Watch Peter Hagelund’s documentary series, ‘Jeg savner min sygdom’ on living with bipolar disorder type 2 here.
For fire år siden blev jeg diagnosticeret med bipolar lidelse type 2.
I hele mit liv har jeg vidst, at jeg var anderledes. Jeg har altid kæmpet med depression og angst, og hvad der viste sig at være hypomani. Da jeg var 22, havde jeg min første slemme depressive episode, og jeg blev nødt til at starte på antidepressiver. Alligevel tog det yderligere 6 år, før jeg officielt blev diagnosticeret med bipolar lidelse type 2.
Det sværeste, ved at have diagnosen bipolar lidelse type 2, er at man ikke oplever den typiske maniske episode, hvor man er over-energisk og på grænsen til psykotisk. I stedet er man hypomanisk, som betyder at man er socialt velfungerende. Man er ikke psykotisk. Man føler sig faktisk rigtig godt tilpas. Så problemet er, at man ikke ender med at tage til sin psykiater og sige, at man føler sig for godt tilpas. Det gjorde jeg i hvert fald ikke!
Årsagen til at min psykiater fandt ud af, at jeg var bipolar, skyldtes at han ikke kunne få mig ud af mine depressioner. Først diagnosticerede han mig med depression og ADD. Men disse diagnoser var ikke rigtige. Da jeg ikke havde den rette diagnose, fik jeg stadig mine store humørsvingninger og meget angst. Da jeg så blev diagnosticeret med den ’rigtige’ diagnose, bipolar lidelse type 2, føltes det faktisk rigtig godt. En masse ting gav mening. Pludselig kunne jeg se, hvorfor jeg havde følt, som jeg havde hele mit liv.
Jeg tror virkelig, at Monsenso kunne have hjulpet min psykiater med at diagnosticere min lidelse tidligere, fordi app’en hjælper mig med at tracke mit stemningsleje og med at blive mereopmærksom på, hvordan jeg har det. På grund af app’en skal jeg hver dag tage en pause og tænke på, hvordan jeg egentlig har haft det, før jeg taster svaret ind. Når jeg tager til psykiater, kan vi sammen se, hvordan jeg har haft det. En god ting ved app’en er, at mit svar ikke afhænger af min hukommelse, men af hvad jeg faktisk svarede den pågældende dag. At indsamle al den her information kan hjælpe mig, og derved min psykiater, præventativt med at undgå fremtidige depressive eller hypomaniske episoder, fordi vi tydeligt kan identificere, når jeg har humørsvingninger.
I august har min dokumentar, om at være bipolar, premiere på nationalt fjernsyn. Reaktionerne har været overvældende. Rigtig mange personer har skrevet til mig og takket mig for at snakke om sygdommen. Jeg havde oprindeligt tænkt mig, at lave dokumentaren således, at ingen personer ville blive flove over at have sygdommen. Jeg tror, det er lykkedes mig.
Mit håb for fremtiden er, at personer bliver diagnosticeret med lidelsen tidligere end jeg blev. Selvfølgelig kommer det til at afhænge af en masse forskellige faktorer, men jeg tror virkelig, at Monsenso kan gøre en forskel. Mit håb er, at andre psykiatere og patienter også begynder at bruge app’en.
Watch Peter Hagelund’s documentary series, ‘Jeg savner min sygdom’ on living with bipolar disorder type 2 here.
Click here to read this story in Danish.
Four years ago, I was diagnosed with bipolar disorder type 2.
For my whole life I had known that something was different about me. I had always struggled with depression and anxiety, and what eventually turned out to be hypomania. When I was 22 I had my first big depression episode and had to start taking anti depressant medications. However, it would take me six more years before I was officially diagnosed with bipolar disorder type 2.
The tricky thing about having the diagnosis of bipolar type 2 is that you are not experiencing the typical manic episode where you are over-energetic and nearly psychotic. Instead, you’re hypomanic, which means that you’re socially well functioning. You’re not psychotic. You actually feel really good. So the problem is that you don’t end up going to your psychiatrist saying that you feel too good. At least I didn’t.
The reason why my psychiatrist found out I was bipolar was because he couldn’t get me out of my depressions. At first, my psychiatrist diagnosed me with depression and ADD. But these diagnoses didn’t fit. When I didn’t have the right diagnosis, I still had my large mood swings, and a lot of anxiety. When I was diagnosed with the ‘right’ diagnosis, of bipolar disorder type 2, it actually felt really nice. A lot of things made sense. Suddenly I could see why I had felt how I had for most of my life.
I really believe that Monsenso could have helped my psychiatrist diagnose my disorder earlier, because the app helps me to keep track of my mood and really helps me to become more aware of how I feel. Due to the app, every single day I have to pause and take a moment to think about how I’ve actually been doing before putting my answers in the app. After doing this, when I go to my psychiatrist we can together see how I’ve actually been. The good thing with the app is that my answer to how I’ve been is not only based on my memory but how I actually answered that day. Logging all of this information has helped my treatment. My psychiatrist and I can better plan how to avoid my future depressive or hypomanic episodes, because we can clearly identify when I am having mood swings.
In August, my documentary about being bipolar aired on national danish television. The reactions have been overwhelming. So many people have messaged me, thanking me for talking about the disease. I had originally made the documentary so that people would not be ashamed about having the disease. I think I have succeed.
My hope for the future is that people will be diagnosed earlier with the disease than me. Of course, that will take a lot of other factors, however I truly believe Monsenso is one of the things that can help. My hope is that other psychiatrists and patients alike will start using the app.
In this video, Monsenso user Mads Trier-Blom speaks of his experience using the Monsenso app as a part of a clinical trial. The Monsenso app has helped Mads to become more connected with his clinician, Bente, so that Bente could help intervene with Mads’s moods even before it turned into an episode.
The app helped him to become more aware of his mood, and other factors, such as sleep, and their influence on his bipolar affective disorder. To Mads, having bipolar disorder means constantly keep a balance, to prevent losing control to either depressive or manic episodes.
“In my life with bipolar disorder, I see myself as a tightrope walker. This metaphor for living with bipolar disorder is very meaningful. I feel like a tightrope walker because when living with bipolar disorder, you constantly have to prevent losing control to either depressive episodes or manic episodes. You are able to avoid this through earlier registration on how your mood is fluctuating, so that the app can help you to keep in control of your life.” says Mads Trier-Blom.
During Mads’s time in his clinical trial, he felt more connected to his clinician, Bente. He recalls an instance where he had missed completing his self-assessments for a couple of days, and Bente had called him to check and see how he was doing. With Bente calling to check in on him, it helped Mads to become more aware of how his mood.
“One day, I was driving in my car and I was a little tense. Suddenly, the phone rang. It was this lady, saying, ‘Hi, my name is Bente and I just wanted to hear about how you are doing. At first, I was like,’Who are you, why are you calling me?’ and then she said, ‘Well, you’re on this trial and I can see that you haven’t made registrations for 3 days. So I thought, ‘Oh yeah, this is true. I am kind of tense at the moment, but yeah I think it’s okay; but still this answering back to the clinician and the clinician is able to call you back which makes you aware and alert.” says Mads Trier-Blom.
In this video, Monsenso User Peter Hagelund speaks about his experience using our mobile health solution to support his bipolar disorder treatment, and how the solution has helped improve and inform his communication with his psychiatrist.
Prior to using the app, Peter & his psychiatrist followed the typical therapeutic setting, they would meet for an appointment every two-three weeks, and they would have a conversation regarding Peter’s past weeks. Peter would usually say that he had been fine for each appointment, but he would sometimes forget important details regarding his previous weeks that he wanted to discuss.
“It can be pretty tricky to remember, two weeks later [between appointments] how you actually felt that day. With the app it’s really easy to go back and see if your mood has been pretty stable over the last two months, or if you had had some ups and downs over a period,” says Peter Hagelund.
With the app, instead of relying solely on their conversation and Peter’s memory during the appointment, Peter’s psychiatrist can now access his logged data and see how he has been doing, as it is happening. His psychiatrist can view how much he has been sleeping, how much he exercises, how much he drinks, how much anxiety he has, and other relevant aspects to his treatment and his disorder.
“By having the [Monsenso] app, my psychiatrist can actually go into it and see how I’ve been doing, as in, yeah, you say you’ve been doing fine, but I can actually see that you’ve had a bit of ups and a bit of downs, and I think [the app] helps your psychiatrist to get a really honest view of how we, as patients, have been.” says Peter Hagelund.
Monsenso’s mHealth solution participates in the R-LiNK Study, a major new study for optimising treatment response to lithium
Copenhagen, Denmark – 16 April 2018 Monsenso is proud to announce our participation in R-LiNK – the major new study for developing a more complete understanding of the reactions and effects of taking lithium. As a part of this study, our solution will be implemented for 300 participants across 15 centres all over Europe.
Lithium is the leading treatment for patients with bipolar disorder. There is a large variability across patient responses when taking lithium. This variability makes it difficult for clinicians to predict how patients will respond to being prescribed lithium.
“Lithium is the oldest drug treatment used regularly in psychiatry and one that has shown evidence of many benefits over the decades it has been used. However, only about one third of patients are “excellent” responders with a future two thirds showing partial or no response. This large EU funded study takes place across Europe and aims to find out which “biomarkers” can be used to predict which patients will respond and for those whom lithium will not help,” said Professor Allan Young, Director of the Centre for Affective Disorders at the Institute of Psychiatry, Psychology & Neuroscience, King’s College London.
R-Link is a multimodal approach to studying lithium initiation, and identifying important biomarkers from receiving lithium treatment. The comprehensive study aims to identify factors related to better responses, safety, and tolerability of lithium treatment. The results of the study can help provide patients and clinicians alike with more accurate information to make informed decisions regarding the prescription of lithium, therefore improving the long term management and prognosis for bipolar patients.
“Mobile health technology can provide new insight into the treatment of mental health and disorders, and mobile phone usage can also provide important new biomarkers for affective disorders.” said Professor Lars Kessing, of the Psychiatric Center Copenhagen and the University of Copenhagen, Faculty of Health Sciences.
The Monsenso mHealth solution will be involved in the phase of the study that will conduct a qualitative and quantitative study on the acceptability and efficacy of connected ecological devices to monitor mood, lithium levels, symptoms, daily behaviour, and enhance patient adherence. Therefore, the solution will include data collection of lithium adherence and outcome/behaviour reporting (via sensor data and daily self-assessment).
“Ensuring adherence to medical treatment on an individual level is key to a successful mental health treatment. Our mHealth solution will contribute to this study by promoting medical adherence, through providing easy, personalised self-monitoring and medication tracking, as well as medication reminders.” said Thomas Lethenborg, CEO of Monsenso.
This study also has the potential to enable the personalisation of lithium based treatment. Findings from this study can also contribute to the overall prevention and reduction of unnecessary side effects from lithium treatment as well as overall ineffective treatments.
Monsenso is now involved in more than ten pan European and domestic research projects in the mental health & affective disorders field.
The study is presently ongoing.
Click here to read the press release in Danish.
This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the grant agreement No.754907.
Using voice analysis to identify peaks on bipolar disorder is a summary of a recently-published research paper titled “Voice analysis as an objective state marker in bipolar disorder.” For additional information, please click on the link.
The human voice is composed of multiple different components, created through complex muscle movements, making each person’s voice individual, like ‘a fingerprint’. Studies analysing speech in affective disorders, date back as early as 1938. Several clinical observations suggest that changes in speech features have been suggested as valid measures, to identify periods of depression and mania in bipolar disorder. For instance, reduced speech activity may be considered a symptom of depression, and increased speech activity may predict a switch to hypomania.
A pilot study conducted by The Copenhagen Clinic for Affective Disorders, with patients with bipolar disorder, aimed to investigate the following:
- Voice features collected during phone calls, as objective markers of affective states in bipolar disorder
- If combining voice features with automatically generated objective smartphone data on behavioural activities (for example, number of text messages and phone calls per day) and electronic self-monitored data (mood) on illness activity, would increase the accuracy as a marker of affective states
The pilot study included the monitoring of 28 outpatients with bipolar disorder, in a natural environment from October 2013 to December 2014. During this period, patients were given a smartphone application developed by Monsenso, to collect voice features, electronic self-monitoring data, and collection of automatically generated data.
- Voice features
The voice features were extracted from the patients’ phone calls throughout the day, using the open-source Media Interpretation by Large feature-space Extraction (openSMILE) toolkit, which is a feature extractor for signal processing and machine learning applications.
- Electronic self-monitoring data
Patients were requested to provide daily electronic self-monitoring data. The parameters evaluated included: mood, sleep length, medication intake, activity level, alcohol consumption, mixed mood, irritability, cognitive problems, stress levels, and individualised early warning signs.
- Automatically generated data
Through the smartphones’ sensors, automated data tracking different aspects of behavioural activities was collected on a daily basis. The data compiled by the smartphones included the number and duration of phone calls and text messages, accelerometer data, and phone usage.
This innovative study revealed that changes in voice features could, in fact, detect individual changes in affective state. The accuracy of the prediction is increased, by combining voice features with automatically generated smartphone data on behavioural activities, and electronic self-monitoring. Therefore, according to the study, voice features collected by smartphones in a natural setting, could be used as an objective state marker in patients with bipolar disorder.
According to the researchers, the monitoring of symptoms in bipolar disorder and the accurate classification of affective states based exclusively on voice features has great potential.
Clinicians would be able to obtain accurate, objective data in real-time on the patients’ affective states based on collected voice features. The smartphone application could be used to monitor symptoms long-term, outside clinical settings, and enable early intervention between outpatient visits.
According to the researchers, at the time the study was conducted, it was the first study ever that investigated the combinations of voice features; automatically generated data, and electronic self-monitored data as state markers in patients with bipolar disorder. Using feature analysis collected in real-time from smartphones for classifying affective states in bipolar disorder reflects an innovative, objective and unobtrusive method for monitoring of illness activity (state) during long-term and in naturalistic settings.
Voice analysis as an objective state marker in bipolar disorder. M. Faurholt-Jepsen, J.Busk, M.Frost, M.Vinberg, E.M.Christensen, O.Winther, J.E.Bardram and L.V.Kessing. 5 May 2016. http://www.nature.com/tp/journal/v6/n7/pdf/tp2016123a.pdf