Cannabis, Decision Making and Bipolar Disorder

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The Last Show with David Cooper 10 min 3 speakers 8 chapters transcribed
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What misconceptions exist about cannabis and brain health?

Jared W. Young 0:03
The missing link between scientific journals and relationship counseling. The Last Show with David Cooper. For years now, we've been told cannabis is bad for your brain, that it fries it. But in a new study looking at one psychiatric condition, bipolar disorder, researchers found that cannabis might actually sharpen people's decision-making. It's kind of a provocative finding, and we're going to dig into it with one of those researchers, Jared Young, a psychiatry professor at the University of California, San Diego. Jared, thanks for being on the show. Thank you very much for having me, dude. Common wisdom, my parents drilling it into my head as a kid, is that cannabis just scrambles your brain, fries it, makes you a poor decision maker.
Jared W. Young 0:47
What made you want to kind of attack that assumption, especially in the case of bipolar disorder?
David Cooper 0:52
Yeah, we all remember those commercials.

How is cannabis associated with decision-making in bipolar disorder?

David Cooper 0:54
And similarly, I grew up in a household that felt the same. In terms of bipolar disorder, if you know about bipolar disorder, people live with bipolar disorder and they switch from extremes to having mania episodes, depressed episodes, something in between. But they're technically not in either episode, but they're not quite the same. And they could show cognitive deficits. And In fact, people with bipolar disorder, their lives are difficult. We really do need new treatments for them and help them out. To the point where the current treatments, people will attempt, like one in three people with bipolar disorder attempt suicide. Wow. And this is really why we get into it.

What is the Iowa gambling task and how is it used in research?

David Cooper 1:34
We're trying to develop treatments. And one thing we noticed... And getting into some of the studies that we've been doing is that people with bipolar disorder use cannabis at much higher rates than the healthy general population. And that's interesting because if it's really bad for you, why are they using it so much? Are they trying to self-medicate? And in fact, many of them report attempts and it helps them. It helps slow them down. It helps them think more clearly rather than racing through and trying to be so goal-oriented and high energy. This kind of sets them back a bit. And that's why they self-report.

How do decision-making patterns differ in bipolar disorder?

David Cooper 2:09
But in science, we listen to self-reports, but we have to follow up with studies to try and understand it. And knowing the fact that cannabis can cause cognitive problems for healthy participants... We're like, well, if it's actually causing problems for people with bipolar disorder, we want to identify that too and give people warnings since cannabis is being legalized across the US, fully legal in Canada and other places. So we wanted to understand it better.
Jared W. Young 2:35
So what is this Iowa gambling task? I guess that's the way that you actually checked what kind of decision-making effects cannabis might have on someone.
David Cooper 2:45
Yeah, the Iowa gambling task is great. It's a test. It's called gambling task developed in Iowa.
Jared W. Young 2:51
Shocker on that one.

What findings suggest cannabis may improve decision-making in bipolar patients?

David Cooper 2:52
Yeah, I know. It's been around for about 30 years, actually. And so it's a real world gambling style where we basically provide the participant with four options. And each of those options either have high rewards or low rewards. And so normally you would go for the higher rewards early on and try and maximize your output. And if you go for the higher awards, though, you also get, at some point in time, you'll get high levels of punishment. We'll take points away from you. And if you go for the lower awards, the levels of punishment are much lower. So even within 10 trials, what we refer to as each step is a trial, even within 10 trials, you'll actually gain more for going to lower awards and you'll lose more going for the higher awards.
David Cooper 3:30
So people go for the higher awards and then they start learning and they're like, oh, crap, I'm going to go for the lower, you know, and they switch to going for the lower awards generally.

What role does dopamine play in decision-making related to cannabis use?

David Cooper 3:38
People with bipolar disorder, on the other hand, don't tend to do that. They tend to be insensitive to punishment and really reduce sensitivity to the lower water. So it's an attempt to try and get real world decision making to maximize outcomes for someone.

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