BD overall is associated with excess mortality from both natural and unnatural causes. Meta-analytic evidence suggests that all-cause mortality is approximately doubled, with particularly high relative risks for suicide (12-fold) and other unnatural causes (7-fold) alongside a substantial increase in natural-cause deaths (2-fold).9 However, most mortality studies have not separated BD-II from BD-I, leaving BD-II’s specific mortality profile uncertain. Limited data indicate substantial premature mortality in BD-II, for example, an estimated 10- to 20-year reduction in life expectancy,1 with cardiovascular disease a major contributor to natural-cause deaths.10,11 This is likely predicated by shared risk factors and operative biological pathways as well as adverse effects of prescribed agents.12 Unnatural causes, especially suicide, also appear elevated. A large Swedish registry13 reported more frequent suicide attempts in BD-II than BD-I, yet meta-analytic work14 suggests that the risk of suicide death is broadly similar across the 2 subtypes. Many BD-II–focused studies have been underpowered or have not analyzed BD-II separately,11,15–17 rendering conclusions tentative. Whether BD-II differs from BD-I in all-cause or cause-specific mortality remains largely unresolved because direct comparisons are scarce.18
Conclusions and Relevance In this cohort study, BD-II was associated with a significant risk of premature mortality across multiple causes; even after accounting for shared familial factors and relative to BD-I, all-cause mortality remained elevated. These findings underscore the importance of comprehensive psychiatric care for individuals with BD-II.
All-Cause and Cause-Specific Mortality in Patients With Bipolar II Disorder – https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2847398
Mental Health
Bixonimania Outbreak!
A completely fabricated disease – Bixonimania and the epistemic fragility of artificial intelligence in medicine: lessons from a fabricated disease – https://www.thelancet.com/journals/landig/article/PIIS2589-7500(26)00071-3/fulltext?
Whereas Cyberchondria is real – https://en.wikipedia.org/wiki/Cyberchondria
Scary Charts – 08.08.26
The class disparity in happiness is nothing new. The GSS data reveal that college-educated men were happier than their less-educated peers going back to the 1980s. And while the GSS shows somewhat steady levels of happiness from the 1980s through the 2000s, other well-being metrics suggest rising discontent in earlier decades. Mortality data, for instance, shows a steady and concerning rise in what researchers call “deaths of despair”—fatalities attributable to drug overdoses, suicide, and alcoholism. The rise in “deaths of despair” has been especially dramatic among white working-class men. Our analysis of death records and population estimates finds that the suicide rate per 100,000 white non-Hispanic men ages 25 to 44 has risen from 31 in 1992 to 54 in 2023, a shocking 71% increase over just three decades.
The entire study and more scary charts can be downloaded here:
The Roots of Working-Class Men’s Discontent
https://ifstudies.org/report-brief/the-roots-of-working-class-mens-discontent
This Is Not Your Grandfather’s Weed
So let me be the doctor who says it plainly. This is not the mild plant of the 1970s. Then, cannabis was 1-3% THC. Today’s products run 15-25%, and concentrates — dabs, vapes, wax — hit 70-90%+. When people say “it’s natural, it’s harmless,” they’re defending a product that no longer exists. We didn’t legalize the old plant. We industrialized a far more potent one.
A Danish registry study followed 6,788 people diagnosed with substance-induced psychosis. Overall, 32.2 percent later developed schizophrenia-spectrum or bipolar disorder. Among those with cannabis-induced psychosis, 47.4 percent later received one of those diagnoses.
A large Ontario cohort found that approximately 26 percent of people who presented to an emergency department with cannabis-induced psychosis were diagnosed with a schizophrenia-spectrum disorder within three years. The corresponding rate after alcohol-induced psychosis was approximately 8.9 percent. Among the substances studied, cannabis-induced psychosis carried the highest risk of later transition to schizophrenia-spectrum illness. Is it cannabis-induced psychosis or bipolar disorder? https://kevinmd.com/2026/07/is-it-cannabis-induced-psychosis-or-bipolar-disorder.html
YIKES.
Take a Break 07.17.26
I Need To Get Out of the House More
Abstract from the study Home alone: Remote work, isolation, and mental health – Science 4 Jun 2026 Vol 392, Issue 6802 https://www.science.org/doi/10.1126/science.aec7671
How does remote work affect isolation and mental health? We drew on five nationally representative surveys of American workers (N = 588,322) conducted from 2011 to 2024, omitting the peak pandemic years of 2020–2021. Our difference-in-differences approach compared changes in mental health among people in remotable jobs—who experienced a large and persistent rise in remote work since COVID-19—to people in nonremotable jobs, where remote work increased far less. We found that remote work increases time spent alone, worsens mental well-being across multiple measures, and increases the use of mental health services and prescriptions. These effects were concentrated among individuals living alone. We estimate that the rise of remote work explains about a third of the increase in isolation and mental distress between 2011–2019 and 2022–2024.
Highlights from the NPR article People love working from home. But does it love them back? A new study says no – https://www.npr.org/2026/06/08/nx-s1-5848125/remote-work-mental-health-isolation
- Workers in remotable jobs had experienced a 58% rise in hours spent alone compared to people in non-remotable jobs
- These workers also saw a 72% rise in chances of spending their whole day with no human contact.
- Remote workers aren’t making up for that lost social connection by socializing after work.
- People in remote jobs also saw a rise in symptoms of emotional distress, evaluated with a standardized questionnaire about symptoms of anxiety and depression.
- They also had more visits to mental health care providers and used more prescription psychiatric meds.
- Remote workers who live alone saw the largest increase (83%) in chances of spending their days with no social contact.
I really need to get out of the house more.
Neurodegenerative Copathology
About 20 years ago, neuropathologists began to report an inconvenient finding in the autopsied brains of people with dementia: Most have evidence of more than one disease. Studies since have shown the brains of up to half of people diagnosed with Alzheimer’s disease also have a key feature of Parkinson’s disease—deposits of the protein alpha synuclein. At the same time, up to half of Parkinson’s patients who develop dementia have elevated levels of beta amyloid and tau proteins, hallmarks of Alzheimer’s. Most dementia patients have multiple brain diseases – https://www.science.org/content/article/most-dementia-patients-have-multiple-brain-diseases-how-should-they-be-treated
Yikes.
Avoidant/Restrictive Food Intake Disorder (ARFID)
Still Taking a Break 12.22.25
Scary Charts 11.15.25 (income matters)
Cognitive disability was strongly associated with socioeconomic factors such as income and education. Adults with household incomes less than $35,000 consistently reported the highest prevalence, increasing from 8.8% (95% CI 8.5%–9.2%) in 2013 to 12.6% (95% CI 12.0%–13.2%) in 2023. By contrast, adults in the highest income bracket (household income ≥ $75,000) had substantially lower prevalence, with a more modest increase from 1.8% (95% CI 1.6%–2.0%) in 2013 to 3.9% (95% CI 3.6%–4.2%) in 2023. Rising Cognitive Disability as a Public Health Concern Among US Adults – Neurology October 21, 2025 issue 105 (8) e214226 https://doi.org/10.1212/WNL.0000000000214226
Overall, income is central to the aging experience. From how well they think they’re aging to how they rate their physical and mental health and financial security, older adults with upper incomes are doing better than those with middle or lower incomes. Aging well: How income and health shape the experiences of older Americans – https://www.pewresearch.org/social-trends/2025/11/06/aging-well-how-income-and-health-shape-the-experiences-of-older-americans/
Yikes.
lifeunderwriter.net 
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