin
ducted through ap i t
the Southwest target therapi(
breast cancer have a specific
It has taken five
to eight years to
develop technology that can be used to accu-
rately study, count and analyze specific cancer
cells. Now that this technology is available,
researchers can apply it to find out how target
therapies - which have a specific effect on
cells - biologically affect cancer, Smerage
The August study showed chemotherapy
was futile for women who already had elevated
numbers of tumor cells previous to treatment,
"I am interested in finding out if it is effec-
tive to switch a patient from one chemotherapy
treatment to another, based on the number of
tumor cells in their blood," Smerage said.
In Smerage's trial, a patient will start off with
a cancer treatment chosen by their doctor. At a
later time, they will come back and have their
blood drawn. Patients with elevated numbers of
cancer cells will
+ either continue
tec nolog y
d out how
es - which
c effect on cells
their treatment or
switch to a differ-
"We will follow
them to see how
long it takes to find
evidence that their
cancer has pro-
For this particular trial, the preliminary
draft of the protocol has been written. A con-
cept has been submitted to the National Can-
cer Institute and it is being evaluated. Once
the concept has been accepted, the protocol
will open as a national trial, probably this
spring, Smerage said.
Regenerative science receives $3 million boost from NIH
rk By Abbv Stassen
that could provide new treatments and
significant bone loss and people with
ven Goldstein, head of the program.
The five-year grant is part of the
training of students, but a small amount